Citation Nr: 22016989 Decision Date: 03/23/22 Archive Date: 03/23/22 DOCKET NO. 17-57 160 DATE: March 23, 2022 REMANDED The claim of entitlement to a disability rating in excess of 10 percent for left ganglion cyst residuals is remanded. The claim of entitlement to a disability rating in excess of 10 percent for right ganglion cyst residuals is remanded. The claim of entitlement to an effective date earlier than January 20, 2005, for the award of a 10 percent rating for left ganglion cyst residuals is remanded. The claim of entitlement to an effective date earlier than September 2, 2014, for the award of a 10 percent rating for right ganglion cyst residuals is remanded. The claim of entitlement to service connection for left carpal tunnel syndrome is remanded. The claim of entitlement to service connection for right carpal tunnel syndrome is remanded. REASONS FOR REMAND The Veteran had honorable active-duty service with the United States Navy from January 1977 to January 1980 and from February 1984 to November 2000. 1. The claim of entitlement to a disability rating in excess of 10 percent for left ganglion cyst residuals is remanded. Please see discussion in Section 2. 2. The claim of entitlement to a disability rating in excess of 10 percent for right ganglion cyst residuals is remanded. The medical evidence shows that the Veteran's bilateral ganglion cyst residuals resulted in sleep impairment, which is not contemplated in the applicable rating criteria. The evidence also indicates that the Veteran's bilateral ganglion cyst residuals resulted in significant occupational impairment, which suggests marked interference with employment. Specifically, the evidence shows that the Veteran worked in the grocery meat department and had trouble gripping and dropping things. Accordingly, a remand is warranted for referral to the Director of Compensation Service for a determination as to the Veteran's entitlement to an extraschedular rating for his bilateral ganglion cyst residuals pursuant to 38 C.F.R. § 3.321 (b) is warranted. 3. The claim of entitlement to an effective date earlier than January 20, 2005, for the award of a 10 percent rating for left ganglion cyst residuals is remanded. Please see discussion in Section 4. 4. The claim of entitlement to an effective date earlier than September 2, 2014, for the award of a 10 percent rating for right ganglion cyst residuals is remanded. The effective date issues are intertwined with the claims of entitlement to increased ratings for the left and right ganglion cyst residuals. Harris v. Derwinski, 1 Vet. App. 180 (1991) (where a claim is inextricably intertwined with another claim, the claims must be adjudicated together). Therefore, further consideration of the claims of entitlement to an earlier effective date must be deferred. 5. The claim of entitlement to service connection for left carpal tunnel syndrome is remanded. Please see discussion in paragraph 6. 6. The claim of entitlement to service connection for right carpal tunnel syndrome is remanded. In the Veteran's September 2014 claim for increase, he referenced a recent electromyography test. The January 2015 and October 2017 VA examination reports confirmed a diagnosis of bilateral carpal tunnel syndrome. The October 2017 VA examiner stated that the carpal tunnel syndrome "is felt to be occupational." Consistent with VA's duty to maximize benefits, the Board must consider all possible schedular bases for separate ratings, including secondary service connection. Morgan v. Wilkie, 31 Vet. App. 162, 164 (2019); Bailey v. Wilkie, 33 Vet. App. 188, 203 (1991) ("VA is required to develop and adjudicate related claims for secondary service connection for disabilities that are reasonably raised during the adjudication of a formally initiated claim for the proper evaluation level for the primary service-connected disability."). Accordingly, the Board will assume jurisdiction for the claims of entitlement to service connection for left carpal tunnel syndrome and right carpal tunnel syndrome as secondary to his service-connected left and right ganglion cyst residuals. The matters are REMANDED for the following action: 1. Forward the Veteran's claims file to the Director of Compensation Service for consideration of an extraschedular evaluation of the Veteran's bilateral ganglion cyst residuals under the provisions of 38 C.F.R. § 3.321 (b)(1). 2. Then, the AOJ should afford the Veteran a VA examination by a physician with sufficient expertise, to determine the nature and etiology of the Veteran's carpal tunnel syndrome. All pertinent evidence of record must be made available to and reviewed by the examiner. Any necessary tests and studies should be accomplished. Following the examination and a review of the relevant records and lay statements, the examiner should state an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran's bilateral carpal tunnel syndrome was caused or aggravated by his service-connected bilateral ganglion cyst residuals. The rationale for all opinions expressed must also be provided. If the examiner is unable to provide any required opinion, he or she should explain why. If an opinion cannot be provided without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, examiner should identify the additional information that is needed. 3. Then, readjudicate the issues on appeal. If the benefits sought on appeal are not granted to the Veteran's satisfaction, the Veteran and his representative should be furnished an appropriate supplemental statement of the case and be afforded the requisite opportunity to respond. Thereafter, the case should be returned to the Board for further appellate review. B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. N. McKinley, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.