Citation Nr: 18147281 Decision Date: 11/02/18 Archive Date: 11/02/18 DOCKET NO. 13-07 755 DATE: November 2, 2018 ORDER Entitlement to service connection for hypertension is granted. Entitlement to service connection for Sjogren’s syndrome is granted Entitlement to service connection for a right hip disability is granted. Entitlement to service connection for a left hip disability is granted. Entitlement to service connection for a neck disability is granted. Entitlement to service connection for a back disability is granted. Entitlement to service connection for asthma is granted. Entitlement to service connection for right carpal tunnel syndrome (CTS) is granted. Entitlement to service connection for left CTS is granted. Entitlement to service connection for a left knee disability is granted. Entitlement to service connection for seizures is granted. Entitlement to service connection for a right shoulder disability is denied. Entitlement to service connection for a left shoulder disability is denied. Entitlement to service connection for irritable bowel syndrome (IBS) is denied. Entitlement to service connection for temporomandibular joint (TMJ) syndrome is denied. Entitlement to a 30 percent rating for headaches is granted. Entitlement to a 10 percent rating for polycystic ovary disease is granted. Entitlement to a compensable rating for allergic rhinitis is denied. Entitlement to a compensable rating for hiatal hernia with gastroesophageal reflux disease (GERD) is denied. Entitlement to a rating in excess of 30 percent for a bipolar disorder is denied. FINDINGS OF FACT 1. Hypertension, Sjogren’s syndrome, a bilaterally hip disability, a neck disability, a back disability, asthma, bilateral CTS, la eft knee disorder, and seizures had their onset in service. 2. The preponderance of the evidence shows that the Veteran was not diagnosed with a bilateral shoulder disability, IBS, and TMJ syndrome at any time during the pendency of the appeal. 3. At all times during the pendency of the appeal the preponderance of the evidence showed that the Veteran’s headaches were manifested by characteristic prostrating attacks averaging one in two months over several months but not with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability. 4. At all times during the pendency of the appeal the preponderance of the evidence showed that the Veteran’s polycystic ovary disease required continuous treatment and this treatment controlled her symptoms. 5. At all times during the pendency of the appeal the preponderance of the evidence showed that the Veteran’s allergic rhinitis was not manifested by at least a greater than 50-percent obstruction of nasal passage on both sides, complete obstruction of one side, or polyps. 6. At all times during the pendency of the appeal the preponderance of the evidence showed that the Veteran’s hiatal hernia with GERD was not manifested by at least persistently recurrent epigastric distress with dysphagia, pyrosis, or regurgitation, accompanied by substernal or arm or shoulder pain, or productive of considerable impairment of health. 7. At all times during the pendency of the appeal the preponderance of the evidence showed that the Veteran’s bipolar disorder was not manifested by at least occupational and social impairment with an occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. CONCLUSIONS OF LAW 1. The criteria for service connection for hypertension, Sjogren’s syndrome, a bilaterally hip disability, a neck disability, a back disability, asthma, bilateral CTS, a left knee disorder, and seizures have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a bilateral shoulder disability, IBS, and TMJ syndrome have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.309. 3. The criteria for a 30 percent rating for headaches have been met at all times during the pendency of the appeal. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.124a, Diagnostic Code 8100. 4. The criteria for a 10 percent rating for polycystic ovary disease have been met at all times during the pendency of the appeal. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.116, Diagnostic Code 7615. 5. The criteria for a compensable rating for allergic rhinitis have not been met at all times during the pendency of the appeal. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.97, Diagnostic Code 6522. 6. The criteria for a compensable rating for a hiatal hernia with GERD have not been met at all times during the pendency of the appeal. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.114, Diagnostic Code 7346. 7. The criteria for a rating in excess of 30 percent for a bipolar disorder have been met at all times during the pendency of the appeal. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 3.102, 4.7, 4.130, Diagnostic Code 9432. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the United States Army from January 1997 to July 2009. She passed away in August 2010. In April 2013, the agency of original jurisdiction (AOJ) accepted the Veteran’s daughter’s claim for substitution. She is now the appellant is the current appeal. The Board of Veterans’ Appeal (Board) also finds that notwithstanding the AOJ’s and the appellant’s representative’s characterizing the appeal as claims for accrued benefits, the issues of appeal are as they appear above-claims for service connection and higher ratings, based on substitution. During the pendency of the appeal, the AOJ granted service connection for fibromyalgia and headaches. Therefore, the Board finds that these issues are no longer in appellate status. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997). In March 2017 the Board remanded the appeal to provide the appellant with the personal hearing she had requested. In May 2017, the appellant withdrew her hearing request. Therefore, the Board finds that adjudication of this appeal may go ahead without holding a hearing. In October 2018 the appellant’s representative waived AOJ review of the additional evidence that had been added to the record since the June 2013 supplemental statement of the case. Therefore, the Board finds that it can adjudicate the appeal without first remanding it for such review. 38 C.F.R. § 20.1304(c). Notwithstanding the United States Court of Appeals for Veterans Claims (Court) holding in Rice v. Shinseki, 22 Vet. App. 447 (2009), the Board finds that the record does not raise a claim for a total rating based on individual unemployability (TDIU) because the appellant does not claim and the record does not show that the Veteran’s service connected disabilities prevented employment prior to her death. The Service Connection Claims The Veteran claimed during her lifetime, and the appellant has claimed since that time, that the Veteran has hypertension, Sjogren’s syndrome, a bilaterally hip disability, a neck disability, a back disability, asthma, bilateral CTS, a left knee disorder, seizures, a bilateral shoulder disability, IBS, and TMJ syndrome and they are due to the Veteran’s military service. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection if the disability is one that is listed in 38 C.F.R. § 3.309. 38 C.F.R. § 3.303(b); see also Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). In addition, service connection may also be granted on the basis of a post-service initial diagnosis of a disease, where the physician relates the current condition to the period of service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(d). Other specifically enumerated disorders will be presumed to have been incurred in service if they manifested to a compensable degree within the first year following separation from active duty. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. In this regard, to establish service connection for the claimed disorders, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999). The requirement of a current disability is “satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim.” See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). In evaluating the evidence, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. Owens v. Brown, 7 Vet. App. 429, 433 (1995). Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Entitlement to service connection for hypertension, Sjogren’s syndrome, a bilaterally hip disability, a neck disability, a back disability, asthma, bilateral CTS, a left knee disorder, and seizures are granted. With the above criteria in mind, service records document the Veteran’s complaints, treatment, and diagnoses for hypertension, Sjogren’s syndrome, a bilaterally hip disability, a neck disability, a back disability, asthma, bilateral CTS, a left knee disorder, and seizures. See, e.g., service treatment records dated from 2000 to 2006 (diagnosing hypertension); service treatment records dated from 2003 to 2008, treatment records from North Carolina University Hospital dated from 2006 to 2009, and VA treatment records dated in 2008 (diagnosing Sjogren’s syndrome); service treatment records dated in 1999 and treatment records from North Carolina University Hospital dated in 2008 (diagnosing bilateral trochanteric bursitis of the hips); service treatment records dated in 1997 and 2000 (diagnosing low back strain) as well as back x-rays dated in October 2006 and January 2008 (showing narrowing at L5-S1), and service treatment records dated in August 2008 and September 2008 (diagnosing lumbago); service treatment records dated from December 2000 to February 2001 (reporting the Veteran had neck pain due to a November 2000 motor vehicle accident), a neck x-ray dated in October 2006 (showing disc narrowing), neck magnetic resonance imaging evaluations (MRIs) dated in December 2003 (diagnosing herniated nucleus pulposus), February 2007 (diagnosing degenerative disc disease), and September 2008 and October 2008 (showing bulging discs), and service treatment records dated in 2008 (diagnosed intervertebral disc degeneration); service treatment records dated in 2003 and 2008 and treatment records from North Carolina University Hospital dated in 2008 (diagnosing asthma); service treatment records dated from 2007 to 2008, private treatment records from Dr. M. Khasru dated in 2008, and December 2008 electromyography (EMG) (diagnosing bilateral CTS); service treatment records dated in May 2009 (diagnosing patellofemoral syndrome) and February 2009 (diagnosing left knee arthritis); and service treatment records dated in 2003 and 2008 and private treatment records from Dr. M. Khasru dated from 2006 to 2009 (diagnosing seizures). Under such circumstances, and granting the Veteran the benefit of any doubt in this matter, the Board finds that service connection for hypertension, Sjogren’s syndrome, a bilaterally hip disability, a neck disability, a back disability, asthma, bilateral CTS, a left knee disorder, and seizures is warranted because the disabilities had their onset in service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. In reaching the above conclusion, the Board has not overlooked the fact that the May 2009 VA examiner did not diagnose these disorders. However, the Board finds the VA examination lacks some probative value because it failed to adequately account for the medical records generated during the Veteran’s active duty that documented her complaints, treatment, and diagnoses for each of these disabilities which disabilities are normally not considered to be transitory in nature. See Madden v. Gober, 125 F.3d. 1477 1481 (Fed. Cir. 1997) (holing that the Board is entitled to discount the credibility of evidence in light of its own inherent characteristics and its relationship to other items of evidence). Entitlement to service connection for a bilateral shoulder disability, IBS, and TMJ syndrome are denied. As to the claims of service connection for a bilateral shoulder disability, IBS, and TMJ syndrome, at the May 2009 VA examinations which was held for the express purpose of diagnosing a bilateral shoulder disability, IBS, and TMJ syndrome, the examiners opined that the Veteran did not have these disabilities. Moreover, the Board finds that the VA opinions are the most probative evidence of record because they were provided after an examination of the Veteran as well as a review of the record on appeal and the opinions are supported by citation to evidence found in the record. See Owens, supra. Again, as above, in reaching this conclusion, the Board has not overlooked the fact that service treatment records documented complaints of shoulder and TMJ pain as well as IBS. However, the Board finds, as the VA examiner must have found, that while service treatment records documented complaints relatable to each of the claimed disabilities, her problems were transitory in nature and resolved by the time she was examined by VA in May 2009. See Owens, supra. Furthermore, the Board finds that the Veteran was competent to report on the symptoms she observed during her lifetime and the appellant is competent to report on what she observed before the Veteran’s death. See Davidson, supra. However, the Board finds that the May 2009 opinions by the VA examiners are more probative than the Veteran’s claims even though service records show she had medical training because the VA examiners have greater medical expertise. See Black v. Brown, 10 Vet. App. 297, 284 (1997) (in evaluating the probative value of medical statements, the Board looks at factors such as the individual knowledge and skill in analyzing the medical data). Likewise, the Board does not find the appellant’s is competent to diagnose any of the claimed disorders because diagnosing them requires special medical training that she does not have. See Davidson, supra. Lastly, the Board finds that the facts of this appeal are distinguishable from those in Saunders v. Wilkie, No. 2017-1466, 2018 U.S. App. LEXIS 8467 (Fed. Cir. Apr. 3, 2018), because in the current appeal the May 2009 VA examination results show that none of the claimed disorders caused a functional impairment that affected the Veteran’s earning capacity before her death. Accordingly, the Board finds that the most probative evidence of record shows that the Veteran did not have diagnoses of a bilateral shoulder disability, IBS, and TMJ syndrome at any time during the pendency of the appeal. See Owens, supra. Therefore, the Board finds that these claims must be denied. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. The Rating Claims Disability evaluations are determined by the application of a schedule of ratings which is based, as far as can practically be determined, on the average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Each service-connected disability is rated on the basis of specific criteria identified by a Diagnostic Code. 38 C.F.R. § 4.27. When rating the Veteran’s service-connected disability, the entire medical history must be borne in mind. Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Separate higher or lower compensable evaluations may be assigned for separate periods of time if such distinct periods are shown by the competent evidence of record during the appeal, a practice known as “staged” ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App. 119, 126 (1999). Regulations require that where there is a question as to which of two evaluations is to be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The assignment of a particular diagnostic code is “completely dependent on the facts of a particular case.” See Butts v. Brown, 5 Vet. App. 532, 538 (1993). One diagnostic code may be more appropriate than another based on such factors as an individual’s relevant medical history, the current diagnosis and demonstrated symptomatology. Any change in a diagnostic code by VA must be specifically explained. Pernorio v. Derwinski, 2 Vet. App. 625 (1992). Entitlement to a compensable rating for headaches is granted. The Veteran’s headaches were rated as noncompensable under 38 C.F.R. § 4.124a, Diagnostic Code 8199-8100. Under 38 C.F.R. § 4.124a, Diagnostic Code 8100, migraine headaches with characteristic prostrating attacks averaging one in two months over the last several months warrants a 10 percent disability rating; with characteristic prostrating attacks occurring on an average once a month over last several months warrants a 30 percent disability rating; and with very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability warrants a 50 percent disability rating. At the May 2009 VA examination, the Veteran reported that she had had problems with headaches since 2002 with her pain in the temple and forehead as well as around and deep into the eyes. As to the severity of her headaches, the Veteran reported that when they occur she stays in bed unable to do anything including housework, they occur once or twice a week, and they last for 48 to 72 hours. The physical examination did not show any affects from the medication the Veteran took for her headaches or complications from the headaches. The examination also showed no detectable persistent alteration in central, peripheral, or sympathetic nervous system activities. The diagnosis was headaches of unspecified nature, managed with analgesics without complications. Additionally, treatment records documented the Veteran’s complaints and treatment for headaches. However, nothing in these medical records contradicts the above VA examiner’s opinion regarding her headaches. See Colvin, supra. The Board finds that the Veteran was both competent and credible to report on the frequency of her headaches because it came to her via her own senses. See Davidson, supra. Therefore, with affording her the benefits of doubt in this matter, the Board finds that most probative evidence of record showed that her headaches were manifested by symptoms that equated to headaches with characteristic prostrating attacks occurring on an average once a month over last several months. Accordingly, the Board finds that the criteria for a 30 percent rating for her headaches have been met at all times during the pendency of the appeal. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.124a, Diagnostic Code 8100; Hart, supra; Fenderson, supra. However, the Board finds that the criteria for a higher, 50 percent evaluation, have not been met at any time during the pendency of the appeal. Id. The Board has reached this conclusion because the record does not show that the Veteran’s headaches caused, among other things, severe economic inadaptability and neither the Veteran nor the appellant is competent to provide such an opinion because it requires training they do not have. See Davidson, supra. Entitlement to a compensable rating for polycystic ovary disease is granted. The Veteran’s polycystic ovary disease was rated as noncompensable under 38 C.F.R. § 4.116, Diagnostic Code 7615 (Ovary, disease, injury, or adhesions, which is rated under the General Rating Formula for Disease, Injury or Adhesions of Female Reproductive Organs) (Diagnostic Codes 7610 through 7615). Under this diagnostic code, a noncompensable rating is warranted for symptoms that do not require continuous treatment; a 10 percent rating is warranted for symptoms that require continuous treatment; and a 30 percent rating is warranted for symptoms that are not controlled by continuous treatment. At the May 2009 VA examination, the Veteran reported that she was diagnosed with polycystic ovary disease in 2008 with a continued problem with irregular periods and spotting throughout the month as well as periods associated with vaginal discharge and pelvic pain. She also reported that she was incontinent of urine but did not use an absorbent pad. She next reported that, while birth controls pills did not help, she has a permanent IUD in place and she finds it helpful. Lastly, the Veteran reported that she is not aware of any side-affects, complications, or functional impairment due to her cysts or her treatment. After a normal examination, the examiner opined that that the Veteran had polycystic ovary disease with no side effects from treatment or complications. Treatment records documented the Veteran’s history of polycystic ovary disease. However, nothing in these medical records show that she had symptoms that require continuous treatment. See Colvin, supra. The Board finds that the Veteran was both competent and credible to report on having problems with a continued problem with irregular periods and spotting throughout the month as well as periods associated with vaginal discharge and pelvic pain and incontinent of urine because it came to her via her own senses. See Davidson, supra. The Board also finds that the most probative evidence of record shows that she required continuous treatment (i.e., having a permanent IUD placed) and this treatment controlled her symptoms. See Owens, supra. Therefore, with affording her the benefits of doubt in this matter, the Board finds that most probative evidence of record showed that the criteria for a 10 percent rating, but no more, for her polycystic ovary disease have been met at all times during the pendency of the appeal. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.116, Diagnostic Code 7615; Hart, supra; Fenderson, supra. Entitlement to a compensable rating for allergic rhinitis is denied. The Veteran’s allergic rhinitis were rated as noncompensable under 38 C.F.R. § 4.97, Diagnostic Code 6522. Allergic rhinitis is evaluated under Diagnostic Code 6522, which provides for a 10 percent rating without polyps, but with greater than 50-percent obstruction of nasal passage on both sides or complete obstruction of one side. Allergic rhinitis with polyps is rated (maximum) 30 percent disabling. 38 C.F.R. § 4.97. With the above criteria in mind, the May 2009 VA examiners opined that that the Veteran did not have any nasal obstruction. While treatment records documented the Veteran’s complaints and treatment for allergic rhinitis, nothing in these medical records contradicts the above VA examiner’s opinion regarding no obstruction and no polyps. See Colvin, supra. Accordingly, the Board finds that the most probative evidence of record showed that the criteria for a compensable rating was not warranted for the Veteran’s allergic rhinitis at any time during the pendency of the appeal because it showed that her disability did not cause a greater than 50-percent obstruction of nasal passage on both sides, a complete obstruction of one side, or polyps. See 38 C.F.R. § 4.97, Diagnostic Code 6522; Hart, supra; Fenderson, supra. Entitlement to a compensable rating for hiatal hernia with GERD is denied. The Veteran’s hiatal hernia with GERD were rated as noncompensable under 38 C.F.R. § 4.114, Diagnostic Code 7399-7346. Diagnostic Code 7346 provides a compensable, 10 percent rating, if the GERD’s adverse symptomatology equates to a hiatal hernia with two or more of the symptoms for the 30 percent evaluation of less severity. 38 C.F.R. § 4.114. A 30 percent rating is warranted if adverse symptomatology equates to a hiatal hernia with persistently recurrent epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. With the above criteria in mind, at the May 2009 VA examination the Veteran reported complained of stomach pain, nausea, vomiting, heartburn, pain behind the breastbone, reflux, and regurgitation. She reported that she treats her symptoms with Reglan and Prilosec. She had not required hospitalization or surgery. It was next noted that the Veteran had enjoyed a good state of health. The examiner thereafter reported that her eating and digestion are undisturbed; she had no history of vomiting, diarrhea, or melena; and the Veteran can carry through with ordinary activities of daily living without major distress. It was next opined that the examination of the abdomen does not show any sign of active, acute, or chronic disease of the abdomen. There was also no anemia or evidence of malnutrition. While treatment records documented the Veteran’s complaints and treatment for hiatal hernia with GERD, nothing in these medical records contradicts the above VA examiner’s opinion regarding her disability not being symptomatic. See Colvin, supra. Accordingly, the Board finds that the most probative evidence of record showed that the criteria for a compensable rating was not warranted for the Veteran’s hiatal hernia with GERD at any time during the pendency of the appeal because it showed that her disability did not cause at least two of the following symptoms-epigastric distress with dysphagia, pyrosis, and regurgitation, accompanied by substernal or arm or shoulder pain, productive of considerable impairment of health. See 38 C.F.R. § 4.114, Diagnostic Code 7346; Hart, supra; Fenderson, supra. Entitlement to a rating in excess of 30 percent for a bipolar disorder is denied. The Veteran’s bipolar disorder was rated as 30 percent disabling under 38 C.F.R. § 4.130, Diagnostic Code 9432 (General Rating Formula for Mental Disorders). This regulation provides a higher, 30 percent rating, when the evidence shows occupational and social impairment with an occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). A 50 percent rating is warranted when the evidence shows occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. Ratings are assigned according to the manifestation of particular symptoms. However, the use of the term “such as” in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). When determining the appropriate disability evaluation to assign, however, the Board’s “primary consideration” is the Veteran’s symptoms. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 118 (Fed. Cir. 2013). Initially, the Board notes that this claim for a higher evaluation for a bipolar disorder was pending before the agency of original jurisdiction on or after August 4, 2014. Therefore, the Board finds that the AMERICAN PSYCHIATRIC ASSOCIATION: DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, 5th Edition (2013) (DSM-5) applies to the current appeal. See 53 Fed. Reg. 14308 (March 19, 2015); 38 C.F.R. §§ 3.384, 4.125, 4.126, 4.127, and 4.130 (2017). Accordingly, the Board’s adjudication of this claim cannot include any discussion of the Global Assessment of Functioning (GAF) scores found in the record. See Golden v. Shulkin, No. 16-1208, Slip opinion at 5 (Vet. App. Feb. 23, 2018). With the above criteria in mind, the Board notes that at the May 2009 VA examination the Veteran reported she had problems with manic spells that last a week or so followed by depression that last one to two months. She also reported having a problem with anxiety as well panic attacks but not on a regular basis. It was also noted that she treats her psychiatric disorder with medication and some counseling. However, on examination the Veteran’s adverse symptomatology was limited to depression, psychomotor retardation, some hypomania, frequent mood swings, anxiety, and occasional panic attacks (less than one a week). Treatment records including the records obtained from the Social Security Administration (SSA) which also include a May 2009 psychiatric evaluation documented the Veteran’s complaints and treatment for a bipolar disorder. However, the Board finds that nothing in these medical records contradicts the above VA examiner’s opinion regarding the manifestations of her psychiatric disorder except for the SSA examiner noting the she had or may have some problems with talking quickly, irritability, suspiciousness, and trouble concentrating. See Colvin, supra. The SSA examiner also opined that the Veteran “may have some mild delusions of persecution or grandiosity . . . [and] . . . and . . . may [have] some narcissistic tendencies [as well as] . . . some paranoia . . .”. In this regard, while the General Rating Formula for Mental Disorders is not an exclusive list, the Board nonetheless finds it significant that the record on appeal, including the May 2009 examinations, is negative for the Veteran’s bipolar disorder causing circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short-and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); and impaired judgment; impaired abstract thinking. In fact, the May 2009 VA and/or SSA examiners opined that she did not have these symptoms and these opinions are not contradicted by any other medical evidence of record. See Colvin, supra. As to symptoms actually observed by the May 2009 VA examiner (i.e., depression, psychomotor retardation, some hypomania, frequent mood swings, anxiety, and occasional panic attacks) and the additional symptoms reported by the May 2009 SSA examination (i.e., talking quickly, irritability, suspiciousness, and trouble concentrating, and paranoia), the Board finds that these symptoms are most similar to the symptomatology given as an example for a 30 percent rating than those for a 50 percent rating. The Board has reached this conclusion because the examples of the symptoms that meet the 30 percent criteria specifically include most of the Veteran’s symptoms-depressed mood, anxiety, and panic attacks (weekly or less often). See Owens, supra. In this regard, the Board also finds the May 2009 SSA examiner’s opinion that the Veteran “may have some mild delusions of persecution or grandiosity... [and]... and... may [have] some narcissistic tendencies” too uncertain to have much, if any, probative value. See Tirpak v. Derwinski, 2 Vet. App. 609 (1992). Lastly, the Board finds that the most probative evidence of record is the May 2009 VA examination and the SSA examination which show that the Veteran’s service-connected bipolar does not cause difficulty in establishing and maintaining effective work and/or social relationships. See Owens, supra. In this regard, the Board finds it significant that the May 2009 VA examiner reported, as to work, that while she had some problems with work stress, anxiety, depression, and unstable moods, she gets along with the public, coworkers, and supervisors as well as can learn new procedures and follow complex instructions. Likewise, as to social relationships, the Board finds it significant that the May 2009 VA and SSA examiner reported, that while divorced, she lives with and takes care of her 16-year old daughter and the VA examination also reported that the Veteran goes to her daughter’s activities, has friends that she goes out and does things with, and she gets along with her mother, stepfather, siblings, child, and friends. Given the above adverse symptomatology, the Board finds that the most probative evidence of record showed that the Veteran’s overall disability picture did not meet the criteria for more than a 30 percent rating for her service-connected bipolar disorder at any time during the pendency of the appeal. 38 C.F.R. § 4.130, Diagnostic Code 9432; Hart, supra; Fenderson, supra. In reaching all the above conclusions, the Board also considered the doctrine of reasonable doubt. 38 U.S.C. § 5107(b). However, as the preponderance of the evidence is against the claim, the doctrine is not for application. See also, e.g., Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001); Gilbert, supra. JOHN J CROWLEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Neil T. Werner, Counsel