Citation Nr: 20021863 Decision Date: 03/27/20 Archive Date: 03/27/20 DOCKET NO. 13-22 843 DATE: March 27, 2020 ORDER A rating in excess of 50 percent for major depressive disorder prior to January 23, 2008 is denied. An increased 70 percent rating (and no higher) for major depressive disorder is granted from (the earlier effective date of) January 23, 2008, subject to the controlling regulations applicable to the payment of monetary benefits. Entitlement to a total rating based on individual unemployability (TDIU) due to major depressive disorder is denied. FINDINGS OF FACT 1. Prior to January 23, 2008, the preponderance of the evidence is against finding that the severity, frequency, and duration of the Veteran’s major depressive disorder symptoms were productive of occupational and social impairment with deficiencies in most areas or more severe symptoms. 2. As of January 23, 2008, the Veteran’s major depressive disorder caused occupational and social impairment with deficiencies in most areas; total occupational and social impairment was not shown. 3. Service-connected disabilities have not rendered the Veteran unable to obtain and retain substantially gainful employment at any time during the appeal period. CONCLUSIONS OF LAW 1. Prior to January 23, 2008, the criteria for a disability rating in excess of 50 percent for service-connected major depressive disorder are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.130, Diagnostic Code (Code) 9434. 2. As of January 23, 2008, the criteria for a disability rating of 70 percent, but no higher, for service-connected major depressive disorder, have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.130, Code 9434. 3. The criteria for entitlement to a TDIU rating have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.340, 3.341, 4.16. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The appellant is a Veteran who served on active duty from November 1981 to November 1983. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a January 2011 rating decision by the Newark, New Jersey Department of Veterans Affairs (VA) Regional Office/Agency of Original Jurisdiction (RO/AOJ) which implemented an August 2010 Board decision granting service connection for major depressive disorder and assigned a 10 percent rating, effective December 5, 1996, the date of receipt of the Veteran’s reopened claim for service connection. An interim June 2013 rating decision granted an increased rating to 50 percent, effective December 5, 1996. The Veteran testified before the undersigned Veterans Law Judge at an October 2014 Board hearing. A transcript of the hearing is of record. At the hearing, the Veteran waived initial RO consideration of evidence added to the file since the most recent adjudication by the RO/Agency of Original Jurisdiction. In December 2015, the Board remanded the appeal for additional development. In September 2017, the Board denied a rating in excess of 50 percent for major depressive disorder for the period prior to August 5, 2015, granted an increased 70 percent rating from that date and remanded the issue of entitlement to a TDIU rating. The Veteran appealed the September 2017 Board decision to the United States Court of Appeals for Veterans Claims (Court). In September 2018, the Court granted a Joint Motion for Partial Remand (JMPR), vacated the September 2017 Board decision to the extent that it did not grant a rating in excess of 50 percent for major depressive disorder from December 5, 1996 to August 5, 2015 and in excess of 70 percent from that date and remanded the matter for action consistent with the JMPR. In April 2019, the Board remanded the appeal for development consistent with the JMPR (completion of the development requested in the September 2017 Board remand in connection with the TDIU claim and readjudication of the major depressive disorder increased rating and TDIU claims). After review of the development accomplished by the AOJ, the Board concludes there has been substantial compliance with the with the prior remand requests. See Donnellan v. Shinseki, 24 Vet. App. 167, 176 (2010) (“It is substantial compliance, not absolute compliance, that is required” under Stegall v. West) (citing Dyment v. West, 13 Vet. App. 141, 146-47 (1999)). In deciding claims, it is the Board’s responsibility to evaluate the entire record on appeal. See 38 U.S.C. § 7104(a). Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss each and every piece of evidence submitted by the Veteran or on his behalf. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). Rather, the Board’s analysis below will focus specifically on what evidence is needed to substantiate the claims and what the evidence in the claims file shows, or fails to show, with respect to the claims. See Timberlake v. Gober, 14 Vet. App. 122, 128-30 (2000). Increased Rating Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Separate diagnostic codes identify the various disabilities. Disabilities must be reviewed in relation to their history. 38 C.F.R. § 4.1. Other applicable, general policy considerations are: interpreting reports of examination in light of the whole recorded history, reconciling the various reports into a consistent picture so that the current rating may accurately reflect the elements of disability, 38 C.F.R. § 4.2; resolving any reasonable doubt regarding the degree of disability in favor of the claimant, 38 C.F.R. § 4.3; where there is a question as to which of two evaluations apply, assigning a higher of the two where the disability picture more nearly approximates the criteria for the next higher rating, 38 C.F.R. § 4.7; and, evaluating functional impairment on the basis of lack of usefulness, and the effects of the disabilities upon the person’s ordinary activity, 38 C.F.R. § 4.10. See Schafrath v. Derwinski, 1 Vet. App. 589 (1991). When an appeal arises from the initially assigned rating, consideration must be given as to whether staged ratings should be assigned to reflect entitlement to a higher rating at any point during the pendency of the claim. Fenderson v. West, 12 Vet. App. 119 (1999). Moreover, staged ratings are appropriate in any increased-rating claim in which distinct time periods with different ratable symptoms can be identified. Hart v. Mansfield, 21 Vet. App. 505 (2007). Major depressive disorder is rated under 38 C.F.R. § 4.130, Code 9434. For the period considered in this appeal, the Veteran’s major depressive disorder has been rated as 50 percent disabling prior to August 5, 2015 and 70 percent from that date. A 50 percent rating is warranted for 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; and difficulty in establishing and maintaining effective work and social relationships. 38 C.F.R. § 4.130, Code 9434. A 70 percent rating is warranted for occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work like setting); inability to establish and maintain effective relationships. Id. The maximum (100 percent) rating is warranted for: total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self and others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. Id. The symptoms listed in the various levels of rating criteria in § 4.130 are non-exhaustive, meaning that VA is not required to find the presence of all, most, or even some of the enumerated symptoms to assign a particular evaluation. Vasquez-Claudio v. Shinseki, 713 F.3d 112, 115 (Fed. Cir. 2013); see Sellers v. Principi, 372 F.3d 1318, 1326-27 (Fed. Cir. 2004); Mauerhan v. Principi, 16 Vet. App. 436, 442 (2002). However, the symptoms listed at the various levels of rating criteria in § 4.130 are deemed by VA to be representative of the corresponding levels of occupational and social deficiency. Bankhead v. Shulkin, 29 Vet. App. 10 (2017). Thus, the fact that a claimant has a symptom listed in one evaluation level without an analogue at lower evaluation levels indicates that the presence of that symptom alone may be cause for finding that the claimant’s condition meets that particular level of disability. Id. In McGrath v. Gober, 14 Vet. App. 28 (2000), the Court held that when the Veteran was actually experiencing symptoms is what is relevant for assigning rating effective dates, not when evidence was created. Thus, the Board will consider whether the evidence of record suggests that the severity of pertinent symptoms increased sometime prior to the date of the examination reports noting pertinent findings. Effective August 4, 2014, VA revised the portion of the Schedule for Rating Disabilities dealing with mental disorders and its adjudication regulations to remove outdated references to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and replace them with references to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). See 79 Fed. Reg. 149, 45094 (August 4, 2014). In Golden v. Shulkin, 29 Vet. App. 221 (2018), the Court held that, given that the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) abandoned the Global Assessment of Functioning (GAF) scale and that VA has formally adopted the DSM-5, GAF scores are inapplicable to assign a psychiatric rating in cases where the DSM-5 applies when the appeal was certified after August 4, 2014. Because the current appeal was certified to the Board in December 2013, the Board may consider GAF scores when analyzing the merits of the increased PTSD rating claim on appeal. As noted above, the Veteran is service connected for major depressive disorder rated 50 percent from December 5, 1996, the date of receipt of his reopened claim for service connection to August 5, 2015 and 70 percent from that date. He claims these staged ratings are an inadequate reflection of his psychiatric impairment and increased ratings are warranted. As explained herein, upon review of the record since his December 5, 1996 date of service connection, the Board finds that the Veteran’s service-connected major depressive disorder was not productive of impairment so as to warrant a rating excess of 50 percent prior to January 23, 2008; however, from this date, the Board finds that the evidence supports a rating of no more than 70 percent disabling. A December 1996 VA treatment report notes that the Veteran presented with vague paranoid ideation that people were following him and talking about him. He also reported more general feelings of isolation and loneliness. A February 1997 treatment report notes the Veteran’s increased stress and depression that he related to numerous disappointments over the past several months (failing to get some financial issues resolved, breaking up with his girlfriend, finding out that his Social Security Disability was being terminated and being rejected by his father after reaching out to him.) A subsequent February 1997 treatment report also notes depression over his inability to make progress in his life and his feeling tempted to relapse (into drug and alcohol abuse). These records note the Veteran’s limited success finding a job and his feeling that, even if he were to get a job, his wages would be garnished for back child support. A May 1997 treatment report notes that he sought admission for cocaine abuse. July 1997 notes from the Compensated Work Therapy program (CWT; also referred to as Compensated Work Program (CWP) or compensated work therapy program (CWTP)) note that the Veteran was generally doing well in his job in the file room and it was felt he was capable of handling the assignment. An August 1997 treatment report shows that the Veteran had been lost to follow-up for several months due to experiencing a relapse; however, he was now doing well attending support group and working for CWP in medical records. In an August 1997 letter, the Veteran’s VA physician noted that he suffered from depression in service and described self-medicating with alcohol, marijuana and cocaine. The examiner noted the Veteran had regained some social functioning with a medication regimen; however, there was significant residual depression despite abstinence from alcohol and drugs for three months. The examiner concluded the Veteran suffers from a chronic major depression, aggravated by alcohol and substance abuse, with onset in service. A May 1998 Outpatient Chemical Dependency Rehabilitation Program Discharge Summary shows that the Veteran had successfully completed the treatment plan goal. He had celebrated 1 year of sobriety/abstinence, was more medication compliant, had been attending church on a more regular basis and continued to work for CWP in the file room. After having been lost to follow-up for 6 months, a June 1998 VA psychology treatment report notes the Veteran was doing well with his CWP assignment; however, he had complications in his personal life that had triggered relapse in the past. During his October 1998 hearing before a hearing officer at the RO, the Veteran described becoming depressed after experiencing difficulty finding a job. VA treatment records show that the Veteran moved into supported housing in June 2000 and began a part-time job at VA in October 2000. These records show that, in November 2000, the Veteran continued to work at VA in a competitive job which he recently got and was doing well. VA treatment records include a January 2001 Social Work Assistant note that the Veteran continued to do well and was enjoying his job at VA Ward. A March 2003 VA treatment report notes that the Veteran was employed as a car salesman and had stopped cocaine and crack smoking 5 years previously. During his March 2005 hearing at the RO, the Veteran reported being employed as a salesperson. During his January 2006 Board hearing (in connection with his service connection claims, before a VLJ other than the undersigned), the Veteran testified that he had been doing well and had no drugs during the past 8 years while he was trying to put his life back together. A February 2007 VA Initial Psychiatric Assessment notes that the Veteran was referred “for evaluation, assessment and treatment of Depression manifested as having difficulty falling asleep, anxiety, irritability, anger, occasional road rage, inability to concentrate, periods of decreased appetite and periods of increased appetite.” The examiner noted that the Veteran had not been compliant with medication. He had been sober for the past 9 years. GAF scores of 41 and 45 were assigned. [Notably, a correction to this report was issued in November 2012; however, the report remained unchanged as to the findings noted above.] In April 2007, the Veteran reported the medication was helpful and he felt less anxious, irritable and angry. He was working hard at his job and was trying his best. A December 2007 treatment report notes the Veteran denied episodes of depression and claimed he had been able to keep his temper in check. A January 23, 2008 VA treatment report notes the Veteran reported difficulty handling his stressful job in the car sales business. He also reported difficulty concentrating and controlling his temper. In February, April and June 2008, the Veteran reported struggling with symptoms of depression such as lack of concentration, irritability, anxiety, anger, occasional inability to sleep and decreased libido and continued difficulties handling his stressful job. These records show that the Veteran reported being fired from his job in September 2008, he admitted to depression and anxiety. In connection with a dispute with his condo board, a November 2008 treatment report notes that the Veteran demonstrated irritability, unwillingness to consider compromise and was argumentative with the treatment provider. December 2008 treatment records show that the Veteran had completed his application for course work for a paralegal program. Regarding negative behavior, the Veteran reported that “his impulses overtake him and he feels unable to contain his feelings and acts on his impulses.” He felt “that he needs to use this as opportunity to change behaviors.” These records note the Veteran was alert and oriented x3, denied suicidal and homicidal ideation, there was no evidence of thought disorder, mood was anxious and depressed, he had full range of affect and fair/good insight, judgment and impulse control. They include GAF scores ranging from 41-45. In a February 2008 letter, the Veteran’s mother stated that, after the military, the Veteran became withdrawn, irritable, angry, depressed and began abusing alcohol and drugs. He was unable to sleep and “became very unstable.” She recalled he was “violent at times to the point that he would stay away for long periods ... from his family, so that he would not hurt anyone.” Similarly, a February 2008 statement from the Veteran’s sister notes he “presently is functioning at a minimal level with the aid of prescription drugs to hold down a job and meet family obligations.” [Notably, these statements were submitted in connection with the Veteran’s claim for service connection for depression and his mother did not specify the time for this period of violence and leaving the family.] A February 2008 letter from the Veteran’s VA treating psychiatrist, J.O.F., M.D., (Dr. F) states that the Veteran “has always reported persistent neurovegetative symptoms of depression that continue to be debilitating due to his actual medical conditions such as recurrent gastritis exacerbated by constant episodes of anxiety and irritability. His condition has deteriorated. His chronic feelings of anger and irritability have led to social isolation and the loss of numerous jobs due to constant arguments with his supervisors coworkers and clients.” Dr. F also noted the Veteran experienced difficulty sleeping and erectile dysfunction secondary to his antidepressive medications. Dr. F stated that the Veteran “has difficulty controlling his anger and is potentially explosive if exposed to a stressful situation. He has isolated from friends and family members. His symptoms from depression have been relatively resistant to treatment and are likely to persist as they [have] been for the past twenty two years. The severity of his symptoms has interfered with his ability to maintain a gainful and stable employment.” A February 2009 VA mental disorders examination report shows that the Veteran’s “last job was car sales representative for a dealership. He worked there for 8 years but was fired 7 months ago after his boss told him ‘(boss) don’t like Jamaicans.’ Vet is currently pursuing retraining as a paralegal.” On examination, the Veteran was pleasant and cooperative (for the most part), alert, oriented x3, with good eye contact. However, there were moments during the interview when the Veteran became tearful (talking about service discharge) or glared back at the examiners when asked questions about which he was defensive. Speech was intelligible and spontaneous and reality testing was generally intact. There was no evidence of psychotic thought process and the Veteran denied auditory or visual hallucinations, delusions or ideas. His thought processes were goal oriented, relevant and coherent and his mood was euthymic (he denied feeling depressed.) The Veteran’s affect was congruent with content and he denied suicidal/homicidal impulses, attempts, or plans or any history of same. There was no gross impairment of short term, immediate, recent or remote memory and he was able to recall two out of three items in five minutes. He had limited insight, fair judgment and good impulse control. A GAF score of 55 was assigned. The examiner concluded that “Major Depression, recurrent, moderate and drug abuse appears to have interfered directly with [the Veteran’s] intimate relationships and occupational advancement.” March 2009 VA treatment records show that the Veteran began a paralegal program and he was excited and apprehensive about being a student again. Subsequent records show he was doing well in the program and spent “pleasant and quiet time” at home during holidays. In September 2009, the Veteran presented with increased irritability and anxiety that he had completed his paralegal course, but VA had not found him a job. He expressed impatience and frustration with the process of finding employment. The Veteran was irritable, angry and depressed. He denied suicidal and homicidal ideation, his affect was labile and he had limited insight, impaired judgment, adequate impulse control and denied substance abuse. A January 2010 VA treatment record shows that the Veteran reported his continued search for a paralegal job and stated that he had a pleasant and quiet Christmas holiday. These records show he reported starting a job as a car salesman in September 2010; however, business was slow, and he was calling his family for financial help. An April 2011 VA mental disorders examination report notes that the Veteran had been employed as a car salesman for the past 10 years and reported being able to work on a full-time basis. The examiner noted that the Veteran is able to maintain his employment and function appropriately. On examination, “[m]ood and affect were appropriate to content of material discussed. Speech was normal. There was no evidence of perceptual impairment and no evidence of thought disorder. Thought content was appropriate to the evaluation. He denied both suicidal and homicidal ideation. He was oriented to time place and person. Memory, concentration, abstract reasoning, judgment, impulse control and insight were all intact.” A GAF score of 66 was assigned. A June 2011 VA treatment record notes that the Veteran reported having had a pleasant Memorial Day weekend at home with his family, was working as a car salesman and business was doing well. In November 2011, the Veteran reported the car sales business was picking up and he was planning to be with his family for Thanksgiving. In his December 2011 notice of disagreement with the 10 percent rating assigned for his depression, the Veteran reported that this disability had worsened and was productive of depressed mood, anxiety, suspicions at home and work, sleepless nights and fatigue (which causes him to be anxious and chatty or have panic attacks). He stated that these episodes cause him to be “written-up” at work and “alienate” him from his family and co-workers. A February 2012 VA treatment report notes that the Veteran reported having “strong arguments” with one of his daughters; however, he was proud that he had not lost his temper. The records include an October 2012 treatment report which notes the Veteran reported having problems at work, arguments with his supervisor and co-workers and stress over his mother getting a pacemaker/being hospitalized. These records show GAF scores of 41 and 45. On March 2013 VA examination, the Veteran reported difficulty falling asleep (and sleeping for only an hour before waking up again), anxiety, irritability, anger, problems with concentration and periods of increased appetite and weight gain. The examination report shows the Veteran had gotten a job in car sales in January 2012 and had been tense, anxious and had not been able to sleep after a “heated argument with his immediate supervisor.” He reported enjoying his second month of Vocational Rehabilitation at Paralegal Studies and spending time with his family during the holidays. The Veteran indicated still having days that he lacks energy, has anxiety and irritability. He denied suicidal and homicidal ideations, plans or intents and had no gross thought disorder or symptoms of psychosis. He had good reality testing, abstracting and calculating abilities were intact and insight, judgment and past and recent memory were good. The Veteran reported being sober for 9 years. The examiner found that the Veteran’s major depressive disorder resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactorily, with normal routine behavior, self-care and conversation. A GAF score of 48 was assigned. VA treatment records include a February 2013 report from the Veteran that he continued to have problems at work, arguments with supervisor and co-workers and heightened level of tension because of slow sales. In his August 2013 substantive appeal (VA Form 9), the Veteran claimed to be in “total isolation of family, including [his] 3 daughters” and having no friends. He indicated that he was still employed, although he had anxiety and was unable to cope with stressful situations at work, with near continuous panic attacks. In a September 2014 letter, in addition to repeating the findings noted in his March 2008 letter regarding the Veteran’s symptoms, his deteriorated condition and the impact on his occupational and social functioning, Dr. F noted that the Veteran lost his job at the end of March “due to constant arguments with his supervisors, co-workers and clients.” A May 2014 VA treatment record shows that the Veteran reported having “left his job” to prevent a physical confrontation after an argument with his supervisor. He planned to get a new job and denied any suicidal or homicidal ideations, plans and intents. Subsequent 2014 mental health treatment records show continued episodes of anxiety and irritability; however, these records note that the Veteran described “pleasant” times spent with family. These records include a GAF score of 41. In an October 2014 statement, the Veteran’s step-father reported that the Veteran had “been given to fits of anger, which has been exemplified by broken furniture and other destructive behavior. We have been concerned that he might hurt himself or someone else due to his lack of self-control.” In a similar October 2014 statement, the Veteran’s sister reported multiple conversations with the Veteran in which he exhibited “questionable behavior.” She also indicated that, “[d]ue to his behavior and disposition his relationship with family has been tainted” and noted that “[h]e can be verbally offensive.” A January 2015 VA treatment record shows the Veteran continued to report episodes of anxiety and irritability; however, he spent “pleasant” time with family and continued looking for a job. In February 2015, he reported having found a new job as a car salesperson. A June 2015 treatment report notes the Veteran had a “pleasant Memorial Day weekend, went to a Friend’s house for a BBQ which he enjoyed.” Other than work, he had no plans for the summer. On August 2015 mental health consultation, the Veteran reported “extreme” pressure at his job. He reported feeling anxious, irritable and angry and feeling so tense many nights that he is unable to sleep, which causes him to be unable to concentrate at his job the next day. In September 2015, the Veteran reported being fired from his job after having an argument with his supervisor and having been unemployed for a month. He reported being anxious, irritable and unable to sleep properly. In November 2015, he also reported symptoms of anger and poor concentration. These records include GAF scores of 41. A January 2016 VA examination report shows that the Veteran’s major depressive disorder is productive of occupational and social impairment with reduced reliability and productivity. It is noted the Veteran reported having limited contact with his family, his daughter does not speak to him because he once struck her, and he feels isolated in comparison to having a strong network in prior years. It is noted that the Veteran lost his job in early 2014 because he “did not see eye to with the owner” and they argued. He subsequently worked for a former employer, got into a disagreement and was fired within 2 months. He was unemployed but interested in working at the time of examination. The examiner noted that the Veteran’s current symptoms were depressed mood nearly every day with morbid thoughts (he reported thinking about death every day, but wants to live) to neutral mood, social isolation, reduced interest in activities, disturbed sleep (delayed onset as well as awakening during the night), difficulty concentrating, irritability and being quick to anger. The examiner noted “that the Veteran began talking about himself in the third person as he was also describing symptoms of paranoia.” He sometime hears voices and thinks people are talking about him, which has resulted in him overreacting to them. The examiner noted that these symptoms are mild, but may indicate a worsening of his mental health state. The examiner concluded that the Veteran’s “functional status appears to have decreased as he has been unable to maintain employment due to problems with angry outbursts/dysfunctional mood regulation. Without intervention, it is unlikely that the Veteran would be able to sustain any employment that required working as part of a team or having to provide consistently good customer service.” Records from the Social Security Administration (SSA) include a March 2016 Mental Status Evaluation Report which, after examination of the Veteran and review of his medical history (consistent with that which is described above), shows diagnoses of psychotic disorder, NOS (not otherwise specified), and history of cocaine abuse. These records show SSA determined the Veteran was “Not Disabled.” A May 2016 VA treatment record shows the Veteran reported frustration over not being able to find a job and was going to start the CWT program June 1st. It is noted that the Veteran’s “impulse control difficulty has been one of the reasons keeping him from a job, as well as the inability to control his temper in stressful situations at his job an in his daily interactions, his persistent depressive symptoms has led to suicidal ideations with no plans or intents. It is also noted that the Veteran “has been unable to keep prolonged relationships.” Private treatment records include a September 2016 discharge summary which notes that the Veteran reported recently using crack cocaine, having stopped his medications and experiencing “fleeting” homicidal and suicidal thoughts without plan or intent. VA treatment records from 2016 to the present note the Veteran’s risk factors including impulsive and/or aggressive tendencies; relational, social, work or financial loss and suicidal thoughts. An October 2019 VA mental disorders examination report includes the opinion that the Veteran’s mental diagnosis is productive of occupational and social impairment with deficiencies in most areas. He reported his wife had left due to a September 2018 domestic violence incident (he punched her in the face) and he did not speak to one of his daughters. He also reported 2 prior incidents in which he had physical altercations with his friends (“dragged his friend out of the car and knocked his teeth out.”) The examiner noted the Veteran’s “secondary condition of Alcohol Use Disorder related to mental health conditions” and opined that “[s]ubstance abuse is very common among people who battle with a depressive disorder.” The examiner further opined that the Veteran “would have severe functional limitations in his occupational environment” and noted the Veteran had reported “he had gotten into verbal altercations with other Veterans and staff” and “cursed other people out at work.” Based on the opinion of the October 2019 VA examiner, a November 2019 rating decision granted service connection for mild alcohol use disorder from October 9, 2019 (the date of the VA examination) and continued the 70 percent rating for recurrent moderate major depressive disorder with mild alcohol use disorder from October 9, 2019. Prior to January 23, 2008 The Board finds the VA examination reports and treatment records prior to January 23, 2008 provide overall evidence against a rating in excess of 50 percent prior to that date, as they do not show that symptoms of the Veteran’s major depressive disorder produced occupational and social impairment with deficiencies in most areas, so as to meet the criteria for the next higher, 70 percent, rating. He did not, for example, display obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; or inability to establish and maintain effective relationships, nor did he exhibit any other unlisted (in the rating criteria) symptoms of similar gravity. The treatment records and examinations from that time revealed no impairment of thought processes or content. Although the Veteran reported vague paranoid ideation in December 1996, this was an isolated incident, it is not shown by the record or reported by the Veteran again during the appeal period. Further, although the Veteran complained of increased stress and depression (and being tempted to relapse into drug and alcohol abuse), these records note he was employed (in his CWP job and subsequently in car sales) and generally doing well, had regained some social functioning with medication, reported 8 years of being drug free during his January 2006 Board hearing and denied episodes of depression and reported keeping his temper in check during VA treatment in December 2007. It is also noted that GAF scores during this period were predominantly in the 40s (reflecting, serious symptoms or serious social and occupational impairment). However, GAF scores, alone, without explanation, are not dispositive and the Veteran’s GAF scores in the 40s are not supported by/consistent with clinically noted symptoms. The records prior to January 23, 2008 show that throughout this period the Veteran was functioning adequately in his daily life activities (he was generally employed, keeping his temper in check and was trying to put his life back together (see, e.g., January 2006 Board hearing transcript))”. Accordingly, a schedular rating in excess of 50 percent is not warranted prior to January 23, 2008. The next higher, 70 percent, rating requires occupational and social impairment with deficiencies in most areas, which simply was not shown prior to this date. From January 23, 2008 However, the Board finds that from January 23, 2008, the Veteran and his family, his treating and evaluating mental health personnel and the VA examiners have reported symptoms that reflect occupational and social impairment with deficiencies in most areas, such as work, family relations, judgment, thinking, and mood. A January 23, 2008 VA treatment report notes he reported difficulty handling his stressful car sales job and problems with concentration and controlling his temper. He reported being fired from his job and disputes with his employer and condominium board. Treatment records during this period note that, although the Veteran was pursuing training as a paralegal, his “condition had deteriorated” and was productive of his unwillingness to compromise, argumentativeness (with the examiner, family, employer and co-workers), inability to control his feeling, acting on his impulses and social isolation. These records including findings of limited insight and impaired judgment. These records show physical violence towards his daughter, spouse and friends as well as fleeting homicidal and suicidal thoughts (for which he has no intent or plan). Treatment records note the Veteran’s reference to himself in the third person and describe symptoms of paranoia and hearing voices. The Board finds no reason to question the credibility of the Veteran’s accounts; they are consistent with reports by his treating mental health personnel and observations by VA examiners and his family. As the functional impairment described meets (or at least approximates) the schedular criteria for a 70 percent rating under Code 9434, the Board finds that such rating is warranted from January 23, 2008 (but not earlier, as the record does not show evidence of such worsening prior to that date). 38 C.F.R. § 4.7. The Board finds that the evidence fails to demonstrate the Veteran’s major depressive disorder was productive of total occupational and social impairment warranting a 100 percent schedular evaluation at any time during the appeal. The evidence shows that, although troubled at times, he has generally been able to maintain relationships with his mother, step-father, siblings and daughters. While the observations by the VA examiners and treatment providers suggest that he has increasingly limited social relationships and increased withdrawal, such impairment is clearly encompassed by the criteria for the 70 percent rating granted herein (which contemplate deficiencies in most areas). In so finding, the Board acknowledges the Veteran’s reports of homicidal and suicidal ideation; however, these thoughts are described as fleeting, note the Veteran wants to live and he denied any plan or intent. As such, it is not shown the Veteran was in persistent danger of acting on these thoughts as anytime during the appeal period. Further, it is noted that the Veteran has reported periodic vague, non-command auditory hallucinations (hearing voices) and persistent delusions or hallucinations are specifically contemplated by the 100 percent rating criteria. However, no such symptom was noted on February 2009, April 2011 and March 2013 VA examinations, the January 2016 examination report described this symptom as mild, no such symptom was noted on October 2019 VA examination, and VA treatment records note such symptoms are periodic. As such, the periodic incidents of hearing voices described in the record simply do not manifest with the severity, frequency and duration consistent with persistent delusions or hallucinations contemplated in the 100 percent rating. The Board also notes that the Veteran does not appear to endorse any of the other symptomatology described in the criteria for a 100 percent rating. For example, the record does not reflect, and the Veteran has not described, a gross impairment in thought processes or communication, grossly inappropriate behavior, intermittent inability to perform activities of daily living, disorientation to time or place, or memory loss for names of close relatives, own occupation, or own name. Accordingly, the Board finds that the schedular criteria for the next higher 100 percent disability evaluation have not been met for any portion of the appeal period The Board notes the Veteran’s GAF scores throughout the appeal period are not consistent with ratings in excess of those now assigned, and do not present an independent basis for assigning ratings in excess of those now assigned. Regarding the lay statements submitted by the Veteran and his family in support of this claim, such statements detail the types of problems that result from the Veteran’s symptoms of major depressive disorder shown. The levels of functioning impairment described are encompassed by the criteria for the 50 percent and 70 percent ratings now assigned for the periods of time on appeal; they do not support assignment of further increases in the schedular ratings. The Board has considered the Veteran’s claim for an increased rating of his service connected major depressive disorder (with mild alcohol use disorder from October 9, 2019) and decided entitlement based on the evidence. The Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, with respect to his claim. See Doucette v. Shulkin, 28 Vet. App. 366, 369-70 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). TDIU It is the established policy of VA that all Veterans who are unable to secure and follow a substantially gainful occupation by reason of service-connected disabilities shall be rated totally disabled. 38 C.F.R. § 4.16. A finding of total disability is appropriate “when there is present any impairment of mind or body which is sufficient to render it impossible for the average person to follow a substantially gainful occupation.” 38 C.F.R. §§ 3.340(a)(1), 4.15. TDIU may be assigned where the schedular rating is less than total and it is found that the disabled person is unable to secure or follow a substantially gainful occupation as a result of either (1) a single service-connected disability ratable at 60 percent or more, or (2) two or more disabilities, provided at least one disability is ratable at 40 percent or more, and there is a sufficient additional service-connected disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a). If a sufficient rating is present, then it must be at least as likely as not that the Veteran is unable to secure or follow a substantially gainful occupation as a result of that disease. See 38 C.F.R. § 4.16(a). The central inquiry is, “whether the Veteran’s service-connected disabilities alone are of sufficient severity to produce unemployability.” Hatlestad v. Brown, 5 Vet. App. 524, 529 (1993). The issue is not whether the Veteran can find employment generally, but whether the Veteran is capable of performing the physical and mental acts required by employment. Van Hoose v. Brown, 4 Vet. App. 361, 363 (1993). “Substantially gainful employment” is that employment “which is ordinarily followed by the nondisabled to earn their livelihood with earnings common to the particular occupation in the community where the Veteran resides.” Moore v. Derwinski, 1 Vet. App. 356, 358 (1991). Consideration may be given to the Veteran’s education, special training, and previous work experience, but not to his age or to the impairment caused by nonservice-connected disabilities. See 38 C.F.R. §§ 3.341, 4.16, 4.19; see also Van Hoose, 4 Vet. App. at 363. The Veteran has claimed that he is unemployable due to his service-connected major depressive disorder. His service-connected major depressive disorder is now rated 70 percent, effective January 23, 2008. Prior to that, his major depressive disorder was rated at 50 percent, effective December 5, 1996. Therefore, as of January 23, 2008, he meets the criteria for consideration of TDIU on a schedular basis. 38 C.F.R. § 4.16(a). Accordingly, the remaining question is whether he is unable to secure or follow a substantially gainful occupation because of his service-connected disabilities from January 23, 2008, and whether there is plausible evidence that the Veteran is unable to secure and follow a substantially gainful occupation by reason of service-connected psychiatric disability warranting referral to the Director of Compensation under 38 C.F.R. § 4.16(b). The Board finds the preponderance of the evidence is against finding that the Veteran was unable to secure or follow a substantially gainful occupation due to his service-connected disabilities since January 23, 2008 or that there is plausible evidence of inability to secure and follow a substantially gainful occupation prior to that date. As to the period prior to January 23, 2008, the evidence shows that the Veteran was employed in some capacity during significant portions of the appeal period. In 1997 he was noted to be working through the CWP program; in approximately 2000 he began working at VA; and from August 2005 to August 2005 he worked full time in sales. Accordingly, there is not plausible evidence that the Veteran was unable to secure and follow a substantially gainful occupation by reason of service-connected psychiatric disability warranting referral to the Director of Compensation under 38 C.F.R. § 4.16(b) during this period. The evidence shows the Veteran has been employed in some capacity during significant portions of the appeal period. See, e.g., September 2010 VA Form 21-8940, Veteran’s Application For Increased Compensation Based on Unemployability (the Veteran reported he had been employed from August 2005 to August 2008, August 2010 to present (this was confirmed by his employer in an April 2011 response to a request for employment information) and had completed 3 years of college and a paralegal studies program); May 2016 statement (Veteran suggested that he was enrolled in the CWT program and worked 40 hours per week) and VA and private treatment records and examination reports during the appeal period described above in which the Veteran reported being employed. Accordingly, in September 2017, the Board remanded the claim for TDIU for further development, including requesting the Veteran complete and return (a) an updated VA Form 21-8940, providing a detailed account of his employment history since December 1996, the appeal period for his claim for an increased rating for his service-connected major depressive disorder and (b) written responses regarding his education level, whether he has any special vocational training, the duties and responsibilities of any current employment, the length of prior employment and his major duties and responsibilities, whether full- or part-time, reason for any time lost, any special accommodations provided and whether his medical conditions prevented him from performing tasks related to his education or training or resulted in termination from employment. Review of the records shows that, although the Veteran completed and returned a VA Form 21-8940 in January 2019, he did not provide the information requested in the September 2017 Board remand. Specifically, he reported being unemployed from January 2014, being in the CWT program full-time from June 2016, full-time employment in housekeeping from October 2017 to the present (also confirmed by his employer in a January 2019 response to a request for employment information), completion of 2 years of college and obtaining a paralegal certificate. However, he did not provide information regarding his employment from December 1996 or the details regarding the duties and responsibilities of his employment and the impact of his medical conditions on such employment. The record shows a December 2018 letter from the AOJ requested the information pursuant to the September 2017 Board remand. The Veteran has not indicated that he did not receive the request for additional information (and the record suggests the January 2019 VA Form 21-8940 was submitted in response to such request) or explained why such information cannot be provided. The record shows the Veteran has been employed in housekeeping/janitorial services since October 2017 (and he had previously been in the CWT program from June 2016). However, the October 2019 VA mental disorders examination report includes the opinion that the Veteran “would have severe functional limitations in his occupational environment” and notes “he had gotten into verbal altercations with other Veterans and staff” and “cursed other people out at work.” In addition, as discussed above, the record shows the Veteran has had earlier periods of employment in car sales and reported stress and conflicts with his employers and co-workers. Prior VA examination reports and treatment records and statements from the Veteran, his treatment providers and family attest to his occupational difficulties as result of his service-connected major depressive disorder during the appeal period. Although SSA determinations are not binding on VA, it is noteworthy that SSA determined the Veteran was not disabled. See Collier v. Derwinski, 1 Vet. App. 413, 417 (1991) (indicating the SSA’s favorable determination, while probative evidence to be considered in a claim with VA, is not dispositive or altogether binding on VA since the agencies have different disability determination requirements). The Board does not doubt that the Veteran’s service connected major depressive disorder, currently rated at 70 percent disabling, has limited him over the years. He has reported conflicts with supervisors and co-workers which have sometimes resulted in the termination of his employment. However, he is currently employed full-time and the evidence does not show his service-connected major depressive disorder itself has precluded substantially gainful employment during the appeal period prior to his current full-time employment. Rather, the record shows the Veteran has had extensive periods of employment throughout the appeal period. Although there were times when he was unemployed, he has not provided information as to the cause of such unemployment in light of his 2 years of college and paralegal certification, as requested in the September 2017 Board remand. Similarly, he has not provided the detailed employment information requested in the September 2017 Board remand, including the duties and responsibilities related to his employment, the impact of his service connected disabilities on his ability to perform employment related tasks or any accommodations provided by his employers. Notably, the duty to assist the Veteran in the development of evidence pertinent to his claim is not a “one-way street,” and his failure to provide the necessary information within his possession prevents VA from assisting him in this matter. Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). The Board concludes that entitlement to a TDIU is not warranted. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, the preponderance of the evidence is against the claim, and the benefit-of-the-doubt doctrine is not applicable. The claim is denied. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Hughes 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.