Citation Nr: 21072167 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 16-18 024 DATE: December 2, 2021 ORDER An initial rating in excess of 30 percent from February 17, 2015 to March 4, 2018 for bipolar disorder is denied. An initial rating in excess of 50 percent from November 4, 2020 to March 3, 2021 for bipolar disorder is denied. FINDINGS OF FACT 1. From February 17, 2015 to March 4, 2018, the Veteran's bipolar disorder was not manifested by at least occupational and social impairment with reduced reliability and productivity due to psychiatric symptomatology. 2. From November 4, 2020 to March 3, 2021, the Veteran's bipolar disorder was not manifested by at least occupational and social impairment with deficiencies in most areas due to psychiatric symptomatology. CONCLUSIONS OF LAW 1. The criteria for entitlement to an initial rating in excess of 30 percent from February 17, 2015 to March 4, 2018 for bipolar disorder have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.21, 4.126, 4.130, Diagnostic Code 9432 (2020). 2. The criteria for entitlement to an initial rating in excess of 50 percent from November 4, 2020 to March 3, 2021 for bipolar disorder have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.21, 4.126, 4.130, Diagnostic Code 9432. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from June 1982 to June 1984. In September 2020 and May 2021, the case was remanded for readjudication. There was substantial compliance with the remand directives as the case was readjudicated in November 2020 and August 2021 supplemental statements of the case (SSOCs). See Stegall v. West, 11 Vet. App. 268, 271 (1998). The case has been returned to the Board for appellate review. Neither the Veteran nor his representative have raised any issues with the duty to notify or duty to assist with regards to the issues discussed below on the merits. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Higher Initial Ratings Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two evaluations are potentially applicable, 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. When reasonable doubt arises as to the degree of disability, such doubt will be resolved in the veteran's favor. 38 C.F.R. § 4.3. Staged ratings are appropriate for an increased rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). The Veteran's disability should be viewed in relation to its history. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Given the nature of the present claim for a higher initial evaluation, the Board has considered all evidence of severity since the effective date for the award of service connection on February 17, 2015. Fenderson v. West, 12 Vet. App. 119 (1999). Pertinent regulations do not require that all cases show all findings specified by the Rating Schedule, but that findings sufficiently characteristic to identify the disease and the resulting disability and above all, coordination of rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21. Procedural History On February 17, 2015, the Veteran's formal request for service connection for mental condition not otherwise specified (NOS) was obtained and associated with the record. In the September 2015 VA rating decision, service connection for bipolar disorder with alcohol abuse (claimed as mental condition NOS) was granted because the disability was deemed to be directly related to his military service. The Veteran was assigned a 30 percent disability rating for the entire appeal period effective from February 17, 2015. See 38 C.F.R. § 4.130, Diagnostic Code 9432. In the November 2020 VA rating decision, the AOJ assigned the service-connected bipolar disorder a 100 percent disability rating effective from March 5, 2018 to November 3, 2020 and a 50 percent disability rating effective thereafter. Id. Most recently, in the May 2021 VA rating decision, the AOJ assigned the service-connected bipolar disorder a 100 percent disability rating effective from March 4, 2021. Id. Since the 30 percent disability rating is not the maximum rating available from February 17, 2015 to March 4, 2018 and the 50 percent disability rating is not the maximum rating available from November 4, 2020 to March 3, 2021, the issue has been returned to the Board and characterized accordingly. See AB v. Brown, 6 Vet. App. 35 (1993). The Board considers whether an initial rating in excess of 30 percent from February 17, 2015 to March 4, 2018 and in excess of 50 percent from November 4, 2020 to March 3, 2021 for bipolar disorder is warranted in this case. Diagnostic Criteria Pursuant to the General Rating Formula for Mental Disorders, a 30 percent rating is warranted when there is occupational and social impairment with 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). 38 C.F.R. § 4.130, Diagnostic Code 9432. The next-higher rating of 50 percent 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. 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); or an inability to establish and maintain effective relationships. Id. The 100 percent, the maximum available, 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 or others; intermittent inability to perform activities of daily living (including maintenance of minimal hygiene); disorientation to time or place; or, memory loss for names of close relatives, occupation, or own name. Id. The Board must conduct a "holistic analysis" that considers all associated symptoms, regardless of whether they are listed as criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); 38 C.F.R. § 4.130. The Board must determine whether unlisted symptoms are similar in severity, frequency, and duration to the listed symptoms associated with specific disability percentages. Then, the Board must determine whether the associated symptoms, both listed and unlisted, caused the level of impairment required for a higher disability rating. Vazquez-Claudio v. Shinseki, 713 F.3d 112, 114-118 (Fed. Cir. 2013). According to the applicable rating criteria, when evaluating a mental disorder, the frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran's capacity for adjustment during periods of remission must be considered. 38 C.F.R. § 4.126(a). In addition, the evaluation must be based on all the evidence of record that bears on occupational and social impairment rather than solely on the examiner's assessment of the level of disability at the moment of the examination. Id. Further, when evaluating the level of disability from a mental disorder, the extent of social impairment is considered, but the rating cannot be assigned solely the basis of social impairment. 38 C.F.R. § 4.126(b). 1. Entitlement to an initial rating in excess of 30 percent from February 17, 2015 to March 4, 2018 for bipolar disorder Review of the evidentiary record from February 17, 2015 to March 4, 2018 documents the following symptomatology for the Veteran's bipolar disorder. In September 2015, the Veteran underwent a VA examination for mental disorders. The Veteran reported having manic periods followed by depression, not sleeping much, easily irritated, lots of energy, rapid thinking, depression then hyper sleeps, lack of motivation, anhedonia, worthlessness, and avoidance of people. He also reported being married for 23 years, having two close friends, and liked going to work and talking to customers. Upon clinical evaluation, the VA examiner marked the presence of the following psychiatric symptomatology: depressed mood, chronic sleep impairment, and disturbances of motivation and mood. The Veteran was observed as cooperative, oriented to person, time, and place and demonstrated normal thought process, average concentration and memory, and no suicidal ideation. The VA examiner concluded the Veteran's level of occupational and social impairment was characterized "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." In June 2016, the Veteran underwent an additional VA examination for mental disorders. The Veteran reported the following symptoms of depression: anhedonia, increased need for sleep, anergia, appetite decrease, feelings of worthlessness, and occasional fleeting passive suicidal ideation which last occurred one month prior. He reported the following symptoms typical of a manic episode: inflated self-esteem, decreased need for sleep, pressured speech, racing thoughts, distractibility, increased goal activity, and excessive involvement in risky or pleasurable activities. He also reported having anger difficulties. He also reported being married, estranged from his daughter for seven years, having regular social contact with five friends, described his social relationships as fair, self-employed as a residential painter for three years, withdrawal secondary to his depression, and anger, rage, verbal aggression, and loss of temper secondary to his manic episodes. Upon clinical evaluation, the VA examiner marked the presence of the following psychiatric symptomatology: depressed mood, anxiety, and disturbances of motivation and mood. The Veteran was observed as casually dressed, cooperative, and demonstrated fluent speech, appropriate psychomotor behavior, constricted affect, euthymic mood, intact insight, thought process was linear, goal directed, and future oriented, and attention, language and memory appeared within normal limits. There were no findings of reported hallucinations, delusions, or homicidal or suicidal ideation. Similar to the September 2015 VA examiner, this VA examiner also concluded the Veteran's level of occupational and social impairment was characterized "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." Review of VA treatment records during the period on appeal from February 17, 2015 to March 4, 2018 shows that in May 2016 the Veteran presented after not having been seen in a year or on any psychotropics recently. He requested information about treatment and reported feeling depressed, lack of motivation, and worthless at time, has not spoken with his daughter in five years, and engages in leisure activities with his wife including going to garage sales. The Veteran reported a month prior he walked across a bridge and had a fleeting thought of jumping off and has a history of thinking he will just drive off a curve but demonstrated no intent, plan, or attempts. He also reported feeling quite anxious a lot, was told he had an anxiety attack a year prior while waiting at a hospital during his mother's surgery, and that he has had attacks like that three times in his life. Lastly the Veteran report having manic episodes, more in the spring and summer, in which he will be irritable, hyper talkative, multitasking, elevated mood, not sleeping, impulsive, and experience depressive periods for about two to three days. Upon observation, the treating physician observed the Veteran as pleasant, cooperative, calm, and demonstrated speech within normal limits, good eye contact, euthymic mood and affect, linear thought process, and fair insight and judgment. The Veteran was prescribed lithium and referred to mood management class and bipolar support group. Subsequently, the Veteran underwent follow up psychiatric sessions. In June 2016, the Veteran reported feeling "more mellow." In July 2016, he reported his negative thoughts have resolved, overall is doing better, and not having suicidal ideation, feeling depressed, staying in bed, or having mood swings. Review of the pertinent evidence of record from February 17, 2015 to March 4, 2018 establishes the Veteran's service-connected bipolar disorder was not manifested by occupational and social impairment with reduced reliability and productivity due to psychiatric symptomatology. As discussed above, the Veteran's bipolar disorder was manifested by manic episodes, depression, sleep impairment, irritability, rapid thinking, anhedonia, worthlessness, avoidance of people, disturbances of motivation and mood, and anxiety. Moreover, the September 2015 and June 2016 VA examiners concluded the Veteran's bipolar disorder was best characterized by 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. The Veteran's overall psychiatric symptomatology did not rise to the level of severity, frequency, or duration to demonstrate more severe occupational and social impairment at any time from February 17, 2015 to March 4, 2018 to warrant a higher rating. In fact, the Veteran demonstrated ongoing effective relationships with his wife and friends, engagement in work and leisure activities, normal speech, cooperation, full orientation, normal thought process and content, average concentration and memory, and intact insight. There were no current findings of memory problems, psychosis, delusions, hallucinations, or homicidal ideation. The Board acknowledges the Veteran's report at the May 2016 VA treatment session of having "occasional fleeting" suicidal thoughts, and at the June 2016 VA examination of having occasional fleeting passive suicidal ideation. While suicidal ideation is contemplated by the 70 percent criteria and the danger of hurting self or others is contemplated by the 100 percent criteria, these reports from the Veteran were not of the frequency, severity, or duration to cause occupational and social impairment with reduced reliability and productivity during this appeal period. In fact, review of VA treatment records dated during the appeal period documents the Veteran's denial of suicidal ideation in July 2016 and the September 2015 and June 2016 VA examiners documented there were no findings of suicidal ideation. Further, his suicidal ideation was described as "occasional fleeting," which is not frequent or severe enough to produce deficiencies in most areas. Additionally, the record does not show, nor does the Veteran contend that his occasional fleeting passive suicidal ideation impacted any areas of his life. Bankhead, 29 Vet. App. at 19. Therefore, it is not of the frequency, severity, or duration to meet the 70 percent criteria. As previously noted, the Veteran reported at the May 2016 VA treatment session that he was told he had an anxiety attack one year prior and reported he has had attacks like that three times in his life. Additionally, at the November 2019 Board hearing the Veteran also reported having had "several panic attacks in the last how many years," he went to a hospital once for a panic attack, and has not experienced a panic attack in a while. The Board acknowledges these lay assertions and that panic attacks (weekly or less often) is one of the criteria listed for the 30 percent rating; however, the severity described by the 50 percent criteria contemplate "panic attacks more than once a week" and by the 70 percent criteria contemplate "near-continuous panic or depression affecting ability to function independently, appropriately and effectively." Review of the record does not show the Veteran experienced panic attacks at least more than once a week at any time during the period on appeal from February 17, 2015 to March 4, 2018. Rather, in light of his reported three attacks in his life, review of the record shows the Veteran was able to function independently, appropriately, and effectively and demonstrated good relationships with his family and friends and was engaged in self-employment with positive interactions with customers. The Veteran has decreased motivation. At his September 2015 VA examination, he reported lack of motivation, which caused him to be frustrated with himself. In May 2016, the Veteran reported lack of motivation as a "big issue" for him, and stated that he sat and watched television a lot. The June 2016 examiner also noted "disturbances of motivation and mood." This is contemplated by the 50 percent criteria. The frequency, severity, and duration of his lack of motivation are not such that they cause reduced reliability and productivity. At his September 2015 VA examination, the Veteran reported working at his job as a painter and carpenter for 20 years. He stated that he liked his work and got along well with his customers, and that the liked talking to his customers. He described himself as "well liked" by his customers. Regarding his lack of motivation, he stated that it caused him to become frustrated with himself. At his June 2016 VA examination, he did not describe the impact of his lack of motivation on his job. The record does not show that lack of motivation impacted his work performance in terms of either reliability or productivity. Additionally, he remained independent in his activities of daily living, competent to manage his funds, and did not require assistance for tasks because of his lack of motivation. His lack of motivation did not impair his ability to be reliable, that is, to be trusted or perform consistently well. His lack of motivation is therefore not severe enough to be contemplated by the 50 percent criteria. The Veteran reported feelings of anger and rage at his June 2016 examination. Impaired impulse control "such as unprovoked irritability with periods of violence" is contemplated by the 70 percent criteria. The Veteran's anger symptoms are not of a severity to be more accurately described by the 70 percent criteria. His impulse control has not been found to be impaired. Additionally, he had not become violent due to his anger. His feelings of anger occur when he drinks alcohol or during manic episodes, and the evidence does not show that they are severe enough to be more accurately described as impaired impulse control. As such, an initial rating in excess of 30 percent is not warranted at any time from February 17, 2015 to March 4, 2018. See 38 C.F.R. § 4.130, Diagnostic Code 9432. The Board is aware that the symptoms listed under the next-higher ratings of 50, 70, and 100 percent are essentially examples of the type and degree of symptoms for that rating, and that the Veteran need not demonstrate those exact symptoms to warrant a higher rating. See Mauerhan v. Principi, 16 Vet. App. 436 (2002). Moreover, entitlement to such an evaluation requires sufficient symptoms of the requirements, or others of similar severity, frequency, or duration, that cause the specific type of occupational and social impairment. See Vazquez-Claudio, 713 F.3d at 117-18. In this case, the Board has considered these higher ratings for the period from February 17, 2015 to March 4, 2018 but finds that it is rated appropriately. The signs and symptoms manifested are contemplated by the currently assigned rating of 30 percent as they do not manifest with the severity required for a higher rating. The Board has considered the Veteran's reported history of symptomatology related to the service-connected bipolar disorder. He is competent to report such symptoms and observations because this requires only personal knowledge as it comes through one's senses. Layno v. Brown, 6 Vet. App. 465, 470 (1994). His credible descriptions of his observable symptoms are not more closely described by the 50, 70, or 100 percent criteria. The Veteran underwent a VA examination on March 5, 2018. This examination was the basis for the grant to 100 percent. For initial rating claims and increased rating claims, "the effective date can be no earlier than the date it was factually ascertainable" that a veteran's disability was diagnosed or worsened. Swain v. McDonald, 27 Vet. App. 219, 224 n. 4 (2015). The effective date should not be "assigned mechanically" as of the date of an examination. Id. at 224. There must be a factual basis for choosing an earlier date. The information contained in the March 5, 2018 examination report does not provide a factual basis for assigning the 100 percent rating prior to that date. The examiner noted that the Veteran "has become homeless" but did not state when this occurred. He reported that he had stopped working, but the record does not show when this occurred. At the examination, he reported not having been seen by a medical provided in one and a half years, so there are no medical records showing an increase in severity of the disability after the June 2016 examination. The selection of March 5, 2018 as the date for the 100 percent evaluation is appropriate. 2. Entitlement to an initial rating in excess of 50 percent from November 4, 2020 to March 3, 2021 for bipolar disorder Review of the evidentiary record from November 4, 2020 to March 3, 2021 documents the following symptomatology for the Veteran's bipolar disorder. On November 4, 2020, the Veteran underwent a VA examination for mental disorders. The Veteran reported being a widower since 2016, he was not in contact with his daughter, he had associates, a girlfriend, and five other friends, and maintains contact with his mother and two brothers. He engages in leisure activities including going to pawn shops, antique shops, car racing, and movies, and "retired for most part . . . painting some." He reported having "no motivation," having panic attacks "occasionally" with the last one being two years ago. He worried and had anxiety. He had periods of "typical hypomania." He denied having irritability or outbursts. Sometimes he felt worthless and thought about death a lot. He had problems concentrating during periods of hypomania when his thoughts raced. He reported that he was very attached to the people in his life and he kept up with them. He stated that he had loving feelings for his girlfriend and family. Upon clinical evaluation, the VA examiner noted that the Veteran was in a "mild depressive phase," and had been of his mood stabilizers for "months." The examiner marked the presence of the following psychiatric symptomatology: depressed mood, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, and difficulty adapting to stressful circumstances including work or a work-like setting. The Veteran was observed as dressed appropriately, cooperative, alert and oriented to time, person, and place, and demonstrated adequate grooming and hygiene, good eye contact, attention and concentration on the questions being asked without difficulty, clear and coherent spontaneous speech, linear and goal directed thinking, normal speech, mildly dysphoric mood, appropriate and stable affect, average range of intellectual functioning, and insight and judgment appeared within normal limits. There were no findings of obvious deficits in speed of cognitive processing, mental efficiency, or visuomotor integration, nor a formal thought disorder, psychotic process, delusions, hallucinations, or affective dysregulation. Similar to the September 2015 and June 2016 VA examiners, this VA examiner also concluded the Veteran's level of occupational and social impairment was characterized "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." Review of VA treatment records during the period on appeal from November 4, 2020 to March 3, 2021 shows that on November 17, 2020, the Veteran described his mood as "fine" and discussed a recent trip visiting family. The examining physician noted, in part, that the Veteran does not require assistance to meet needs of daily living, has intermittent mental health symptoms present and well controlled, usually triggered by life stressors and only slight impairment in functioning, healthy strong relationships with family/friends, active community involvement and/or employment, no significant or enduring difficulties in interpersonal interactions, positive relationships with family/significant others, and assertively contributes to these relationships. In February 2021, the Veteran reported his plans to visit family, discussed his positive healthy relationships with family, as well denied any thoughts of engagement in suicide-related behavior or made any suicide attempts since his last suicide risk screening on March 22, 2018. A few days later in February 2021, the Veteran underwent an individual psychotherapy and suicide risk assessment to address concerns with stress and anxiety. He reported the following intermittent symptoms related to his bipolar disorder since his wife died in 2017: anhedonia, intrusive thoughts, isolation/loneliness, inability to form regular sleeping pattern, increased sadness, and use of alcohol to cope. He denied any past or present thoughts, intent, plan, or attempts of killing himself as well as any homicidal ideation, plan, or intent. The Veteran was observed as displaying appropriate behavior, euthymic mood, congruent affect, normal delivery and content of speech, and linear thought processes. There were no findings of a thought disorder or psychosis. The examining physician concluded the Veteran presented with adjustment disorder with depressed mood and moderate alcohol use disorder and referred the Veteran to behavioral health interdisciplinary program (BHIP) and substance use disorder (SUD) clinics. Review of the pertinent evidence of record from November 4, 2020 to March 3, 2021 establishes the Veteran's service-connected bipolar disorder was not manifested by occupational and social impairment with deficiencies in most areas due to psychiatric symptomatology. As discussed above, the Veteran's bipolar disorder was manifested by depressed mood, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, difficulty adapting to stressful circumstances including work or a work-like setting, anhedonia, intrusive thoughts, isolation/loneliness, increased sadness, and use of alcohol to cope, and engagement in leisure activities and relationships with family and friends. Moreover, the November 2020 VA examiner concluded the Veteran's bipolar disorder was best characterized by 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. Furthermore, VA treatment providers noted in November 2020 the Veteran's mental health symptoms were intermittent and well controlled, and in February 2021 the Veteran's denial of suicidal or homicidal ideation, plan, or intent. The Veteran's overall psychiatric symptomatology did not rise to the level of severity, frequency, or duration to demonstrate more severe occupational and social impairment at any time from November 4, 2020 to March 3, 2021 to warrant a higher rating. In fact, the Veteran demonstrated ongoing effective relationships with his girlfriend, extended family, and friends, and engagement in social activities. Therefore the impact of his psychiatric condition on his relationships is more accurately described as "difficulty" to establish and maintain them, as opposed to the more severe "inability," which is contemplated by the 70 percent criteria, and does not rise the level of a deficiency in the area of family relationships. He had good hygiene, normal speech, cooperation, appropriate attention, full orientation, unremarkable thought process and content, and insight and judgment within normal limits. There were no current findings of memory loss for names of close relatives, occupation or own name problems, psychosis, violent behavior, threat of danger or injury to self or others, delusions, hallucinations, homicidal thoughts, or suicidal thoughts or ideation. He does not have a deficiency in judgment or thinking and does not attend school. He was not working during this period and therefore the area of work does not apply. Regarding mood, his depression was described as being in a "mild phase" at the November 2020 examination and that he had periods of depression and anxiety. Although the 70 percent criteria contemplate depression and panic, his depression and anxiety are not severe enough to result in deficiencies in most areas. The 70 percent criteria contemplate a severity of "near continuous" mood symptoms such that they interfere with the ability to function independently. The Veteran's panic is not near-continuous, and even though he had mood disturbance, he remained able to function independently, as documented in the medical records. As such, an initial rating in excess of 50 percent is not warranted at any time from November 4, 2020 to March 3, 2021. See 38 C.F.R. § 4.130, Diagnostic Code 9432. The Board is aware that the symptoms listed under the next-higher ratings of 70 and 100 percent are essentially examples of the type and degree of symptoms for that rating, and that the Veteran need not demonstrate those exact symptoms to warrant a higher rating. See Mauerhan, 16 Vet. App. at 436. Moreover, entitlement to such an evaluation requires sufficient symptoms of the requirements, or others of similar severity, frequency, or duration, that cause the specific type of occupational and social impairment. See Vazquez-Claudio, 713 F.3d at 117-18. In this case, the Board has considered these higher ratings for the period from November 4, 2020 to March 3, 2021 but finds that it is rated appropriately. The signs and symptoms manifested are contemplated by the currently assigned rating of 50 percent as they do not manifest with the severity required for a higher rating. The Board has considered the Veteran's reported history of symptomatology related to the service-connected bipolar disorder. He is competent to report such symptoms and observations because this requires only personal knowledge as it comes through one's senses. Layno, 6 Vet. App. at 470. His credible descriptions of his observable symptoms are not more closely described by the 70 or 100 percent criteria. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Carter, 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.