Citation Nr: 21015843 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 13-04 517 DATE: March 18, 2021 ORDER Entitlement to an initial rating in excess of 70 percent for unspecified depressive disorder is denied. FINDING OF FACT Throughout the period on appeal, the Veteran’s unspecified depressive disorder was manifested by, at worst, occupational and social impairment with deficiencies in most areas and without total occupational and social impairment. CONCLUSION OF LAW The criteria for an initial rating in excess of 70 for unspecified depressive disorder have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1—4.14, 4.125, 4.126, 4.130, Diagnostic Code 9434. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from July 1982 to March 1988. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2008 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) Montgomery, Alabama. The Veteran appeared at videoconference Board hearing in March 2017. A hearing transcript has been associated with the record. In December 2020, the Veteran and his representative were notified via letter that the Veterans Law Judge who had conducted the previous hearing had since retired and were given the opportunity to request a new hearing. The letter also stated that if he did not respond to this letter within 30 days, the Board would assume that he did not want another hearing and would proceed accordingly. Neither the Veteran nor his representative responded to that notice. Therefore, the Board is proceeding with this adjudication. This case was most recently before the Board in November 2017, at which time the appeal was remanded to the Agency of Original Jurisdiction (AOJ) for further development. Specifically, the case was remanded to obtain a new VA examination to determine the current severity of the Veteran’s unspecified depressive disorder. Such an examination was conducted in October 2019. The Board therefore determines that there has been substantial compliance with its previous remand. Stegall v. West, 11 Vet. App. 268 (1998). The case has now been returned to the Board for appellate action. Increased Rating – Unspecified Depressive Disorder The Veteran contends that his unspecified depressive disorders symptoms are more severe than contemplated by the rating assigned. Specifically, the Veteran’s representative’s symptoms warrant a 100 percent rating due to the overwhelming negative impact on his everyday life, his unemployability, as determined by VA and his extreme difficulty in social circumstances and difficulty with relationships that further exacerbated his symptoms. Disability ratings are determined by application of the criteria set forth in VA’s Schedule for Rating Disabilities, which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. When a question arises as to which of two ratings applies under a particular diagnostic code, the higher rating is assigned if the disability more closely approximates the criteria for the higher rating. Otherwise, the lower rating applies. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. Although a rating specialist is directed to review the recorded history of a disability in order to make a more accurate evaluation, see 38 C.F.R. § 4.2, the regulations do not give past medical reports precedence over current findings. Francisco v. Brown, 7 Vet. App. 55 (1994). However, the Board must also consider staged ratings. Hart v. Mansfield, 21 Vet. App. 505, 509–10 (2007). The Veteran’s entire history is considered when assigning disability ratings. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). A review of the recorded history of a disability is necessary to make an accurate rating. 38 C.F.R. §§ 4.2, 4.41. The regulations do not give past medical reports precedence over current findings where such current findings are adequate and relevant to the rating issue. Francisco v. Brown, 7 Vet. App. 55 (1994); Powell v. West, 13 Vet. App. 31 (1999). The Board will consider entitlement to staged ratings to compensate for times since filing the claim when the disability may have been more severe than at other times during the course of the claim on appeal. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). The assignment of a particular diagnostic code is 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. In reviewing the claim for a higher rating, the Board must consider which diagnostic code or codes are most appropriate for application in the veteran’s case and provide an explanation for the conclusion. See Tedeschi v. Brown, 7 Vet. App. 411, 414 (1995). The Veteran’s unspecified depressive disorder was rated under the General Rating Formula for Psychiatric Disabilities (General Rating Formula). 38 C.F.R. § 4.130. Psychiatric disabilities are rated based on the General Rating Formula codified in 38 C.F.R. § 4.130, which provides disability ratings are based on a spectrum of symptoms. “A veteran may qualify for a given disability rating by demonstrating the particular symptoms associated with that percentage, or others of a similar severity, frequency, and duration.” Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117 (Fed. Cir. 2013). VA must consider all symptoms of a claimant’s condition that affect the level of occupational and social impairment, including, if applicable, those identified in the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (4th ed. 1994) (DSM-IV) and (5th ed. 2013) (DSM-5). See Mauerhan v. Principi, 16 Vet. App. 436, 442–43 (2002). VA is to engage in a holistic analysis in which it assesses the severity, frequency, and duration of the signs and symptoms of the veteran’s service-connected mental disorder; quantifies the level of occupational and social impairment caused by those signs and symptoms; and assigns an evaluation that most nearly approximates that level of occupational and social impairment. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017). Under the General Rating Formula for Mental Disorders per 38 C.F.R. § 4.130, a 70 percent rating is assigned for occupational and social impairment with deficiencies in most areas, such as work, school, family relationships, 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 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); and inability to establish and maintain effective relationships. 38 C.F.R. § 4.130, Diagnostic Code 9434. A 100 percent rating is assigned for total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent ability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; and memory loss for names of closes relatives, own occupation, or own name. Id. In addition, when evaluating a mental disorder, the rating agency shall consider the frequency, severity, and duration of psychiatric symptoms, the lengths of remissions, and the Veteran’s capacity for adjustment during periods of remission. 38 C.F.R. § 4.126(a). The rating agency shall assign an evaluation based on all 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. However, when evaluating the level of disability from a mental disorder, the rating agency will consider the extent of social impairment, but shall not assign an evaluation on the basis of social impairment. The Board notes that with regard to the use of the phrase “such as” in 38 C.F.R. § 4.130 (General Rating Formula for Mental Disorders), ratings are assigned according to the manifestations of particular symptoms. However, the use of the phrase “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 only 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). Accordingly, the evidence considered in determining the level of impairment under 38 C.F.R. § 4.130 is not restricted to the symptoms provided in the Diagnostic Code. Instead, VA must consider all symptoms of a claimant’s condition that affect the level of occupational and social impairment. The Board acknowledges that psychiatric examinations frequently include assignment of a global assessment of functioning (GAF) score. The American Psychiatric Association has released the Diagnostic and Statistical Manual of Mental Disorders (5th Ed.) (DSM-5), and 38 C.F.R. § 4.130 has been revised to refer to the DSM-5. The DSM-5 does not contain information regarding GAF scores. Effective August 4, 2014, VA amended the portion of its Schedule for Rating Disabilities dealing with mental disorders to remove outdated references to the DSM-IV and replace them with references to the DSM-5. See 79 Fed. Reg. 45,093, 45,094 (Aug. 4, 2014). VA adopted as final, without change, the interim final rule and clarified that the provisions of the final rule did not apply to claims that were pending before the Board, this Court, or the U.S. Court of Appeals for the Federal Circuit on August 4, 2014, even if such claims were subsequently remanded to the agency of original jurisdiction. See 80 Fed. Reg. 14,308 (Mar. 19, 2015). In Golden v. Shulkin, 29 Vet. App. 221 (2018), the Court held that given that the DSM-5 abandoned the GAF scale and that VA has formally adopted the DSM-5, the Board errs when it uses GAF scores to assign a psychiatric rating in cases where the DSM-5 applies. This appeal was certified to the Board in November 2020. As such, the DSM-5 applies, and the GAF scores will not be considered. A review of the record reveals that the Veteran sought mental health treatment from VA and private facilities, as well as treatment for his other health needs. To the extent that the Veteran’s treatment records contain information relevant to the severity of his mental health, to include mental health screenings, the Board will summarize this evidence. Turning to the evidence, at an August 2008 VA examination, the Veteran described his relationships with his mother, grandmother, and siblings as “good.” He reported one suicidal attempt in 1985 in the military as a result of his depression. He had never married and did not have children, and had an on-and-off girlfriend that he described as a “good girlfriend.” He stated he was somewhat close with his siblings and very close with his mother, he lived alone, near his mother. He was close with two nieces and one nephew, and saw them about three to four times per month. He saw his brother about three to four times per month. With regard to his interpersonal relationships, he stated he was mostly a loner and that his relationships were “ok,”, he got along well with everyone, and had no best friends after his best friend died two years prior. The Veteran reported he saw his girlfriend the past week, drank beer with his brothers, cooked out, and watched TV sports. He sold scrap medal with two others occasionally, and was not involved with groups, clubs, or church. He stated he mostly played on the computer, listened to radio talk shows, watched TV, and fished. During the August 2008 VA examination, the Veteran reported mental health symptoms, with periods occurring one two times in two weeks that lasting about three days, that included poor sleep, staying in bed and/or staying inside without leaving up to three days, and avoiding others during these times, racing thoughts, worrying about minor things, drinking more alcohol and eating very little during these periods, forgetfulness, intermittent crying, low energy, lack of grooming, and avoiding all during these times, worrying about money, and worrying something bad is going to happen. Mental status examination conducted during the August 2008 VA examination showed the Veteran presented as clean, neatly groomed, appropriately dressed, casually dressed with unremarkable psychomotor activity and unremarkable, spontaneous, clear, and coherent speech. He was noted to be cooperative and friendly, have a normal affect and anxious mood, that the was easily distracted, and oriented to person, time, and place. He was further noted to have unremarkable thought process with reported losing focus and getting distracted, some “bad thoughts,” when depressed such as dying and death, no delusions, intact judgment, average intelligence and partially intact insight, onset and maintenance problems about once per week with difficulty doing anything. There were hallucinations, inappropriate behavior, homicidal ideation or suicidal ideation. He was noted to interpret proverbs appropriately, have some obsessive ritualistic behavior described as praying, playing solitaire, and sitting on porch daily and panic attacks. Impulse control was found to be good and he was able to maintain minimum personal hygiene, have some problems with activities of daily living, described as laying down in bed for a few days a week when depressed, and mildly impaired recent and immediate memory. The examiner noted the Veteran was not capable of managing his financial affairs, did not know the amount of his benefit payment, nor the amount of the monthly bills, and noted the Veteran had a gambling problem and certain bills would be late. The August 2008 VA examiner noted the Veteran retired in August 1999 due to sarcoidosis and subsequent depression. The examiner noted the Veteran plaid solitaire and the numbers helped him to predict the type of day he would have, and noted the Veteran had some obsessive compulsive disorder (OCD) characteristics. The Veteran felt limited by sickness and an inability to get out and function about three days per week, due to physical problems and co-occurring depression. He stated he felt more depression than physical at times. The examiner noted the Veteran’s depression had worsened and not limited him more than his physical illness. There was not total occupational and social impairment due to mental disorder signs and symptoms. There was not total occupational and social impairment, and mental disorder signs and symptoms resulted in deficiencies in thinking and mood, but not family relationships. There was reduced reliability and productivity due to mental disorder symptoms that manifested in being nonfunctional for about three days per week, inability to get out of bed, and avoiding calls and people. At a February 2010 VA examination, the Veteran reported that he saw his mother and sister frequently and that he no longer had a girlfriend. His reported his mother had a tumor or stroke in May 2009, that she required 24 hour care that he helped provide and that his mother was bed-ridden. The examiner noted that medical records indicate his sister had the tumor or stroke and required care but the discrepancy could not be resolved. The Veteran stated he saw his brother occasionally and that he saw his friends “not too often” but saw them more regularly during the football season when they would watch the games weekly and grill out. His hobbies included fishing, collecting coins and antiques and cards, and playing solitaire. He reported one prior suicide attempt in 1985. There was no history of violence or assaultiveness. The examiner noted the Veteran was considered moderately impaired with regard to psychosocial functioning. The Veteran’s mental health treatment included individual psychotherapy and antidepressant medications and the Veteran indicated that he did not feel his medications were working very well. The Veteran endorsed moderate intermittent depressed mood, “pretty good” appetite, fluctuations in weight, eating less when feeling down, transient suicidal thoughts but stated he would not act on them, no active suicidal ideation, intent, or plan. Mental status examination conducted during the February 2010 VA examination showed the Veteran presented as clean, neatly groomed, appropriately dressed and casually dressed with unremarkable psychomotor activity and unremarkable, clear, and coherent speech. He was noted to be cooperative, relaxed, attentive, have a constricted affect, depressed mood, intact attention and be oriented to person, time, and place. Thought process and content were found to be unremarkable, there were no delusions, judgment was intact, intelligence was average, insight was intact and there was sleep impairment, described as difficulty with onset and maintenance with occasional daytime fatigue two to three times per week. Behavior was found to be appropriate and there were obsessive and ritualistic behaviors, described as playing solitaire for hours. No panic attacks or homicidal thoughts were reported but there were some passive transient suicidal ideations without active suicidal intent, ideation, or plan. Impulse control was found to be good without episodes of violence, irritability was present, self-seclusion when angry was present and the Veteran denied engaging in verbal or physical altercations. He was found to be able to maintain minimum personal hygiene without problems with activities of daily living, and normal memory. The examiner noted that the Veteran was capable of managing his financial affairs. The examiner noted that the Veteran was retired and was not considered unemployable due to his depression and that the Veteran reported he stopped working due to physical problems. There examiner found that there was not total occupational and social impairment due to mental disorder signs and symptoms but there was occasional decrease in work efficiency with intermittent periods of inability to perform occupational tasks due to mental disorder signs and symptoms with generally satisfactory functioning that was manifested by depressed mood, sleep disruption, fatigue, and irritability. A May 2011 letter from the Veteran’s private doctor, Dr. L.L. indicates the Veteran was found to be mentally competent and able to take care of his own affairs. At a February 2015 VA examination, the examiner found the Veteran’s current symptoms resulted in moderate impairments in psychosocial functioning and opined the Veteran was competent to manage his funds for VA purposes. The examiner noted the Veteran was able to name the sources and amounts of his monthly income and expenses, and had been independently responsible for paying his own bills since 2012. He was currently assisting his mother with her mortgage, played the stock market as a hobby, was able to describe a diversified portfolio of mutual funds, several blue chip and a few speculative stocks, and denied any major losses from participating in the stock market. He denied gambling in recent years. The examiner opined the Veteran’s unspecified depressive disorder manifested with reduced reliability and productivity. During the February 2015 VA examination, the Veteran reported he was currently dating and that his relationship was going “pretty good.” He saw or talked with his mother on a daily basis, his sister had passed away, and he continued to have a close relationship with his brother and saw him often. He reported good family relationships as a whole. He denied having other friends aside from his brother, and stayed pretty much to himself. He did not sell metal, did not have membership in clubs or organizations, and did not attend church. He spent his days watching television and following the stock market, making renovations or other various projects to his home, and denied playing solitaire. He also reported researching on the computer about health related information, enjoyed gardening, assisting mother with his finances, and was helping his mother with obtaining a conventional mortgage. He had ongoing mental health treatment and saw his psychiatrist every three months. He was prescribed psychotropic medications. He denied psychiatric hospitalizations and suicide attempts. The February 2015 VA examiner found that symptoms attributable to the Veteran’s unspecified depressive disorder included a depressed mood, chronic sleep impairment, mild memory loss such as forgetting names, directions or recent events and a flattened affect. Other symptoms included disturbances of motivation and mood as well as difficulty in establishing and maintaining effective work and social relationships. Behavioral observations showed the Veteran presented as cleanly and casually dressed, unshaven but adequately groomed in appearance, alert, pleasant, cooperative with interview, quiet and subdued with constricted and dysphoric affect. Mood was found to be “good,” speech was soft and somewhat monotone but otherwise unremarkable, speed of thinking and responding were within normal limits, thought processes were logical and goal directed with no overt evidence of mental content symptomatology, perceptual disturbance, or gross cognitive confusion. Insight and judgment were found to be good, verbal abstract reasoning and interpretation of proverbs were within normal limits and frustration tolerance was adequate. The Veteran denied significant problems with attention, concentration, and memory, and no significant cognitive difficulties were observed. He drove himself to the appointment. Other symptoms included depression with periods of intense depressed mood when something bad happened, crying spells brought on by bad news or tragedies and truncated level of interest from hobbies and activities. The Veteran denied feelings of helplessness or hopelessness, suicidal ideation or attempts and verbal or psychical acting out in anger. He did report that he would withdraw when angry, that he became easily tearful when hearing about innocent people being harmed, that he had varying motivation, energy and appetite, that his sleep had improved but that there was still some impairment and intermittent mild situationally appropriate anxiety. Panic attacks, excessive sorry, depressive ruminations, obsessive-compulsive disorder symptoms, hallucinations or trust issues were denied. The examiner found the Veteran was capable of managing his financial affairs. At an October 2015 VA examination, the examiner found the Veteran’s current symptoms manifested in occupational and social impairment with reduced reliability and productivity. Since his last examination, the Veteran reported that he was no longer dating his most recent girlfriend and they had dated one year. The Veteran reported that he saw his mother daily, that he had a great relationship with his mother, that he had a “great” relationship with his brother, that his father had recently denied, that he was involved in litigation with his aunts due to his father’s estate, and that he had a strained relationship with his aunts but that they never had a relationship prior to his father’s death. He reported he had one friend with whom he went fishing on occasion but he preferred solitary activities, that he spent his days ridings bikes in the morning, attending yoga weekly, checking on his mother daily, maintaining his garden, that he enjoyed cooking, and that he had some stock market monitoring. He reported he had a “great” financial situation, and had been granted personal control over his VA benefits. He continued taking psychotropic medications, and reported that his current medications worked “pretty good.” He did not have psychiatric hospitalizations nor suicidal ideations since his last VA examination. The October 2015 VA examiner found that the Veteran’s symptoms attributable to his unspecified depressive disorder included a depressed mood, anxiety, chronic sleep impairment, a flattened affect, disturbances of motivation and mood, and difficulty in establishing and maintaining effective work and social relationships. Behavioral observations showed the Veteran presented as clean and casually dressed, well-groomed in appearance, alert, pleasant, and cooperative with a constricted and dysphoric affect. Mood was found to be a “little anxious but good” mood, speech was found to be unremarkable, thinking and responding were found to be within normal limits and thought processes were found to be logical and goal-directed with no overt evidence of mental content symptomatology, perceptual disturbance, or gross cognitive function. Insight and judgment were found to be good and verbal abstract reasoning and interpretation of proverbs were found to be within normal limits. Attention, concentration, and memory were found to be good and no significant cognitive complaints reported. The Veteran drove himself to the examination. Other symptoms included cyclical depression, periodic tearfulness when exposed to sad news in the media, guilt, fluctuating motivation with low motivation and energy on some days and irritability on occasion. The Veteran reported the avoidance of confrontation when angry, a good appetite, sleep disturbance and impairment and mild intermittent anxiety. Suicidal ideation, homicidal ideation, panic attacks, obsessive-compulsive symptoms, hallucinations, delusions or paranoid ideations were denied. Delusions or paranoid ideations were not observed. The examiner found the Veteran was capable of managing his own financial affairs. At his March 2017 Board hearing, the Veteran testified that his mental health symptoms warranted a higher rating due to symptoms that included an inability to function two to three days a week, a dislike being around people and others, an inability to be in public and people, not being able to find work, difficulty socializing, and seeing mental health providers every four to six months. Additionally, the Veteran testified he took medication for his mental health symptoms, and had severe limitations on occupational functioning, as determined by the Social Security Administration. At a March 2019 VA examination, the examiner found the Veteran’s current symptoms manifested 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. The Veteran reported he continued to frequently visit and check on his mother, that he was on good terms with his brother and that he had a friend with whom he went fishing. He stated he went fishing about one to two times a week, gardened in the warmer months, and researched things he found interesting on the internet. Symptoms attributable to his unspecified depressive disorder included a depressed mood, anxiety, chronic sleep impairment, and mild memory loss, such as forgetting names, directions or recent events. Behavioral observations showed the Veteran presented as casually dressed, that he had adequate grooming and hygiene, with unremarkable psychomotor activity and clear and coherent speech. Thought process and content were unremarkable without signs of distorted thoughts or perceptions, polite, cooperative, and affect slightly constricted. Other symptoms included episodes of dysphoric mood and he added that he would try to stay busy and not dwell on negative thoughts or feeling, that he was mostly “okay, ” the he attempted to limit his exposure to things that negatively impact his mood. He also reported sleep disturbance but that his sleep has been “pretty good” lately, that he forgets the small things, that he needed to motivate himself to accomplish tasks, and pretty good appetite on most days. The examiner noted the Veteran was capable of managing his financial affairs. Mental status examination conducted during the March 2019 VA examination showed that the Veteran was fully oriented, had adequate attention, good abstract reasoning, average judgment, average intelligence, fair insight and fair to good impulse control. Suicidal and homicidal ideation were denied. The examiner noted that the Veteran testified in March 2017 claiming his mental health symptoms had worsened, and cited his need to isolate himself a few days a year, that he was prevented from being around people and working, and that he saw his mental health provider less often. The examiner noted that the Veteran’s depression was mild or moderate, and consistent with VA health records, and although he had some fluctuation in symptoms, overall, he had been stable for a number of years. Additionally, the Veteran maintained several close relationships, engaged in goal-directed activities, reality testing was sound, and no indications that he was a safety threat to himself or others. Moreover, the examiner noted that the Veteran seeing his mental health provider less frequently was in no way evidence of deteriorating mental health, and that this occurred when the patient becomes more stable, and the Veteran’s appointments have occurred fairly consistently for years. At an October 2019 VA examination, the examiner found the Veteran’s current symptoms manifested in occupational and social impairment with reduced reliability and productivity. The Veteran reported he remained close with his mother who lived nearby, was close with his brother, and that he was not dating. He enjoyed watching the stock market, fishing, riding his bicycle and gardening. Symptoms attributable to his unspecified depressive disorder included a depressed mood, anxiety, chronic sleep impairment, mild memory loss such as forgetting names, directions or recent events, a flattened affect, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and difficulty in adapting to stressful circumstances, including work or a work like setting. Behavioral observations showed that the Veteran presented as casually dressed, appropriately groomed, cooperative, that he maintained adequate eye contact, that he normal psychomotor activity, that he had speech within normal limits and that thought processes were logical, organized, and goal directed. He was found to be alert and fully oriented. Concentration was fair, memory was impaired for recent events, judgment was good, insight was intact, mood “better than it was” and abstract reasoning was excellent. There was no evidence of a thought disorder. The examiner found the Veteran was capable of managing his financial affairs. June 2020 and August 2020 advisory opinions issued by the Director of Compensation Service of VA granted entitlement to a total rating based on individual unemployability due to service connected disability (TDIU), to include as on an extraschedular basis, due to his sarcoidosis. Specifically, the Director of Compensation Service noted the Veteran was service connected for sarcoidosis and unspecified depressive disorder, and found that the Veteran’s sarcoidosis symptoms were deemed sufficient to warrant entitlement to a TDIU on an extraschedular basis from December 7, 2000 to May 9, 2002. The Board notes that entitlement to a TDIU was granted effective May 10, 2002, the date that service connection for a depressive disorder was granted and evaluated as 70 percent disabling. Further review of the record shows that the Veteran receives treatment at the VA Medical Center for various disabilities, to include his unspecified depressive disorder. However, there is no indication from the treatment notes of record that the Veteran has reported symptoms that are worse than those noted in the VA examination reports of record. Notably, the Veteran has consistently reported his mood that fluctuated between “good,” “pretty good,” and at times a “little worse” or “so so.” Mental status examination consistently showed the Veteran presented as adequately groomed with good hygiene and that he denied suicidal ideations homicidal ideations, delusions or hallucinations. Such examinations also found thought processes to be logical and goal directed, speech to be appropriate, concentration to be adequate, memory to be intact, and mood symptoms to be well controlled. Additionally, the Veteran consistently reported a good relationship with his mother. Based on the foregoing, the Board finds that an initial rating in excess of 70 percent for unspecified depressive disorder is not warranted. In this regard, the Board finds that such disability was manifested by occupational and social impairment with deficiencies in most areas but without total occupational and social impairment. The record reflects that the Veteran’s symptoms have not been consistent with total occupational and social impairment such that a 100 percent rating is warranted at any point during the appeal period. The Veteran was unemployed during the appeal period and that a TDIU was awarded based, at least in part, on the Veteran’s unspecified depressive disorder; thus occupational impairment was shown. However, total social impairment was not demonstrated as the Veteran maintained a relationship with his mother and brother, had a on and off girlfriend, and also reported having a few friends. The Veteran had reported a strained relationship with his aunts due to litigation regarding his father’s estate but also reported that they did not have much of a relationship prior to that time. He also reported having a relationship with his sister prior to her death and that he helped his mother with her finances and home. Such does not constitute total social impairment. Moreover, the Veteran has not displayed gross impairment in thought processes or communication nor has the record shown that he is a persistent danger of hurting himself or others or grossly inappropriate behavior. The Veteran has reported some passive and transient suicidal ideation, and denied homicidal ideations. However, homicidal or suicidal attempts were never attempted or started during the appeal period. Moreover, there is no evidence that the Veteran has experienced hallucinations or delusions, or obsessive rituals. The Board notes the Veteran had some obsessive-compulsive type symptoms, specifically playing solitaire to predict his day, but that the Veteran stopped playing solitaire without requiring any medical treatment. Further, the Veteran has not displayed disorientation to time or place, or memory loss for names of close relatives, his prior occupations, or his own name. Additionally, there is no evidence or allegation that he was unable to maintain minimal personal hygiene. Mental status examinations during the appeal period consistently found the Veteran’s grooming and hygiene to be appropriate, adequate or good. There is no evidence or allegation that the Veteran’s psychiatric symptoms manifested in interference or difficulties resulted in the inability to perform activities of daily life, to include maintenance of minimal hygiene. Moreover, this is not a disability picture indicating total occupational and social impairment at any time during the appeal period. In assessing the severity of his unspecified depressive disorder, the Board has considered the competent lay assertions regarding symptoms experienced and observed. See, e.g., Layno v. Brown, 6 Vet. App. 465, 470 (1994) and Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). However, the criteria needed to support higher ratings as the required medical findings that are within the province of trained medical professionals. See Jones v. Brown, 7 Vet. App. 134, 137-138 (1994). As such, the lay assertions are not considered more persuasive than the objective medical findings which, as indicated above, do not support assignment of any higher rating pursuant to any applicable criteria at any point pertinent to this appeal. The Board notes the contentions of the Veteran and his representative that the Veteran’s unspecified depressive disorder is more severe than currently shown on examination; and the Board observes that the Veteran, while competent to report his observable symptoms, he is not competent to report that his mental health symptoms are of sufficient severity to warrant a higher rating under VA’s tables for rating such disabilities because such an opinion requires medical expertise which he has not been shown to have. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006); Charles v. Principi, 16 Vet. App. 370 (2002). Despite the foregoing, the Board acknowledges the Veteran’s reports of additional unspecified depressive disorder symptoms, to include inability to get out of bed for a few days a week, and the overwhelming negative impact on his daily life. However, even after considering such contentions as to the effects of the disability on his daily life, the Board finds that the criteria for a higher rating are not met. The Rating Schedule contemplates such impairment under the ordinary conditions of daily life. 38 C.F.R. § 4.10; see also Martinak v. Nicholson, 21 Vet. App. 447, 455 (2007). This argument is therefore without merit. The Board has considered whether a staged rating under Hart, supra is appropriate; however, the Board finds that his symptomatology has been stable throughout the period on appeal. Therefore, assigning a staged rating is not warranted. The Veteran and/or his representative has not raised any other issues, nor have any other issues been reasonably raised by the record in regard to the increased rating claim adjudicated herein. Doucette v. Shulkin, 28 Vet. App. 366 (2017). Accordingly, the Board finds that an initial rating in excess of 70 percent for unspecified depressive disorder is not warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. KRISTY L. ZADORA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Mariah N. Sim, Associate 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.