Citation Nr: A24045809 Decision Date: 08/12/24 Archive Date: 08/12/24 DOCKET NO. 210818-179542 DATE: August 12, 2024 ORDER Entitlement to a disability rating in excess of 30 percent for service-connected bipolar disorder from May 26, 2015, forward is granted. FINDING OF FACT The Veteran suffered from occupational and social impairment with deficiencies in most areas from May 26, 2015, forward. CONCLUSION OF LAW The criteria for a disability rating of 70 percent for bipolar disorder from May 26, 2015, forward have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9432. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 2008 to October 2013. This matter comes before the Board of Veterans' Appeals (Board) from a July 2021 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In the August 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the July 2021 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. The Veteran contends that he is entitled to a rating in excess of 30 percent from the beginning of her claim. Under the General Formula for Mental Disorders (General Formula), 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). The Board concludes that the Veteran's symptoms more closely approximated the symptoms associated with a 70 percent rating, and resulted in a level of impairment that most closely approximated the level of impairment associated with a 70 percent rating for the entire period on appeal. A noncompensable rating is assigned when a mental condition has been formally diagnosed, but symptoms are not severe enough to either require continuous medication, or to interfere with occupational and social functioning. A 10 percent rating is assigned when mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of occasional stress, or symptoms controlled by medication cause occupational and social impairment. A 30 percent rating is assigned when symptoms such as depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, or mild memory loss (such as forgetting names, directions, or recent events), cause 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 normal conversation). A 50 percent rating is assigned when symptoms such 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; or difficulty in establishing and maintaining effective work and social relationships cause occupational and social impairment with reduced reliability and productivity. A 70 percent rating is assigned when symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; 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 worklike setting); or inability to establish and maintain effective relationships cause occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood. 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 or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; or memory loss for names of close relatives, own occupation or own name. Treatment records demonstrate that the Veteran suffered with housing and economic hardship issues in the years after her military service. The Veteran was living with a friend and apart from her children. See CAPRI, March 2016. In January 2019 and March 2019, the Veteran submitted lay statements from friends. These statements demonstrated that, after the Veteran's discharge from service, the Veteran suffered from agitation, flashbacks, and isolation. The Veteran also became argumentative, binge drank, had anxiety attacks, nightmares, and cried frequently. See Buddy/Lay Statements, January 2019, March 2019. Treatment records from March 2019 demonstrate that the Veteran had recent suicidal ideations. See CAPRI, April 2019. The Veteran underwent a VA examination in March 2021 where she had occupational and social impairment with reduced reliability and productivity. She had an on and off again relationship, talked to her mother, sisters, brother, and cousins, did not have close friends, did not trust others, isolated, and was currently employed. Her symptoms included depressed mood, anxiety, suspiciousness, panic attacks that occur weekly or less often, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, difficulty establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, including work or a work like setting, and impaired impulse control. The Veteran stated that after her discharge from service she had suicidal thoughts, with the last time she had suicidal thoughts being about two and a half years ago, and she also stated she had homicidal thoughts towards her ex-husband. Again, the Veteran stated that after her service she had trouble with homelessness, lost custody of her children for a period of time, and her family disowned her after her discharge. See Correspondence, Marc 2021. Finally, in her NOD, she continued to state that after service she was unable to focus and keep a job, dealt with homelessness, lost custody of kids due to excessive substance abuse and suicidal thoughts, and had panic attacks weekly. See VA Form 10182 Notice of Disagreement, August 2021. Resolving the benefit of the doubt in favor of the Veteran, the Board finds the severity, frequency, and duration of the Veteran's unlisted symptoms more closely approximate the symptoms contemplated by a 70 percent rating. See 38 C.F.R. § 4.126. The Veteran reported that she suffered from suicidal ideations throughout the appeals period and even reported some homicidal ideation towards her ex-husband. She further struggled with homelessness and employment. The Board notes that the Veteran expressed suicidal ideation, which is similar to persistent danger of self-harm, which is contemplated by the 100 percent criteria. Bankhead v. Shulkin, 29 Vet. App. 10, 19 (2017). However, the severity, frequency, and duration of the Veteran's suicidal ideation has not risen to the level contemplated by the 100 percent disability rating. The Veteran regularly denied thoughts, intent, or a plan involving self-harm. Further, the Veteran was not totally occupationally or socially impaired. She is currently employed and maintains relationships with her family. In short, the evidence of record demonstrates that the Veteran suffered from occupational and social impairment with deficiencies in most areas for the entire period on appeal. Frederic P. Gallun Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.H., 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.