Citation Nr: A25041215 Decision Date: 05/06/25 Archive Date: 05/06/25 DOCKET NO. 201118-124499 DATE: May 6, 2025 ORDER Entitlement to an initial disability rating in excess of 30 percent from July 11, 2019 for unspecified depressive and anxiety disorder is denied. FINDING OF FACT From July 11, 2019, the severity, frequency, and duration of the Veteran's symptoms of unspecified depressive and anxiety disorder did not more closely approximate occupational and social impairment with reduced reliability and productivity. CONCLUSION OF LAW The criteria for entitlement to a disability rating in excess of 30 percent from July 11, 2019 for unspecified depressive and anxiety disorder have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.126, 4.130, Diagnostic Code 9435. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 2009 to August 2010 and from October 2018 to March 2019. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in March 2020 by a Department of Veterans Affairs (VA) Regional Office (RO). The March 2020 rating decision granted service connection for unspecified depressive and anxiety disorder with an evaluation of 30 percent from March 17, 2019. Because the March 2020 rating decision was issued after February 19, 2019, it is subject to the Appeals Modernization Act ("AMA"). 38 C.F.R. §§ 3.2400(a)(1); 19.2(a). In the November 2020 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on September 9, 2021. Therefore, the Board may only consider the evidence of record at the time of the March 2020 AOJ decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. This matter was previously before the Board in April 2024, when the Board granted entitlement to an initial disability rating of 70 percent, but no higher, from March 17, 2019 to July 10, 2019 for unspecified depressive and anxiety disorder, denied entitlement to an initial disability rating in excess of 30 percent from July 11, 2019 for unspecified depressive and anxiety disorder, and remanded entitlement to service connection for sleep apnea and entitlement to a total disability rating based upon individual unemployability (TDIU). The April 2024 decision was appealed to the Court of Appeals for Veterans Claims (Court). In January 2025, the Court issued a Joint Motion for Partial Remand (JMPR) vacating and remanding the portion of the April 2024 Board decision denying entitlement to an initial disability rating in excess of 30 percent from July 11, 2019 for unspecified depressive and anxiety disorder. The portion of the April 2024 Board decision that granted an increased rating for unspecified depressive and anxiety disorder to 70 percent from March 17, 2019 to July 10, 2019 was not disturbed. Entitlement to an initial disability rating in excess of 30 percent from July 11, 2019 for unspecified depressive and anxiety disorder The parties to the January 2024 JMPR found that the Board erred by failing to provide adequate reasons or bases for its decision to deny entitlement to an initial disability rating in excess of 30 percent from July 11, 2019 for unspecified depressive and anxiety disorder. Specifically, the parties agreed that the Board erred when it, as part of its rationale for denying entitlement to an increased rating, indicated even though the Veteran's VA treatment records reflected passive suicidal ideation from July 11, 2019 through August 2019, there was no evidence of suicidal ideation throughout the remainder of the period on appeal. The Board acknowledges that the Veteran asserted he still struggles with suicidal ideation daily [at his September 9, 2021, personal hearing]; however, the Board finds this statement less probative because it is contradicted by the medical evidence of record showing the Veteran denied suicidal ideation since September 2019. The parties noted that at the September 2021 Board hearing, the Veteran responded to a question about whether he had "recurring suicidal ideations or thoughts" since being out of the military by stating that medication helped, but "it's something that I kind of struggle with I'd say daily, so yeah." The parties agreed that this statement could be read to reflect the report of a current struggle. Additionally, the parties agreed that the Board did not provide an adequate statement of reasons or bases for its conclusion that the lack of reported suicidal ideation in other records after September 2019 contradicted the September 2021 statement. Therefore, the parties found remand was required for the Board to reassess the Appellant's September 2021 testimony. Second, the parties noted that the Board's discussion of entitlement to an increased rating from July 11, 2019 did not include discussion of impaired impulse control (such as unprovoked irritability with periods of violence). The parties noted that at the September 2021 Board hearing, the Veteran indicated that he had a "short fuse," got into arguments, and had difficulty interacting with other people. Additionally, the parties noted that the September 2019 VA examination report indicated that the Veteran had both "[r]eckless or self-destructive behavior," as well as "[i]rritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects." The parties agreed that the Board erred when it did not consider and discuss whether these pieces of evidence reflected impaired impulse control as contemplated by the rating criteria and agreed that remand was therefore also required on this basis. Disability ratings are determined by applying a schedule of ratings that is based on average impairment of earning capacity. Separate diagnostic codes (DCs) identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R., Part 4. Each disability must be viewed in relation to its history and the limitation of activity imposed by the disabling condition should be emphasized. 38 C.F.R. § 4.1. 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. See Francisco v. Brown, 7 Vet. App. 55, 58 (1994). The Board will also consider the appropriateness of "staged" ratings based on the facts found. Hart v. Mansfield, 21 Vet. App. 505, 509-10 (2007). Further, the evaluation of the same disability under various diagnoses is to be avoided. 38 C.F.R. § 4.14. If a reasonable doubt arises regarding the degree of disability after careful consideration of all procurable and assembled data, such doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3. Where there is a question as to which of two ratings shall be applied, the higher rating 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. Unspecified depressive and anxiety disorder is rated under the schedule of ratings for mental disorders, 38 C.F.R. § 4.130, and is currently rated under Diagnostic Code 9435. In relevant part, the rating criteria are as follows: A 30 percent disability 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 normal conversation) due to 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). A 50 percent disability rating is warranted when there is occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short and long term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. 38 C.F.R. § 4.130. A 70 percent rating is warranted when there is 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 situations (including work or a work-like setting); and inability to establish and maintain effective relationships. The highest rating of 100 percent is warranted when there is 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; memory loss for names of close relatives, own occupation, or own name. 38 C.F.R. § 4.130. The list of symptoms under the rating criteria above are meant to be examples of symptoms that would warrant the respective rating, but are not meant to be exhaustive, and the Board need not find all or even some of the symptoms to award a specific rating. Mauerhan v. Principi, 16 Vet. App. 436, 442-43 (2002). However, a veteran may only qualify for a given disability rating under § 4.130 by demonstrating symptoms associated with that percentage, or others of similar severity, frequency, and duration, and that those symptoms have resulted in the type of occupational and social impairment associated with that percentage. See Vazquez-Claudio v. Shinseki, 713 F.3d 112, 117-18 (Fed. Cir. 2013). Further, when evaluating a mental disorder, the Board must consider the "frequency, severity, and duration of psychiatric symptoms, the length of remissions, and the Veteran's capacity for adjustment during periods of remission." 38 C.F.R. § 4.126(a). The Board must also "assign an evaluation 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 examination." Id. The Board must analyze the credibility and probative value of the evidence, account for the evidence that it finds persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. Kahana v. Shinseki, 24 Vet. App. 428, 433 (2011). This includes weighing the credibility and probative value of lay evidence against the remaining evidence of record. See King v. Shinseki, 700 F.3d 1339 (Fed. Cir. 2012); Kahana, 24 Vet. App. at 433-34. In determining the weight to be assigned to evidence, credibility can be affected by inconsistent statements, internal inconsistency of statements, inconsistency with other evidence of record, facial implausibility, bad character, interest, bias, self- interest, malingering, desire for monetary gain, and witness demeanor. Caluza v. Brown, 7 Vet. App. 498, 511, 512 (1995), aff'd per curiam, 78 F.3d. 604 (Fed. Cir. 1996). The Board finds that from July 11, 2019, a rating in excess of 30 percent is not warranted for the Veteran's unspecified depressive and anxiety disorder. For the reasons below, the Board finds that from July 11, 2019, the Veteran's symptomatology more closely approximated occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, rather than occupational and social impairment with reduced reliability and productivity, which is required for the higher 50 percent rating. Prior to July 11, 2019, the Veteran is in receipt of a 70 percent disability rating for unspecified depressive and anxiety disorder. During that time, the Veteran's VA treatment records indicate that he attempted suicide on March 13, 2019 when he experienced a "breakdown" after a conflict with his wife. See March 2019 VA treatment record. He was then placed on suicide watch for four days, during which time he again attempted suicide. See March 2019 VA treatment record. Thereafter, the Veteran was discharged home, where he lived with his mother (apart from his wife) and took time off work. See March 2019 VA treatment record. In March 2019, the Veteran was placed on VA's high risk for suicide list based on his prior suicide attempts. See March 2019 VA treatment records. At that time, the Veteran stated that he was only eating one meal per day due to stress and that he had lost about ten pounds. See March 2019 VA treatment record. Additionally, he reported symptoms of trouble sleeping, depression, psychomotor retardation, fatigue, feelings of worthlessness and guilt, difficulty concentrating, irritability, and suicidal ideation occurring most of the day, every day. Id. He described his symptoms of depression as "the worst they've ever been," and reported ongoing symptoms of anxiety. Id. He also reported unwanted memories from traumatic events during deployment to Afghanistan and moderate hyperarousal symptoms, including irritability, hypervigilance, exaggerated startle, and sleep disturbance. Id. His primary concern was anger and irritability, and he reported frequent outbursts involving yelling and hitting or throwing inanimate objects, though he denied physical aggression towards others. Id. At that time, the Veteran was living with his mother with occasional contact with his wife. Id. At the end of March 2019, the Veteran reported an incident where he got into an argument with his wife and he "blew up" and threw picture frames against the wall. See March 2019 VA treatment records. He reported symptoms including persistent negative emotional state, anhedonia, feeling distant or cut off from others, and difficulty experiencing positive emotions. Id. The Veteran stated that he was drinking six to seven beers daily, starting mid-day, and he identified this pattern of drinking as a barrier to engaging in productive activities. Id. In April 2019, the Veteran reported that he was not getting any better. See April 2019 VA treatment records. He endorsed little interest or pleasure in doing things, feeling depressed, trouble sleeping, and difficulty concentrating nearly every day over the past two weeks. Id. He also reported poor appetite and thoughts that he would be better off dead or of hurting himself for more than half the days over the past two weeks. Id. He expressed that these symptoms made it extremely difficult to do his work, take care of things at home, or get along with others. Id. He stated that since he had been home from the military, he had been drinking alcohol almost every day, when he previously only drank once per week. Id. Additionally, he stated that he was still living with his mom, fought with his wife all the time, and remained off from work. Id. He reported that he was having difficulty getting out of bed and he had only been to the gym twice since being home. Id. He further stated that he was not sleeping on a normal schedule, and he had trouble concentrating. He continued to endorse suicidal ideation, though it had been mostly passive since returning home. Id. He was assessed as being at moderate risk for harm to self or others. Id. In May 2019, the Veteran reported that he had returned to work, but about a week later he was arrested after an altercation with his wife where he stated that he pushed her away after she attacked him, and she fell to the ground. See May 2019 VA treatment records. She called the police, and he was arrested and later charged with a felony. He was placed on administrative leave from work following his arrest. Id. A no contact order was instituted between the Veteran and his wife. His mood was observed as depressed, and he continued to report passive suicidal ideation but denied plan or intent. He further reported increased intrusive symptoms, including nightmares and unwanted memories, related to traumatic deployment experiences. Id. He endorsed little interest or pleasure in doing things and trouble sleeping several days over the past two weeks, and feeling depressed with thoughts that he would be better off dead or of hurting himself in some way more than half the days over the past two weeks. Id. He stated that these symptoms made it very difficult for him to work, take care of things at home, or to get along with others. Id. He further reported symptoms of trouble relaxing and becoming easily annoyed or irritable several days over the past two weeks, and feeling anxious, not able to stop worrying, and afraid something awful might happen more than half the days over the past two weeks. Additionally, he conveyed that he and his wife were not having any contact and he was still living with his mother. Id. In June 2019, the veteran reported that he was doing better and that being apart from his wife had been good for him. See June 2019 treatment records. In the beginning of June, he hoped to return to work; however, he later discovered that he was being terminated from his position. Id. It was noted that the Veteran had adjusted to several medication changes over the prior several months and that there was no reason to believe he could not return to work without restrictions on his medication regimen. Id. He reported increased anger and irritability related to the legal charges against him and his upcoming discharge from work. Id. He also noted an increase in unwanted, intrusive memories of traumatic experiences during service. Id. He reported benefit from seeking social support and he planned to take a trip with his friends. Id. His mood was observed as depressed, and he continued to report passive suicidal ideation but denied current plan or intent. Id. His status on VA's high risk list for suicide was evaluated, and he continued to remain on the high risk list. Id. The Veteran submitted a lay statement in June 2019, wherein he stated that he had never been the same since his deployment. See June 2019 Lay Statement. He stated that he felt anxious, nervous, and always on edge. Id. Additionally, he reported that he began to have marital problems due to not being able to trust anyone and doing things that were out of his character, including extra marital affairs, anger issues, drinking more alcohol than usual, and feeling lonely and depressed. From July 11, 2019, the Veteran is currently in receipt of a 30 percent rating for unspecified depressive and anxiety disorder. This is the period at issue in the present appeal. On July 11, 2019, the VA treatment records indicate that the Veteran reported mild improvements in his mood and anxiety over the past two weeks. See July 2019 VA treatment records. He stated that he recently went on vacation with his friends, and he planned to move back into his house. Id. He described feelings of anger and irritability related to limited support he received at work and through the military. He identified a number of activities he planned to engage in daily, and he noted benefit from being busy and making the most of time. Id. He continued to report passive suicidal ideation involving fleeting thoughts, but he noted that these thoughts were less frequent recently and denied plan or intent in the past month. Id. He also denied any increase in suicidal ideation related to recent stressors. Id. Thereafter, in August 2019, the Veteran continued to report maintained mild improvements in mood and anxiety and stated that "things [were] going pretty well for the most part." See August 2019 VA treatment records. He stated that his mood was stable at that time. He reported continuing to engage in pleasant activities each day, including going to the beach, riding his motorcycle, and swimming, and noted a significant benefit from this as well as seeking social support from a number of friends. Id. In the beginning of August, he reported occasional, passive suicidal ideation involving fleeting thoughts over the past month but denied plan or intent. He continued to live with his mother and remained off from work, though he sought assistance in updating his resume and getting a new job. Id. An August 2019 treatment record concerning the Veteran's efforts to obtain a new job indicated that the Veteran's mental health issues appeared to be fairly well controlled at that time. In September 2019, the Veteran continued to report maintained slight improvements in mood and anxiety. See September 2019 VA treatment records. There was no evidence of suicidal ideation, and the Veteran denied thoughts of harming himself over the past month. Id. The Veteran reported trouble sleeping and he was provided psychoeducation about sleep. Id. He also indicated that he had a job lined up, which he anticipated to start within the next two weeks. Id. Additionally, a VA examination was provided in September 2019 concerning the Veteran's psychiatric condition, wherein the examiner found that the Veteran had "occupational and social impairment due to mild or transient symptoms which decreased work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication." At the examination, the Veteran reported significant marital conflict over the past couple of years, including verbal arguments and physical altercations, fueled in part by moderate to heavy drinking by both partners. They previously separated and the Veteran moved in with his mother. The Veteran reported that in May 2019, his wife called the police during a domestic dispute, and he was charged with felony domestic violence. Additionally, he reported that he and his wife had resumed contact, were considering re-engaging in couples therapy, and that he had a handful of close friends from childhood and the military. The examiner noted that the Veteran had strong social support from his mother, brother, and a couple of friends. He stated that he played pick-up basketball in his neighborhood on Tuesday evenings, and he was independent with daily living activities. He denied any difficulty keeping up with routine chores or errands, and he was able to drive without any problem. He stated that he walked his dogs most days, recently began going to the gym three days a week, sometimes went to the beach, and enjoyed riding his motorcycle. He preferred to avoid crowds but could tolerate them. He identified his most problematic symptoms as irritability, feeling nervous or on edge most of the time, variable sleep, variable energy/motivation, and worries about future employment. The examiner noted symptoms including irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects, reckless or destructive behavior, and sleep disturbance. The Veteran further reported occasional intrusive memories of Afghanistan and denied cognitive concerns. He also denied recent suicidal ideation, intent, or plan. Toward the end of September 2019, the Veteran was taken off the VA's high-risk list for suicide. See September 2019 VA treatment record. In October 2019, the Veteran continued to report maintained improvements in mood and anxiety and described generally feeling "ok." See October 2019 VA treatment records. He reported ongoing uncertainty about his relationship with his wife, as they continued to live separately, but they were spending more time together. Id. He had difficulty recalling examples of increased irritability/frustration but noted ongoing concern about how he became quickly frustrated. Id. He denied thoughts of harming himself in the past month, including passive suicidal ideation. Id. He remained unemployed but stated that he had an interview for a job and was waiting to hear back. Id. He was hopeful that he would get the job and begin working in the next few weeks. Id. In November 2019, the Veteran reported generally maintained improvements in mood and anxiety but noted difficulty sleeping. See November 2019 VA treatment records. He also reported increased nightmares and unwanted memories. Id. He continued to spend time with friends, go to the gym, and work on projects around the house and acknowledged interest in "doing a little more." Id. He denied any increased irritability or anger recently. Id. In December 2019, the Veteran reported symptoms of depression, including little interest or pleasure in doing things and trouble falling asleep, and stated that these symptoms made it somewhat difficult to work, take care of things at home, or get along with others. See December 2019 VA treatment records. He denied suicidal ideation, trouble concentrating, feeling tired, or thoughts that he would be better off dead or of hurting himself. Id. He further endorsed symptoms of anxiety, including feeling nervous, not being able to stop or control worrying, worrying too much, becoming easily annoyed or irritable, and feeling afraid as if something awful might happen. Id. He stated that he was living with his wife again and that she had recently discovered she was pregnant. Id. The provider noted that the Veteran's two suicide attempts in March were concerning, though both occurred prior to returning to Rhode Island. The provider noted that the Veteran had passive suicidal ideation since that time. In January 2020, the Veteran reported generally feeling "pretty good" in the past month. See January 2020 VA treatment records. He was going to begin working as a delivery driver in February and looked forward to working full-time. Id. He reported improvements in his sleep. Id. His mood was observed as euthymic, and the Veteran denied thoughts of harming himself in the past month, including passive suicidal ideation. In February 2020, the Veteran reported generally feeling "pretty good" in the past month, but also noted feeling "kind of blah" at times. See February 2020 VA treatment records. It was noted that he and his wife recently returned from a vacation. Id. He denied suicidal ideation at that time. A VA examination was provided in February 2020, where the examiner noted that the Veteran's most recent progress notes indicated a reduction of mental health symptoms over time, re-engagement in marital therapy, and recent employment as a delivery driver beginning in February 2020. The examiner found that the Veteran's treatment notes indicated that the Veteran's mental health conditions were chronic conditions that persisted for almost one year and had only recently begun to resolve. At the September 2021 hearing, the Veteran reported that he currently worked part-time on a delivery route. See September 2021 Hearing Transcript. When asked about the impact of his psychiatric symptoms, the Veteran stated that "it's been kind of just the same since I got out - if not - it's kind of getting worse." He reported that his depression and anxiety made it kind of hard for him to get out and be as active as he used to be. He stated that he had been struggling with alcohol, which he had medication for. He indicated that while he had some peers at his job, he did not have a lot, and the job was "kind of like a self-employed job." He endorsed acting on impulse and stated that he had more of a short fuse with people. He indicated that he picked his current job so he would not have to be around people. He reported taking days off work because of his mental health conditions. He asserted that he did not really get out much, tended to isolate, and that it was difficult for him to interact or socialize with others, though he noted that he talked to friends once or twice a week. He denied isolating himself from his family but stated that he was "short" and "kind of distant" with them. When asked whether he had any recurring suicidal ideations or thoughts since being out of the military, the Veteran responded "[y]es, but with the medication it - it's helped. But I have more -- pretty much it's -- it's something that I kind of struggle with I'd say daily, so yeah." For the entire period on appeal, VA treatment providers regularly documented that the Veteran was well groomed, neatly and appropriately dressed, alert and well-oriented, and that his memory was intact. See March 2019 - January 2020 VA treatment records. Additionally, they consistently noted that the Veteran's speech and thought process were normal, logical, and that his language was intact. Id. The Board finds that the Veteran's symptoms showed a more noticeable and sustained improvement at his July 11, 2019 appointment, consistent with occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, and that his symptoms maintained at this level for the remainder of the period on appeal. Specifically, at the July 11, 2019 appointment, the Veteran reported mild improvements in mood and anxiety in the past two weeks, that he recently went on vacation with friends, that he planned to move back into his house, and that he had a number of activities he planned to engage in, noting benefit from being busy. From July 11, 2019, the VA treatment records consistently reflected that the Veteran had symptoms of depression, anxiety, trouble sleeping, nightmares, and irritability. The Board finds that these symptoms resulted in occupational impairment consistent with a 30 percent rating during that period. Specifically, while the Veteran was unemployed from July 2019 - February 2020, the Veteran was actively pursuing employment opportunities during that period and expressed a willingness and ability to be employed. Additionally, a June 2019 VA treatment record indicated that there was no reason to believe the Veteran could not return to work without restrictions in his current medication regimen. The Veteran became employed in February 2020 and at the September 2021 hearing the Veteran confirmed that he maintained that job. While the Board acknowledges that the Veteran asserted it was difficult for him to go to work, that he chose a job where he would have less peers, and that he sometimes took days off due to his mental health issues, the Board finds that such occupational impairment is contemplated by a 30 percent rating, which accounts for occupational impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. Additionally, the Board acknowledges that the Veteran had challenges in his relationship with his wife from July 11, 2019, and that the Veteran asserted that his depression and anxiety symptoms made it difficult for him to socialize and interact with others during this period. However, the evidence shows that the Veteran maintained social support from his mother and friends, went on a trip with his friends, played basketball in his neighborhood on a weekly basis, and regularly went to the gym during this time. Additionally, the Veteran's relationship with his wife showed improvement during this period, with the Veteran spending more time with her, re-engaging in marital therapy, and eventually living with her again. The Board finds that this evidence weighs against finding occupational and social impairment with reduced reliability and productivity due to difficulty in establishing and maintaining effective social relationships. Rather, the Veteran demonstrated difficulty in social relationships that more nearly approximated a 30 percent evaluation. While the Veteran endorsed symptoms of anxiety and depression during the period from July 11, 2019, these symptoms are specifically contemplated by the 30 percent rating criteria. Furthermore, the Veteran does not assert, nor does the evidence reflect, that he experienced panic attacks more than once a week, as contemplated by the 50 percent rating criteria. As for the other criteria required for a 50 percent rating, the Board finds the documented symptomatology from July 11, 2019 does not rise to the requisite level of severity. The record does not suggest that the Veteran exhibited flattened affect; circumstantial, circumlocutory, or stereotyped speech; difficulty in understanding complex commands; impairment of short- and long-term memory; impaired judgment; or impaired abstract thinking. While the Board acknowledges that the Veteran experienced some difficulty with motivation and mood, the Board finds that these difficulties are more closely approximated by the 30 percent rating criteria, which accounts for depressed mood. Additionally, in the September 2019 VA examination, the examiner found that the Veteran's psychiatric condition resulted in "occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication," which is the level of severity described under the 10 percent rating. While the adjudicator makes the determination as to what evaluation is warranted for the Veteran's unspecified depressive and anxiety disorder, and the Board finds that the Veteran's symptoms from July 11, 2019 more closely approximate a 30 percent evaluation, the examiner's conclusion is nonetheless evidence against a finding that the Veteran's psychiatric condition caused occupational and social impairment with reduced reliability and productivity to warrant a 50 percent evaluation. Likewise, the Board finds the disability picture does not rise to the level of a 70 percent rating from July 11, 2019. The Board acknowledges that the 70 percent rating criteria contemplates suicidal ideation and that there is evidence of record indicating the presence of some suicidal ideation during the period on appeal. In some cases, the mere presence of suicidal ideation (ranging from passive thoughts of one's own death to active thoughts of engaging in suicide-related behavior), may cause occupational and social impairment with deficiencies in most areas. See Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017). However, the mere presence of suicidal ideation alone will not necessarily warrant an automatic 70 percent rating. Rather, "VA must 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." See Bankhead, 29 Vet. App at 22. Here, there are two pieces of evidence indicating the presence of suicidal ideation during the period on appeal: the VA treatment records and the Veteran's Board hearing testimony. Specifically, the VA treatment records show that the Veteran reported passive suicidal ideation from July 11, 2019 through August 2019, but repeatedly denied suicidal ideation from September 2019 through February 2020. Moreover, the July 2019 - August 2019 VA treatment records described the Veteran's suicidal ideation as passive, fleeting, and less frequent than it had been previously. As for the Veteran's Board hearing testimony, when asked whether he had any recurring suicidal ideations or thoughts since being out of the military, the Veteran responded "[y]es, but with the medication it - it's helped. But I have more -- pretty much it's -- it's something that I kind of struggle with I'd say daily, so yeah." The Board finds there is a credibility issue with the Veteran's hearing testimony concerning the severity and frequency of his psychiatric symptoms. Specifically, during the Board hearing, when asked about the impact of his psychiatric symptoms, the Veteran responded that "it's been kind of just the same since I got out - if not - it's kind of getting worse." See September 2021 Hearing Transcript. However, this conflicts with the VA treatment records, in which the Veteran's psychiatric providers repeatedly documented that his mental health symptoms improved over time since his discharge, specifically during the period of July 2019 to February 2020. See July 2019 - February 2020 VA treatment records. Additionally, to the extent the Veteran's statement concerning recurrent suicidal ideation can be interpreted to mean that he experienced recurrent suicidal ideation since his discharge, the Board also finds this statement not credible because it is contradicted by the VA treatment records, which show that he reported suicidal ideation from March 2019 through August 2019, but repeatedly denied suicidal ideation from September 2019 through February 2020. Thus, while the Board finds the Veteran competent to report his subjective psychiatric symptoms, the Board finds the Veteran's Board hearing testimony is not credible to accurately establish the severity and frequency of his psychiatric symptoms because it is contradicted by the VA treatment records. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); see also Caluza v. Brown, 7 Vet. App. 498, 511, 512 (1995), aff'd per curiam, 78 F.3d. 604 (Fed. Cir. 1996) (holding that in determining the weight to be assigned to evidence, credibility can be affected by inconsistent statements, internal inconsistency of statements, inconsistency with other evidence of record, facial implausibility, bad character, interest, bias, self- interest, malingering, desire for monetary gain, and witness demeanor.). Accordingly, to the extent the Veteran's hearing testimony concerning suicidal ideation can be interpreted to mean that he experienced daily suicidal ideation as of September 2021, given the previously discussed credibility issues with the Veteran's testimony, this statement alone is insufficient to establish the existence of a current symptom of daily suicidal ideation resulting in occupational and social impairment with deficiencies in most areas. Thus, the only credible evidence of file concerning the Veteran's symptom of suicidal ideation from July 11, 2019 are the VA treatment records. The Board notes that the VA treatment records that were obtained within the evidentiary window are dated April 2012 - February 2020. Therefore, the VA treatment records do not shed light on whether the Veteran experienced suicidal ideation beyond February 2020, including daily suicidal ideation as of September 2021, as asserted by the Veteran. Rather, the treatment records indicate that the Veteran endorsed suicidal ideation from July 11, 2019 through August 2019, but denied suicidal ideation from September 2019 through February 2020. Additionally, as discussed above, the suicidal ideation noted from July 2019 - August 2019 VA was described as passive, fleeting, and less frequent. The Board finds that such severity and frequency does not rise to the level of occupational and social impairment with deficiencies in most areas to warrant a 70 percent rating from July 11, 2019. Instead, the Board finds that this evidence establishes that the Veteran had infrequent and passive suicidal ideation from July 11, 2019 that resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. As for the other criteria contained in the 70 percent rating criteria, the Board finds the documented symptomatology does not rise to this level of severity. The record does not suggest that the Veteran exhibited obsessional rituals, and his speech and thoughts were regularly documented as logical and normal. Additionally, even though the Veteran exhibited symptoms of anxiety and depression during this period, he did not exhibit near-continuous symptoms of panic or depression affecting the ability to function independently, appropriately, and effectively. While the Board acknowledges that the Veteran endorsed not being able to stop or control worrying in December 2019, the Board finds that such symptom did not rise to the level of near-continuous panic affecting the ability to function independently, appropriately, and effectively. Rather, the evidence shows that during the period on appeal the Veteran was able to function on his own, engage in daily activities, obtain a new job, and socialize with others. Moreover, the record shows that the Veteran was regularly documented as well-groomed and appropriately dressed, which goes against finding that the Veteran neglected his personal appearance or hygiene. Additionally, while the record shows the Veteran experienced some difficulty in going to work and interacting with others, the Board finds that this did not rise to the level of difficulty in adapting to stressful circumstances or an inability to establish and maintain effective relationships as contemplated by the 70 percent rating. As for whether the Veteran exhibited impaired impulse control (such as unprovoked irritability with periods of violence), the Board finds that while the Veteran reported feelings of anger, irritability, and impaired impulse control during the period on appeal, there was no evidence during that period that the Veteran ever became violent or that these symptoms were so severe as to cause occupational and social impairment with deficiencies in most areas. The Board acknowledges that the September 2019 VA examiner indicated that the Veteran had reckless or self-destructive behavior as well as irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. However, upon further review of the examination, the instances of irritable behavior and angry outbursts that were referenced by the examiner occurred prior to July 11, 2019, including his marital conflict involving verbal arguments and physical altercations and his felony criminal charge concerning a domestic dispute in May 2019. The VA treatment records reveal that the marital conflict referenced by the examiner occurred prior to the period on appeal from March 2019 through May 2019. Furthermore, while the VA treatment records indicate that the Veteran experienced irritability and anger from July 2019, they do not indicate any evidence of violence or verbal or physical aggression toward others. Indeed, an October 2019 VA treatment record indicated that while the Veteran noted ongoing concern about how quickly he became frustrated, he had difficulty recalling any recent example of increased irritability/frustration. Additionally, the September 2019 VA examiner stated that the Veteran's mental health symptoms had improved over time and described his current symptom of irritability as "mild." Moreover, the examiner concluded that the Veteran's symptoms resulted in occupational and social impairment due to mild or transient symptoms which decreased work efficiency and ability to perform occupational tasks only during periods of significant stress, or; symptoms controlled by medication. While the adjudicator makes the determination as to what evaluation is warranted for the Veteran's unspecified depressive and anxiety disorder, the examiner's conclusion is nonetheless evidence against a finding that the Veteran's irritability caused occupational and social impairment with deficiencies in most areas as is required for a 70 percent rating. Additionally, the Board acknowledges that at the September 2021 Board hearing, when the Veteran was asked whether he acted on impulse, he responded, "I do," and further testified as to having a "short fuse," getting into arguments, and having difficulty interacting with other people. However, the Board finds there is insufficient evidence to suggest that such symptoms caused occupational and social impairment with deficiencies in most areas as to warrant a 70 percent rating from July 11, 2019. To the contrary, the Veteran testified at the hearing that he maintained his current employment and spoke to friends once a week or two. While the Board has considered that the Veteran testified he sometimes took days off due to his mental health, had difficulty interacting with others, was "short" with family members, and had infrequent contact with friends once or twice a week, the Board finds such level of impairment is contemplated by a 30 percent rating, which accounts for occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks. Therefore, the Board finds that from July 11, 2019, the Veteran's symptoms of unspecified depressive and anxiety disorder are more closely approximated by the assigned 30 percent disability rating. As described above, the evidence persuasively weighs against the Veteran showing occupational and social impairment with reduced reliability and productivity, nor are his symptoms of similar severity, frequency, and duration to warrant a 50 percent disability rating. Similarly, the Board finds that the disability picture does not rise to the level of severity of the 70 percent rating or the 100 percent rating. In sum, considering the total disability picture, the Board finds the evidence persuasively weighs against an initial rating in excess of 30 percent from July 11, 2019. Therefore, the benefit of the doubt doctrine is not for application and a rating in excess of 30 percent for unspecified depressive and anxiety disorder is denied from July 11, 2019. 38 C.F.R. § 4.7. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Corcoran, 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.