DETERMING DISABILITY WITH THE GLOBAL ASSESSMENT OF FUNCTIONING(GAF)

Global Assessment of Functioning(GAF) is a numeric scale(1-100) used by mental health clinicians and physicians to rate subjectively the social, occupational, and physical functioning of individuals. It is to decide how well one is meeting various problems in living. The scale is presented and described on page 34 in The Diagnostic and Statistical Manuel of Mental Disorders(DSM)-IV-TR. The GAF is no longer in the new DSM-5. It has been replaced by WHODUS(World Health Organization's Disability Assessments Schedule. GAF levels are commonly used by the Veterans Benefits Administration in determining the appropriate level of disability compensation to be paid to veterans who suffer from service connected psychiatric disorders. In disability cases before the Social Security Administration, they determine if GAF is consistent with the narrative report. It is just one tool used by the administration. It is not used in isolation from the rest of the evidence to make a disability decision. GAF SCALE 91-100 No symptoms 81-90 Absent or minimal symptoms Mild anxiety before an exam Generally satisfied with life No more than everyday problems or concerns 71-80 If symptoms are present, they are expectable to psychosocial stressors(difficult concentrating after family argument, slight impairment in social, occupational or school functioning Temporarily falling behind in school work) 61-70 Some mild symptoms(depressed mood and mild insomnia)or some difficulty in social occupational or school functioning(occasional truancy or theft within the household) but generally functioning pretty well, has some interpersonal relationships 51-60 Moderate symptoms(occasional panic attacks) or moderate difficulty in social, occupational or school functioning(few friends, conflicts with peers or co-workers) 41-50 Serious symptoms(suicidal ideation, severe obsessional rituals, frequent shoplifting)or any serious impairment in social, occupational, or school functioning(no friends, unable to keep a job or cannot work) 31-40 Some impairment in reality testing or communication(speech is at times illogical, obscure or irrelevant) or major impairment in several areas, such as work or school, family relations, judgement, thinking or mood(depressed adult avoids friends, neglects family and is unable to work; child frequently beats up younger children, is defiant at home and is failing at school) 21-30 Behavior is considerably influenced by delusions or hallucinations, or serious impairment in communication or judgement(sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) or inability to function in almost all areas(stays in bed all day, no job, home or friends) 11-20 Some danger of hurting self or others(suicide attempts without clear expectation of death, frequently violent, manic excitement, or occasionally fails to maintain personal hygiene or gross impairment in communication(largely incoherent or mute) 1-10 Persistent danger of severely hurting others or self(recurrent violence) or persistent minimal personal hygiene or serious suicidal act with expectation of death 0 Inadequate information