PTSD ANDTHE GLOBAL
ASSESSMENT FUNCTIONING (GAF) SCALE AND HOW IT APPLIES TO THE VETERAN |
The Global Assessment of Functioning (GAF) Scale is a numeric scale (0 thru 100) used by mental health clinicians and doctors to rate the social, occupational and psychological functioning of adults. The scale is presented and described in the DSM-IV-TR manual. The following is GAF levels are commonly used by the Veterans Benefits Administration of the United States Department of Veterans Affairs in determining the appropriate level of disability compensation to be paid to veterans who suffer from service connected psychiatric disorders.
Consider psychological, social, and occupational functioning on a hypothetical continuum of mental health – illness. Do not include impairment in functioning due to physical or environmental limitations.
The following scores are being provided to the veteran as a way of understanding where is the big picture of the illness where he stands with regards to his Global Assessment Functioning Scale when the Veterans Administration rates the veteran from his PTSD claim |
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100 – 91 Superior functioning in a wide range of activities, life’s problems never seem to get out of hand, is sought out by others because of his/her many positive qualities, no general symptoms.
90 – 81 Absent or minimal symptoms (e.g. mild anxiety before an exam) good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied with life, no more than everyday problems or concerns (e.g. an occasional argument with family members).
80 – 71 If symptoms are present, they are transient and expectable reactions to Psychosocial stressors (e.g. difficulty concentrating after family argument) no more than slight impairment in social, or occupational environment.
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71 – 61 Some mild symptoms (e.g. depressed mood and mild insomnia) OR some difficulty in social, or occupational environment, budgetary functioning pretty well. Has some meaningful interpersonal relationships.
60 – 51 Moderate Symptoms (e.g. flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational environment (e.g. few friends, conflicts with peers or co-workers.
50 – 41 Serious Symptoms (e.g. suicidal ideation, severe obsessional rituals, OR serious impairment in a social, or occupational environment (e.g. no friends, unable to keep a job).
40 – 31 Some impairment in reality testing or communication (e.g. speech is at times illogical, obscure, or irrelevant) OR major impairment in several areas, such as family relations, work, judgment, thinking or mood (e.g. depressed individual avoids friends, neglects family, and unable to work.
30 – 21 Behavior considerably influenced by delusions or hallucinations OR serious impairment in communications or judgment (e.g. sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) OR the inability to function in almost all
Areas (e.g. stays in bed all day; no job, home or friends)
20-11 Some danger of hurting oneself, or others (e.g. suicide attempts without clear expectation of death, frequently violent; manic excitement) OR occasionally fails to maintain minimal personal hygiene (e.g. smears feces) OR gross impairment in communications (e.g. largely incoherent or mute).
10 – 1 Persistent danger of severely hurting self or others (e.g. recurrent violence) OR persistent inability to maintain personal hygiene OR serious suicidal act with clear expectation of death. |
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GENERAL RATING FORMULA FOR MENTAL DISORDERS
Total occupational and social impairment, due to such symptoms as: gross impairment in thought process 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………………………… 100%
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; difficult in adapting to stressful circumstances (including work or a work like setting); inability to establish and maintain effective relationships…………………….70%
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…………….50%
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 conversations normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events)
…………………………………...30%
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 continuous medication...………10%
A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication ………... 0% |
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