have had several requests pertaining to the Global Assessment of
Functioning Scale (GAF) Scale which is used widely in the VA when determining
a veterans level for PTSD compensation. So, I decided that I'd just
it to the entire list as it contains information that affects most of us
Vietnam veterans with PTSD. All of your GAF Scores are available to you
are required by your psychiatrist to submit them to the VARO annually.
I can't stress how important it is for every veteran
to take their
records after each visit to the VA and sign a release of Information for a
copy of treatment for that day.
Global Assessment of Functioning Scale (DSM-IV Axis
V). This 100-point
scale measures a patients overall level of psychological, social, and
occupational functioning on a hypothetical continuum. The GAF Report decision
tree is designed to guide clinicians through a methodical and comprehensive
consideration of all aspects of a patients symptoms and functioning to
determine a patients GAF rating in less than 3 minutes. The GAF Report
addresses the growing need for accuracy and reliability in determining and
reporting on GAF ratings by ensuring all aspects of a patients functioning
are considered. Use the “current” or “past week” rating to indicate
management needs, the “at discharge” rating to document progress and
of care, and the “highest level in past year” rating as a target for
termination of treatment. The GAF scale is particularly useful for managed
care-driven diagnostic evaluations to determine eligibility for treatment and
disability benefits and to delineate the level of care required for patients.
On completion of the GAF Report questions, a
10-point range is
automatically determined. Then, using the sliding rating scale, you can
quickly indicate the specific GAF rating within this 10-point range, using
clinical judgment and hypothetical comparison with other patients in the
range. Explanation screens provide clarification of specific questions
throughout the assessment. The report, which summarizes a patients results,
can be produced immediately after an assessment.
It is important for every veteran filing for a claim
service-connected benefits to be aware of his or her GAF score.
Assessment of Functioning
Consider psychological, social, and occupational functioning on a
hypothetical continuum of mental health-illness. Do not include impairment
functioning due to physical (or environmental) limitations. You do not need
to know the numbers but rather what the GAF measures and is used for.
intermediate codes when appropriate, e.g., 45, 68, 72.)
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 or her
many positive qualities. No symptoms
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
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 occupational, or school
functioning (e.g., temporarily falling behind in schoolwork).
mild symptoms (e.g., depressed mood and mild insomnia) OR some
difficulty in social occupational, or school functioning (e.g., occasional
truancy or theft within the household), but generally functioning pretty
well, has some meaningful interpersonal relationships.
Moderate symptoms (e.g., flat affect and circumstantial speech,
occasional panic attacks) OR moderate difficulty in social, occupational, or
school functioning (e.g., few friends, conflicts with peers or co-workers).
symptoms (e.g., suicidal ideation, severe obsessional rituals,
frequent shoplifting) OR any serious impairment in social, occupational or
school functioning (e,g., no friends, unable to keep a job).
impairment in reality testing or communication (e.g., speech is
at times illogical, obscure, or irrelevant) OR major impairment in several
areas, such as work or school, family relations, judgment, thinking, or mood
(e.g., depressed man avoids friends, neglects family, and is unable to work;
child frequently beats up younger children, is defiant at home, and is
failing at school).
Behavior is considerably influenced by delusions or hallucinations OR
serious impairment in communication or judgment (e.g., sometimes incoherent,
acts grossly inappropriately, suicidal preoccupation) OR inability to
function in almost all areas (e.g., stays in bed all day, no job, home, or
danger of hurting self or others (e
.g., suicidal 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 communication (e.g., largely incoherent or mute).
Persistent danger of severely hurting self or others (e.g., recurrent
violence) OR persistent inability to maintain minimal personal hygiene OR
serious suicidal act with clear expectation of death.
this day to the ending of the world,
we in it shall be remember'd;
few, we happy few, we band of brothers;
he to-day that sheds his blood with me
be my brother; be he ne'er so vile,
day shall gentle his condition:
gentlemen in England now a-bed
think themselves accursed they were not here,
hold their manhoods cheap whiles any speaks
fought with us upon Saint Crispin's day".
Henry V by William Shakespeare