Global Assessment of Functioning (GAF) Scores

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I 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 submit
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 and
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 current
management needs, the “at discharge” rating to document progress and quality
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 for
service-connected benefits to be aware of his or her GAF score.

Global Assessment of Functioning

Scale 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. You do not need
to know the numbers but rather what the GAF measures and is used for.


Code (Note. Use intermediate codes when appropriate, e.g., 45, 68, 72.)

91-100 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 or her
many positive qualities. No symptoms


81-90 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)


71-80 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).

61-70 Some 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.

51-60 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).


41-50 Severe 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).


31-40 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 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).

21-30 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
friends).

11-20 Some 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).

1-10 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.


0 Inadequate information.

 

 

"From this day to the ending of the world,

But we in it shall be remember'd;

We few, we happy few, we band of brothers;

For he to-day that sheds his blood with me

Shall be my brother; be he ne'er so vile,

This day shall gentle his condition:

And gentlemen in England now a-bed

Shall think themselves accursed they were not here,

And hold their manhoods cheap whiles any speaks

That fought with us upon Saint Crispin's day".

 

 

From Henry V by William Shakespeare