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ranger11bv

Current Axis And Gaf According To Dsm- Iv

Question

Here it be:

The Global Assessment of Functioning (GAF) is a numeric scale (0 through 100) used by mental health clinicians and physicians to subjectively rate the social, occupational, and psychological functioning of adults, e.g., how well or adaptively one is meeting various problems-in-living. The scale is presented and described in the DSM-IV-TR on page 34. The highest ratings are 91-100, "Superior functioning in a wide range of activities.. No symptoms" and the lowest ratings (besides a 0, for "Inadequate information") are 1-10, "Persistent danger of severely hurting self or others...OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death."

Global Assessment of Functioning (GAF) 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.

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

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 symptoms.

90-81 Absent of 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, there are transient and expectable reactions to psycho-social 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).

70-61 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 relationships.

60-51 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).

50-41 Serious 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).

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 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).

30-21 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).

20-11 Some danger of hurting self or others (e.g., suicidal attempts without clear expectation of death; frequent 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).

10-1 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.

Axis codes:

* Axis I:

Clinical Disorders, most V-Codes, and conditions that need Clinical attention.

Diagnosis Flow Charts.

* Axis II:

Personality Disorders and Mental Retardation.

* Axis III:

General Medical Conditions.

* Axis IV:

Psychosocial and Environmental Problems.

* Axis V:

Global Assessment of Functioning Scale.

Edited by ranger11bv

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ranger,

And your point or question is ?

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Question: How is it that I fall in line with the DSM-IV perimeters yet not rated??

Point: as far as I can tell, this is the most up to date list. Nothing special. Plus a few members asked about it since Im going through all the VA BS they thought I would know. I just Googled it. No big.Why?

Edited by ranger11bv

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Question: How is it that I fall in line with the DSM-IV perimeters yet not rated??

ranger,

The first hurdle is to get the disability SC'd, then they evaluate the percentage and effective date.

The GAF score is only one issue they factor into the percentage of disability to be granted.

Heck, one could have a GAF score of 08 - but if it is determined to not be SC'd, then the GAF score

isn't relevant at all.

GAF's can change from day to day - week to week and month to month.

The following is a copy and paste authored by Patrick428, he has given me permission to share this

with VBA claimants anywhere that I deem it to be appropriate.

To begin with I am a Licensed Psychologist with 25 years of practice experience with specialization in PTSD, Mood Disorders (Depression and Anxiety), Forensics, and Psychological testing.

My experience ranges from individual therapy to working with veterans both in the VA and Social Security System.

I am currently retired and 100% by the VA for wounds, mental and physical problems related to Agent Orange that came as a result of my time as a Marine Force Recon in Vietnam.

So to start with I will describe many common terms needed to be understood and given examples when warranted.

R/O (Rule Out): Is a term found on either Axis I or II saying that there is not enough evidence to support the diagnosis at this time.

Deferred: Is a way of a clinician saying, "I just met you and I am not sure if you have this or not." Usually found when the patient has first entered the mental health system or has been out of the mental health system for a long period of time.

Secondary: Disorders that have manifested because of the first or primary disorder and also contribute to the severity of the primary disorder.

A full diagnostic example is as follows.

There are varieties of how they are written, but this is the universally accepted model:

Axis I: Major depression, recurrent without psychotic features (Primary)

Generalized Anxiety Disorder (Secondary)

Axis II: Borderline Personality Disorder or None

Axis III: Ulcers and heart problems (usually medical problems that contribute to the mental disorder)

Axis IV: Psychosocial Stressors: Lose of employment and child abuse

Severity: 1 None; 2 Mild; 3 Moderate; 4 Severe; 5 Chronic

Axis V: Current GAF: 50

Highest GAF past year 60 GAF :

Is referred to as Global Assessment of Functioning.

This is a scale from 1 - 100 suggesting a pattern of behavior at any given movement in time. GAF is a fluid score and is never static (think of your blood pressure when applying GAF).

The lower the score more problematic behavior becomes.

91 - 100 Not much happening and you can tolerate most stress very easily.

(Blood pressure normal)

81 - 90 Some minor setbacks, maybe late bill that was not paid causing a flurry of minor stress, but is usually resolved. (Blood pressure slight elevated, but returns to normal rapidly)

71 -80 Minor problems within the home (work) and some stress that is enduring, but usually dealt with. They called about the bill that you forgot to pay (Blood pressure slightly elevated).

61 - 70 Minor to moderate problems such as not having the money to pay the bill and you are under pressure by your creditor to pay it. (Blood pressure is elevated and in need of attention).

51 - 60 Your being sued for not paying your bill, and your wife or husband has announced they are tired of living this way. Your kids do not know who you are anymore. (Blood pressure above 140/90 and dual medications are needed).

41 - 50 Wife or husband announces they are leaving and the bill collector has placed a lien on your property. You have called your creditor and your spouse idiots and you say to hell with them. (Blood pressure is severe and strong doses of medication are needed)

31 - 40 You threaten to kill your creditor and your spouse and everyone around you is against you. (Blood pressure is in the stroke range).

21 - 30 You bought a weapon and can of gas and your going to resolve the issue once and for all. It causes you to be either incarcerated or committed. (Blood pressure is causing severe chest pains and your stroking).

11 - 20 The best you can do is verbally babble and drool on yourself. (Blood pressure has caused a stroke).

0 - 10 You are no longer with us as you now live in a parallel universe. (It does not matter now).

It is not my intention to make light of the scale, but I wish to show the reality of the levels.

Axis I. A grouping of mental syndromes from a common etiology or pathology. What is usual found on Axis I disorders are: Mood, Sexual, Psychotic Substance Abuse, Child Disorders (except Mental Retardation), and Organic Syndromes (e.g.,Depression caused by a stroke).

Axis II. Are disorders of the Personality and Mental Retardation. Here Personality Disorders in Cluster A, B, and C are found.

Cluster A. Disorders deemed to be problems associated with peculiar behaviors(Schizoid).

Cluster B. Disorders where the individual violates the right of other people and often has little regard for others (Antisocial).

Cluster C. Disorders where dependency and inability to fit in socially with others is the common theme(Avoidant).

Personality is how one perceives, relates, and thinks about the environment and of oneself.

Personality Disorder is a maladaptive problem with the personality that causes extensive interference and ability to function in society. This is a pervasive pattern of behavior manifesting itself in the early development of an individual and prevents the individual from functioning normally in society.

Illusion: An illusion is a visual perception or misinterpretation of something real.

Hallucination: A hallucination is a false perception of a sensory experience (tactile, visual, auditory, taste, smell, or in body experience).

Delusion: Is a false belief carried to an extreme.

Psychotic. Loss of touch with reality

Depersonalization: Feelings of detachment from others. Feelings like being one's own dream.

Affect: Mood behaviors. Moods can be blunted, flat, inappropriate, labile (frequent mood changes), and restricted.

PTSD: Post-traumatic Stress Disorder. Can come in forms of mild, moderate, severe, chronic and delayed. May be seen on Axis I written as: PTSD, Chronic and Delayed.

Psychiatrist: Is Medical Doctor who specializes in mental illness and uses medications for its' treatment.

Psychologist: Is a person who performs psychological testing, assessment, and therapy.

M.S.W. Master's in Social Work and usually coordinates community-based programs and also performs therapy. But is restricted to therapy only.

Psychological Battery includes:

Personality Inventory (MMPI, etc)

Intelligence Scale (IQ test Wechsler or Stanford-Binet)

Neurological Tests (Bender-Gestalt, Wechsler Memory Test, etc).

Mood Inventories (Depression Scale; Anxiety Scales)

Trauma Scales (Mississippi, TSI)

Mental Status Examination

Mental Status Examinations:

Mini Mental Status exam - 20 minutes

Full Mental Status Examination - 1 hour

Specialized Tests as warranted for the purpose of narrowing the cause of many problems.

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Question. What about stays in a VA hospital? All metal related.

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Question. What about stays in a VA hospital? All metal related.

ranger,

If the VBA has your hospital admissions in the record then they should be factored into

the adjudication of your claim issues.

Still, the most important item of all is for the VBA to grant SC of the issue/s.

You can't even argue percentage and effective date assigned, until the issue is granted.

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