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Gaf Score

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usmcman001

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I finally got a copy of c&p and have a GAF of 58. What does that mean? Does that effect rating? Thanks

Your GAF score is a “Global Assessment of Function” numerical short hand used by mental health practitioners to document how a patient is doing over all mentally. According to the DSM IV, there are numerous ratings set forth below.

For example a GAF of (91 - 100): would reflect 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.

A GAF of (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 argument with family members).

A GAF of (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).

A GAF of (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.

A GAF of (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).

A GAF of (41 - 50): 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).

A GAF of (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).

A GAF of (21 - 30): Behavior is considerably influenced by delusions or hallucinations or serious impairment, in communication, or judgment (e.g., stays in bed all day, no job, home or friends).

A GAF of (11 - 20): Some danger of hurting self 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 communication (e.g., largely incoherent or mute).

A GAF of (1 - 10): Persistent danger or severely hurting self or others (e.g., recurrent violence) or persistent inability to maintain minimal hygiene or serious suicidal act with clear expectation of death.

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usmc,

Here's a BVA case that provides some additional info, relevant to your question.

GAF scores can change hourly, daily, weekly, monthly, etc...

http://www.va.gov/vetapp10/Files4/1039147.txt

The GAF score is a scale reflecting the "psychological, social,

and occupational functioning on a hypothetical continuum of

mental health-illness." Richard v. Brown, 9 Vet. App. 266, 267

(1996). A score of 41 to 50 is assigned where there are

"erious 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)." DIAGNOSTIC AND STATISTICAL MANUAL OF

MENTAL DISORDERS (DSM-IV) 47 (4th ed. 1994). A score of 51 to 60

is appropriate where there are "[m]oderate 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)." Id.

It is not expected that all cases will show all the findings

specified; however, findings sufficiently characteristic to

identify the disease and the disability therefrom and

coordination of rating with impairment of function will be

expected in all instances. 38 C.F.R. § 4.21.

In a claim for an increased rating, "staged" ratings may be

warranted where the factual findings show distinct time periods

when the service-connected disability exhibits symptoms that

would warrant different ratings. Hart v. Mansfield, 21 Vet. App.

505 (2007). As explained in detail below, the Board has found

that "staged" ratings are appropriate in this case.

Prior to May 4, 2010

During this period, the Veteran's psychiatric disability picture

most nearly approximated the criteria for the 50 percent rating

that was assigned. The psychiatric disability was manifested by

depressed mood, occasional panic attacks, irritability, some

paranoia, restricted and dysphoric affect, anxiety, flashbacks,

recurrent thoughts about Vietnam, some hypervigilance,

exaggerated startle response, some impairment of recent and

remote memory, difficulty concentrating, and chronic sleep

impairment with nightmares. However, symptoms of psychiatric

disability consistent with (or of equivalent severity) the

criteria for a 70 percent rating are not shown, and the symptoms

demonstrated are not shown to have been productive of

occupational and social impairment with deficiencies in most

areas. There is no evidence of suicidal or homicidal ideation,

obsessional rituals that interfere with routine activities (as

the only obsessive ritual discussed was checking to make sure the

locks were locked), speech intermittently illogical, obscure, or

irrelevant, near-continuous panic or depression, spatial

disorientation, or neglect of personal appearance and hygiene.

While there is evidence of some social impairment during this

time period, as reflected by social isolation and a lack of

friends, he has maintained relations (albeit strained at times)

with his son and the son's mother. Notably, he has a good

relationship with his elderly father (and his care of the father

of itself reflects a high level of functioning). The Board also

notes that both the January 2007 VA examiner (who assigned a GAF

score of 55, reflecting moderate symptoms or moderate impairment

in social and/or occupational functioning), and the July 2008 VA

examiner found that the Veteran had no problem with activities of

daily living (contraindicating deficiencies in most areas) for

the Veteran, and that the July 2008 examiner specifically found

the Veteran's psychiatric symptoms to be only mild to moderate.

In March 2008, the Veteran was assigned a GAF score of 50, and in

June 2008, he was assigned a GAF score of 45 to 50; such scores

reflect that his psychiatric disability was considered manifested

by serious symptoms or serious impairment in social and/or

occupational functioning. However, the characterizations were an

anomaly when compared against the treatment records that follow

immediately thereafter (and assigned GAF scores of 55) and the

July 2008 examination that found his symptoms were mild to

moderate (i.e., reflective of a GAF score greater than 50 and as

high as 70). See 38 C.F.R. § 4.126. Notably, symptoms

reflective of occupational and social impairment with

deficiencies in most areas were not alleged or noted. As was

previously noted, throughout this period the Veteran's activities

of daily living were noted to be unimpaired. It was noted that

he had retired based on age/longevity. The symptoms of the

Veteran's psychiatric disability during this time period are not

shown to have been more than or to have been productive of more

than moderate impairment in social and/or occupational

functioning. Consequently, the preponderance of the evidence is

against a rating in excess of 50 percent prior to May 4, 2010.

From May 4, 2010

The Board finds from May 4, 2010, the date of a VA examination,

the evidence reasonably supports the assignment of a 70 percent

(but no higher) rating for the Veteran's service-connected

psychiatric disability. The psychiatric disability picture has

been characterized by a severely nervous and irritable mood,

depression, anxiety, low self-esteem, obsessive rumination on

military events, nightmares, flashbacks, hypervigilance,

exaggerated startle response, decreased energy, difficulty

concentrating, social isolation, avoidance behavior, and some

memory loss, severe sleep impairment, and difficulty in

establishing and maintaining effective social relationships.

Such symptoms were reported on May 4, 2010 VA examination. The

examiner noted that the symptoms of the Veteran's psychiatric

disability were increasing in severity, with severe arousal

symptoms (as indicated by severe sleep disturbance,

hypervigilance, and feeling guarded, suspiciousness and paranoid

tendencies). The examiner also noted many episodes of nightmares

and flashbacks of such intensity that they induced panic attacks

as related to recall of the past in Vietnam. The examiner found

the Veteran had moderate-to-severe functional impairment, and had

very little relationship with his son, and no friends of his own.

Accordingly, from May 4, 2010, the schedular criteria for a 70

percent rating are reasonably shown to be met.

The Board has also considered whether a still higher (100

percent) schedular rating is warranted. Although the Veteran's

psychiatric disability has caused some social isolation, and the

evidence shows that he has difficulty establishing and

maintaining relationships, he maintains a caring/responsible

relationship with his father and (somewhat more limited)

relations with his son and the son's mother. His everyday living

activities are unimpaired, and he exhibits highly responsible

behavior in tending to his father. His reasoning and judgment

are considered fair. Total occupational and social impairment

due to his psychiatric disability symptoms is simply not shown,

and a schedular 100 percent rating is not warranted.

The Board has also considered whether referral for consideration

of an extraschedular rating is indicated. Inasmuch as all

symptoms of the Veteran's psychiatric disability (and the

associated functional impairment described) are fully encompassed

by the schedular criteria for a 70 percent rating, the schedular

criteria are not shown to be inadequate. See Thun v. Peake, 22

Vet. App. 111 (2008). Consequently, referral for extraschedular

consideration is not warranted. Finally, as the Veteran retired

as a laborer based on age/longevity, and SSA records indicate

that he suffered a work-related injury and received SSA benefits

for non-service connected disabilities (coronary artery disease

and disc disease), and has not alleged unemployability due to his

service-connected psychiatric disability, the matter of

entitlement to a total rating based on individual unemployability

due to service connected disability is not raised by the record.

See Rice v. Shinseki, 22 Vet. App. 447 (2009).

ORDER

For the period prior to May 4, 2010 a rating in excess of 50

percent for the Veteran's service connected psychiatric

disability is denied; for the period beginning on such date, a

staged increased rating of 70 percent is granted, subject to the

regulations governing payment of monetary awards.

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