The Global Assessment of Functioning (GAF) scale is a scoring system used by mental health professionals to assess how well an individual is functioning in his or her everyday life. It is generally used to measure the impact a person’s mental health condition is having on his or her ability to accomplish tasks of daily living. Scores range from 0 to 100, with 100 representing superior functioning. Medical professionals take into account the difficulty the individual being tested faces in their daily life, including with social, psychological, occupational, and academic functioning before assigning a score.
The main purpose of the GAF score is to provide physicians with a way to determine how much help a person with a mental health condition may need due to their illness, which could include things like regular counseling or constant medical care. An example of the system’s scoring criteria is provided below:
- 100 to 91. Superior functioning with no symptoms that impair functioning.
- 90 to 81. Absent minimal symptoms, such as anxiety before an exam.
- 80 to 71. Slight impairment in work or school with occasional symptoms that are expected reactions to psychological stressors.
- 70 to 61. Mild symptoms, such as mild insomnia or depressed mood or some difficulty in social, occupational, or home situations.
- 60 to 51. Moderate symptoms, such as occasional panic attacks, or some difficulty in building meaningful social relationships.
- 50 to 41. Serious symptoms, such as suicidal thoughts or severe, obsessive rituals. The person could also have severe impairment in work, such as being unable to keep a job.
- 40 to 31. Some impairment in communication, psychosis (loss of touch with reality) or both, or major impairment in school, work, family life, judgment, thinking, or mood.
- 30 to 21. A person experiences frequent delusions or hallucinations or features severely impaired communication or judgment. They’re unable to function in almost all areas, such as staying in bed all day, and have no meaningful relationships.
- 20 to 11. A person is in danger of hurting themselves or others. They may have made suicide attempts, display frequent violent behaviors, or have major impairment in communication, such as muteness or speaking incoherently.
- 10 to 1. A person is in almost constant danger of hurting themselves or others, has made a serious suicidal act with clear expectation of death, or both.
- 0. There’s inadequate information to assess the person.
Because the GAF system is based on a standard set of criteria, an individual’s GAF score can pass from one doctor to another, and the receiving physician can determine the patient’s functioning level rather quickly. However, because the scoring is subjective depending on the physician running the evaluation, two doctors could potentially assign the same person a different GAF score. This is part of the reason that in recent years, many psychologists and mental health professionals have moved away from using GAF scores and instead have opted to use the WHODAS 2.0 to determine the functioning level of their patients.
What Is The WHODAS 2.0?
The World Health Organization Disability Assessment Schedule 2 (WHODAS 2.0) was first introduced with the publication of the fifth edition of the Diagnostic and Statistical Manual (DSM-5). Mental health providers use the DSM-5 to assess and identify mental health conditions using a common criteria, thus creating a standard method for diagnosing many different mental health conditions. With the introduction of WHODAS 2.0 in the most recent DSM, this method of assessing mental health disorders became the new standard of the American Psychiatric Association.
The WHODAS 2.0 is considered to be a more accurate assessment of an individual’s functioning because it is more reliable and accurate across different communities and geographic regions than the GAF. Additionally, because the WHODAS 2.0 is a self-administered test, it limits the physician’s role in the testing process, which has been shown to generate more reliable results compared to the GAF by lowering the possibility of cross-provider inconsistency.
The actual WHODAS 2.0 test consists of an assessment by the patient which evaluates his or her ability to perform in each of the following six domains over the last 30 days:
- Understanding and Communicating
- Getting Around (mobility)
- Getting along with people (social functioning and interpersonal functioning)
- Life activities (home, academic, and occupational functioning)
- Participation in society (participation in family, social, and community activities).
The test itself either comes in a 12 or 36 question format, and each format can be self-administered, proxy-administered, or rater-administered. There are two scoring methods available after the completion of the test, including a simple scoring method and a complex scoring method. The simple scoring method is done by hand and does not convert to a standardized scale. The complex method requires a computer to score based on item-response theory.
How Do These Assessments Relate To VA Disability Benefits?
Both the GAF and WHODAS 2.0 have been used by the VA to assess the severity of veterans’ mental health conditions. Though the GAF is now outdated, some physicians may still reference a veteran’s GAF score when presenting the history of the veteran’s condition, and decision ratings officers may consider GAF scores when determining possible effective date adjustments for a veteran’s condition. Determining the severity of a veteran’s mental health condition is incredibly important for rating purposes because the amount of compensation a veteran receives due to his or her service connected mental health condition is directly dependent on how much that condition impacts his or her ability to function. The outcome of a GAF or WHODAS 2.0 assessment could play a role in determining the schedular disability rating assigned to a veteran’s mental health condition, which in turn determines the amount of VA disability compensation the veteran will receive.
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If you are a veteran with a mental health condition who is looking for assistance with your VA disability claim, please contact our office today. Our experienced veterans disability lawyers are ready to help you get the compensation you deserve.