PART 4--SCHEDULE FOR RATING DISABILITIES

Subpart B--Disability Ratings

4.129 Mental disorders due to traumatic stress.

General Rating Formula for Mental Disorders:
Total occupational and social impairment, due to
such symptoms as: gross impairment in thought
processes or communication; persistent delusions
or hallucinations; grossly inappropriate behavior;
persistent danger of hurting self or others;
intermittent inability to perform activities of
daily living (including maintenance of minimal
personal hygiene); disorientation to time or
place; memory loss for names of close relatives,
own occupation, or own name....................... 100
Occupational and social impairment, with
deficiencies in most areas, such as work, school,
family relations, judgment, thinking, or mood, due
to such symptoms as: suicidal ideation;
obsessional rituals which interfere with routine
activities; speech intermittently illogical,
obscure, or irrelevant; near-continuous panic or
depression affecting the ability to function
independently, appropriately and effectively;
impaired impulse control (such as unprovoked
irritability with periods of violence); spatial
disorientation; neglect of personal appearance and
hygiene; difficulty in adapting to stressful
circumstances (including work or a worklike
setting); inability to establish and maintain
effective relationships........................... 70
Occupational and social impairment with reduced
reliability and productivity due to such symptoms
as: flattened affect; circumstantial,
circumlocutory, or stereotyped speech; panic
attacks more than once a week; difficulty in
understanding complex commands; impairment of
short- and long-term memory (e.g., retention of
only highly learned material, forgetting to
complete tasks); impaired judgment; impaired
abstract thinking; disturbances of motivation and
mood; difficulty in establishing and maintaining
effective work and social relationships........... 50
Occupational and social impairment with occasional
decrease in work efficiency and intermittent
periods of inability to perform occupational tasks
(although generally functioning satisfactorily,
with routine behavior, self-care, and conversation
normal), due to such symptoms as: depressed mood,
anxiety, suspiciousness, panic attacks (weekly or
less often), chronic sleep impairment, mild memory
loss (such as forgetting names, directions, recent
events)........................................... 30
Occupational and social impairment due to mild or
transient symptoms which decrease work efficiency
and ability to perform occupational tasks only
during periods of significant stress, or; symptoms
controlled by continuous medication............... 10
A mental condition has been formally diagnosed, but
symptoms are not severe enough either to interfere
with occupational and social functioning or to
require continuous medication.....................

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Global Assessment of Functioning (GAF)
Scale (DSM - IV Axis V)

Basic description of functioning

91 - 100
Person has no problems, or has superior functioning in several areas, or is admired and sought after by others due to positive qualities

81 - 90
Person has few, or or no symptoms. Good functioning in several areas. No more than everyday problems or concerns.

71 - 80
Person has symptoms/problems, but they are temporary, expectable reactions to stressors. There is no more than slight impairment in any area of psychological functioning.

61 - 70
Mild symptoms in one area OR difficulty in one of the following: social, occupational, or school functioning. Thus, the person is generally functioning pretty well and has some meaningful interpersonal relationships.

51 - 60
Moderate symptoms, or moderate difficulty in one of the following: social, occupational, or school functioning.

41 - 50
Serious symptoms, or serious impairment in one of the following: social, occupational, or school functioning.

31 - 40
Some impairment in reality testing, or impairment in speech and communication, or serious impairment in several of the following: occupational or school functioning, interpersonal relationships, judgment, thinking, or mood.

21 - 30
Presence of hallucinations or delusions which influence behavior, or serious impairment in ability to communicate with others OR serious impairment in judgment, or inability to function in almost all areas.

11 - 20
There is some danger of harm to self, or others, or occasional failure to maintain personal hygiene, or the person is virtually unable to communicate with others due to being incoherent or mute.

1 - 10
Persistent danger of harming self or others OR persistent inability to maintain personal hygiene, or the person has made a serious attempt at suicide.


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CHAPTER I--DEPARTMENT OF VETERANS AFFAIRS

PART 4--SCHEDULE FOR RATING DISABILITIES--Table of Contents

Subpart A--General Policy in Rating

Sec. 4.25 Combined ratings table.

Table I, Combined Ratings Table, results from the consideration of
the efficiency of the individual as affected first by the most disabling
condition, then by the less disabling condition, then by other less
disabling conditions, if any, in the order of severity. Thus, a person
having a 60 percent disability is considered 40 percent efficient.
Proceeding from this 40 percent efficiency, the effect of a further 30
percent disability is to leave only 70 percent of the efficiency
remaining after consideration of the first disability, or 28 percent
efficiency altogether. The individual is thus 72 percent disabled, as
shown in table I opposite 60 percent and under 30 percent.
(a) To use table I, the disabilities will first be arranged in the
exact order of their severity, beginning with the greatest disability
and then combined with use of table I as hereinafter indicated. For
example, if there are two disabilities, the degree of one disability
will be read in the left column and the degree of the other in the top
row, whichever is appropriate. The figures appearing in the space where
the column and row intersect will represent the combined value of the
two. This combined value will then be converted to the nearest number
divisible by 10, and combined values ending in 5 will be adjusted
upward. Thus, with a 50 percent disability and a 30 percent disability,
the combined value will be found to be 65 percent, but the 65 percent
must be converted to 70 percent to represent the final degree of
disability. Similarly, with a disability of 40 percent, and another
disability of 20 percent, the combined value is found to be 52 percent,
but the 52 percent must be converted to the nearest degree divisible by
10, which is 50 percent. If there are more than two disabilities, the
disabilities will also be arranged in the exact order of their severity
and the combined value for the first two will be found as previously
described for two disabilities. The combined value, exactly as found in
table I, will be combined with the degree of the third disability (in
order of severity). The combined value for the three disabilities will
be found in the space where the column and row intersect, and if there
are only three disabilities will be converted to the nearest degree
divisible by 10, adjusting final 5's upward. Thus, if there are three
disabilities ratable at 60 percent, 40 percent, and 20 percent,
respectively, the combined value for the first two will be found
opposite 60 and under 40 and is 76 percent. This 76 will be combined
with 20 and the combined value for the three is 81 percent. This
combined value will be converted to the nearest degree divisible by 10
which is 80 percent. The same procedure will be employed when there are
four or more disabilities. (See table I).
(b) Except as otherwise provided in this schedule, the disabilities
arising from a single disease entity, e.g., arthritis, multiple
sclerosis, cerebrovascular accident, etc., are to be rated separately as
are all other disabiling conditions, if any. All disabilities are

[[Page 365]]

then to be combined as described in paragraph (a) of this section. The
conversion to the nearest degree divisible by 10 will be done only once
per rating decision, will follow the combining of all disabilities, and
will be the last procedure in determining the combined degree of
disability.

Table I--Combined Ratings Table
[10 combined with 10 is 19]
----------------------------------------------------------------------------------------------------------------
10 20 30 40 50 60 70 80 90
----------------------------------------------------------------------------------------------------------------
19...................................... 27 35 43 51 60 68 76 84 92
20...................................... 28 36 44 52 60 68 76 84 92
21...................................... 29 37 45 53 61 68 76 84 92
22...................................... 30 38 45 53 61 69 77 84 92
23...................................... 31 38 46 54 62 69 77 85 92
24...................................... 32 39 47 54 62 70 77 85 92
25...................................... 33 40 48 55 63 70 78 85 93
26...................................... 33 41 48 56 63 70 78 85 93
27...................................... 34 42 49 56 64 71 78 85 93
28...................................... 35 42 50 57 64 71 78 86 93
29...................................... 36 43 50 57 65 72 79 86 93
30...................................... 37 44 51 58 65 72 79 86 93
31...................................... 38 45 52 59 66 72 79 86 93
32...................................... 39 46 52 59 66 73 80 86 93
33...................................... 40 46 53 60 67 73 80 87 93
34...................................... 41 47 54 60 67 74 80 87 93
35...................................... 42 48 55 61 68 74 81 87 94
36...................................... 42 49 55 62 68 74 81 87 94
37...................................... 43 50 56 62 69 75 81 87 94
38...................................... 44 50 57 63 69 75 81 88 94
39...................................... 45 51 57 63 70 76 82 88 94
40...................................... 46 52 58 64 70 76 82 88 94
41...................................... 47 53 59 65 71 76 82 88 94
42...................................... 48 54 59 65 71 77 83 88 94
43...................................... 49 54 60 66 72 77 83 89 94
44...................................... 50 55 61 66 72 78 83 89 94
45...................................... 51 56 62 67 73 78 84 89 95
46...................................... 51 57 62 68 73 78 84 89 95
47...................................... 52 58 63 68 74 79 84 89 95
48...................................... 53 58 64 69 74 79 84 90 95
49...................................... 54 59 64 69 75 80 85 90 95
50...................................... 55 60 65 70 75 80 85 90 95
51...................................... 56 61 66 71 76 80 85 90 95
52...................................... 57 62 66 71 76 81 86 90 95
53...................................... 58 62 67 72 77 81 86 91 95
54...................................... 59 63 68 72 77 82 86 91 95
55...................................... 60 64 69 73 78 82 87 91 96
56...................................... 60 65 69 74 78 82 87 91 96
57...................................... 61 66 70 74 79 83 87 91 96
58...................................... 62 66 71 75 79 83 87 92 96
59...................................... 63 67 71 75 80 84 88 92 96
60...................................... 64 68 72 76 80 84 88 92 96
61...................................... 65 69 73 77 81 84 88 92 96
62...................................... 66 70 73 77 81 85 89 92 96
63...................................... 67 70 74 78 82 85 89 93 96
64...................................... 68 71 75 78 82 86 89 93 96
65...................................... 69 72 76 79 83 86 90 93 97
66...................................... 69 73 76 80 83 86 90 93 97
67...................................... 70 74 77 80 84 87 90 93 97
68...................................... 71 74 78 81 84 87 90 94 97
69...................................... 72 75 78 81 85 88 91 94 97
70...................................... 73 76 79 82 85 88 91 94 97
71...................................... 74 77 80 83 86 88 91 94 97
72...................................... 75 78 80 83 86 89 92 94 97
73...................................... 76 78 81 84 87 89 92 95 97
74...................................... 77 79 82 84 87 90 92 95 97
75...................................... 78 80 83 85 88 90 93 95 98
76...................................... 78 81 83 86 88 90 93 95 98
77...................................... 79 82 84 86 89 91 93 95 98
78...................................... 80 82 85 87 89 91 93 96 98
79...................................... 81 83 85 87 90 92 94 96 98
80...................................... 82 84 86 88 90 92 94 96 98
81...................................... 83 85 87 89 91 92 94 96 98
82...................................... 84 86 87 89 91 93 95 96 98
83...................................... 85 86 88 90 92 93 95 97 98

[[Page 366]]


84...................................... 86 87 89 90 92 94 95 97 98
85...................................... 87 88 90 91 93 94 96 97 99
86...................................... 87 89 90 92 93 94 96 97 99
87...................................... 88 90 91 92 94 95 96 97 99
88...................................... 89 90 92 93 94 95 96 98 99
89...................................... 90 91 92 93 95 96 87 38 99
90...................................... 91 92 93 94 95 96 97 98 99
91...................................... 92 93 94 95 96 96 97 98 99
92...................................... 93 94 94 95 96 97 98 98 99
93...................................... 94 94 95 96 97 97 98 99 99
94...................................... 95 95 96 96 97 98 98 99 99
----------------------------------------------------------------------------------------------------------------


(Authority: 38 U.S.C. 1155)

[41 FR 11293, Mar. 18, 1976, as amended at 54 FR 27161, June 28, 1989;
54 FR 36029, Aug. 31, 1989]

Notice
Please do not post on this topic. There is no reason for posting. Go to Open Discussion or a topic addressing your statement or inquiry.
Thanks,

Sir,
All this is so hard to figure out,of what it
actualy means...With a GAF score. I have just
compleated The PTSD residential rehabilitation
program at Miami VA Health care.Feb.20-May9th.
And have been given a GAFscore of 45,what dose
this mean?? If possable Email me at
wwlove@bellsouth.net All I realy Know is I
Have suffered with this for 38+years...
W.W.Love

WW
I have e-mailed an answer to you.
GAF is how well you function in everyday life a 45 is where you have a difficult time in adjusting with people in all functions. Please check the PTSD forum Open Discussion and get involved there.

Dave

quote:

Originally posted by DaveBarker:
Notice
Please do not post on this topic. There is no reason for posting. Go to Open Discussion or a topic addressing your statement or inquiry.
Thanks,

A GAF score of, say, 45, is a severe impairment in the Activities of Daily Living, which are referred to as the ADL's. For more information about GAF scores, go right here.