Yuku free message boards

MoNamVet wrote:

---

In reading the Best Practice Manual for PTSD, it goes into alot of the problems with the GAF score. Talks about the reliability problems, bias problems, co-morbidity problems. That said, I don't know the answer to your question, maybe some of the experts will weigh in.

MoNamVet is correct that the Best Practices Manual for PTSD does discuss GAF scores. To paraphrase the manual, the GAF should support the rating, not the rating support the GAF.  In other words (and this is not where co-morbid mental health issues are present), the rater should first determine the level of disability, such as moderate social and occupational impairment and the GAF score should support that rating.  In this example a GAF of 55 would reflect moderate impairment.

The manual goes on to say that if there is a wide variation between the GAF and the rating, the rater should explain this in the decision.  However, I have yet to hear of any decision where this has, in fact, occurred.

In my NOD, I pointed out the GAF score, the facts in the exam and the obvious fault in the opinion based upon the examiner's narrative.  I was first rated at 50% due to "moderate impairment."  The GAF score was 42, no other AXIS I except PTSD, and the examiner said that I was unemployed for two years and could not maintain employment due to my PTSD.  Obviously, the moderate assertion, with the GAF and the narrative were not in line.

It really all goes to how badly you are occupationally and socially impaired, with the emphasis on the occupational  more than the social impairment.  This is the main focus in PTSD disability.  If you have PTSD,  but are high functioning (long work history, long term relationship, minor symptoms), you will probably be rated 0 to 10%.   If you are mildly impacted by your PTSD, a rating of 10 to 30%, moderately 50 to 70%  and severely 70% (to possibly include I/U) or 100%.  These are ranges and given the same set of facts, different raters reach different conclusions as to the extent to disability.  So, IMHO, rating is a highly developed art form and not a science.