Many of the cases we handle involve mental impairments that either partially or fully disable a person from work activity. Although many conditions have "listings" that are considered in assessing a person's ability to work, mental impairments are unique.
Essentially, and Administrative Law Judge is looking at two issues with a mental impairment. First, is there a diagnosable condition? Second, assuming there is a diagnosable mental impairment, how much does it interfere with a person's ability to function in workplace?
Much of the framework been answering these questions comes from a publication known as the "Diagnostic and Statistical Manual of Mental Disorders, or "DSM" This is a dictionary of diagnoses published by the American Psychiatric Association. In prior editions, this publication included a metric known as the "global assessment of functioning," also referred to as "GAF." Social Security Judges often referred to the GAF when assessing a person's ability to function. However, the most recent edition of the DSM does not include the GAF. This raises the question as to whether Social Security would still consider this metric in determining whether a person is disabled for a mental impairment.
So far, it appears that Social Security will still consider the GAF as a form of opinion evidence. However, a recent policy statement clarifies how this fits into the overall assessment of mental impairment claims.
Essentially, the GAF is only one part of the puzzle. How much weight a decision maker gives to the GAF depends on whether it is consistent with other evidence in the file, and how familiar the person making the rating is with the particular claimant. The factors that judges and other decision makers must consider include the following:
1. There has to be some form of supporting evidence. It is often said that a GAF number is only a "snapshot opinion about the level of functioning at a particular time." Unless the person assigning the GAF rating explains the reasons behind the rating itself, it is not generally a reliable picture of the Claimant's ability to function over a period of time.
2. The GAF score is never the last word of the severity of an impairment. It does not get controlling weight from a treating mental health provider unless there is support for the assessment, and the assessment itself is consistent with other evidence in the file.
3. Nonetheless, in a treating mental health professional gives a GAF, it is a medical opinion, and if a judge wants to dismiss or reject the GAF, he or she must explain why.
4. This kind of rating is not helpful to diagnose and "intellectual disability" because it is not specific, and not a standardized measure of intelligence, which may be true for an IQ test or other intellectual testing.
5. The scores do not equate to a mental residual functional capacity assessment. In other words, the GAF is not the same as measuring the ability to meet the mental demands of unskilled work, and there is really no connection between a GAF score and the "B" criteria used in the mental disorder listings.
In other words, the GAF rating is helpful, but it will not be read in isolation, and must be consistent with the other evidence in the file.
If you are appealing a Social Security Disability denial involving a mental impairment, and have questions about medical opinions, call us at 503-325-8600. We have vast experience working with mental health providers to prove disability claims.