Will My GAF Score Affect Whether I Can Get Social Security Disability?

The Global Assessment of Function (GAF) is a way of describing a person's symptoms and mental abilities on a scale of 1 to 100. The higher the score, the better the person functions. This rating system applies only to mental disorders, and the doctor completing the form is supposed to disregard any limitations caused by physical problems.

Although a low GAF score can support a disability claim based on mental health, the Social Security Administration (SSA) might not give it much weight—depending on the credentials of the health care provider who provided the score and the other medical evidence in your file.

Where GAF Scoring Comes From

The American Psychiatric Association (APA) periodically issues guidelines classifying mental disorders and their diagnoses, called the Diagnostic and Statistical Manual of Mental Disorders (DSM). The manual's fourth edition (DSM-IV) introduced the GAF scoring system.

The GAF score reflects a doctor or psychologist's subjective judgment of an applicant's symptom severity and psychological, social, and occupational functioning. To come up with the GAF score, the doctor or psychologist rates both symptom severity and functioning and then assigns a single composite score to account for both. When someone's functioning and symptoms fall into different score ranges, the GAF rating reflects the worse of the two.

GAF scores can be somewhat ambiguous because the GAF rating doesn't indicate:

• whether there's a difference in function and symptom scores
• which the rating reflects when function and symptom scores differ, or
• which specific mental abilities are being affected.

Social Security currently uses the fifth edition of the manual (DSM-5) as a loose framework for its mental disorder "listings," which specify the criteria an applicant must meet to automatically qualify as disabled. But DSM-5 dropped the GAF system because it was of little benefit to clinicians, and there were questions about its reliability.

So, for all disability claims filed after March 17, 2017, an applicant's GAF scores can only be considered as "other medical evidence," meaning they have little weight in a disability determination. Social Security has found the GAF system to be largely incompatible with its technique for evaluating mental impairments because they don't offer specific information about which functions are affected by mental health symptoms.

How Social Security Uses GAF Scores

Social Security considers GAF scores differently than other organizations when determining disability based on a mental impairment.

Social Security's Reliance on GAF Scores

Social Security has never had an official policy to grant disability benefits based on a GAF score. And the SSA generally doesn't rely on GAF scores to determine mental status. In fact, using GAF scores as the sole basis for a disability decision would violate Social Security regulations.

Social Security's technique for evaluating mental impairments is based on how much your impairment interferes with your ability to function. Because GAF ratings don't address specific functions, they can't be used as the basis for a disability finding for a mental impairment. (Note that your application for disability can't be denied just because of high GAF scores either.)

VA vs. SSA Disability

The Department of Veterans Affairs (VA) assigns great importance to the GAF scoring system for determining the severity of disability under their system. But the VA and Social Security disability systems don't work the same way. The two systems have very different disability determination processes.

For one, VA beneficiaries can have a partial disability rated as a percentage and receive a comparable benefit. But Social Security disability determinations are all or nothing—based on whether or not your condition prevents you from working. Social Security will either find that you're completely disabled or that you're not disabled.

Because of the differences between the two systems, a finding by the VA that you have a mental disability doesn't guarantee that Social Security will also find you disabled.

How Social Security Looks at Functioning

Social Security's listings for mental disorders contain specific criteria generally accepted by the medical community for making a diagnosis. Depending on the type of mental disorder, these clinical findings could include any of the following:

• memory problems
• fears
• intellectual difficulties
• hallucinations
• delusions
• fears, or
• other symptoms.

After confirming your diagnosis, your disorder's overall severity is decided using all the other information in your file. Specifically, severity is based on your capacity or incapacity to function independently and effectively in ways that would affect your ability to work. (20 C.F.R. § 404.1520a.) There are four areas of functioning that Social Security considers:

• your ability to understand, remember, or apply information
• social functioning (how you interact with others)
• your ability to concentrate and stay on a task until you finish in a reasonable amount of time, and
• self-management and the ability to adapt to changes.

If Social Security receives a GAF score as a part of your medical evidence, it's simply one element of your disability assessment. Your GAF score carries relatively little weight compared to more objective and detailed information about your mental disorder. That's because the GAF scoring criteria are very general, and the rating offers no information on how the score was reached.

GAF Scores Chart

The entire GAF scoring system can be put on a single page:

GAF Rating	Symptoms and Functioning
91-100	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.
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 occasional argument with family members).
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 failing behind in schoolwork).
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.
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).
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).
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).
21-30	Behavior is considerably influenced by delusions or hallucinations OR serious impairment in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) OR inability to function in almost all areas (e.g., stays in bed all day; no job, home, or friends).
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).
1-10	Persistent danger of severely hurting self or others (e.g., recurrent violence) OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death.
0	Inadequate information

GAF Scores Aren't Objective Medical Evidence

Social Security is required to decide if a disability applicant has a "medically determinable impairment." To fit this criterion, you must have a physical or psychological impairment that can be shown using medically accepted, objective evidence (like test results) that a claims examiner or judge can use to make an independent disability decision.

Consider an alleged heart attack, for example. To reach that diagnosis, Social Security would need objective tests, such as:

• heart tracings
• an imaging study, or
• enzymes from damaged heart muscle.

In contrast, the GAF score is someone's conclusion about how severe your symptoms are and/or how badly your functioning is impaired. GAF scores fail to have the quality of the standardized psychological testing, like IQ tests, that Social Security accepts for some listings. Since they aren't based on medically accepted testing or laboratory results, they prove nothing objectively. Social Security needs more evidence to get the complete picture of your mental impairment.

However, Social Security doesn't consider a GAF score meaningless. Like other opinion-based evidence, a GAF score is a pointer to a possible problem. Like an alleged heart attack, it points to the need for more objective evidence.

What if a low GAF score (which indicates severe symptoms and/or poor mental functioning) conflicts with other evidence that shows a much better ability to function? Because the GAF score is, by its nature, subjective, the conflict would require further investigation. Social Security can gather more evidence to either support or disagree with a GAF score by:

• contacting the applicant's treating doctor, psychologist, or therapist
• arranging for a mental status consultative examination with a doctor or psychologist paid for by Social Security
• getting more information from the applicant or family members, or
• contacting a former employer.

How Was Your GAF Score Used in Deciding Your Case?

When a Social Security claims examiner, medical consultant, or administrative law judge writes a rationale for an applicant's approval or denial, the reasoning used to make the decision should be explained. You'll generally find this information in the award letter or denial notice you receive.

If a high GAF score is in the applicant's file (meaning the applicant has a good ability to function mentally), but it doesn't fit with all the other evidence in a case, this also suggests a conflict that should be resolved. Resolving the conflict could sometimes be as simple as the claims examiner or medical consultant explaining why the other information in your file invalidates the high GAF score.

In a written rationale for denial, an applicant's file might mention a high GAF score as one factor supporting that conclusion. In a written rationale for approval of disability benefits, a low GAF score might similarly be cited as a part of consistent data supporting such a decision.

Whether high or low, a GAF score isn't a compelling piece of medical evidence because it's a vague expression of one person's opinion—and the SSA doesn't decide cases on vague opinions. Hence, GAF scores can be used only in the context of all the other evidence in your file.

Learn more about the kind of medical evidence you need to prove you're disabled, including what Social Security considers an acceptable medical source.

_{Updated October 30, 2023}