PART 4--SCHEDULE FOR RATING DISABILITIES Subpart B--Disability Ratings 4.129 Mental disorders due to traumatic stress.

Posted Tue 03 October 2006 12:33 PM Tue 03 October 2006 11:33 AM 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..................... 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.