Is a GAF Score of 65 Too High?

Every now and then I see a claim involving mental impairments where the GAF score assessed in the clinician's treatment notes is higher than you want to see as a disability lawyer. 

A GAF score of 65, for example, normally would not denote a disabling mental impairment. However, most of the GAF scores in a disability case are assessed in periods when claimant is not working. The GAF score would not necessarily remain as high should the claimant attempt to work.

This reasoning is recognized in Social Security's regulations and rulings. 20 C.F.R. Part 404, Subpart P, Appendix 1, § 12.00C3 states:

We must exercise great care in reaching conclusions about your ability or inability to complete tasks under the stresses of employment during a normal workday or work week based on a time-limited mental status examination or psychological testing by a clinician, or based on your ability to complete tasks in other settings that are less demanding, highly structured, or more supportive.

Social Security Ruling 85-15 states, in part:

The reaction to the demands of work (stress) is highly individualized, and mental illness is characterized by adverse responses to seemingly trivial circumstances. The mentally impaired may cease to function effectively when facing such demands as getting to work regularly, having their performance supervised, and remaining in the workplace for a full day. A person may become panicked and develop palpitations, shortness of breath, or feel faint while riding in an elevator; another may experience terror and begin to hallucinate when approached by a stranger asking a question. Thus, the mentally impaired may have difficulty meeting the requirement of even so-called "low stress" jobs.

First Circuit case law echoes this conclusion. See Lancellotta v. Sec'y, H.H.S., 806 F.2d 284 (1st Cir. 1986), which cites Ruling 85-15 and notes its requirement for an individualized consideration of the claimant's reaction to the stress of the workplace.

In summary, a GAF score of 65 is not what you want to see as a Social Security disability attorney for a claim relying principally on mental impairments. But it is not the end of the world, and the GAF score should be put in a proper context for the U.S. administrative law judge deciding the claim.

Comments

[Nick]

Excellent post. We encounter similar issues in the Eighth and Tenth Circuits.