The Global Assessment of Functioning (GAF) score was historically utilized by mental health professionals to gauge an individual’s overall psychological, social, and occupational function. This scale provided clinicians with a standardized method to rate how well a person was managing the challenges of daily life. The GAF was prominently featured as Axis V in the multi-axial diagnostic system of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). It was intended to offer a simple, global rating of severity independent of a specific psychiatric diagnosis.
Decoding the GAF Scale
The GAF is a 100-point scale, with higher scores indicating better mental health and functional capacity, and lower scores signifying more severe impairment. The scale is divided into ten 10-point ranges, each describing a different level of functioning and symptom severity. For example, a score between 91 and 100 represents superior functioning across a wide range of activities with virtually no symptoms. Conversely, the 61 to 70 range describes a person with some mild symptoms or some difficulty in social or occupational settings, though they are generally functioning well.
Progression down the scale marks a clear deterioration in real-world capacity and an increase in symptom severity. A score in the 41 to 50 range indicates either serious symptoms, like frequent suicidal ideation or severe obsessional rituals, or any serious impairment in functioning. The lowest scores, 1 to 10, are reserved for individuals who pose a persistent danger of severely hurting themselves or others, or who are nearly incapable of maintaining minimal personal hygiene. Clinicians are instructed to assign the score that reflects the worse of the two—symptom severity or level of functioning—at the time of the evaluation.
The Disability Threshold: What Score Qualifies?
While no single GAF score is legally mandated to qualify a person as disabled, administrative bodies often use the scale as a benchmark for severe functional limitation. The Social Security Administration (SSA), for instance, has historically considered a GAF score of 50 or below as a strong indicator of the functional impairment required for disability benefits. A score in the 41–50 range suggests a substantial inability to perform work-related activities or maintain social function, which aligns with the SSA’s criteria for a severe impairment. This range explicitly includes serious impairment in occupational functioning, such as being unable to keep a job.
The GAF score is used as medical evidence that corroborates a claimant’s reported functional limitations, but it is not the sole deciding factor in a disability determination. Since 2017, the SSA officially views the GAF score as “other medical evidence,” meaning it carries less weight than detailed medical reports and objective findings. An adjudicator must look beyond the number itself to confirm that the documented symptoms and limitations correlate directly with the assigned score. Consistently low GAF scores over a prolonged period can support a claim by demonstrating enduring and substantial functional limitations.
Why GAF is No Longer Standard
The GAF scale was eliminated from the DSM-5 due to concerns regarding its reliability and validity. Critics noted that the scale lacked conceptual clarity because it attempted to combine symptom severity, which can fluctuate rapidly, with enduring functional impairment into a single number. This conflation often led to poor inter-rater reliability, meaning different clinicians could assign significantly different GAF scores to the same individual. The American Psychiatric Association decided the GAF did not adequately serve as a measure of functional impairment for modern clinical use.
The DSM-5 now encourages clinicians to use the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) as a preferred measure of functioning and disability. WHODAS 2.0 is a more detailed, multi-domain assessment that aligns with international standards for health information. Despite its clinical obsolescence, the GAF score persists in administrative and legal contexts, including disability claims and court records. This persistence is due to the fact that older medical records still contain GAF scores, and some governmental agencies have been slow to transition to the newer assessment tools.