Understanding The GAF Scale In California Workers’ Compensation Claims Arising From Psychological Injuries
Physical injuries aren’t the only consequence of industrial accidents in the state of California. Psychological injuries can also occur, whether directly from a traumatic event or series of events over time in the workplace, or indirectly as a side-effect of a physical injury. A direct psychological injury could result from verbal abuse from a co-worker, or from witnessing a terrible physical injury suffered at the workplace. An indirect psychological injury could be depression, anxiety, or loss of sleep caused by worry over the potential health or financial consequences of a physical injury. A hybrid injury – both physical and psychological – could be a sexual assault in the workplace.
Categorization of Injuries in California Workers’ Compensation Cases and the GAF Scale
In California, the categorization of an injury as physical, psychological, or both matters because of its bearing on the type of examination to be conducted on the injured employee. An employee suffering from only physical injuries will only be required to undergo a medical evaluation by a qualified medical examiner. In this type of evaluation, a neutral third-party doctor – loyal to neither the employee or employer – evaluates the nature and extent of the employee’s physical injuries. After reaching a determination as to the nature and extent, the doctor assigns a type and percentage of disability to the injuries, and estimates that employee’s future medical treatment needs. All of this information is included in a report – the request for authorization of medical treatment – that is sent for approval to the employer’s insurance carrier.
Whereas physical injuries resulting from an industrial accident in California are evaluated via the qualified medical examination process, psychological injuries are measured using the Global Assessment of Function (GAF) scale. This is because in the view of the psychology community, it is not helpful to measure impairment resulting from psychiatric disabilities using the percentage system applied by the American Medical Association to physical disabilities. This reflects a debate over certainty. More specifically, while it is not especially problematic to use percentages to gauge the permanent disability impact of a physical injury such as chronic lower back pain, the same cannot be said for impairment caused by mental disorders. Thus, the GAF scale seeks to replace the inflexible percentage system with an accounting of the many factors that affect mental and behavioral impairment.
Located on Axis V of the Multiaxial Assessment system created by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition 3, the GAF is a 100 point scale that ranges from 1 to 100. A rating of 1, for example, corresponds with impairments such as an ongoing and strong danger of hurting oneself or others or an inability to maintain personal hygiene. A rating of 100, for example, corresponds with advanced functioning an array of activities.
For a more in-depth understanding of the impact of GAF scale on an evaluation of any psychological injuries you have sustained in an industrial accident, contact an experienced California workers’ compensation attorney.