If the requested opinion cannot be expressed without resorting to speculation or making improbable assumptions say so, and explain why. Include results of all diagnostic and clinical tests conducted in the examination report. The Diagnosis must conform to DSM-IV and be supported by the findings on the examination report. If the diagnosis is changed, explain fully whether the new diagnosis represents a progression of the prior diagnosis or development of a new or separate condition. If there are multiple mental disorders, delineate to the extent possible the symptoms associated with each and a discussion of relationship.
Evaluation is based on the effects of the signs and symptoms on occupational and social functioning.
If it is not possible to separate the effects, state why. If so, include the GAF score and note whether it refers to current functioning over the past year, etc. If multiple Axis I or Axis II diagnoses exist, attempt to the extent possible, to provide a GAF score for the service connected conditions alone as well as a separate overall GAF score based on all mental disorders present, and explain and discuss your rationale. If it is not possible to separate the symptomatology, explain why.