DVBCARC1 ;ALB ISC/THM-TEXT FOR A&A/HOUSEBOUND EXAM ; 5/17/91 9:16 AM ;;2.7;AMIE;;Apr 10, 1995 ; PTXT F AW=0:1 S AX=$T(@TXT+AW) S AY=$P(AX,";;",2) D:AY["|TOP|" HD2^DVBCARCK W:AY="END" !! Q:AY="END" I AY'["|TOP|" W AY,! G:TXT="TXT3" ^DVBCARC2 Q ; TXT2 ;;A. Indicate whether or not the veteran REQUIRES an attendant in reporting ;; for this exam, and if so, identify the nurse or attendant and the ;; mode of travel employed: ;; ;; ;; ;; ;; ;; ;;B. Indicate whether or not the veteran is hospitalized, and if so, state ;; where and the date of admission: ;; ;; ;; ;; ;; ;; ;;C. Indicate whether or not the veteran is blind (best corrected vision ;; is 5/200 or worse in both eyes, or central vision field is five degrees ;; or less) or is permanently bedridden (if either skip items "D" through ;; "I" and go directly to "J"): ;;END TXT3 ;; ;; ;; ;;F. Extremeties and spine: ;; ;; 1. Upper extremities (reporting each upper extremity separately) - ;; ;; a. Describe functional restrictions with reference to strength ;;and coordination and ability for self-feeding, fastening clothing, bathing, ;;shaving, and attending to the needs of nature - ;; ;; ;; ;; ;; ;; ;; ;; b. Indicate level of amputation or length of stump and state ;;whether or not use of prothesis is feasible - ;;|TOP| ;; ;; ;; 2. Lower extremities (reporting each lower extremity separately) - ;; ;; a. Describe functional restrictions with reference to extent ;;of limitation of motion, muscle atrophy, contractures, weakness, lack ;;of coordination, or other interference - ;; ;; ;; ;; b. Indicate any deficits of weight bearing, balance and propulsion - ;; ;; ;; ;; ;; ;; c. If amputated, give level or length of stump and whether use ;;of prosthesis is feasible - ;; ;; ;; ;; ;; ;; 3. Spine, trunk, and neck - ;; ;; a. Describe any limitation of motion or deformity of lumbar, ;;thoracic, and cervical spine - ;; ;; ;; ;; ;; ;; b. Note if deformity of thoracic spine interferes with breathing - ;; ;; ;; ;; ;; ;; ;;G. Capacity to protect oneself from the hazards/dangers of daily environment: ;; ;; 1. Describe briefly any pathological processes involving other body ;;parts and systems, including the effects of advancing age, such as dizziness, ;;loss of memory, poor balance affecting ability to ambulate, perform self- ;;care, or travel beyond the premises of the home or the ward or clinical ;;area if hospitalized - ;;|TOP| ;; 2. Describe where the veteran goes and what he/she does during a ;;typical day - ;; ;; ;; ;; ;; ;; ;;END ; TXT10 ;;Once the existence of at least one permanent disability ;; rated as being 100% disabling has been established, additional ;; benefits are payable if the veteran is so helpless as to require ;; the regular aid and attendance of another person in attending to ;; the ordinary activities of daily living, or in protecting ;; himself/herself from the ordinary hazards of his/her daily ;; environment, or is restricted to his/her home or the immediate ;; vicinity thereof, including the ward or immediate clinical area, ;; if hospitalized. ;; ;; If a general medical examination is included as a part of this ;; request specific findings as to the individual body systems and ;; extremeties already noted in that examination need not be repeated. ;; Items "G" through "L", as the examiner deems appropriate, must be ;; completed in all cases unless the veteran is blind or permanently ;; bedridden (see item "C"). ;; ;;END