DVBCDACK ;ALB/GTS-557/THM-DISEASES OF THE ARTERIES/VEINS ; 12/26/90 12:23 PM ;;2.7;AMIE;;Apr 10, 1995 ; S PG=1,HD91="Department of Veterans Affairs" S HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet" EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 0105 Worksheet" S HD7="DISEASES OF THE ARTERIES AND VEINS (CARDIOVASCULAR)",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!! W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",?14,HD7 W !!!!,"Narrative:" W ?13,"Once a diagnosis is established, details about the",!?13,"permanent medical residuals and how they affect the",! W ?13,"veteran's industrial capabilities are very important as",!?13,"the degree of impairment is used by the rating board to",! W ?13,"determine the percentage of disability and payments therefore.",!! I '$D(CMBN) W "A. Medical history (if a disability is already service connected, then",!?22,"provide data since last VA rating examination):",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!!!!!!!!!!! D HD2 W $S($D(CMBN):"A. ",1:"D. "),"Specific evaluation information required by the rating board",!?4,"(if the information requested is included elsewhere, do not",!?4,"repeat here):",!!!?8,"1. Blood pressure -",!!!!!! W ?8,"2. Pulsation -",!!!!!!?8,"3. Skin appearance -",!!!!!! W ?8,"4. Skin temperature (to the touch) -",!!!!!!?8,"5. Paresthesias -",!!!!!! W ?8,"6. Cardiac involvement -",!!!!!! D:$D(CMBN) HD2 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!! D:'$D(CMBN) HD2 W $S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",! K LN,LN1,LN2 Q ; HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for "_NAME,! W HD8,!!! Q ; SETIOF ; ** Set device control var's D HOME^%ZIS Q