DVBCNKCK ;ALB/GTS-557/THM-NECK EXAM ; 12/10/90 2:06 PM ;;2.7;AMIE;;Apr 10, 1995 ; S PG=1,HD91="Department of Veterans Affairs",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet" EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1440 Worksheet" S HD7="NECK, ABNORMALITIES OF, ",HD6="NOT RESULT OF INJURY OR BONE DISEASE",HD8="For "_HD7_HD6 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!! W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7,!?14,HD6 W !!!!,"Narrative:" W ?13,"The report of examination should include any abnormal position",!?13,"of the head, range of motion of the head, evidence of",!?13,"paralysis of the neck muscles, and asymmetry produced by",!?13,"abnormal swelling or masses.",!! I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"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):",!!! W ?8,"1. Range of motion -",!!!!!?8,"2. Deformity -",!!!!!?8,"3. Weakness -",!!!!! W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!! D:$Y>50 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 ",HD7,!?5,HD6,!?5,"for "_NAME,!!! Q ; SETIOF ; ** Set device control var's D HOME^%ZIS Q