DVBCWEA1 ;ALB/CMM EATING DISORDERS WKS TEXT - 1 ; 6 MARCH 1997 ;;2.7;AMIE;**12**;Apr 10, 1995 ; ; TXT ; ;;A. Review of Medical Records: ;; ;; ;; ;; ;;B. Medical History (Subjective Complaints): ;; ;; Comment on: ;; 1. PAST MEDICAL HISTORY ;; ;; a. Previous hospitalizations and outpatient care for parenteral ;; nutrition or tube feeding. ;; ;; ;; b. Medical and occupational history from the time between the ;; last such rating examination and the present needs to be ;; accounted for, UNLESS the purpose of this examination is to ;; ESTABLISH service connection, then a complete medical history ;; since discharge from military service is required. ;; ;; ;; c. Periods of incapacitation (during which bed rest and treatment ;; by a physician are required due to the eating disorder). ;; Describe the frequency and duration. ;; ;; ;; d. Current treatment, response, side effects. ;; ;; ;; 2. PRESENT MEDICAL, OCCUPATIONAL AND SOCIAL HISTORY - over the past ;; one year. ;; ;; a. History of onset of eating disorder. ;; ;; b. Its course, treatment, and current status to include symptoms. ;; ;; c. Extent of time lost from work over the past 12 month period ;; and social impairment. If employed, identify current occupation ;; and length of time at this job. ;; ;; ;; 3. SUBJECTIVE COMPLAINTS: ;; ;; a. Describe fully. ;; ;; ;;C. Examination (Objective Findings): ;; ;; Address each of the following and fully describe: ;; 1. Mental status exam to confirm or establish diagnosis in ;; accordance with DSM-IV. ;; ;; 2. Additionally, please provide this specific information. ;; ;; a. Current weight. ;; ;; ;; b. Expected minimum weight based on age, height, and body build. ;; ;; ;; c. Obtain weight history. ;; ;; ;; 3. Additionally, to allow evaluation by the rating specialist, ;; describe and fully explain the existence, frequency, and extent ;; of the following signs and symptoms and relate how they ;; interfere with employment: ;; ;; a. Binge eating. ;; ;; ;; b. Self-induced vomiting or other measure to prevent weight gain ;; when weight is already below expected minimum normal weight. ;; ;; ;;D. Diagnostic Tests (including psychological testing if deemed necessary): ;; ;; 1. Provide specific evaluation information required by the rating ;; board or on a BVA Remand. Diagnostic Tests (See the examination ;; request remarks for specifics.): ;; ;; a. COMPETENCY: State whether the veteran is capable of managing ;; his or her benefit payments in the individual's own best ;; interests. (A physical disability which prevents the veteran ;; from attending to financial matters in person is not a proper ;; basis for a finding of incompetency unless the veteran is, ;; by reason of that disability, incapable of directing someone ;; else in handling the individual's financial affairs.) ;; ;;TOF ;; b. OTHER OPINION: Furnish any other specific opinion requested ;; by the rating board or BVA Remand, furnishing the complete ;; rationale and citation of medical texts or treatise supporting ;; opinion, if medical literature review was undertaken. If the ;; requested opinion is medically not ascertainable on exam or ;; testing, please state WHY. If the requested opinion cannot ;; be expressed without resorting to speculation or making ;; improbable assumptions say so, and explain why. If the opinion ;; asks "...is it at least as likely as not...", fully explain ;; the clinical findings and rationale for the opinion. ;; ;; ;; 2. Include results of all diagnostic and clinical tests conducted ;; in the examination report. ;; ;; ;;E. Diagnosis: ;; ;; ;;Signature: Date: ;;END