source: FOIAVistA/tag/r/AUTOMATED_MED_INFO_EXCHANGE-DVBA-DVBC/DVBCWGW1.m@ 628

DVBCWGW1 ;ALB/JFP GULF WAR GUIDELINES WKS TEXT - 1 ; 13 FEB 1998
 ;;2.7;AMIE;**16**;Apr 10, 1995
 ;
 ;
TXT ;
 ;;Introduction:
 ;;  Disability examinations of Gulf War veterans have unique requirements
 ;;  because this group of veterans is eligible for compensation not only
 ;;  for disability due to diagnosed illnesses, but also for disability
 ;;  due to undiagnosed illnesses.  An undiagnosed illness is established
 ;;  when findings are present that cannot be attributed to a known,
 ;;  clearly defined diagnosis, after all likely diagnostic possibilities
 ;;  for such abnormalities have been ruled out.  Examiners should follow
 ;;  the guidelines in the "Handout of Instructions for Compensation and
 ;;  Pension Examinations" but will also need to request more laboratory
 ;;  tests and specialists' examinations than average in these cases.
 ;;
 ;;Guidelines:
 ;;1.  Thoroughly review the claims file.
 ;;2.  Address all conditions and symptoms specified on the examination
 ;;    request and also address all additional conditions and symptoms
 ;;    that you can elicit from the veteran during the examination, even
 ;;    if not specified on the request form.
 ;;3.  Conduct a comprehensive general medical examination, following the
 ;;    AMIE General Medical Examination worksheet.  For all conditions
 ;;    and symptoms which the General Medical Examination worksheet does
 ;;    not address in detail, follow the appropriate additional AMIE 
 ;;    worksheets, and request specialists' examinations as indicated.
 ;;    Provide details about the onset, frequency, duration, and severity
 ;;    of all complaints and state what precipitates and what relieves
 ;;    them.
 ;;4.  List all diagnosed conditions and state which symptoms, abnormal
 ;;    physical findings, and abnormal laboratory test results are
 ;;    associated with each.  If all symptoms, abnormal physical findings
 ;;    and abnormal laboratory test results are associated with a 
 ;;    diagnosed condition, additional specialist examinations for
 ;;    diagnostic purposes are not needed.  Diagnosed conditions will be
 ;;    handled as standard claims for service connection.  Symptom-based
 ;;    "diagnoses" such as (but not limited to) myalgia, arthralgia,
 ;;    headache, and diarrhea, are not considered as diagnosed conditions
 ;;    for compensation purposes. 
 ;;5.  However, if there are symptoms, abnormal physical findings, or
 ;;    abnormal laboratory test results that have not been determined to
 ;;    be part of a known clinical diagnosis, further specialist
 ;;    examinations will be required to address these findings.
 ;;6.  Provide the specialist with all examination reports and test
 ;;    results.  Specify the symptoms, abnormal physical findings, and
 ;;    abnormal laboratory test results that have not been attributed to
 ;;    a known clinical diagnosis.  Request that the specialist determine
 ;;    which of these, if any, can be attributed in this veteran to a
 ;;    known clinical diagnosis and which, if any, cannot be attributed
 ;;    in this veteran to a known clinical diagnosis.
 ;;7.  After the specialists' examinations have been completed, and all
 ;;    laboratory test results received, make a final report providing a
 ;;    list of diagnosed conditions.  Separately list all symptoms,
 ;;    abnormal physical findings, and abnormal laboratory test results
 ;;    that cannot be attributed to a known clinical diagnosis. Reconcile
 ;;    all differences among the examiners, by consultation or workgroup
 ;;    as necessary, before the examination is returned to the regional
 ;;    office.
 ;;
 ;;END