source: FOIAVistA/tag/r/AUTOMATED_MED_INFO_EXCHANGE-DVBA-DVBC/DVBCWPG3.m@ 628

DVBCWPG3 ;ALB/RLC - REVIEW EXAM PTSD WORKSHEET TEXT ; 05/18/2006 12:00pm
 ;;2.7;AMIE;**87**;Apr 10, 1995;Build 6
 ;Per VHA Directive 10-92-142, this routine should not be modified
 ;
TXT ;
 ;;
 ;;M.  Effects of PTSD on Occupational and Social Functioning
 ;;
 ;;Evaluation of PTSD is based on its effects on occupational and social
 ;;functioning.  Select the appropriate assessment of the veteran from the
 ;;choices below:
 ;;
 ;;   - Total occupational and social impairment due to PTSD signs and symptoms.
 ;;
 ;;     Provide examples and pertinent symptoms, including those already reported.
 ;;
 ;;                           OR
 ;;
 ;;   - PTSD signs and symptoms result in deficiencies in most of the following
 ;;     areas:
 ;;     work, school, family relations, judgment, thinking, and mood.
 ;;
 ;;     Provide examples and pertinent symptoms, including those already 
 ;;     reported for each affected area.
 ;;TOF
 ;;                           OR
 ;;
 ;;   - There is reduced reliability and productivity due to PTSD signs and
 ;;     symptoms.
 ;;
 ;;     Provide examples and pertinent symptoms, including those already reported.
 ;;
 ;;                           OR
 ;;
 ;;   - There is occasional decrease in work efficiency or there are intermittent
 ;;     periods of inability to perform occupational tasks due to signs and
 ;;     symptoms, but generally satisfactory functioning (routine behavior,
 ;;     self-care, and conversation normal).
 ;;
 ;;     Provide examples and pertinent symptoms, including those already reported.
 ;;
 ;;                           OR
 ;;
 ;;   - There are PTSD signs and symptoms that are transient or mild and
 ;;     decrease work efficiency and ability to perform occupational tasks
 ;;     only during periods of significant stress.
 ;;
 ;;     Provide examples and pertinent symptoms, including those already reported.
 ;;
 ;;                           OR
 ;;
 ;;   - PTSD symptoms require continuous medication.
 ;;
 ;;                           OR
 ;;
 ;;   - Select all that apply.
 ;;   - PTSD symptoms are not severe enough to require continuous medication.
 ;;   - PTSD symptoms are not severe enough to interfere with occupational
 ;;     and social functioning.
 ;;
 ;;
 ;;   Include your name; your credentials, (i.e., board certified psychiatrist,
 ;;   licensed psychologist, psychiatry resident or psychology intern,
 ;;   LCSW, or NP); circumstances under which you performed the examination,
 ;;   if applicable (i.e., under the close supervision of an attending
 ;;   psychiatrist or psychologist); name of supervising psychiatrist or
 ;;   psychologist, if applicable.
 ;;
 ;;
 ;;Signature:                                               Date:
 ;;
 ;;
 ;;Signature of Supervising
 ;;psychiatrist or psychologist:                            Date:
 ;;END