source: FOIAVistA/tag/r/AUTOMATED_MED_INFO_EXCHANGE-DVBA-DVBC/DVBCWPW1.m@ 628

DVBCWPW1 ;ALB/CMM PULMONARY TB AND MYCO. DIS. 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.  Activity of pulmonary tuberculosis or other mycobacterial disease.
 ;;
 ;; 
 ;;    2.  Date of inactivity if it is not active.
 ;;
 ;;
 ;;    3.  Identity of organism (if possible).
 ;;
 ;;
 ;;C.  Physical examination (Objective Findings):
 ;;
 ;;    Address each of the following and fully describe current findings:
 ;;    1.  Extent of structural damage to lungs.
 ;;
 ;;
 ;;    2.  If patient was hospitalized for 6 months or more, what is the
 ;;        condition at the end of hospitalization?
 ;;
 ;;
 ;;    3.  If patient was hospitalized for 12 months or more, what is the
 ;;        condition at the end of hospitalization?
 ;;
 ;;
 ;;D.  Diagnostic and Clinical Tests:
 ;;
 ;;    Provide:
 ;;    Pulmonary Function Tests, if indicated. When the results of 
 ;;    pre-bronchodilator pulmonary function tests are NORMAL, post-
 ;;    bronchodilator studies are not required for VA evaluation purposes.  
 ;;    IN ALL OTHER CASES, post-bronchodilator studies shuld be conducted
 ;;    unless contraindicated (because of allergy to medication, etc.) or
 ;;    if the veteran was on bronchodilators before the test and had taken 
 ;;    his or her medication within a few hours of the study.  An examiner 
 ;;    who determines that a post-bronchodilator study should not be 
 ;;    performed should provide an explanation of why not.  If there is 
 ;;    a disparity between the results of different pulmonary function 
 ;;    tests (FEV-1, FVC, etc.), the examiner should indicate which test
 ;;    result is the best indicator of the veteran's level of pulmonary 
 ;;    functioning.
 ;;
 ;;
 ;;E.  Diagnosis:
 ;;
 ;;    In reactivated cases, is this reactivation of the old disease or a
 ;;    separate and distinct new infection.  
 ;;
 ;;
 ;;
 ;;ADDITIONAL NOTE TO THE PHYSICIAN:
 ;;In all claims, if the disease is inactive and if the inactivity was 
 ;;confirmed at a non-VA facility, obtain the name and mailing address of
 ;;the facility from the veteran so that the Regional Office may request
 ;;the report.
 ;;
 ;;
 ;;Signature:                             Date:
 ;;END