DVBCWRO1 ;ALB/ESW RESPIRATORY WKS TEXT - 1 ; 6 OCT 2000 ;;2.7;AMIE;**34**;Apr 10, 1995 ; ; TXT ; ;;A. Review of Medical Records: ;; ;;B. Medical History (Subjective Complaints): ;; Comment on: ;; ;; 1. Productive cough, sputum, hemoptysis, and/or anorexia. ;; 2. Extent of dyspnea on exertion. ;; 3. If veteran is asthmatic, report frequency of attacks and ;; baseline functional status between attacks. ;; 4. Treatment (type, frequency and duration including a need for ;; oxygen), response, side effects. ;; 5. Describe frequency and duration of any periods of incapacitation ;; (defined as requiring bed rest and treatment by a physician). ;; ;;C. Physical Examination (Objective Findings): ;; ;; Address each of the following as appropriate to the condition ;; being examined and fully describe current findings: ;; ;; 1. Presence of cor pulmonale, RVH, or pulmonary hypertension. ;; 2. Weight loss or gain. ;; 3. For restrictive disease, describe condition underlying restrictive ;; disease, e.g., kyphoscoliosis, pectus excavatum, etc., unless already ;; of record. ;; ;;D. Diagnostic and Clinical Tests: ;;Provide: ;; ;;1. PULMONARY FUNCTION TESTS (unless carried out within past six months and ;; the report is either in the claims folder or will be attached to this ;; examination report, e.g., PFT's were in VAMC records at your facility). ;; Spirometric pulmonary function testing should include FVC,FEV-1, and ;; the FEV-1/FVC ratio. Both pre- and post-bronchodilatation test results should ;; be reported. If post-bronchodilatation testing is not conducted ;; in a particular case, please provide an explanation of why not. A DLCO may ;; or may not be done routinely as part of pulmonary function testing ;; at a particular facility. If there is a disparity between the results of ;; different tests, please indicate which tests are more likely to accurately ;; reflect the severity of the condition. ;;TOF ;; DLCO note: ;; If the DLCO was not done as a routine part of pulmonary function testing, ;; the examiner should use his or her judgment, based on the specific ;; condition (e.g., whether it is obstructive, interstitial, etc.) and ;; other available information about the condition, as to whether a DLCO test ;; is needed, since it is not useful in all situations. If it may provide ;; useful information about the severity of the condition, it should be ;; requested and reviewed before the examination report is submitted. ;; If the examiner determines that the DLCO test is not needed, a statement ;; as to why not (e.g., there are decreased lung volumes that would not yield ;; valid test results) should be included in the report. Such a statement ;; could avoid a remand from BVA when the test is not done. However, ;; in the case of a BVA remand in which the DLCO is requested, the DLCO MUST ;; be done unless there is a medical contraindication. ;; ;;2. Chest X-ray (if no recent results available). ;;3. Include results of all diagnostic and clinical tests conducted ;; in the examination report. ;; ;;E. Diagnosis: ;; ;; ;;Signature: Date: ;;END