source: FOIAVistA/trunk/r/AUTOMATED_MED_INFO_EXCHANGE-DVBA-DVBC/DVBCARC1.m@ 1094

Last change on this file since 1094 was 628, checked in by George Lilly, 15 years ago

initial load of FOIAVistA 6/30/08 version

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1DVBCARC1 ;ALB ISC/THM-TEXT FOR A&A/HOUSEBOUND EXAM ; 5/17/91 9:16 AM
2 ;;2.7;AMIE;;Apr 10, 1995
3 ;
4PTXT F AW=0:1 S AX=$T(@TXT+AW) S AY=$P(AX,";;",2) D:AY["|TOP|" HD2^DVBCARCK W:AY="END" !! Q:AY="END" I AY'["|TOP|" W AY,!
5 G:TXT="TXT3" ^DVBCARC2 Q
6 ;
7TXT2 ;;A. Indicate whether or not the veteran REQUIRES an attendant in reporting
8 ;; for this exam, and if so, identify the nurse or attendant and the
9 ;; mode of travel employed:
10 ;;
11 ;;
12 ;;
13 ;;
14 ;;
15 ;;
16 ;;B. Indicate whether or not the veteran is hospitalized, and if so, state
17 ;; where and the date of admission:
18 ;;
19 ;;
20 ;;
21 ;;
22 ;;
23 ;;
24 ;;C. Indicate whether or not the veteran is blind (best corrected vision
25 ;; is 5/200 or worse in both eyes, or central vision field is five degrees
26 ;; or less) or is permanently bedridden (if either skip items "D" through
27 ;; "I" and go directly to "J"):
28 ;;END
29TXT3 ;;
30 ;;
31 ;;
32 ;;F. Extremeties and spine:
33 ;;
34 ;; 1. Upper extremities (reporting each upper extremity separately) -
35 ;;
36 ;; a. Describe functional restrictions with reference to strength
37 ;;and coordination and ability for self-feeding, fastening clothing, bathing,
38 ;;shaving, and attending to the needs of nature -
39 ;;
40 ;;
41 ;;
42 ;;
43 ;;
44 ;;
45 ;;
46 ;; b. Indicate level of amputation or length of stump and state
47 ;;whether or not use of prothesis is feasible -
48 ;;|TOP|
49 ;;
50 ;;
51 ;; 2. Lower extremities (reporting each lower extremity separately) -
52 ;;
53 ;; a. Describe functional restrictions with reference to extent
54 ;;of limitation of motion, muscle atrophy, contractures, weakness, lack
55 ;;of coordination, or other interference -
56 ;;
57 ;;
58 ;;
59 ;; b. Indicate any deficits of weight bearing, balance and propulsion -
60 ;;
61 ;;
62 ;;
63 ;;
64 ;;
65 ;; c. If amputated, give level or length of stump and whether use
66 ;;of prosthesis is feasible -
67 ;;
68 ;;
69 ;;
70 ;;
71 ;;
72 ;; 3. Spine, trunk, and neck -
73 ;;
74 ;; a. Describe any limitation of motion or deformity of lumbar,
75 ;;thoracic, and cervical spine -
76 ;;
77 ;;
78 ;;
79 ;;
80 ;;
81 ;; b. Note if deformity of thoracic spine interferes with breathing -
82 ;;
83 ;;
84 ;;
85 ;;
86 ;;
87 ;;
88 ;;G. Capacity to protect oneself from the hazards/dangers of daily environment:
89 ;;
90 ;; 1. Describe briefly any pathological processes involving other body
91 ;;parts and systems, including the effects of advancing age, such as dizziness,
92 ;;loss of memory, poor balance affecting ability to ambulate, perform self-
93 ;;care, or travel beyond the premises of the home or the ward or clinical
94 ;;area if hospitalized -
95 ;;|TOP|
96 ;; 2. Describe where the veteran goes and what he/she does during a
97 ;;typical day -
98 ;;
99 ;;
100 ;;
101 ;;
102 ;;
103 ;;
104 ;;END
105 ;
106TXT10 ;;Once the existence of at least one permanent disability
107 ;; rated as being 100% disabling has been established, additional
108 ;; benefits are payable if the veteran is so helpless as to require
109 ;; the regular aid and attendance of another person in attending to
110 ;; the ordinary activities of daily living, or in protecting
111 ;; himself/herself from the ordinary hazards of his/her daily
112 ;; environment, or is restricted to his/her home or the immediate
113 ;; vicinity thereof, including the ward or immediate clinical area,
114 ;; if hospitalized.
115 ;;
116 ;; If a general medical examination is included as a part of this
117 ;; request specific findings as to the individual body systems and
118 ;; extremeties already noted in that examination need not be repeated.
119 ;; Items "G" through "L", as the examiner deems appropriate, must be
120 ;; completed in all cases unless the veteran is blind or permanently
121 ;; bedridden (see item "C").
122 ;;
123 ;;END
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