1 | DVBCPICK ;ALB/GTS-557/THM-NON TB DISEASES/INJURIES ; 6/27/91 12:56 PM
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2 | ;;2.7;AMIE;;Apr 10, 1995
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3 | ;
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4 | S PG=1,HD91="Department of Veterans Affairs",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
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5 | EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
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6 | W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1505 Worksheet" S HD7="NON-TUBERCULOUS DISEASES AND INJURIES OF THE RESPIRATORY SYSTEM",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
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7 | W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
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8 | W !!!!,"Narrative:"
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9 | F I=1:1 S LY=$T(TXT+I) Q:LY["END" W ?13,$P(LY,";;",2),! I $Y>55 D HD2
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10 | W !! I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",! D HD2
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11 | W $S($D(CMBN):"A. ",1:"D. "),"Specific evaluation information required by the rating board",!?4,"(if the information requested is included elsewhere, do not",!?4,"repeat here):",!!!
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12 | W ?8,"1. State if active malignant process is present. If so, nothing",!?11,"further is needed -",!!!!!!
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13 | W ?8,"2. If malignancy is inactive, report date/place of last",!?11,"surgery, radiation or chemical therapy -",!!!!!!
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14 | W ?8,"3. For non-malignant diseases, injuries, residuals of inactive or",!?11,"cured malignancies -",!!?11,"a. Report structural changes to the lungs -",!!!!! D:$D(CMBN) HD2
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15 | W ?11,"b. Provide pulmonary function studies -",!!!!!
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16 | W ?11,"c. Schedule additional special studies as necessary to evaluate",!?15,"any extra-pulmonary manifestations that may be detected -",!!!!!!
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17 | W ?11,"d. State whether the disease is in remission or demonstrably",!?15,"active -",!!!!!!
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18 | D:'$D(CMBN) HD2 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!,$S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
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19 | K LN,LN1,LN2
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20 | Q
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21 | ;
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22 | HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",!,HD7,!!,"for "_NAME,!!!
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23 | Q
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24 | ;
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25 | SETIOF ; ** Set device control var's
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26 | D HOME^%ZIS
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27 | Q
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28 | ;
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29 | TXT ;
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30 | ;;In reporting structural changes to the lungs for the Regional
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31 | ;;Office disability evaluations, the residuals are critical
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32 | ;;(e.g., fibrosis, scarring, absent or resected parts, limitation
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33 | ;;of expansion of the chest or excursion of diaphragm, presence
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34 | ;;of bullet or missile in lung, granuloma).
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35 | ;;
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36 | ;;The Rating Schedule requires a pulmonary function test (PFT) in
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37 | ;;certain lung diseases. In the majority of the cases, PFTs and a
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38 | ;;thorough description of the veteran's exercise tolerance will be
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39 | ;;sufficient for rating evaluation purposes. If such tests are, in
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40 | ;;the examiner's opinion, not needed or medically contraindicated,
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41 | ;;the examiner should explain why. Generally, PFTs need not be
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42 | ;;repeated if recent studies (within the past six months) are of
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43 | ;;record. If the examiner feels that an arterial blood gas test is
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44 | ;;appropriate for diagnostic purposes, the results should be reported
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45 | ;;in paragraph E below.
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46 | ;;END
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