source: FOIAVistA/trunk/r/AUTOMATED_MED_INFO_EXCHANGE-DVBA-DVBC/DVBCSCCK.m@ 1757

Last change on this file since 1757 was 628, checked in by George Lilly, 15 years ago

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1DVBCSCCK ;ALB/GTS-557/THM-SCAR EXAM ; 12/27/90 1:52 PM
2 ;;2.7;AMIE;;Apr 10, 1995
3 ;
4 S PG=1,HD91="Department of Veterans Affairs",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
5EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
6 W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1445 Worksheet" S HD7="SCARS, OTHER THAN BURNS (ORTHOPEDIC/DISFIGUREMENT)",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
7 W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
8 W !!!!,"Narrative:"
9 W ?13,"The type of injury or infection causing the wound or scar,",!?13,"its date, the treatment used and the response to such",!?13,"treatment should be described. Point of entrance and exit of",!?13,"missiles are important "
10 W "in evaluating injuries of nerves, vessels,",!?13,"and muscles. Photographs, if indicated, (see Physician's Guide,",!?13,"Paragraph 1.19) should be submitted.",!!!
11 I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",! D HD2
12 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):",!!!
13 W ?8,"1. Position, shape, texture, length, width, color, depth -",!!!!!?8,"2. Keloid formation, adherance, herniation -",!!!!!?8,"3. Inflammation, swelling, depression, vascular supply, ulceration -",!!!!!
14 W ?8,"4. Tender and painful on objective demonstration -",!!!!!?8,"5. Cosmetic effects (submit photographs of all facial",!?29,"and other significant scars) -",!!!!!?8,"6. Limitation of function of part affected -",!!!!! D:$D(CMBN) HD2
15 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!! D:'$D(CMBN) HD2 W $S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
16 K LN,LN1,LN2
17 Q
18 ;
19HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",!,HD7,!!,"for "_NAME,!!!
20 Q
21SETIOF ; ** Set device control var's
22 D HOME^%ZIS
23 Q
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