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1DVBCWEA3 ;BPOIFO/ESW - EATING DISORDERS WKS TEXT - 1 ; 10/1/02 5:33pm
2 ;;2.7;AMIE;**46**;Apr 10, 1995
3 ;Per VHA Directive 10-92-142, this routine should not be modified
4 ;
5TXT ;
6 ;;
7 ;;A. Review of Medical Records:
8 ;;
9 ;;
10 ;;B. Medical History (Subjective Complaints):
11 ;;
12 ;; Comment on:
13 ;; 1. PAST MEDICAL HISTORY
14 ;;
15 ;; a. Previous hospitalizations and outpatient care for parenteral
16 ;; nutrition or tube feeding.
17 ;; b. Medical and occupational history from the time between the
18 ;; last such rating examination and the present needs to be
19 ;; accounted for, UNLESS the purpose of this examination is to
20 ;; ESTABLISH service connection, then a complete medical history
21 ;; since discharge from military service is required.
22 ;; c. Periods of incapacitation (during which bed rest and treatment
23 ;; by a physician are required due to the eating disorder).
24 ;; Describe the frequency and duration.
25 ;; d. Current treatment, response, side effects.
26 ;;
27 ;;
28 ;; 2. PRESENT MEDICAL, OCCUPATIONAL AND SOCIAL HISTORY - over the past
29 ;; one year.
30 ;;
31 ;; a. History of onset of eating disorder.
32 ;; b. Its course, treatment, and current status to include symptoms.
33 ;; c. Extent of time lost from work over the past 12 month period
34 ;; and social impairment. If employed, identify current occupation
35 ;; and length of time at this job.
36 ;;
37 ;;
38 ;; 3. SUBJECTIVE COMPLAINTS:
39 ;;
40 ;; a. Describe fully.
41 ;;
42 ;;TOF
43 ;;C. Examination (Objective Findings):
44 ;;
45 ;; Address each of the following and fully describe:
46 ;;
47 ;; 1. Mental status exam to confirm or establish diagnosis in
48 ;; accordance with DSM-IV.
49 ;;
50 ;; 2. Additionally, please provide this specific information:
51 ;; a. Current weight.
52 ;; b. Expected minimum weight based on age, height, and body build.
53 ;; c. Obtain weight history.
54 ;;
55 ;; 3. Additionally, to allow evaluation by the rating specialist,
56 ;; describe and fully explain the existence, frequency, and extent
57 ;; of the following signs and symptoms and relate how they
58 ;; interfere with employment:
59 ;; a. Binge eating.
60 ;; b. Self-induced vomiting or other measure to prevent weight gain
61 ;; when weight is already below expected minimum normal weight.
62 ;;
63 ;;D. Diagnostic Tests (including psychological testing if deemed necessary):
64 ;;
65 ;; 1. Provide specific evaluation information required by the rating
66 ;; board or on a BVA Remand. Diagnostic Tests (See the examination
67 ;; request remarks for specifics.):
68 ;;
69 ;; a. CAPACITY TO MANAGE FINANCIAL AFFAIRS
70 ;;
71 ;; Mental competency, for VA benefits purposes, refers only to
72 ;; the ability of the veteran to manage VA benefit payments in his
73 ;; or her own best interest, and not to any other subject.
74 ;; Mental incompetency, for VA benefits purposes, means that
75 ;; the veteran, because of injury or disease, is not capable of
76 ;; managing benefit payments in his or her best interest.
77 ;; In order to assist raters in making a legal determination as to
78 ;; competency, please address the following:
79 ;; What is the impact of injury or disease on the veteran's ability
80 ;; to manage his or her financial affairs, including consideration
81 ;; of such things as knowing the amount of his or her VA benefit
82 ;; payment, knowing the amounts and types of bills owed monthly,
83 ;; and handling the payment prudently? Does the veteran handle
84 ;; the money and pay the bills himself or herself?
85 ;;
86 ;; Based on your examination, do you believe that the veteran is
87 ;; capable of managing his or her financial affairs?
88 ;; Please provide examples to support your conclusion.
89 ;;
90 ;; If you believe a Social Work Service assessment is needed before
91 ;; you can give your opinion on the veteran's ability to manage his
92 ;; or her financial affairs, please explain why.
93 ;;
94 ;; b. OTHER OPINION: Furnish any other specific opinion requested
95 ;; by the rating board or BVA Remand, furnishing the complete
96 ;; rationale and citation of medical texts or treatise supporting
97 ;; opinion, if medical literature review was undertaken. If the
98 ;; requested opinion is medically not ascertainable on exam or
99 ;; testing, please state WHY. If the requested opinion cannot
100 ;; be expressed without resorting to speculation or making
101 ;; improbable assumptions say so, and explain why. If the opinion
102 ;; asks "...is it at least as likely as not...", fully explain
103 ;; the clinical findings and rationale for the opinion.
104 ;;
105 ;;
106 ;; 2. Include results of all diagnostic and clinical tests conducted
107 ;; in the examination report.
108 ;;
109 ;;
110 ;;E. Diagnosis:
111 ;;
112 ;;
113 ;;Signature: Date:
114 ;;END
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