source: FOIAVistA/trunk/r/AUTOMATED_MED_INFO_EXCHANGE-DVBA-DVBC/DVBCWEA5.m@ 794

DVBCWEA5 ;BPOIFO/RLC - EATING DISORDERS WKS TEXT - 1 ; 12/26/06 14:00pm
 ;;2.7;AMIE;**118**;Apr 10, 1995;Build 3
 ;Per VHA Directive 10-92-142, this routine should not be modified
 ;
TXT ;
 ;;
 ;;The following health care providers can perform initial examinations for
 ;;Eating Disorders:
 ;;a board-certified or board "eligible" psychiatrist;
 ;;a licensed doctorate-level psychologist;
 ;;a doctorate-level mental health provider under the close supervision of a
 ;;board-certified or board eligible psychiatrist or licensed doctorate-level
 ;;psychologist;
 ;;a psychiatry resident under close supervision of a board-certified or
 ;;board eligible psychiatrist or licensed doctorate-level psychologist;
 ;;or a clinical or counseling psychologist completing a one-year internship
 ;;or residency (for purposes of a doctorate-level degree) under close
 ;;supervision of a board-certified or board eligible psychiatrist or licensed
 ;;doctorate-level psychologist.
 ;;
 ;;The following health care providers can perform review examinations for
 ;;Eating Disorders:
 ;;a board-certified or board "eligible" psychiatrist;
 ;;a licensed doctorate-level psychologist;
 ;;a doctorate-level mental health provider under the close supervision of a
 ;;board-certified or board eligible psychiatrist or doctorate-level
 ;;psychologist;
 ;;a psychiatry resident under close supervision of a board-certified or 
 ;;board eligible psychiatrist or licensed doctorate-level psychologist;
 ;;a clinical or counseling psychologist completing a one year internship or
 ;;residency (for purposes of a doctorate-level degree) under close
 ;;supervision of a board-certified or board eligible psychiatrist or licensed
 ;;doctorate-level psychologist;
 ;;a licensed clinical social worker (LCSW) or
 ;;a nurse practitioner, a clinical nurse specialist or physician assistant,
 ;;if they are clinically privileged to perform activities required for C&P
 ;;mental disorder examinations, under close supervision of a board-certified
 ;;or board eligible psychiatrist or licensed doctorate-level psychologist.
 ;;
 ;;A. Review of Medical Records:
 ;;
 ;;
 ;;B. Medical History (Subjective Complaints):
 ;;
 ;;   Comment on:
 ;;
 ;;   1. PAST MEDICAL HISTORY
 ;;
 ;;      a. Medical and occupational history from the time between the
 ;;         last such rating examination and the present needs to be 
 ;;         accounted for, UNLESS the purpose of this examination is to
 ;;         ESTABLISH service connection, then a complete medical and
 ;;         occupational history since discharge from military service is
 ;;         required.
 ;;      b. History of onset of eating disorder, course, and treatment.
 ;;      c. Previous hospitalizations for parenteral nutrition or tube feeding.
 ;;      d. Periods of incapacitation (during which bedrest and treatment
 ;;         by a physician are required due to the eating disorder).
 ;;         Describe the frequency and duration.
 ;;
 ;;   2. Present Medical, Occupational and Social History - over the past
 ;;      one year.
 ;;
 ;;      a. Current status of eating disorder.
 ;;      b. Current treatment, response, side effects.
 ;;      c. Extent of time lost from work over the past 12 month period.
 ;;         If employed, identify current occupation and length of time at
 ;;         this job.
 ;;      d. Describe any social impairment over the past 12 month period.
 ;;
 ;;   3. Subjective Complaints:
 ;;
 ;;      a. Describe fully any current symptoms.
 ;;      b. Additionally, to allow evaluation by the rating specialist,
 ;;         describe and fully explain the existence, frequency, and extent
 ;;         of the following signs and symptoms and relate how they interfere
 ;;         with employment:
 ;;
 ;;            -  Binge eating followed by self-induced vomiting
 ;;               or other measures to prevent weight gain.
 ;;
 ;;            -  Measures taken to resist weight gain when weight is already
 ;;               below expected minimum normal weight.
 ;;
 ;;C. Examination (Objective Findings):
 ;;
 ;;   Address each of the following and fully describe:
 ;;
 ;;   1. Mental status exam to confirm or establish diagnosis in 
 ;;      accordance with DSM-IV.
 ;; 
 ;;   2. Additionally, please provide this specific information:
 ;;
 ;;      a. Current weight.
 ;;      b. Expected minimum weight based on age, height, and body build.
 ;;      c. Obtain weight history.
 ;; 
 ;;D. Diagnostic Tests (including psychological testing if deemed necessary):
 ;; 
 ;;   1. Provide specific evaluation information required by the rating 
 ;;      board or on a BVA Remand. Diagnostic Tests (See the examination
 ;;      request remarks for specifics.):
 ;; 
 ;;           a. CAPACITY TO MANAGE FINANCIAL AFFAIRS Mental competency, for
 ;;              VA benefits purposes, refers only to the ability of the
 ;;              veteran to manage VA benefit payments in his or her own best
 ;;              interest, and not to any other subject.  Mental incompetency,
 ;;              for VA benefits purposes, means that the veteran, because
 ;;              of injury or disease, is not capable of managing benefit
 ;;              payments in his or her best interest.  In order to assist
 ;;              raters in making a legal determination as to competency,
 ;;              please address the following:
 ;;              - What is the impact of injury or disease on the veteran's ability
 ;;                to manage his or her financial affairs, including consideration
 ;;                of such things as knowing the amount of his or her VA benefit
 ;;                payment, knowing the amounts and types of bills owed monthly,
 ;;                and handling the payment prudently? Does the veteran handle
 ;;                the money and pay the bills?
 ;;
 ;;              - Based on your examination, do you believe that the veteran is
 ;;                capable of managing his or her financial affairs?
 ;;                Please provide examples to support your conclusion.
 ;;
 ;;              - If you believe a Social Work Service assessment is needed before
 ;;                you can give your opinion on the veteran's ability to manage his
 ;;                or her financial affairs, please explain why.
 ;;
 ;;      b.  OTHER OPINION: Furnish any other specific opinion requested
 ;;          by the rating board or BVA Remand, furnishing the complete 
 ;;          rationale and citation of medical texts or treatise supporting 
 ;;          opinion, if medical literature review was undertaken. If the
 ;;          requested opinion is medically not ascertainable on exam or
 ;;          testing, please state WHY. If the requested opinion cannot be
 ;;          expressed without resorting to speculation or making improbable
 ;;          assumptions say so, and explain why. If the opinion asks "...is
 ;;          it at least as likely as not...", fully explain the clinical
 ;;          findings and rationale for the opinion.
 ;;
 ;;  2.  Include results of all diagnostic and clinical tests conducted 
 ;;      in the examination report.
 ;;
 ;;
 ;;E. Diagnosis:
 ;;
 ;;
 ;;Include your name; your credentials, (i.e., board certified psychiatrist,
 ;;licensed psychologist; psychiatry resident or psychology intern,
 ;;LCSW, or NP); and circumstances under which you performed the examination,
 ;;if applicable (i.e., under the close supervision of an attending
 ;;psychiatrist or psychologist); name of supervising psychiatrist or
 ;;psychologist, if applicable.
 ;;
 ;;
 ;;Signature:                                            Date:
 ;;
 ;;
 ;;Signature of Supervising
 ;;  Psychiatrist or Psychologist:                       Date:
 ;;END