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1DVBCWPA1 ;ALB/CMM POW, GENERAL WKS TEXT - 1 ; 7 MARCH 1997
2 ;;2.7;AMIE;**79**;Apr 10, 1995
3 ;
4 ;
5TXT ;
6 ;;
7 ;;Narrative: This is the protocol for conducting initial examinations on former
8 ;;POWs. Approach these veterans with the greatest sensitivity because the
9 ;;POW experience likely resulted in a great deal of psychological and physical
10 ;;trauma. Details about beatings, torture, forced marches, forced labor, diet,
11 ;;disease, brainwashing, extremes of hot and cold, and anxiety may be
12 ;;significant parts of the veteran's history; eliciting these details requires
13 ;;that one establish a trusting relationship with the veteran. Examine
14 ;;veteran for each disability / disease / condition veteran is claiming
15 ;;as a consequence of the POW experience. A former POW may be entitled
16 ;;to service connection for presumptive POW diseases; the worksheet contains
17 ;;a list of these presumptive diseases. Based on veteran's claim(s) and your
18 ;;findings, please refer to and follow additional worksheets to assure
19 ;;the examination provides information adequate for rating purposes.
20 ;;
21 ;;
22 ;;
23 ;;PRESUMPTIVE POW DISABILITIES:
24 ;;
25 ;; o Any of the anxiety states
26 ;; o Any other nutritional deficiency
27 ;; o Atherosclerotic heart disease, ischemic heart disease, coronary artery
28 ;; disease and beriberi heart disease to include complications (e.g.,
29 ;; myocardial infarction, congestive heart failure, arrhythmia).
30 ;; o Avitaminosis
31 ;; o Beriberi (including beriberi heart disease which includes ischemic
32 ;; heart disease in a former POW who experienced localized edema
33 ;; during captivity)
34 ;; o Chronic dysentery
35 ;; o Cirrhosis of the liver
36 ;; o Dysthymic disorder (or depressive neurosis)
37 ;; o Helminthiasis
38 ;; o Hypertension and hypertensive vascular disease to include complications
39 ;; o Irritable bowel syndrome.
40 ;; o Malnutrition (including optic atrophy associated with malnutrition)
41 ;; o Organic residuals of frostbite
42 ;; o Pellagra
43 ;; o Peptic ulcer disease
44 ;; o Peripheral neuropathy
45 ;; o Post-traumatic arthritis
46 ;; o Psychosis
47 ;; o Stroke (ischemic stroke, hemorrhagic stroke and embolic stroke)
48 ;; to include complications
49 ;;
50 ;;
51 ;;A. Review of Medical Records:
52 ;;
53 ;; 1. Include a review of VA form 10-0048, Former POW Medical
54 ;; History, which the veteran should have completed, prior to
55 ;; conducting the examination.
56 ;;
57 ;;
58 ;; 2. Review the Social Survey.
59 ;;
60 ;;B. Medical History (Subjective Complaints): NOTE: If the veteran
61 ;; has had a previous protocol examination, only an interval history
62 ;; is required.
63 ;;
64 ;; Comment on:
65 ;; 1. Past medical history, including childhood and adult illnesses
66 ;; and surgery.
67 ;;
68 ;;
69 ;; 2. Family history.
70 ;;
71 ;;
72 ;; 3. Social history - state civilian and military occupations,
73 ;; including dates and locations. Describe use of alcohol,
74 ;; tobacco, and drugs.
75 ;;
76 ;;
77 ;; 4. Complete system review, commenting on all positive symptoms.
78 ;;
79 ;; a. Describe initial symptoms, time of onset, and current
80 ;; symptoms of all presumptive POW disabilities found.
81 ;;
82 ;;
83 ;; b. Comment on amount of weight lost as a prisoner. Record
84 ;; initial and release weights.
85 ;;
86 ;;
87 ;; 5. Describe current treatment (specify type, frequency, duration,
88 ;; response, side effects).
89 ;;
90 ;;
91 ;;C. Physical Examination (Objective Findings):
92 ;;
93 ;; Address each of the following and fully describe current findings:
94 ;; The examiner should incorporate all ancillary study results into
95 ;; the final diagnoses.
96 ;; 1. VS: Heart rate, blood pressure (If the diagnosis of hypertension
97 ;; has not been established, take 2 or more blood pressure readings
98 ;; on at least 3 different days. If hypertension has been
99 ;; diagnosed, take 2 or more blood pressure readings.), respirations,
100 ;; height, weight, maximum weight in past year, weight change in
101 ;; past year, body build, and state of nutrition.
102 ;;
103 ;;
104 ;; 2. DOMINANT HAND: Indicate the dominant hand and how determined
105 ;; (i.e., writes, eats, combs hair, etc.).
106 ;;
107 ;;
108 ;; 3. POSTURE AND GAIT: (If abnormal, describe.)
109 ;;
110 ;;
111 ;; 4. SKIN, INCLUDING APPENDAGES: (If abnormal, describe appearance,
112 ;; location, extent of lesions, and limitations to daily activity.)
113 ;; If there are laceration or burn scars, describe location,
114 ;; measurements (cm. x cm.), depression, type of tissue loss,
115 ;; adherence, disfigurement, and tenderness. For each burn scar,
116 ;; state if due to a 2nd or 3rd degree burn. (NOTE: If skin
117 ;; condition or scars are disfiguring, obtain COLOR PHOTOGRAPHS
118 ;; of affected area(s).
119 ;;
120 ;;
121 ;; 5. HEMIC AND LYMPHATIC: (Describe local or generalized adenopathy,
122 ;; tenderness, suppuration, etc.)
123 ;;
124 ;;
125 ;; 6. HEAD AND FACE: Describe scars, deformities, etc.
126 ;;
127 ;;
128 ;; 7. EYES: Describe external eye, pupil reaction, movements,
129 ;; field of vision, any uncorrectable refractive error or any
130 ;; retinopathy.
131 ;;
132 ;;
133 ;; 8. EARS: Describe canals, drums, perforations, discharge.
134 ;;
135 ;;
136 ;; 9. NOSE, SINUSES, MOUTH AND THROAT: Include gross dental findings.
137 ;;
138 ;;
139 ;; 10. NECK: Describe lymph nodes, thyroid, etc.
140 ;;
141 ;;
142 ;; 11. CHEST: Inspection, palpation, percussion, auscultation. If
143 ;; abnormal, describe limitations of daily living (i.e., How far
144 ;; can veteran walk, how many flights of stairs can he or she
145 ;; climb, etc.).
146 ;;
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