| 1 | DVBCWPM1 ;ALB/ESW PULMONARY TB AND MYCO. DIS. WKS TEXT - 1 ; 10 Oct 2000 | 
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| 2 | ;;2.7;AMIE;**34**;Apr 10, 1995 | 
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| 3 | ; | 
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| 4 | TXT ; | 
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| 5 | ;;A. Review of Medical Records: | 
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| 6 | ;; | 
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| 7 | ;;B. Medical History (Subjective Complaints): | 
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| 8 | ;;    Comment on: | 
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| 9 | ;; | 
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| 10 | ;;    1. Activity of pulmonary tuberculosis or other mycobacterial disease. | 
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| 11 | ;;    2. Date of inactivity if it is not active. | 
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| 12 | ;;    3. Identity of organism (if possible). | 
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| 13 | ;; | 
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| 14 | ;;C. Physical examination (Objective Findings): | 
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| 15 | ;;    Address each of the following and fully describe current findings: | 
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| 16 | ;; | 
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| 17 | ;;    1. Extent of structural damage to lungs. | 
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| 18 | ;;    2. If patient was hospitalized for 6 months or more, what is the | 
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| 19 | ;;       condition at the end of hospitalization? | 
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| 20 | ;;    3. If patient was hospitalized for 12 months or more, what is the | 
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| 21 | ;;        condition at the end of hospitalization? | 
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| 22 | ;; | 
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| 23 | ;;D. Diagnostic and Clinical Tests: | 
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| 24 | ;;Provide: | 
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| 25 | ;; | 
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| 26 | ;;1. Pulmonary Function Tests, if indicated. If performed, include the results | 
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| 27 | ;;   in the examination report, The FEV-1,FVC, and FEV-1/FVC should be included. | 
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| 28 | ;;   Both pre- and post-bronchodilatation pulmonary function test results should | 
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| 29 | ;;   be reported. If post-bronchodilatation test is not conducted in a particular | 
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| 30 | ;;   case, please provide an explanation of why not. A DLCO may or may not be | 
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| 31 | ;;   done routinely as part of pulmonary function testing at a particular | 
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| 32 | ;;   facility. If there is a disparity between the results of different tests, | 
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| 33 | ;;   please indicate which tests are more likely to accurately reflect | 
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| 34 | ;;   the severity of the condition. | 
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| 35 | ;; | 
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| 36 | ;;      DLCO note: If DLCO was not done as a routine part of pulmonary function | 
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| 37 | ;;      testing, the examiner should use his or her judgment, based on | 
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| 38 | ;;      the specific condition (.e.g., whether it is obstructive, | 
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| 39 | ;;      interstitial, etc.) and other available information about the condition, | 
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| 40 | ;;      as to whether a DLCO test is needed, since it is not useful in all | 
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| 41 | ;;      situations. If it may provide useful information about the severity | 
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| 42 | ;;      of the condition, it should be requested and reviewed before | 
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| 43 | ;;      the examination report is submitted. If the examiner determines that | 
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| 44 | ;;      the DLCO test is not needed, a statement as to why not (e.g., there are | 
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| 45 | ;;      decreased lung volumes that would not yield valid test results) should be | 
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| 46 | ;;      included in the report. Such a statement could avoid a remand from BVA | 
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| 47 | ;;      when the test is not done. However in the case of a BVA remand in which | 
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| 48 | ;;      the DLCO is requested, the DLCO MUST be done unless there is a medical | 
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| 49 | ;;      contraindication. | 
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| 50 | ;; | 
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| 51 | ;;E. Diagnosis: | 
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| 52 | ;; | 
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| 53 | ;;      1. In reactivated cases, is this reactivation of the old disease | 
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| 54 | ;;         or a separate and distinct new infection? | 
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| 55 | ;; | 
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| 56 | ;;ADDITIONAL NOTE TO THE EXAMINER: | 
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| 57 | ;; | 
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| 58 | ;;In all claims, if the disease is inactive and if the inactivity was confirmed | 
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| 59 | ;;at a non-VA facility, obtain the name and mailing address of the facility | 
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| 60 | ;;from the veteran so that the Regional Office may request the report. | 
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| 61 | ;; | 
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| 62 | ;; | 
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| 63 | ;;Signature:                             Date: | 
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| 64 | ;;END | 
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