| [613] | 1 | DVBCAACK ;ALB/GTS-557/THM-ALIMENTARY APPENDAGES ; 2/6/91 6:40 AM
|
|---|
| 2 | ;;2.7;AMIE;;Apr 10, 1995
|
|---|
| 3 | ;
|
|---|
| 4 | S PG=1,HD91="Department of Veterans Affairs"
|
|---|
| 5 | S HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
|
|---|
| 6 | EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
|
|---|
| 7 | W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 305 Worksheet" S HD7="ALIMENTARY APPENDAGES (DIGESTIVE)",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
|
|---|
| 8 | W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",?14,HD7
|
|---|
| 9 | W !!!!,"Narrative:"
|
|---|
| 10 | W ?13,"Detailed description of chronic, active symptomatology in the",!?13,"""subjective complaints"" portion of this or the main examination is",!?13,"critical to the degree of disability assigned for the veteran.",!!
|
|---|
| 11 | I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!!!!!!!!!! D:'$D(CMBN) 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):",!!!?8,"1. Abdominal discomfort -",!!!!!!
|
|---|
| 13 | W ?8,"2. Food intolerance -",!!!!!!?8,"3. Nausea (frequency) -",!!!!!!?8,"4. Vomiting (frequency) -",!!!!!!?8,"5. Degree of pain -",!!!!!! D:$D(CMBN) HD2 W ?8,"6. Anorexia -",!!!!!!
|
|---|
| 14 | W ?8,"7. Malaise -",!!!!!! D:'$D(CMBN) HD2 W ?8,"8. Weight loss -",!!!!!!?8,"9. Generalized weakness -",!!!!!!
|
|---|
| 15 | W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!,$S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
|
|---|
| 16 | K LN,LN1,LN2
|
|---|
| 17 | Q
|
|---|
| 18 | ;
|
|---|
| 19 | HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for "_NAME,!
|
|---|
| 20 | W HD8,!!!
|
|---|
| 21 | Q
|
|---|
| 22 | SETIOF ; ** Set device control variables **
|
|---|
| 23 | D HOME^%ZIS
|
|---|
| 24 | Q
|
|---|
