| [613] | 1 | DVBCHNCK ;ALB/GTS-557/THM-HAND,THUMB, FINGER ; 12/10/90 1:39 PM
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| 2 | ;;2.7;AMIE;;Apr 10, 1995
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| 3 | ;
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| 4 | S PG=1,HD91="Department of Veterans Affairs",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
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| 5 | EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
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| 6 | W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1420 Worksheet" S HD7="HAND, THUMB, AND FINGERS",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
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| 7 | W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
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| 8 | W !!!!,"Narrative:"
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| 9 | W ?13,"The hand should be evaluated as a unit intricately adapted",!?13,"for grasping, pushing, pulling, twisting, probing, writing,",!?13,"touching, and expression. Do not designate fingers numerically;",!?13,"use thumb, index, "
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| 10 | W "middle, ring and little. Specify which hand is",!?13,"involved and state whether the individual is right or left-handed."
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| 11 | W !?13,"Designate the joints as wrist, MP (metacarpophalangeal), PIP,",!?13,"(proximal interphalangeal) or DIP (distal interphalangeal).",!?13,"Designate phalanges as proximal, middle or distal.",!!!
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| 12 | I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",! D HD2 W !!
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| 13 | 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. Anatomical defects -",!!!!!!!
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| 14 | W ?8,"2. Functional defects (motion of thumb and fingers should be described",!?11,"as to how near, in inches, the tip of thumb can approximate the",!?11,"fingers, or how near the tips of fingers can "
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| 15 | W "approximate the median",!?11,"transverse fold of the palm.) -",!!!!!!!!!!?8,"3. Grasping objects (strength and dexterity) -",!!!!!!!!!!
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| 16 | D:$D(CMBN) HD2 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!! D:'$D(CMBN) HD2
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| 17 | W $S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
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| 18 | K LN,LN1,LN2
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| 19 | Q
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| 20 | ;
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| 21 | HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
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| 22 | Q
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| 23 | ;
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| 24 | SETIOF ; ** Set device control var's
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| 25 | D HOME^%ZIS
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| 26 | Q
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