| [613] | 1 | DVBCMDCK ;ALB/GTS-557/THM-MISCELLANEOUS NEUROLOGICAL DISORDERS EXAM ; 12/10/90 8:36 AM
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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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
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| 6 | W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1225 Worksheet" S HD7="MISCELLANEOUS NEUROLOGICAL DISORDERS",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
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| 7 | W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
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| 8 | W !!!!,"Narrative:"
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| 9 | S LX="TXT" F I=1:1 S LY=$T(@LX+I) Q:LY["END" W ?13,$P(LY,";;",2),!
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| 10 | W !! I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:" D HD2
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| 11 | 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):",!!!
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| 12 | S LX="TXT1" F I=1:1 S LY=$T(@LX+I) Q:LY["END" W $P(LY,";;",2),!
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| 13 | W !!!!!!! S LX="TXT2" F I=1:1 S LY=$T(@LX+I) Q:LY["END" W $P(LY,";;",2),!
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| 14 | W !!!!!!!!!!!! D:$D(CMBN) HD2 S LX="TXT3" F I=1:1 S LY=$T(@LX+I) Q:LY["END" W $P(LY,";;",2),!
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| 15 | W !!!!!!!!!!!! D:'$D(CMBN) HD2 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!!!
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| 16 | W $S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
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| 17 | K LN,LN1,LN2
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| 18 | Q
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| 19 | ;
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| 20 | HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
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| 21 | Q
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| 22 | ;
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| 23 | SETIOF ; ** Set device control var's
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| 24 | D HOME^%ZIS
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| 25 | Q
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| 26 | ;
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| 27 | TXT ;
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| 28 | ;;If the diagnosis is NOT established or is questioned at some later
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| 29 | ;;date, schedule necessary special studies, including admission
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| 30 | ;;for a period of examination and observation, as appropriate to
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| 31 | ;;provide a definitive diagnosis.
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| 32 | ;;END
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| 33 | ;
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| 34 | TXT1 ;
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| 35 | ;; 1. Migraine: Obtain the best possible history of frequency and duration
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| 36 | ;; of attacks and description of level of activity the veteran can maintain
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| 37 | ;; during the attacks. For example, state if the attacks are prostrating in
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| 38 | ;; nature or if ordinary activity is possible -
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| 39 | ;;END
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| 40 | TXT2 ;
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| 41 | ;; 2. Tics and paramyoclonus complex: Ascertain the muscle group(s)
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| 42 | ;; involved and obtain the best possible history of frequency and severity
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| 43 | ;; of attacks -
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| 44 | ;;END
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| 45 | TXT3 ;
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| 46 | ;; 3. Chorea, choreiform disorders, etc: Describe manifestations by
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| 47 | ;; impairment of strength, coordination, tremor, etc., with particular
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| 48 | ;; attention to the effects of the performance of ordinary activities
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| 49 | ;; of daily living -
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| 50 | ;;END
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