| [613] | 1 | DVBCNLCK ;ALB/GTS-557/THM-NOT ELSEWHERE CLASSIFIED EXAM ; 11/9/90 1:16 PM
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| 2 | ;;2.7;AMIE;;Apr 10, 1995
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| 3 | ;Note: This is a generic exam format for the
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| 4 | ; 'Not Elsewhere Classified' exams.
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| 5 | ;
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| 6 | XX S MX="EXM" F I=1:1 S MY=$T(@MX+I) Q:MY["$END"!(MY="") S TNAM=$P(TNAM,"(NEC)",1) S X=$L(TNAM) S:$E(TNAM,X,X)=" " TNAM=$E(TNAM,1,X-1) Q:MY[TNAM
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| 7 | Q:MY="" S MY=$P(MY,";;",2),NARR=$P(MY,U,2),PREF=$P(MY,U,3),WKSNUM=$P(MY,U,4),DXCMT=$P(MY,U,5)
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| 8 | S PG=1,HD91="Department of Veterans Affairs",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
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| 9 | EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
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| 10 | W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# "_WKSNUM_" Worksheet" S HD7=TNAM_", NOT ELSEWHERE CLASSIFIED",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
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| 11 | W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
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| 12 | W !!!!,"Narrative:"
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| 13 | S LX="TXT" F I=1:1 S LY=$T(@LX+I) Q:LY["$END" D:LY["{}" FMT W ?13,$P(LY,";;",2),!
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| 14 | W !! I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:" D HD2
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| 15 | 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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| 16 | W ?5,"1) How does the residual disability affect the earning capacity",!?9,"of the veteran in job performance?",!!!!!!?5,"2) How does the residual disability affect normal everyday activities?",!!!!!!
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| 17 | W ?5,"3) If the disability has constant activity, are there",!?9,"any periods of remission during the year?",!!!!!!
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| 18 | W ?5,"4) If there are acute exacerbations, what effects are there on",!?9,"everyday life?",!!!!!!
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| 19 | D:$D(CMBN) HD2 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:" W:DXCMT]"" !!?5,DXCMT W !!!!!!!!!!!!!!
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| 20 | D:'$D(CMBN) HD2 W $S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
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| 21 | K LN,LN1,LN2
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| 22 | Q
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| 23 | ;
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| 24 | HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for",!,HD7,!!,"for ",NAME,!!!
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| 25 | Q
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| 26 | ;
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| 27 | SETIOF ; ** Set device control var's
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| 28 | D HOME^%ZIS
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| 29 | Q
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| 30 | ;
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| 31 | TXT ;
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| 32 | ;;This exam is to handle the balance of currently recognized
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| 33 | ;;{} disorders and to allow for new disorders not yet
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| 34 | ;;classified for V. A. compensation evaluations. The severity
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| 35 | ;;of a condition is based upon the residual disability. If
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| 36 | ;;there is a disease process that affects multiple systems or
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| 37 | ;;extremeties, please evaluate each separately.
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| 38 | ;;$END
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| 39 | ;
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| 40 | FMT S LZ=$P(LY,"{}",1),LY=$P(LY,"{}",2),LY=LZ_NARR_LY
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| 41 | Q
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| 42 | ;
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| 43 | EXM ;;$EXAMS
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| 44 | ;;MENTAL^mental^None^0905^(Including psychological testing if deemed necessary)
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| 45 | ;;CARDIOVASCULAR^cardiovascular^None^0105
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| 46 | ;;DIGESTIVE^digestive^None^0310
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| 47 | ;;ENDOCRINE DISORDERS^endocrine^None^0415
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| 48 | ;;GENITOURINARY^genitourinary^None^0610
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| 49 | ;;GYNECOLOGICAL^gynecological^None^0710
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| 50 | ;;NEPHROLOGICAL^nephrological^None^1115
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| 51 | ;;NEUROLOGICAL^neurological^Chapter 13^1230
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| 52 | ;;ORGANS OF SENSE^organs of sense^None^1320
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| 53 | ;;MUSCULOSKELETAL^musculoskeletal^None^1455
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| 54 | ;;PULMONARY^pulmonary^None^1515
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| 55 | ;;SKIN^skin^None^1610
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