source: WorldVistAEHR/trunk/r/AUTOMATED_MED_INFO_EXCHANGE-DVBA-DVBC/DVBCPWC2.m@ 701

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1DVBCPWC2 ;ALB ISC/THM-POW PROTOCOL MENTAL DISORDER EXAM ; 5/6/91 9:40 AM
2 ;;2.7;AMIE;;Apr 10, 1995
3 ;
4 S PG=1,HD91="Department of Veterans Affairs",HD9="Full Exam Worksheet"
5EN W @IOF,!?25,HD91,!?22,"Compensation and Pension Examination",! S HD7="MENTAL DISORDERS - POW PROTOCOL",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!!
6 W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
7 W !!,"Physician's Guide Reference: Chapter 14, 17, 20",!!,"Narrative: "
8 W !!,"A. Medical and occupational history:",!!
9 W ?8,"1. Immediate pre-military events -",!!!!!!!!!?8,"2. Events as a POW -",!!!!!!!!!?8,"3. Post-active service events (to present) -",!!!!!!!!!
10 W ?8,"4. Employment history prior to and following",!?11,"active service -" D HD2
11 W "B. Subjective complaints (include the veteran's history of unusually ",!?27,"traumatic events as a POW, if not elsewhere",!?27,"indicated) -",!!!!!!!!!!!!!!! W "C. Objective findings:",! D HD2
12 W "D. Specific evaluation information required by the rating board",!?4,"(if the information requested is included elsewhere, do not",!?4,"repeat here):",!!!
13 S LX="TXT1" F I=1:1 S LY=$T(@LX+I) Q:LY["$END" W $P(LY,";;",2),!
14 W !!!!!!!!!!!!,"E. Diagnosis:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
15 K LN,LN1,LN2
16 G ^DVBCPWC3
17 ;
18HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
19 Q
20TXT1 ;
21 ;; 1. State if the veteran is capable of managing his/her benefit
22 ;; payments in the individual's own best interests without restriction
23 ;; (a physical disability which prevents the veteran from attending
24 ;; to financial matters in person is not a proper basis for a finding
25 ;; of incompetency unless the veteran is, by reason of that disability,
26 ;; incapable of directing someone else in handling the individual's
27 ;; his financial affairs) -
28 ;;$END
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