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1DVBCWEA5 ;BPOIFO/RLC - EATING DISORDERS WKS TEXT - 1 ; 12/26/06 14:00pm
2 ;;2.7;AMIE;**118**;Apr 10, 1995;Build 3
3 ;Per VHA Directive 10-92-142, this routine should not be modified
4 ;
5TXT ;
6 ;;
7 ;;The following health care providers can perform initial examinations for
8 ;;Eating Disorders:
9 ;;a board-certified or board "eligible" psychiatrist;
10 ;;a licensed doctorate-level psychologist;
11 ;;a doctorate-level mental health provider under the close supervision of a
12 ;;board-certified or board eligible psychiatrist or licensed doctorate-level
13 ;;psychologist;
14 ;;a psychiatry resident under close supervision of a board-certified or
15 ;;board eligible psychiatrist or licensed doctorate-level psychologist;
16 ;;or a clinical or counseling psychologist completing a one-year internship
17 ;;or residency (for purposes of a doctorate-level degree) under close
18 ;;supervision of a board-certified or board eligible psychiatrist or licensed
19 ;;doctorate-level psychologist.
20 ;;
21 ;;The following health care providers can perform review examinations for
22 ;;Eating Disorders:
23 ;;a board-certified or board "eligible" psychiatrist;
24 ;;a licensed doctorate-level psychologist;
25 ;;a doctorate-level mental health provider under the close supervision of a
26 ;;board-certified or board eligible psychiatrist or doctorate-level
27 ;;psychologist;
28 ;;a psychiatry resident under close supervision of a board-certified or
29 ;;board eligible psychiatrist or licensed doctorate-level psychologist;
30 ;;a clinical or counseling psychologist completing a one year internship or
31 ;;residency (for purposes of a doctorate-level degree) under close
32 ;;supervision of a board-certified or board eligible psychiatrist or licensed
33 ;;doctorate-level psychologist;
34 ;;a licensed clinical social worker (LCSW) or
35 ;;a nurse practitioner, a clinical nurse specialist or physician assistant,
36 ;;if they are clinically privileged to perform activities required for C&P
37 ;;mental disorder examinations, under close supervision of a board-certified
38 ;;or board eligible psychiatrist or licensed doctorate-level psychologist.
39 ;;
40 ;;A. Review of Medical Records:
41 ;;
42 ;;
43 ;;B. Medical History (Subjective Complaints):
44 ;;
45 ;; Comment on:
46 ;;
47 ;; 1. PAST MEDICAL HISTORY
48 ;;
49 ;; a. Medical and occupational history from the time between the
50 ;; last such rating examination and the present needs to be
51 ;; accounted for, UNLESS the purpose of this examination is to
52 ;; ESTABLISH service connection, then a complete medical and
53 ;; occupational history since discharge from military service is
54 ;; required.
55 ;; b. History of onset of eating disorder, course, and treatment.
56 ;; c. Previous hospitalizations for parenteral nutrition or tube feeding.
57 ;; d. Periods of incapacitation (during which bedrest and treatment
58 ;; by a physician are required due to the eating disorder).
59 ;; Describe the frequency and duration.
60 ;;
61 ;; 2. Present Medical, Occupational and Social History - over the past
62 ;; one year.
63 ;;
64 ;; a. Current status of eating disorder.
65 ;; b. Current treatment, response, side effects.
66 ;; c. Extent of time lost from work over the past 12 month period.
67 ;; If employed, identify current occupation and length of time at
68 ;; this job.
69 ;; d. Describe any social impairment over the past 12 month period.
70 ;;
71 ;; 3. Subjective Complaints:
72 ;;
73 ;; a. Describe fully any current symptoms.
74 ;; b. Additionally, to allow evaluation by the rating specialist,
75 ;; describe and fully explain the existence, frequency, and extent
76 ;; of the following signs and symptoms and relate how they interfere
77 ;; with employment:
78 ;;
79 ;; - Binge eating followed by self-induced vomiting
80 ;; or other measures to prevent weight gain.
81 ;;
82 ;; - Measures taken to resist weight gain when weight is already
83 ;; below expected minimum normal weight.
84 ;;
85 ;;C. Examination (Objective Findings):
86 ;;
87 ;; Address each of the following and fully describe:
88 ;;
89 ;; 1. Mental status exam to confirm or establish diagnosis in
90 ;; accordance with DSM-IV.
91 ;;
92 ;; 2. Additionally, please provide this specific information:
93 ;;
94 ;; a. Current weight.
95 ;; b. Expected minimum weight based on age, height, and body build.
96 ;; c. Obtain weight history.
97 ;;
98 ;;D. Diagnostic Tests (including psychological testing if deemed necessary):
99 ;;
100 ;; 1. Provide specific evaluation information required by the rating
101 ;; board or on a BVA Remand. Diagnostic Tests (See the examination
102 ;; request remarks for specifics.):
103 ;;
104 ;; a. CAPACITY TO MANAGE FINANCIAL AFFAIRS Mental competency, for
105 ;; VA benefits purposes, refers only to the ability of the
106 ;; veteran to manage VA benefit payments in his or her own best
107 ;; interest, and not to any other subject. Mental incompetency,
108 ;; for VA benefits purposes, means that the veteran, because
109 ;; of injury or disease, is not capable of managing benefit
110 ;; payments in his or her best interest. In order to assist
111 ;; raters in making a legal determination as to competency,
112 ;; please address the following:
113 ;; - What is the impact of injury or disease on the veteran's ability
114 ;; to manage his or her financial affairs, including consideration
115 ;; of such things as knowing the amount of his or her VA benefit
116 ;; payment, knowing the amounts and types of bills owed monthly,
117 ;; and handling the payment prudently? Does the veteran handle
118 ;; the money and pay the bills?
119 ;;
120 ;; - Based on your examination, do you believe that the veteran is
121 ;; capable of managing his or her financial affairs?
122 ;; Please provide examples to support your conclusion.
123 ;;
124 ;; - If you believe a Social Work Service assessment is needed before
125 ;; you can give your opinion on the veteran's ability to manage his
126 ;; or her financial affairs, please explain why.
127 ;;
128 ;; b. OTHER OPINION: Furnish any other specific opinion requested
129 ;; by the rating board or BVA Remand, furnishing the complete
130 ;; rationale and citation of medical texts or treatise supporting
131 ;; opinion, if medical literature review was undertaken. If the
132 ;; requested opinion is medically not ascertainable on exam or
133 ;; testing, please state WHY. If the requested opinion cannot be
134 ;; expressed without resorting to speculation or making improbable
135 ;; assumptions say so, and explain why. If the opinion asks "...is
136 ;; it at least as likely as not...", fully explain the clinical
137 ;; findings and rationale for the opinion.
138 ;;
139 ;; 2. Include results of all diagnostic and clinical tests conducted
140 ;; in the examination report.
141 ;;
142 ;;
143 ;;E. Diagnosis:
144 ;;
145 ;;
146 ;;Include your name; your credentials, (i.e., board certified psychiatrist,
147 ;;licensed psychologist; psychiatry resident or psychology intern,
148 ;;LCSW, or NP); and circumstances under which you performed the examination,
149 ;;if applicable (i.e., under the close supervision of an attending
150 ;;psychiatrist or psychologist); name of supervising psychiatrist or
151 ;;psychologist, if applicable.
152 ;;
153 ;;
154 ;;Signature: Date:
155 ;;
156 ;;
157 ;;Signature of Supervising
158 ;; Psychiatrist or Psychologist: Date:
159 ;;END
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