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1DVBCWGW1 ;ALB/JFP GULF WAR GUIDELINES WKS TEXT - 1 ; 13 FEB 1998
2 ;;2.7;AMIE;**16**;Apr 10, 1995
3 ;
4 ;
5TXT ;
6 ;;Introduction:
7 ;; Disability examinations of Gulf War veterans have unique requirements
8 ;; because this group of veterans is eligible for compensation not only
9 ;; for disability due to diagnosed illnesses, but also for disability
10 ;; due to undiagnosed illnesses. An undiagnosed illness is established
11 ;; when findings are present that cannot be attributed to a known,
12 ;; clearly defined diagnosis, after all likely diagnostic possibilities
13 ;; for such abnormalities have been ruled out. Examiners should follow
14 ;; the guidelines in the "Handout of Instructions for Compensation and
15 ;; Pension Examinations" but will also need to request more laboratory
16 ;; tests and specialists' examinations than average in these cases.
17 ;;
18 ;;Guidelines:
19 ;;1. Thoroughly review the claims file.
20 ;;2. Address all conditions and symptoms specified on the examination
21 ;; request and also address all additional conditions and symptoms
22 ;; that you can elicit from the veteran during the examination, even
23 ;; if not specified on the request form.
24 ;;3. Conduct a comprehensive general medical examination, following the
25 ;; AMIE General Medical Examination worksheet. For all conditions
26 ;; and symptoms which the General Medical Examination worksheet does
27 ;; not address in detail, follow the appropriate additional AMIE
28 ;; worksheets, and request specialists' examinations as indicated.
29 ;; Provide details about the onset, frequency, duration, and severity
30 ;; of all complaints and state what precipitates and what relieves
31 ;; them.
32 ;;4. List all diagnosed conditions and state which symptoms, abnormal
33 ;; physical findings, and abnormal laboratory test results are
34 ;; associated with each. If all symptoms, abnormal physical findings
35 ;; and abnormal laboratory test results are associated with a
36 ;; diagnosed condition, additional specialist examinations for
37 ;; diagnostic purposes are not needed. Diagnosed conditions will be
38 ;; handled as standard claims for service connection. Symptom-based
39 ;; "diagnoses" such as (but not limited to) myalgia, arthralgia,
40 ;; headache, and diarrhea, are not considered as diagnosed conditions
41 ;; for compensation purposes.
42 ;;5. However, if there are symptoms, abnormal physical findings, or
43 ;; abnormal laboratory test results that have not been determined to
44 ;; be part of a known clinical diagnosis, further specialist
45 ;; examinations will be required to address these findings.
46 ;;6. Provide the specialist with all examination reports and test
47 ;; results. Specify the symptoms, abnormal physical findings, and
48 ;; abnormal laboratory test results that have not been attributed to
49 ;; a known clinical diagnosis. Request that the specialist determine
50 ;; which of these, if any, can be attributed in this veteran to a
51 ;; known clinical diagnosis and which, if any, cannot be attributed
52 ;; in this veteran to a known clinical diagnosis.
53 ;;7. After the specialists' examinations have been completed, and all
54 ;; laboratory test results received, make a final report providing a
55 ;; list of diagnosed conditions. Separately list all symptoms,
56 ;; abnormal physical findings, and abnormal laboratory test results
57 ;; that cannot be attributed to a known clinical diagnosis. Reconcile
58 ;; all differences among the examiners, by consultation or workgroup
59 ;; as necessary, before the examination is returned to the regional
60 ;; office.
61 ;;
62 ;;END
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