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[613]1DVBCWPM1 ;ALB/ESW PULMONARY TB AND MYCO. DIS. WKS TEXT - 1 ; 10 Oct 2000
2 ;;2.7;AMIE;**34**;Apr 10, 1995
3 ;
4TXT ;
5 ;;A. Review of Medical Records:
6 ;;
7 ;;B. Medical History (Subjective Complaints):
8 ;; Comment on:
9 ;;
10 ;; 1. Activity of pulmonary tuberculosis or other mycobacterial disease.
11 ;; 2. Date of inactivity if it is not active.
12 ;; 3. Identity of organism (if possible).
13 ;;
14 ;;C. Physical examination (Objective Findings):
15 ;; Address each of the following and fully describe current findings:
16 ;;
17 ;; 1. Extent of structural damage to lungs.
18 ;; 2. If patient was hospitalized for 6 months or more, what is the
19 ;; condition at the end of hospitalization?
20 ;; 3. If patient was hospitalized for 12 months or more, what is the
21 ;; condition at the end of hospitalization?
22 ;;
23 ;;D. Diagnostic and Clinical Tests:
24 ;;Provide:
25 ;;
26 ;;1. Pulmonary Function Tests, if indicated. If performed, include the results
27 ;; in the examination report, The FEV-1,FVC, and FEV-1/FVC should be included.
28 ;; Both pre- and post-bronchodilatation pulmonary function test results should
29 ;; be reported. If post-bronchodilatation test is not conducted in a particular
30 ;; case, please provide an explanation of why not. A DLCO may or may not be
31 ;; done routinely as part of pulmonary function testing at a particular
32 ;; facility. If there is a disparity between the results of different tests,
33 ;; please indicate which tests are more likely to accurately reflect
34 ;; the severity of the condition.
35 ;;
36 ;; DLCO note: If DLCO was not done as a routine part of pulmonary function
37 ;; testing, the examiner should use his or her judgment, based on
38 ;; the specific condition (.e.g., whether it is obstructive,
39 ;; interstitial, etc.) and other available information about the condition,
40 ;; as to whether a DLCO test is needed, since it is not useful in all
41 ;; situations. If it may provide useful information about the severity
42 ;; of the condition, it should be requested and reviewed before
43 ;; the examination report is submitted. If the examiner determines that
44 ;; the DLCO test is not needed, a statement as to why not (e.g., there are
45 ;; decreased lung volumes that would not yield valid test results) should be
46 ;; included in the report. Such a statement could avoid a remand from BVA
47 ;; when the test is not done. However in the case of a BVA remand in which
48 ;; the DLCO is requested, the DLCO MUST be done unless there is a medical
49 ;; contraindication.
50 ;;
51 ;;E. Diagnosis:
52 ;;
53 ;; 1. In reactivated cases, is this reactivation of the old disease
54 ;; or a separate and distinct new infection?
55 ;;
56 ;;ADDITIONAL NOTE TO THE EXAMINER:
57 ;;
58 ;;In all claims, if the disease is inactive and if the inactivity was confirmed
59 ;;at a non-VA facility, obtain the name and mailing address of the facility
60 ;;from the veteran so that the Regional Office may request the report.
61 ;;
62 ;;
63 ;;Signature: Date:
64 ;;END
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