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1DVBCWPW1 ;ALB/CMM PULMONARY TB AND MYCO. DIS. WKS TEXT - 1 ; 6 MARCH 1997
2 ;;2.7;AMIE;**12**;Apr 10, 1995
3 ;
4 ;
5TXT ;
6 ;;A. Review of Medical Records:
7 ;;
8 ;;
9 ;;
10 ;;B. Medical History (Subjective Complaints):
11 ;;
12 ;; Comment on:
13 ;; 1. Activity of pulmonary tuberculosis or other mycobacterial disease.
14 ;;
15 ;;
16 ;; 2. Date of inactivity if it is not active.
17 ;;
18 ;;
19 ;; 3. Identity of organism (if possible).
20 ;;
21 ;;
22 ;;C. Physical examination (Objective Findings):
23 ;;
24 ;; Address each of the following and fully describe current findings:
25 ;; 1. Extent of structural damage to lungs.
26 ;;
27 ;;
28 ;; 2. If patient was hospitalized for 6 months or more, what is the
29 ;; condition at the end of hospitalization?
30 ;;
31 ;;
32 ;; 3. If patient was hospitalized for 12 months or more, what is the
33 ;; condition at the end of hospitalization?
34 ;;
35 ;;
36 ;;D. Diagnostic and Clinical Tests:
37 ;;
38 ;; Provide:
39 ;; Pulmonary Function Tests, if indicated. When the results of
40 ;; pre-bronchodilator pulmonary function tests are NORMAL, post-
41 ;; bronchodilator studies are not required for VA evaluation purposes.
42 ;; IN ALL OTHER CASES, post-bronchodilator studies shuld be conducted
43 ;; unless contraindicated (because of allergy to medication, etc.) or
44 ;; if the veteran was on bronchodilators before the test and had taken
45 ;; his or her medication within a few hours of the study. An examiner
46 ;; who determines that a post-bronchodilator study should not be
47 ;; performed should provide an explanation of why not. If there is
48 ;; a disparity between the results of different pulmonary function
49 ;; tests (FEV-1, FVC, etc.), the examiner should indicate which test
50 ;; result is the best indicator of the veteran's level of pulmonary
51 ;; functioning.
52 ;;
53 ;;
54 ;;E. Diagnosis:
55 ;;
56 ;; In reactivated cases, is this reactivation of the old disease or a
57 ;; separate and distinct new infection.
58 ;;
59 ;;
60 ;;
61 ;;ADDITIONAL NOTE TO THE PHYSICIAN:
62 ;;In all claims, if the disease is inactive and if the inactivity was
63 ;;confirmed at a non-VA facility, obtain the name and mailing address of
64 ;;the facility from the veteran so that the Regional Office may request
65 ;;the report.
66 ;;
67 ;;
68 ;;Signature: Date:
69 ;;END
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