DVBCARC1 ;ALB ISC/THM-TEXT FOR A&A/HOUSEBOUND EXAM ; 5/17/91 9:16 AM
;;2.7;AMIE;;Apr 10, 1995
;
PTXT F AW=0:1 S AX=$T(@TXT+AW) S AY=$P(AX,";;",2) D:AY["|TOP|" HD2^DVBCARCK W:AY="END" !! Q:AY="END" I AY'["|TOP|" W AY,!
G:TXT="TXT3" ^DVBCARC2 Q
;
TXT2 ;;A. Indicate whether or not the veteran REQUIRES an attendant in reporting
;; for this exam, and if so, identify the nurse or attendant and the
;; mode of travel employed:
;;
;;
;;
;;
;;
;;
;;B. Indicate whether or not the veteran is hospitalized, and if so, state
;; where and the date of admission:
;;
;;
;;
;;
;;
;;
;;C. Indicate whether or not the veteran is blind (best corrected vision
;; is 5/200 or worse in both eyes, or central vision field is five degrees
;; or less) or is permanently bedridden (if either skip items "D" through
;; "I" and go directly to "J"):
;;END
TXT3 ;;
;;
;;
;;F. Extremeties and spine:
;;
;; 1. Upper extremities (reporting each upper extremity separately) -
;;
;; a. Describe functional restrictions with reference to strength
;;and coordination and ability for self-feeding, fastening clothing, bathing,
;;shaving, and attending to the needs of nature -
;;
;;
;;
;;
;;
;;
;;
;; b. Indicate level of amputation or length of stump and state
;;whether or not use of prothesis is feasible -
;;|TOP|
;;
;;
;; 2. Lower extremities (reporting each lower extremity separately) -
;;
;; a. Describe functional restrictions with reference to extent
;;of limitation of motion, muscle atrophy, contractures, weakness, lack
;;of coordination, or other interference -
;;
;;
;;
;; b. Indicate any deficits of weight bearing, balance and propulsion -
;;
;;
;;
;;
;;
;; c. If amputated, give level or length of stump and whether use
;;of prosthesis is feasible -
;;
;;
;;
;;
;;
;; 3. Spine, trunk, and neck -
;;
;; a. Describe any limitation of motion or deformity of lumbar,
;;thoracic, and cervical spine -
;;
;;
;;
;;
;;
;; b. Note if deformity of thoracic spine interferes with breathing -
;;
;;
;;
;;
;;
;;
;;G. Capacity to protect oneself from the hazards/dangers of daily environment:
;;
;; 1. Describe briefly any pathological processes involving other body
;;parts and systems, including the effects of advancing age, such as dizziness,
;;loss of memory, poor balance affecting ability to ambulate, perform self-
;;care, or travel beyond the premises of the home or the ward or clinical
;;area if hospitalized -
;;|TOP|
;; 2. Describe where the veteran goes and what he/she does during a
;;typical day -
;;
;;
;;
;;
;;
;;
;;END
;
TXT10 ;;Once the existence of at least one permanent disability
;; rated as being 100% disabling has been established, additional
;; benefits are payable if the veteran is so helpless as to require
;; the regular aid and attendance of another person in attending to
;; the ordinary activities of daily living, or in protecting
;; himself/herself from the ordinary hazards of his/her daily
;; environment, or is restricted to his/her home or the immediate
;; vicinity thereof, including the ward or immediate clinical area,
;; if hospitalized.
;;
;; If a general medical examination is included as a part of this
;; request specific findings as to the individual body systems and
;; extremeties already noted in that examination need not be repeated.
;; Items "G" through "L", as the examiner deems appropriate, must be
;; completed in all cases unless the veteran is blind or permanently
;; bedridden (see item "C").
;;
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCARC1 3931 printed Sep 23, 2025@19:19:36 Page 2
DVBCARC1 ;ALB ISC/THM-TEXT FOR A&A/HOUSEBOUND EXAM ; 5/17/91 9:16 AM
+1 ;;2.7;AMIE;;Apr 10, 1995
+2 ;
PTXT FOR AW=0:1
SET AX=$TEXT(@TXT+AW)
SET AY=$PIECE(AX,";;",2)
if AY["|TOP|"
DO HD2^DVBCARCK
if AY="END"
WRITE !!
if AY="END"
QUIT
IF AY'["|TOP|"
WRITE AY,!
+1 if TXT="TXT3"
GOTO ^DVBCARC2
QUIT
+2 ;
TXT2 ;;A. Indicate whether or not the veteran REQUIRES an attendant in reporting
+1 ;; for this exam, and if so, identify the nurse or attendant and the
+2 ;; mode of travel employed:
+3 ;;
+4 ;;
+5 ;;
+6 ;;
+7 ;;
+8 ;;
+9 ;;B. Indicate whether or not the veteran is hospitalized, and if so, state
+10 ;; where and the date of admission:
+11 ;;
+12 ;;
+13 ;;
+14 ;;
+15 ;;
+16 ;;
+17 ;;C. Indicate whether or not the veteran is blind (best corrected vision
+18 ;; is 5/200 or worse in both eyes, or central vision field is five degrees
+19 ;; or less) or is permanently bedridden (if either skip items "D" through
+20 ;; "I" and go directly to "J"):
+21 ;;END
TXT3 ;;
+1 ;;
+2 ;;
+3 ;;F. Extremeties and spine:
+4 ;;
+5 ;; 1. Upper extremities (reporting each upper extremity separately) -
+6 ;;
+7 ;; a. Describe functional restrictions with reference to strength
+8 ;;and coordination and ability for self-feeding, fastening clothing, bathing,
+9 ;;shaving, and attending to the needs of nature -
+10 ;;
+11 ;;
+12 ;;
+13 ;;
+14 ;;
+15 ;;
+16 ;;
+17 ;; b. Indicate level of amputation or length of stump and state
+18 ;;whether or not use of prothesis is feasible -
+19 ;;|TOP|
+20 ;;
+21 ;;
+22 ;; 2. Lower extremities (reporting each lower extremity separately) -
+23 ;;
+24 ;; a. Describe functional restrictions with reference to extent
+25 ;;of limitation of motion, muscle atrophy, contractures, weakness, lack
+26 ;;of coordination, or other interference -
+27 ;;
+28 ;;
+29 ;;
+30 ;; b. Indicate any deficits of weight bearing, balance and propulsion -
+31 ;;
+32 ;;
+33 ;;
+34 ;;
+35 ;;
+36 ;; c. If amputated, give level or length of stump and whether use
+37 ;;of prosthesis is feasible -
+38 ;;
+39 ;;
+40 ;;
+41 ;;
+42 ;;
+43 ;; 3. Spine, trunk, and neck -
+44 ;;
+45 ;; a. Describe any limitation of motion or deformity of lumbar,
+46 ;;thoracic, and cervical spine -
+47 ;;
+48 ;;
+49 ;;
+50 ;;
+51 ;;
+52 ;; b. Note if deformity of thoracic spine interferes with breathing -
+53 ;;
+54 ;;
+55 ;;
+56 ;;
+57 ;;
+58 ;;
+59 ;;G. Capacity to protect oneself from the hazards/dangers of daily environment:
+60 ;;
+61 ;; 1. Describe briefly any pathological processes involving other body
+62 ;;parts and systems, including the effects of advancing age, such as dizziness,
+63 ;;loss of memory, poor balance affecting ability to ambulate, perform self-
+64 ;;care, or travel beyond the premises of the home or the ward or clinical
+65 ;;area if hospitalized -
+66 ;;|TOP|
+67 ;; 2. Describe where the veteran goes and what he/she does during a
+68 ;;typical day -
+69 ;;
+70 ;;
+71 ;;
+72 ;;
+73 ;;
+74 ;;
+75 ;;END
+76 ;
TXT10 ;;Once the existence of at least one permanent disability
+1 ;; rated as being 100% disabling has been established, additional
+2 ;; benefits are payable if the veteran is so helpless as to require
+3 ;; the regular aid and attendance of another person in attending to
+4 ;; the ordinary activities of daily living, or in protecting
+5 ;; himself/herself from the ordinary hazards of his/her daily
+6 ;; environment, or is restricted to his/her home or the immediate
+7 ;; vicinity thereof, including the ward or immediate clinical area,
+8 ;; if hospitalized.
+9 ;;
+10 ;; If a general medical examination is included as a part of this
+11 ;; request specific findings as to the individual body systems and
+12 ;; extremeties already noted in that examination need not be repeated.
+13 ;; Items "G" through "L", as the examiner deems appropriate, must be
+14 ;; completed in all cases unless the veteran is blind or permanently
+15 ;; bedridden (see item "C").
+16 ;;
+17 ;;END
