DVBCCRCK ;ALB/GTS-557/THM-THE CRANIAL NERVES ; 12/27/90 1:10 PM
;;2.7;AMIE;;Apr 10, 1995
;
S PG=1,HD91="Department of Veterans Affairs"
S HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1205 Worksheet" S HD7="THE CRANIAL NERVES",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
W !!!!,"Narrative:"
S LX="TXT" F I=1:1 S LY=$T(@LX+I) Q:LY["END" W ?13,$P(LY,";;",2),!
W !! I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:" D HD2
W $S($D(CMBN):"A. ",1:"D. "),"Specific evaluation information required by the rating board",!?4,"(if the information requested is included elsewhere, do not",!?4,"repeat here):",!!!
W ?5,"1. Identify the nerve and the side -",!!!!!!?5,"2. Identify the disorder (paralysis, neuritis, neuralgia) -",!!!!!!
W ?5,"3. Describe in detail, quantifying as much as possible, the",!?9,"motor and sensory impairment. Note if the entire nerve is",!?9,"affected or only that part of the distribution distal to a",!?9,"particular localized lesion -",!!!!!!
D HD2 ;W ?5,"4. Is tinnitus present? If so is it constant or intermittent? -",!!!!!! D HD2
W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!!!,$S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
K LN,LN1,LN2
Q
;
HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
Q
;
SETIOF ; ** Set device control var's
D HOME^%ZIS
Q
;
TXT ;
;;The first through fourth, sixth and eighth cranial nerves are
;;covered under the instructions for examination of the Organs
;;of Special Sense. This exam is limited to the examination of
;;the fifth, seventh, and ninth through twelfth cranial nerves.
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCCRCK 2146 printed Sep 23, 2025@19:19:50 Page 2
DVBCCRCK ;ALB/GTS-557/THM-THE CRANIAL NERVES ; 12/27/90 1:10 PM
+1 ;;2.7;AMIE;;Apr 10, 1995
+2 ;
+3 SET PG=1
SET HD91="Department of Veterans Affairs"
+4 SET HD9=$SELECT($DATA(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
EN if '$DATA(IOF)
DO SETIOF
if (IOST?1"C-".E)
WRITE @IOF
+1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
WRITE ?33,"# 1205 Worksheet"
SET HD7="THE CRANIAL NERVES"
SET HD8="For "_HD7
WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
+2 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
+3 WRITE !!!!,"Narrative:"
+4 SET LX="TXT"
FOR I=1:1
SET LY=$TEXT(@LX+I)
if LY["END"
QUIT
WRITE ?13,$PIECE(LY,";;",2),!
+5 WRITE !!
IF '$DATA(CMBN)
WRITE "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:"
DO HD2
+6 WRITE $SELECT($DATA(CMBN):"A. ",1:"D. "),"Specific evaluation information required by the rating board",!?4,"(if the information requested is included elsewhere, do not",!?4,"repeat here):",!!!
+7 WRITE ?5,"1. Identify the nerve and the side -",!!!!!!?5,"2. Identify the disorder (paralysis, neuritis, neuralgia) -",!!!!!!
+8 WRITE ?5,"3. Describe in detail, quantifying as much as possible, the",!?9,"motor and sensory impairment. Note if the entire nerve is",!?9,"affected or only that part of the distribution distal to a",!?9,"particular localized lesion -",!!!!!!
+9 ;W ?5,"4. Is tinnitus present? If so is it constant or intermittent? -",!!!!!! D HD2
DO HD2
+10 WRITE $SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!!!,$SELECT($DATA(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
+11 KILL LN,LN1,LN2
+12 QUIT
+13 ;
HD2 SET PG=PG+1
WRITE @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
+1 QUIT
+2 ;
SETIOF ; ** Set device control var's
+1 DO HOME^%ZIS
+2 QUIT
+3 ;
TXT ;
+1 ;;The first through fourth, sixth and eighth cranial nerves are
+2 ;;covered under the instructions for examination of the Organs
+3 ;;of Special Sense. This exam is limited to the examination of
+4 ;;the fifth, seventh, and ninth through twelfth cranial nerves.
+5 ;;END
