DVBCDBCK ;ALB/GTS-557/THM-DISEASES/INJURIES OF THE BRAIN ; 12/28/90 9:26 AM
;;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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1210 Worksheet" S HD7="DISEASES/INJURIES OF THE BRAIN",HD8="For "_HD7 W !?(40-($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. State if a tumor is present. If so, note type and whether ",!?9,"malignant -",!!!!!!!!
W ?5,"2. If a malignancy is present but is now cured or in remission,",!?9,"report the date of last surgery, radiation therapy, chemotherapy",!?9,"or other treatment -",!!!!!!!!
W ?5,"3. Describe in detail the motor and sensory impairment of the affected",!?9,"cranial nerves -",!!!!!!!!
D:$D(CMBN) HD2 W ?5,"4. Describe in detail any functional impairment of the peripheral",!?9,"and autonomic systems -",!!!!!!!!
D:'$D(CMBN) HD2 W ?5,"5. Describe any psychiatric manifestations in detail -",!!!!!!?5,"6. "
S LX="TXT1" F I=1:1 S LY=$T(@LX+I) Q:LY["END" W:$X'=5 ?5,$P(LY,";;",2),!
W !!!!!!!!!,$S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!!! D:$D(CMBN) HD2
W $S($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 ;
;;Since disorders of the brain are likely to produce psychiatric
;;manifestations as well as neurological, special psychiatric
;;examinations will often be necessary. If special senses are
;;impaired, the examiner should order additional testing as
;;appropriate.
;;END
TXT1 ;
;;State if the veteran is capable of managing his/her benefit payments
;; in the individual's own best interest without restriction (a physical
;; disability which prevents the veteran from attending to financial
;; matters in person is not a proper basis for a finding of incompetency
;; unless the veteran is, by reason of that disability, incapable of
;; directing someone else in handling the individual's financial
;; affairs) -
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCDBCK 2926 printed Apr 09, 2024@20:46:51 Page 2
DVBCDBCK ;ALB/GTS-557/THM-DISEASES/INJURIES OF THE BRAIN ; 12/28/90 9:26 AM
+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 '$DATA(IOF)
DO SETIOF
if (IOST?1"C-".E)
WRITE @IOF
+1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
WRITE ?33,"# 1210 Worksheet"
SET HD7="DISEASES/INJURIES OF THE BRAIN"
SET HD8="For "_HD7
WRITE !?(40-($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. State if a tumor is present. If so, note type and whether ",!?9,"malignant -",!!!!!!!!
+8 WRITE ?5,"2. If a malignancy is present but is now cured or in remission,",!?9,"report the date of last surgery, radiation therapy, chemotherapy",!?9,"or other treatment -",!!!!!!!!
+9 WRITE ?5,"3. Describe in detail the motor and sensory impairment of the affected",!?9,"cranial nerves -",!!!!!!!!
+10 if $DATA(CMBN)
DO HD2
WRITE ?5,"4. Describe in detail any functional impairment of the peripheral",!?9,"and autonomic systems -",!!!!!!!!
+11 if '$DATA(CMBN)
DO HD2
WRITE ?5,"5. Describe any psychiatric manifestations in detail -",!!!!!!?5,"6. "
+12 SET LX="TXT1"
FOR I=1:1
SET LY=$TEXT(@LX+I)
if LY["END"
QUIT
if $X'=5
WRITE ?5,$PIECE(LY,";;",2),!
+13 WRITE !!!!!!!!!,$SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!!!
if $DATA(CMBN)
DO HD2
+14 WRITE $SELECT($DATA(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
+15 KILL LN,LN1,LN2
+16 QUIT
+17 ;
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 ;;Since disorders of the brain are likely to produce psychiatric
+2 ;;manifestations as well as neurological, special psychiatric
+3 ;;examinations will often be necessary. If special senses are
+4 ;;impaired, the examiner should order additional testing as
+5 ;;appropriate.
+6 ;;END
TXT1 ;
+1 ;;State if the veteran is capable of managing his/her benefit payments
+2 ;; in the individual's own best interest without restriction (a physical
+3 ;; disability which prevents the veteran from attending to financial
+4 ;; matters in person is not a proper basis for a finding of incompetency
+5 ;; unless the veteran is, by reason of that disability, incapable of
+6 ;; directing someone else in handling the individual's financial
+7 ;; affairs) -
+8 ;;END
