DVBCFTCK ;ALB/GTS-557/THM-FEET EXAM ; 2/4/91 7:40 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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1415 Worksheet" S HD7="FEET (ORTHOPEDIC)",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
W !!!!,"Narrative:"
W ?13,"The findings in each foot will be separately and carefully",!?13,"described, as this will affect the evaluation. The nomenclature",!?13,"of toes for examination purposes will be the great toe, the second,",!
W ?13,"third, fourth and fifth toes, named from the medial or inner side",!?13,"and which foot is being examined. The functional loss should",!?13,"be related to the anatomical condition.",!!
I '$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 ?8,"1. Posture (standing, squatting, supination, pronation and",!?22,"rising on toes and heels) -",!!!!!
W ?8,"2. Appearance -",!!!!!?8,"3. Function -",!!!!!?8,"4. Deformity -",!!!!!?8,"5. Gait -",!!!!!?8,"6. Secondary skin and vascular changes -" D HD2
W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!! D:$Y>50 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,!,NAME,!!!
Q
;
SETIOF ; ** Set device control var's
D HOME^%ZIS
Q
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCFTCK 1999 printed Nov 22, 2024@16:54:20 Page 2
DVBCFTCK ;ALB/GTS-557/THM-FEET EXAM ; 2/4/91 7:40 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 '$DATA(IOF)
DO SETIOF
if (IOST?1"C-".E)
WRITE @IOF
+1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
WRITE ?33,"# 1415 Worksheet"
SET HD7="FEET (ORTHOPEDIC)"
SET HD8="For "_HD7
WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
+2 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
+3 WRITE !!!!,"Narrative:"
+4 WRITE ?13,"The findings in each foot will be separately and carefully",!?13,"described, as this will affect the evaluation. The nomenclature",!?13,"of toes for examination purposes will be the great toe, the second,",!
+5 WRITE ?13,"third, fourth and fifth toes, named from the medial or inner side",!?13,"and which foot is being examined. The functional loss should",!?13,"be related to the anatomical condition.",!!
+6 IF '$DATA(CMBN)
WRITE "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!!!!!!!!!!
DO HD2
+7 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):",!!!
+8 WRITE ?8,"1. Posture (standing, squatting, supination, pronation and",!?22,"rising on toes and heels) -",!!!!!
+9 WRITE ?8,"2. Appearance -",!!!!!?8,"3. Function -",!!!!!?8,"4. Deformity -",!!!!!?8,"5. Gait -",!!!!!?8,"6. Secondary skin and vascular changes -"
DO HD2
+10 WRITE $SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!
if $Y>50
DO HD2
WRITE $SELECT($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,!,NAME,!!!
+1 QUIT
+2 ;
SETIOF ; ** Set device control var's
+1 DO HOME^%ZIS
+2 QUIT
