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Routine: DVBCGSCK

DVBCGSCK.m

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  1. DVBCGSCK ;ALB/GTS-557/THM-GYNECOLOGICAL, NOT ELSEWHERE CLASSIFIED ; 6/6/90 8:18 AM
  1. ;;2.7;AMIE;;Apr 10, 1995
  1. EN S DVBAX="For GYNECOLOGICAL, NOT ELSEWHERE CLASSIFIED"
  1. S PG=1 D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
  1. W !?22,"Compensation and Pension Examination",!?33,"# 0710 Worksheet",!,?(IOM-$L(DVBAX)\2),DVBAX,!!
  1. W "Name: ",NAME,?45,"SSN: ",SSN,!,?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: GYNECOLOGICAL, NOT ELSEWHERE CLASSIFIED",!!
  1. W "Physician's Guide Reference: None",!!,"Narrative:",!!
  1. F I=0:1 S LY=$T(TXT+I) D:LY["TOF" HD2 Q:LY["END" W:LY'["TOF" $P(LY,";;",2),! I $Y>55 D HD2
  1. K I,LY,DVBAX Q
  1. ;
  1. TXT ;;This exam is to handle the balance of currently recognized gynecological
  1. ;;disorders and to allow for new disorders not yet classified for V.A.
  1. ;;compensation evaluations. The severity of a condition is based upon the
  1. ;;residual disability. If there is a disease process that affects multiple
  1. ;;systems or extremeties, please evaluate each separately.
  1. ;;
  1. ;;
  1. ;;A. Medical history (W/P):
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  1. ;;B. Subjective findings (W/P):
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  1. ;;C. Objective findings (W/P):
  1. ;;TOF
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  1. ;;D. Evaluation Information for the Rating Board:
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  1. ;; Residual disability effect on:
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  1. ;; 1) earning capacity/job performance (F/T):
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  1. ;; 2) everyday activities (F/T):
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  1. ;; 3) Is disability constant? (YES/NO):
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  1. ;; 4) If NO, give frequency, length of remissions (F/T):
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  1. ;; 5) Acute exacerbations effect on everyday life. (F/T)
  1. ;;TOF
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  1. ;;E. Diagnosis (W/P):
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  1. ;;F. Diagnostic tests (Lab,X-Ray, etc) (W/P):
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  1. ;; Signature: ______________________________
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  1. ;; Date: _________________________
  1. ;;END
  1. Q
  1. ;
  1. HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for "_NAME,!
  1. W "For GYNECOLOGICAL, NOT ELSEWHERE CLASSIFIED",!!!
  1. Q
  1. ;
  1. SETIOF ; ** Set device control var's
  1. D HOME^%ZIS
  1. Q