DVBCHPCK ;ALB/GTS-557/THM-HIP EXAM ; 5/19/91 1:02 PM
;;2.7;AMIE;;Apr 10, 1995
;
S PG=1,HD91="Department of Veterans Affairs",HD9=$S($D(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
EN D:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1425 Worksheet" S HD7="HIP",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
W !!!!,"Narrative:"
W ?13,"Loss of range of motion of the hip will be recorded from",!?13,"the anatomical position (0 degrees) varying from 125 degrees",!
W ?13,"in flexion to 30 degrees in extension, from 25 degrees in",!?13,"adduction to 45 degrees "
W "in abduction, and from 60 degrees in",!?13,"external rotation to 40 degrees in internal rotation. To gain",!?13,"a true picure of hip flexion, i.e. movement between the pelvis",!
W ?13,"and femur in the hip joint, the opposide thigh should be",!,?13,"extended to minimize motion between the pelvis and spine.",!!
I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!! W "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. Describe movements of the thigh as it may rotate",!?8,"in a circular manner about the femoral head in the "
W !?8,"acetabulum. Discuss any pain, tenderness, weakness",!?8,"and fatigue on standing and any unusual motions on ",!?8,"walking -",!!!!!!!!!!!
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,!,"for "_NAME,!!!
Q
;
SETIOF ; ** Set device control var's
D HOME^%ZIS
Q
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCHPCK 2129 printed Sep 23, 2025@19:20:27 Page 2
DVBCHPCK ;ALB/GTS-557/THM-HIP EXAM ; 5/19/91 1:02 PM
+1 ;;2.7;AMIE;;Apr 10, 1995
+2 ;
+3 SET PG=1
SET HD91="Department of Veterans Affairs"
SET HD9=$SELECT($DATA(CMBN):"Abbreviated",1:"Full")_" Exam Worksheet"
EN if '$DATA(IOF)
DO SETIOF
if (IOST?1"C-".E)
WRITE @IOF
+1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
WRITE ?33,"# 1425 Worksheet"
SET HD7="HIP"
SET HD8="For "_HD7
WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
+2 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
+3 WRITE !!!!,"Narrative:"
+4 WRITE ?13,"Loss of range of motion of the hip will be recorded from",!?13,"the anatomical position (0 degrees) varying from 125 degrees",!
+5 WRITE ?13,"in flexion to 30 degrees in extension, from 25 degrees in",!?13,"adduction to 45 degrees "
+6 WRITE "in abduction, and from 60 degrees in",!?13,"external rotation to 40 degrees in internal rotation. To gain",!?13,"a true picure of hip flexion, i.e. movement between the pelvis",!
+7 WRITE ?13,"and femur in the hip joint, the opposide thigh should be",!,?13,"extended to minimize motion between the pelvis and spine.",!!
+8 IF '$DATA(CMBN)
WRITE "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!
WRITE "C. Objective findings:"
DO HD2
+9 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):",!!
+10 WRITE ?5,"1. Describe movements of the thigh as it may rotate",!?8,"in a circular manner about the femoral head in the "
+11 WRITE !?8,"acetabulum. Discuss any pain, tenderness, weakness",!?8,"and fatigue on standing and any unusual motions on ",!?8,"walking -",!!!!!!!!!!!
+12 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: _________________________",!
+13 KILL LN,LN1,LN2
+14 QUIT
+15 ;
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
