DVBCJNCK ;ALB/GTS-557/THM-JOINT EXAM ; 5/17/91 8:47 AM
;;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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1430 Worksheet" S HD7="JOINTS (ORTHOPEDIC)",HD8="FOR "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
W !!!!,"Narrative:"
W ?13,"Do not use negative values to indicate inability to achieve",!?13,"full extension. The anatomical position is the reference",!?13,"position EXCEPT with the regard to rotation of the shoulder",!?13,"and pronation/supination "
W "of the forearm (see fig. 2.1 and 2.2",!?13,"of the Physician's Guide). To give uniformity in describing",!?13,"limitation of motion or ankylosis of a joint, THE USE OF A",!?13,"GONIOMETER IS REQUIRED.",!!!
I '$D(CMBN) W "A. Medical history:",!!!!!!!!!! W "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. Swelling -",!!!!!?8,"2. Deformity -",!!!!!
W ?8,"3. Other impairment of knee: subluxation or lateral instability;",!?11,"non-union, with loose motion; malunion -",!!!!!
D:$D(CMBN) HD2 W ?8,"4. Range of motion (complete chart below)-",!!?11,"Note: Enter joint names in blanks under numbers below. If more",!
W ?11,"than four joints are involved, please extend your dictation in the",!?11,"same format.",!!
S LN="|============|============|============|============|",LN1="| | | | |",LN2="|------------|------------|------------|------------|"
W ?19,"------------------ JOINT EXAMINED -------------------",!!?25,"1",?32,"|",?38,"2",?45,"|",?51,"3",?58,"|",?65,"4",?71,"|",!?19,LN,!,"Range of:",?19,LN1,!,"----- --",?19,LN,!
F JX="Flexion","Extension","Rotation","Abduction","Adduction","Pronation","Supination","Deviation (radial)","Deviation (ulnar)","Plantar Flexion","Dorsiflexion" W JX,?19,LN1,!?19,LN2,!
D HD2 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!
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 JOINTS for "_NAME,!!!
Q
;
SETIOF ; ** Set device control var's
D HOME^%ZIS
Q
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCJNCK 2742 printed Sep 23, 2025@19:20:38 Page 2
DVBCJNCK ;ALB/GTS-557/THM-JOINT EXAM ; 5/17/91 8:47 AM
+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 '$DATA(IOF)
DO SETIOF
if (IOST?1"C-".E)
WRITE @IOF
+1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
WRITE ?33,"# 1430 Worksheet"
SET HD7="JOINTS (ORTHOPEDIC)"
SET HD8="FOR "_HD7
WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
+2 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
+3 WRITE !!!!,"Narrative:"
+4 WRITE ?13,"Do not use negative values to indicate inability to achieve",!?13,"full extension. The anatomical position is the reference",!?13,"position EXCEPT with the regard to rotation of the shoulder",!?13,"and pronation/supination "
+5 WRITE "of the forearm (see fig. 2.1 and 2.2",!?13,"of the Physician's Guide). To give uniformity in describing",!?13,"limitation of motion or ankylosis of a joint, THE USE OF A",!?13,"GONIOMETER IS REQUIRED.",!!!
+6 IF '$DATA(CMBN)
WRITE "A. Medical history:",!!!!!!!!!!
WRITE "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. Swelling -",!!!!!?8,"2. Deformity -",!!!!!
+9 WRITE ?8,"3. Other impairment of knee: subluxation or lateral instability;",!?11,"non-union, with loose motion; malunion -",!!!!!
+10 if $DATA(CMBN)
DO HD2
WRITE ?8,"4. Range of motion (complete chart below)-",!!?11,"Note: Enter joint names in blanks under numbers below. If more",!
+11 WRITE ?11,"than four joints are involved, please extend your dictation in the",!?11,"same format.",!!
+12 SET LN="|============|============|============|============|"
SET LN1="| | | | |"
SET LN2="|------------|------------|------------|------------|"
+13 WRITE ?19,"------------------ JOINT EXAMINED -------------------",!!?25,"1",?32,"|",?38,"2",?45,"|",?51,"3",?58,"|",?65,"4",?71,"|",!?19,LN,!,"Range of:",?19,LN1,!,"----- --",?19,LN,!
+14 FOR JX="Flexion","Extension","Rotation","Abduction","Adduction","Pronation","Supination","Deviation (radial)","Deviation (ulnar)","Plantar Flexion","Dorsiflexion"
WRITE JX,?19,LN1,!?19,LN2,!
+15 DO HD2
WRITE $SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!
+16 WRITE $SELECT($DATA(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
+17 KILL LN,LN1,LN2
+18 QUIT
+19 ;
HD2 SET PG=PG+1
WRITE @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for JOINTS for "_NAME,!!!
+1 QUIT
+2 ;
SETIOF ; ** Set device control var's
+1 DO HOME^%ZIS
+2 QUIT
