DVBCNKCK ;ALB/GTS-557/THM-NECK EXAM ; 12/10/90 2:06 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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1440 Worksheet" S HD7="NECK, ABNORMALITIES OF, ",HD6="NOT RESULT OF INJURY OR BONE DISEASE",HD8="For "_HD7_HD6 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7,!?14,HD6
W !!!!,"Narrative:"
W ?13,"The report of examination should include any abnormal position",!?13,"of the head, range of motion of the head, evidence of",!?13,"paralysis of the neck muscles, and asymmetry produced by",!?13,"abnormal swelling or masses.",!!
I '$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. Range of motion -",!!!!!?8,"2. Deformity -",!!!!!?8,"3. Weakness -",!!!!!
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,!?5,HD6,!?5,"for "_NAME,!!!
Q
;
SETIOF ; ** Set device control var's
D HOME^%ZIS
Q
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCNKCK 1717 printed Dec 13, 2024@01:45 Page 2
DVBCNKCK ;ALB/GTS-557/THM-NECK EXAM ; 12/10/90 2:06 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 '$DATA(IOF)
DO SETIOF
if (IOST?1"C-".E)
WRITE @IOF
+1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
WRITE ?33,"# 1440 Worksheet"
SET HD7="NECK, ABNORMALITIES OF, "
SET HD6="NOT RESULT OF INJURY OR BONE DISEASE"
SET HD8="For "_HD7_HD6
WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
+2 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7,!?14,HD6
+3 WRITE !!!!,"Narrative:"
+4 WRITE ?13,"The report of examination should include any abnormal position",!?13,"of the head, range of motion of the head, evidence of",!?13,"paralysis of the neck muscles, and asymmetry produced by",!?13,"abnormal swelling or masses.",!!
+5 IF '$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 ?8,"1. Range of motion -",!!!!!?8,"2. Deformity -",!!!!!?8,"3. Weakness -",!!!!!
+8 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: _________________________",!
+9 KILL LN,LN1,LN2
+10 QUIT
+11 ;
HD2 SET PG=PG+1
WRITE @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!?5,HD6,!?5,"for "_NAME,!!!
+1 QUIT
+2 ;
SETIOF ; ** Set device control var's
+1 DO HOME^%ZIS
+2 QUIT
