Routine: DVBCPDCK

DVBCPDCK ;ALB/GTS-557/THM-PULMONARY TB/OTHER MYCOBACTERIAL DISEASES ; 6/27/91  12:48 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,"# 1515 Worksheet" S HD7="PULMONARY TUBERCULOSIS AND MYCOBACTERIAL DISEASES",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,"Is pulmonary tuberculosis or other mycobacterial disease",!?13,"active?  If so, identify the organism.  In reactivated",!?13,"cases, it is necessary to know whether this is reactivation",!

 W ?13,"of the old disease or a separate and distinct new infection.",!!!

 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 ?4,"1. IN ALL CASES:",!!?8,"a. Date of inactivity -",!!!!!?8,"b. Extent of structural damage to lungs -",!!!!!!?8,"c. Provide pulmonary function studies -",!!!!!?4,"2. In PENSION CASES ONLY:",!!!

 W ?8,"a. Disease condition after six months of treatment -",!!!!!?8,"b. Disease condition after twelve months of treatment -",!!!!!

 D:$D(CMBN) HD2 W "  Additional note to the physician:",!!!,"In all claims, if the disease is inactive and if the inactivity was confirmed",!

 W "at a non-VA facility, obtain the name and mailing address of the facility",!,"from the veteran so that the "

 W "Regional Office may request the report.",!

 D:'$D(CMBN) 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

HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",!,HD7,!!,"for "_NAME,!!!

SETIOF ;  ** Set device control var's

 D HOME^%ZIS

--- Routine Detail   --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCPDCK   2306     printed  Apr 09, 2024@20:53:50                                                                                                                                                                                                    Page 2

DVBCPDCK  ;ALB/GTS-557/THM-PULMONARY TB/OTHER MYCOBACTERIAL DISEASES ; 6/27/91  12:48 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,"# 1515 Worksheet"

           SET HD7="PULMONARY TUBERCULOSIS AND MYCOBACTERIAL DISEASES"

           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,"Is pulmonary tuberculosis or other mycobacterial disease",!?13,"active?  If so, identify the organism.  In reactivated",!?13,"cases, it is necessary to know whether this is reactivation",!

 +5        WRITE ?13,"of the old disease or a separate and distinct new infection.",!!!

 +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 ?4,"1. IN ALL CASES:",!!?8,"a. Date of inactivity -",!!!!!?8,"b. Extent of structural damage to lungs -",!!!!!!?8,"c. Provide pulmonary function studies -",!!!!!?4,"2. In PENSION CASES ONLY:",!!!

 +9        WRITE ?8,"a. Disease condition after six months of treatment -",!!!!!?8,"b. Disease condition after twelve months of treatment -",!!!!!

 +10       if $DATA(CMBN)

               DO HD2

           WRITE "  Additional note to the physician:",!!!,"In all claims, if the disease is inactive and if the inactivity was confirmed",!

 +11       WRITE "at a non-VA facility, obtain the name and mailing address of the facility",!,"from the veteran so that the "

 +12       WRITE "Regional Office may request the report.",!

 +13       if '$DATA(CMBN)

               DO HD2

           WRITE $SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!

           WRITE $SELECT($DATA(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!

 +14       KILL LN,LN1,LN2

 +15       QUIT

 +16      ;

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

DVBCPDCK.m