- DVBCPRCK ;ALB/GTS-557/THM-THE PERIPHERAL NERVES EXAM ; 12/27/90 1:32 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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
- W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1230 Worksheet" S HD7="THE PERIPHERAL NERVES",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
- W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
- W !!!!,"Narrative: None",!!
- W !! I '$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):",!!!
- S LX="TXT1" F I=1:1 S LY=$T(@LX+I) Q:LY["END" W $P(LY,";;",2),!
- D:$D(CMBN) HD2 S LX="TXT2" F I=1:1 S LY=$T(@LX+I) Q:LY["END" W $P(LY,";;",2),!
- D:'$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
- 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
- ;
- TXT1 ;
- ;; 1. Where disability is the result of brain disease or injury, spinal cord
- ;; disease or injury, cervical disc disease, or trauma to the nerve roots
- ;; themselves, report sensory and motor impairment by reference to the
- ;; distribution of the affected groups as paralysis, neuritis or
- ;; neuralgia. Report each affected extremity separately -
- ;;
- ;;
- ;; a. In the upper extremities -
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;; b. In the lower extremities -
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;END
- TXT2 ;
- ;; 2. Where disability is NOT from the above, identify the specific major
- ;; nerve involved, localize the lesion and describe specific impairment
- ;; of motor and sensory function, fine motor control, etc.. Again
- ;; characterization as paralysis, neuritis or neuralgia is necessary
- ;; Indicate whether any muscle wasting or atrophy represents direct
- ;; effect of nerve damage or merely disuse. Report each affected
- ;; extremity separately -
- ;;
- ;;
- ;; a. In the upper extremities -
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;; b. In the lower extremities -
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;
- ;;END
- --- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCPRCK 2772 printed Feb 18, 2025@23:11:41 Page 2
- DVBCPRCK ;ALB/GTS-557/THM-THE PERIPHERAL NERVES EXAM ; 12/27/90 1:32 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 '$DATA(IOF)
- DO SETIOF
- if (IOST?1"C-".E)
- WRITE @IOF
- +1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
- WRITE ?33,"# 1230 Worksheet"
- SET HD7="THE PERIPHERAL NERVES"
- SET HD8="For "_HD7
- WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
- +2 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
- +3 WRITE !!!!,"Narrative: None",!!
- +4 WRITE !!
- IF '$DATA(CMBN)
- WRITE "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:"
- DO HD2
- +5 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):",!!!
- +6 SET LX="TXT1"
- FOR I=1:1
- SET LY=$TEXT(@LX+I)
- if LY["END"
- QUIT
- WRITE $PIECE(LY,";;",2),!
- +7 if $DATA(CMBN)
- DO HD2
- SET LX="TXT2"
- FOR I=1:1
- SET LY=$TEXT(@LX+I)
- if LY["END"
- QUIT
- WRITE $PIECE(LY,";;",2),!
- +8 if '$DATA(CMBN)
- DO HD2
- WRITE $SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!!!
- +9 WRITE $SELECT($DATA(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
- +10 KILL LN,LN1,LN2
- +11 QUIT
- +12 ;
- 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
- +3 ;
- TXT1 ;
- +1 ;; 1. Where disability is the result of brain disease or injury, spinal cord
- +2 ;; disease or injury, cervical disc disease, or trauma to the nerve roots
- +3 ;; themselves, report sensory and motor impairment by reference to the
- +4 ;; distribution of the affected groups as paralysis, neuritis or
- +5 ;; neuralgia. Report each affected extremity separately -
- +6 ;;
- +7 ;;
- +8 ;; a. In the upper extremities -
- +9 ;;
- +10 ;;
- +11 ;;
- +12 ;;
- +13 ;;
- +14 ;;
- +15 ;;
- +16 ;; b. In the lower extremities -
- +17 ;;
- +18 ;;
- +19 ;;
- +20 ;;
- +21 ;;
- +22 ;;
- +23 ;;
- +24 ;;
- +25 ;;END
- TXT2 ;
- +1 ;; 2. Where disability is NOT from the above, identify the specific major
- +2 ;; nerve involved, localize the lesion and describe specific impairment
- +3 ;; of motor and sensory function, fine motor control, etc.. Again
- +4 ;; characterization as paralysis, neuritis or neuralgia is necessary
- +5 ;; Indicate whether any muscle wasting or atrophy represents direct
- +6 ;; effect of nerve damage or merely disuse. Report each affected
- +7 ;; extremity separately -
- +8 ;;
- +9 ;;
- +10 ;; a. In the upper extremities -
- +11 ;;
- +12 ;;
- +13 ;;
- +14 ;;
- +15 ;;
- +16 ;;
- +17 ;;
- +18 ;;
- +19 ;; b. In the lower extremities -
- +20 ;;
- +21 ;;
- +22 ;;
- +23 ;;
- +24 ;;
- +25 ;;
- +26 ;;
- +27 ;;
- +28 ;;END