DVBCPWC2 ;ALB ISC/THM-POW PROTOCOL MENTAL DISORDER EXAM ; 5/6/91 9:40 AM
;;2.7;AMIE;;Apr 10, 1995
;
S PG=1,HD91="Department of Veterans Affairs",HD9="Full Exam Worksheet"
EN W @IOF,!?25,HD91,!?22,"Compensation and Pension Examination",! S HD7="MENTAL DISORDERS - POW PROTOCOL",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 !!,"Physician's Guide Reference: Chapter 14, 17, 20",!!,"Narrative: "
W !!,"A. Medical and occupational history:",!!
W ?8,"1. Immediate pre-military events -",!!!!!!!!!?8,"2. Events as a POW -",!!!!!!!!!?8,"3. Post-active service events (to present) -",!!!!!!!!!
W ?8,"4. Employment history prior to and following",!?11,"active service -" D HD2
W "B. Subjective complaints (include the veteran's history of unusually ",!?27,"traumatic events as a POW, if not elsewhere",!?27,"indicated) -",!!!!!!!!!!!!!!! W "C. Objective findings:",! D HD2
W "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 $P(LY,";;",2),!
W !!!!!!!!!!!!,"E. Diagnosis:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
K LN,LN1,LN2
G ^DVBCPWC3
;
HD2 S PG=PG+1 W @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
Q
TXT1 ;
;; 1. State if the veteran is capable of managing his/her benefit
;; payments in the individual's own best interests without restriction
;; (a physical disability which prevents the veteran from attending
;; to financial matters in person is not a proper basis for a finding
;; of incompetency unless the veteran is, by reason of that disability,
;; incapable of directing someone else in handling the individual's
;; his financial affairs) -
;;$END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCPWC2 2081 printed Oct 16, 2024@17:46:17 Page 2
DVBCPWC2 ;ALB ISC/THM-POW PROTOCOL MENTAL DISORDER EXAM ; 5/6/91 9:40 AM
+1 ;;2.7;AMIE;;Apr 10, 1995
+2 ;
+3 SET PG=1
SET HD91="Department of Veterans Affairs"
SET HD9="Full Exam Worksheet"
EN WRITE @IOF,!?25,HD91,!?22,"Compensation and Pension Examination",!
SET HD7="MENTAL DISORDERS - POW PROTOCOL"
SET HD8="For "_HD7
WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!!
+1 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
+2 WRITE !!,"Physician's Guide Reference: Chapter 14, 17, 20",!!,"Narrative: "
+3 WRITE !!,"A. Medical and occupational history:",!!
+4 WRITE ?8,"1. Immediate pre-military events -",!!!!!!!!!?8,"2. Events as a POW -",!!!!!!!!!?8,"3. Post-active service events (to present) -",!!!!!!!!!
+5 WRITE ?8,"4. Employment history prior to and following",!?11,"active service -"
DO HD2
+6 WRITE "B. Subjective complaints (include the veteran's history of unusually ",!?27,"traumatic events as a POW, if not elsewhere",!?27,"indicated) -",!!!!!!!!!!!!!!!
WRITE "C. Objective findings:",!
DO HD2
+7 WRITE "D. Specific evaluation information required by the rating board",!?4,"(if the information requested is included elsewhere, do not",!?4,"repeat here):",!!!
+8 SET LX="TXT1"
FOR I=1:1
SET LY=$TEXT(@LX+I)
if LY["$END"
QUIT
WRITE $PIECE(LY,";;",2),!
+9 WRITE !!!!!!!!!!!!,"E. Diagnosis:",!!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
+10 KILL LN,LN1,LN2
+11 GOTO ^DVBCPWC3
+12 ;
HD2 SET PG=PG+1
WRITE @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",NAME,!!!
+1 QUIT
TXT1 ;
+1 ;; 1. State if the veteran is capable of managing his/her benefit
+2 ;; payments in the individual's own best interests without restriction
+3 ;; (a physical disability which prevents the veteran from attending
+4 ;; to financial matters in person is not a proper basis for a finding
+5 ;; of incompetency unless the veteran is, by reason of that disability,
+6 ;; incapable of directing someone else in handling the individual's
+7 ;; his financial affairs) -
+8 ;;$END
