- DVBCSKCK ;ALB/GTS-557/THM-SKIN, OTHER THAN SCARS ; 12/11/90 7:31 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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
- W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1610 Worksheet" S HD7="SKIN, OTHER THAN SCARS",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
- W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
- W !!!!,"Narrative:"
- W ?13,"When furnishing the history of the present skin disease",!?13,"include a description of the skin changes, when the disorder",!?13,"first appeared, and the progression of the illness since that",!?13,"time. Note whether"
- W " remissions or exacerbations occurred",!?13,"and whether they were related to the occupation or treatment.",!?13,"Include the duration of remissions and factors that",!?13,"may have influenced the course of the disorder.",!!!
- I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints: "
- I '$D(CMBN) W ?24,"(List the types of complaints such as itching",!,"burning, pain and anesthesia. Note whether environmental factors such as",!,"temperature or seasonal change affect the severity of the symptoms.)",! D HD2
- I '$D(CMBN) W "C. Objective findings:",!!!!!!!!!!!!!
- 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. Description of skin disorder -",!!!!!?8,"2. Distribution of skin disorder -",!!!!!?8,"3. Configuration and characteristics of lesions -",!!!!!!?8,"4. Nervous manifestations -",!!
- W !!!?8,"5. Attach color photograph if condition is disfiguring.",!
- D HD2 W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!!!!!,$S($D(CMBN):"C. ",1:"F. "),"Diagnosis:",!!
- W "(Note: If current diagnosis differs from the skin condition",!,"for which the examination was ordered, then review prior records and",!,"express opinion whether current disease is a new problem or original ",!,"diagnosis was in error.)"
- W !!!!!!!!!!!!?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
- --- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCSKCK 2548 printed Feb 18, 2025@23:15:07 Page 2
- DVBCSKCK ;ALB/GTS-557/THM-SKIN, OTHER THAN SCARS ; 12/11/90 7:31 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 '$DATA(IOF)
- DO SETIOF
- if (IOST?1"C-".E)
- WRITE @IOF
- +1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
- WRITE ?33,"# 1610 Worksheet"
- SET HD7="SKIN, OTHER THAN SCARS"
- SET HD8="For "_HD7
- WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
- +2 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
- +3 WRITE !!!!,"Narrative:"
- +4 WRITE ?13,"When furnishing the history of the present skin disease",!?13,"include a description of the skin changes, when the disorder",!?13,"first appeared, and the progression of the illness since that",!?13,"time. Note whether"
- +5 WRITE " remissions or exacerbations occurred",!?13,"and whether they were related to the occupation or treatment.",!?13,"Include the duration of remissions and factors that",!?13,"may have influenced the course of the disorder.",!!!
- +6 IF '$DATA(CMBN)
- WRITE "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints: "
- +7 IF '$DATA(CMBN)
- WRITE ?24,"(List the types of complaints such as itching",!,"burning, pain and anesthesia. Note whether environmental factors such as",!,"temperature or seasonal change affect the severity of the symptoms.)",!
- DO HD2
- +8 IF '$DATA(CMBN)
- WRITE "C. Objective findings:",!!!!!!!!!!!!!
- +9 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):",!!!
- +10 WRITE ?8,"1. Description of skin disorder -",!!!!!?8,"2. Distribution of skin disorder -",!!!!!?8,"3. Configuration and characteristics of lesions -",!!!!!!?8,"4. Nervous manifestations -",!!
- +11 WRITE !!!?8,"5. Attach color photograph if condition is disfiguring.",!
- +12 DO HD2
- WRITE $SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!!!!!!!,$SELECT($DATA(CMBN):"C. ",1:"F. "),"Diagnosis:",!!
- +13 WRITE "(Note: If current diagnosis differs from the skin condition",!,"for which the examination was ordered, then review prior records and",!,"express opinion whether current disease is a new problem or original ",!,"diagnosis was in error.)"
- +14 WRITE !!!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
- +15 KILL LN,LN1,LN2
- +16 QUIT
- +17 ;
- HD2 SET PG=PG+1
- WRITE @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for ",HD7,!,"for ",!,NAME,!!!
- +1 QUIT
- SETIOF ; ** Set device control var's
- +1 DO HOME^%ZIS
- +2 QUIT