- DVBCSPCK ;ALB/GTS-557/THM-SPINAL EXAM ; 5/17/91 9:08 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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
- W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 1450 Worksheet" S HD7="SPINE (ORTHOPEDIC)",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
- W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
- W !!!!,"Narrative:"
- W ?13,"Complete description of spinal orthosis, its impact on",!?13,"motion before and after application, and whether the ",!?13,"usage is constant or intermittent should be part of the",!?13,"findings.",!!?13,"To give uniformity in "
- W "describing limitation of motion or",!?13,"ankylosis, THE USE OF A GONIOMETER IS REQUIRED. Report",!?13,"each spinal segment separately.",!!!
- I '$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. Postural abnormalities -",!!!!!?8,"2. Fixed deformity -",!!!!!?8,"3. Musculature of back -",!!!!!
- W ?8,"4. Range of motion:",!!?10,"a. Forward flexion -",!!!!?10,"b. Backward extension -",!!!!?10,"c. Left lateral flexion -",!!!! D:$D(CMBN) HD2
- W ?10,"d. Right lateral flexion -",!!!!?10,"e. Rotation to left -",!!!!!?10,"f. Rotation to right -",!!!!!
- W ?8,"5. Objective evidence of pain on motion -",!!!!! D:'$D(CMBN) HD2 W ?8,"6. Identify and describe any evidence of neurological involvement -",!!!!!
- W $S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!,$S($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
- --- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCSPCK 2208 printed Feb 18, 2025@23:15:09 Page 2
- DVBCSPCK ;ALB/GTS-557/THM-SPINAL EXAM ; 5/17/91 9:08 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 '$DATA(IOF)
- DO SETIOF
- if (IOST?1"C-".E)
- WRITE @IOF
- +1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
- WRITE ?33,"# 1450 Worksheet"
- SET HD7="SPINE (ORTHOPEDIC)"
- SET HD8="For "_HD7
- WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
- +2 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
- +3 WRITE !!!!,"Narrative:"
- +4 WRITE ?13,"Complete description of spinal orthosis, its impact on",!?13,"motion before and after application, and whether the ",!?13,"usage is constant or intermittent should be part of the",!?13,"findings.",!!?13,"To give uniformity in "
- +5 WRITE "describing limitation of motion or",!?13,"ankylosis, THE USE OF A GONIOMETER IS REQUIRED. Report",!?13,"each spinal segment separately.",!!!
- +6 IF '$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 ?8,"1. Postural abnormalities -",!!!!!?8,"2. Fixed deformity -",!!!!!?8,"3. Musculature of back -",!!!!!
- +9 WRITE ?8,"4. Range of motion:",!!?10,"a. Forward flexion -",!!!!?10,"b. Backward extension -",!!!!?10,"c. Left lateral flexion -",!!!!
- if $DATA(CMBN)
- DO HD2
- +10 WRITE ?10,"d. Right lateral flexion -",!!!!?10,"e. Rotation to left -",!!!!!?10,"f. Rotation to right -",!!!!!
- +11 WRITE ?8,"5. Objective evidence of pain on motion -",!!!!!
- if '$DATA(CMBN)
- DO HD2
- WRITE ?8,"6. Identify and describe any evidence of neurological involvement -",!!!!!
- +12 WRITE $SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!,$SELECT($DATA(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
- +13 KILL LN,LN1,LN2
- +14 QUIT
- +15 ;
- 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