Routine: DVBCSPCK

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

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[HDVBCSPCK   2208     printed  Apr 09, 2024@20:55:36                                                                                                                                                                                                    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

DVBCSPCK.m