- DVBCTTCK ;ALB/GTS-557/THM-TESTES, TRAUMA, OR DISEASE ; 12/7/90 8:41 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:'$D(IOF) SETIOF W:(IOST?1"C-".E) @IOF
- W !?25,HD91,!?22,"Compensation and Pension Examination",! W ?33,"# 0625 Worksheet" S HD7="TESTIS, TRAUMA, OR DISEASE (GU)",HD8="For "_HD7 W !?(40-($L(HD9)\2)),HD9,!?(40-($L(HD8)\2)),HD8,!!
- W !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
- W !!!!,"Narrative:"
- W ?13,"Loss of use of a testis when based upon its small size or soft",!?13,"consistency must be described by a board of at least three",!?13,"physicians including at least one urologist. The board of",!
- W ?13,"physicians should review the physician's guide for special",!?13,"instructions.",!!
- I '$D(CMBN) W "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!
- D:'$D(CMBN) 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. Atrophy or absence of one or both testis -",!!!!!?8,"2. Measurements -",!!!!!?8,"3. Consistency -",!!!!!
- W ?8,"4. Comparison -",!!!!!,$S($D(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!
- I $Y>50 D HD2
- 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 "_NAME,!,HD8,!!!
- Q
- SETIOF ; ** Set device control var's
- D HOME^%ZIS
- Q
- --- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCTTCK 1799 printed Jan 18, 2025@02:50:16 Page 2
- DVBCTTCK ;ALB/GTS-557/THM-TESTES, TRAUMA, OR DISEASE ; 12/7/90 8:41 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 '$DATA(IOF)
- DO SETIOF
- if (IOST?1"C-".E)
- WRITE @IOF
- +1 WRITE !?25,HD91,!?22,"Compensation and Pension Examination",!
- WRITE ?33,"# 0625 Worksheet"
- SET HD7="TESTIS, TRAUMA, OR DISEASE (GU)"
- SET HD8="For "_HD7
- WRITE !?(40-($LENGTH(HD9)\2)),HD9,!?(40-($LENGTH(HD8)\2)),HD8,!!
- +2 WRITE !,"Name: ",NAME,?45,"SSN: ",SSN,!?45,"C-number: ",CNUM,!,"Date of exam: ____________________",!!,"Place of exam: ___________________",!!,"Type of Exam: ",HD7
- +3 WRITE !!!!,"Narrative:"
- +4 WRITE ?13,"Loss of use of a testis when based upon its small size or soft",!?13,"consistency must be described by a board of at least three",!?13,"physicians including at least one urologist. The board of",!
- +5 WRITE ?13,"physicians should review the physician's guide for special",!?13,"instructions.",!!
- +6 IF '$DATA(CMBN)
- WRITE "A. Medical history:",!!!!!!!!!!,"B. Subjective complaints:",!!!!!!!!!!,"C. Objective findings:",!
- +7 if '$DATA(CMBN)
- DO HD2
- 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. Atrophy or absence of one or both testis -",!!!!!?8,"2. Measurements -",!!!!!?8,"3. Consistency -",!!!!!
- +9 WRITE ?8,"4. Comparison -",!!!!!,$SELECT($DATA(CMBN):"B. ",1:"E. "),"Diagnostic/clinical test results:",!!!!!!!!!!
- +10 IF $Y>50
- DO HD2
- +11 WRITE $SELECT($DATA(CMBN):"C. ",1:"F. "),"Diagnosis:",!!!!!!!!!!?25,"Signature: ______________________________",!!?30,"Date: _________________________",!
- +12 KILL LN,LN1,LN2
- +13 QUIT
- +14 ;
- HD2 SET PG=PG+1
- WRITE @IOF,!,"Page: ",PG,!!,"Compensation and Pension Exam for "_NAME,!,HD8,!!!
- +1 QUIT
- SETIOF ; ** Set device control var's
- +1 DO HOME^%ZIS
- +2 QUIT