DVBCWEA1 ;ALB/CMM EATING DISORDERS WKS TEXT - 1 ; 6 MARCH 1997
;;2.7;AMIE;**12**;Apr 10, 1995
;
;
TXT ;
;;A. Review of Medical Records:
;;
;;
;;
;;
;;B. Medical History (Subjective Complaints):
;;
;; Comment on:
;; 1. PAST MEDICAL HISTORY
;;
;; a. Previous hospitalizations and outpatient care for parenteral
;; nutrition or tube feeding.
;;
;;
;; b. Medical and occupational history from the time between the
;; last such rating examination and the present needs to be
;; accounted for, UNLESS the purpose of this examination is to
;; ESTABLISH service connection, then a complete medical history
;; since discharge from military service is required.
;;
;;
;; c. Periods of incapacitation (during which bed rest and treatment
;; by a physician are required due to the eating disorder).
;; Describe the frequency and duration.
;;
;;
;; d. Current treatment, response, side effects.
;;
;;
;; 2. PRESENT MEDICAL, OCCUPATIONAL AND SOCIAL HISTORY - over the past
;; one year.
;;
;; a. History of onset of eating disorder.
;;
;; b. Its course, treatment, and current status to include symptoms.
;;
;; c. Extent of time lost from work over the past 12 month period
;; and social impairment. If employed, identify current occupation
;; and length of time at this job.
;;
;;
;; 3. SUBJECTIVE COMPLAINTS:
;;
;; a. Describe fully.
;;
;;
;;C. Examination (Objective Findings):
;;
;; Address each of the following and fully describe:
;; 1. Mental status exam to confirm or establish diagnosis in
;; accordance with DSM-IV.
;;
;; 2. Additionally, please provide this specific information.
;;
;; a. Current weight.
;;
;;
;; b. Expected minimum weight based on age, height, and body build.
;;
;;
;; c. Obtain weight history.
;;
;;
;; 3. Additionally, to allow evaluation by the rating specialist,
;; describe and fully explain the existence, frequency, and extent
;; of the following signs and symptoms and relate how they
;; interfere with employment:
;;
;; a. Binge eating.
;;
;;
;; b. Self-induced vomiting or other measure to prevent weight gain
;; when weight is already below expected minimum normal weight.
;;
;;
;;D. Diagnostic Tests (including psychological testing if deemed necessary):
;;
;; 1. Provide specific evaluation information required by the rating
;; board or on a BVA Remand. Diagnostic Tests (See the examination
;; request remarks for specifics.):
;;
;; a. COMPETENCY: State whether the veteran is capable of managing
;; his or her benefit payments in the individual's own best
;; interests. (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 financial affairs.)
;;
;;TOF
;; b. OTHER OPINION: Furnish any other specific opinion requested
;; by the rating board or BVA Remand, furnishing the complete
;; rationale and citation of medical texts or treatise supporting
;; opinion, if medical literature review was undertaken. If the
;; requested opinion is medically not ascertainable on exam or
;; testing, please state WHY. If the requested opinion cannot
;; be expressed without resorting to speculation or making
;; improbable assumptions say so, and explain why. If the opinion
;; asks "...is it at least as likely as not...", fully explain
;; the clinical findings and rationale for the opinion.
;;
;;
;; 2. Include results of all diagnostic and clinical tests conducted
;; in the examination report.
;;
;;
;;E. Diagnosis:
;;
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWEA1 4229 printed Apr 09, 2024@20:45:19 Page 2
DVBCWEA1 ;ALB/CMM EATING DISORDERS WKS TEXT - 1 ; 6 MARCH 1997
+1 ;;2.7;AMIE;**12**;Apr 10, 1995
+2 ;
+3 ;
TXT ;
+1 ;;A. Review of Medical Records:
+2 ;;
+3 ;;
+4 ;;
+5 ;;
+6 ;;B. Medical History (Subjective Complaints):
+7 ;;
+8 ;; Comment on:
+9 ;; 1. PAST MEDICAL HISTORY
+10 ;;
+11 ;; a. Previous hospitalizations and outpatient care for parenteral
+12 ;; nutrition or tube feeding.
+13 ;;
+14 ;;
+15 ;; b. Medical and occupational history from the time between the
+16 ;; last such rating examination and the present needs to be
+17 ;; accounted for, UNLESS the purpose of this examination is to
+18 ;; ESTABLISH service connection, then a complete medical history
+19 ;; since discharge from military service is required.
+20 ;;
+21 ;;
+22 ;; c. Periods of incapacitation (during which bed rest and treatment
+23 ;; by a physician are required due to the eating disorder).
+24 ;; Describe the frequency and duration.
+25 ;;
+26 ;;
+27 ;; d. Current treatment, response, side effects.
+28 ;;
+29 ;;
+30 ;; 2. PRESENT MEDICAL, OCCUPATIONAL AND SOCIAL HISTORY - over the past
+31 ;; one year.
+32 ;;
+33 ;; a. History of onset of eating disorder.
+34 ;;
+35 ;; b. Its course, treatment, and current status to include symptoms.
+36 ;;
+37 ;; c. Extent of time lost from work over the past 12 month period
+38 ;; and social impairment. If employed, identify current occupation
+39 ;; and length of time at this job.
+40 ;;
+41 ;;
+42 ;; 3. SUBJECTIVE COMPLAINTS:
+43 ;;
+44 ;; a. Describe fully.
+45 ;;
+46 ;;
+47 ;;C. Examination (Objective Findings):
+48 ;;
+49 ;; Address each of the following and fully describe:
+50 ;; 1. Mental status exam to confirm or establish diagnosis in
+51 ;; accordance with DSM-IV.
+52 ;;
+53 ;; 2. Additionally, please provide this specific information.
+54 ;;
+55 ;; a. Current weight.
+56 ;;
+57 ;;
+58 ;; b. Expected minimum weight based on age, height, and body build.
+59 ;;
+60 ;;
+61 ;; c. Obtain weight history.
+62 ;;
+63 ;;
+64 ;; 3. Additionally, to allow evaluation by the rating specialist,
+65 ;; describe and fully explain the existence, frequency, and extent
+66 ;; of the following signs and symptoms and relate how they
+67 ;; interfere with employment:
+68 ;;
+69 ;; a. Binge eating.
+70 ;;
+71 ;;
+72 ;; b. Self-induced vomiting or other measure to prevent weight gain
+73 ;; when weight is already below expected minimum normal weight.
+74 ;;
+75 ;;
+76 ;;D. Diagnostic Tests (including psychological testing if deemed necessary):
+77 ;;
+78 ;; 1. Provide specific evaluation information required by the rating
+79 ;; board or on a BVA Remand. Diagnostic Tests (See the examination
+80 ;; request remarks for specifics.):
+81 ;;
+82 ;; a. COMPETENCY: State whether the veteran is capable of managing
+83 ;; his or her benefit payments in the individual's own best
+84 ;; interests. (A physical disability which prevents the veteran
+85 ;; from attending to financial matters in person is not a proper
+86 ;; basis for a finding of incompetency unless the veteran is,
+87 ;; by reason of that disability, incapable of directing someone
+88 ;; else in handling the individual's financial affairs.)
+89 ;;
+90 ;;TOF
+91 ;; b. OTHER OPINION: Furnish any other specific opinion requested
+92 ;; by the rating board or BVA Remand, furnishing the complete
+93 ;; rationale and citation of medical texts or treatise supporting
+94 ;; opinion, if medical literature review was undertaken. If the
+95 ;; requested opinion is medically not ascertainable on exam or
+96 ;; testing, please state WHY. If the requested opinion cannot
+97 ;; be expressed without resorting to speculation or making
+98 ;; improbable assumptions say so, and explain why. If the opinion
+99 ;; asks "...is it at least as likely as not...", fully explain
+100 ;; the clinical findings and rationale for the opinion.
+101 ;;
+102 ;;
+103 ;; 2. Include results of all diagnostic and clinical tests conducted
+104 ;; in the examination report.
+105 ;;
+106 ;;
+107 ;;E. Diagnosis:
+108 ;;
+109 ;;
+110 ;;Signature: Date:
+111 ;;END
