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Routine: DVBCWEA5

DVBCWEA5.m

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DVBCWEA5 ;BPOIFO/RLC - EATING DISORDERS WKS TEXT - 1 ; 12/26/06 14:00pm

 ;;2.7;AMIE;**118**;Apr 10, 1995;Build 3

 ;Per VHA Directive 10-92-142, this routine should not be modified

 ;

TXT ;

 ;;

 ;;The following health care providers can perform initial examinations for

 ;;Eating Disorders:

 ;;a board-certified or board "eligible" psychiatrist;

 ;;a licensed doctorate-level psychologist;

 ;;a doctorate-level mental health provider under the close supervision of a

 ;;board-certified or board eligible psychiatrist or licensed doctorate-level

 ;;psychologist;

 ;;a psychiatry resident under close supervision of a board-certified or

 ;;board eligible psychiatrist or licensed doctorate-level psychologist;

 ;;or a clinical or counseling psychologist completing a one-year internship

 ;;or residency (for purposes of a doctorate-level degree) under close

 ;;supervision of a board-certified or board eligible psychiatrist or licensed

 ;;doctorate-level psychologist.

 ;;

 ;;The following health care providers can perform review examinations for

 ;;Eating Disorders:

 ;;a board-certified or board "eligible" psychiatrist;

 ;;a licensed doctorate-level psychologist;

 ;;a doctorate-level mental health provider under the close supervision of a

 ;;board-certified or board eligible psychiatrist or doctorate-level

 ;;psychologist;

 ;;a psychiatry resident under close supervision of a board-certified or 

 ;;board eligible psychiatrist or licensed doctorate-level psychologist;

 ;;a clinical or counseling psychologist completing a one year internship or

 ;;residency (for purposes of a doctorate-level degree) under close

 ;;supervision of a board-certified or board eligible psychiatrist or licensed

 ;;doctorate-level psychologist;

 ;;a licensed clinical social worker (LCSW) or

 ;;a nurse practitioner, a clinical nurse specialist or physician assistant,

 ;;if they are clinically privileged to perform activities required for C&P

 ;;mental disorder examinations, under close supervision of a board-certified

 ;;or board eligible psychiatrist or licensed doctorate-level psychologist.

 ;;

 ;;A. Review of Medical Records:

 ;;

 ;;

 ;;B. Medical History (Subjective Complaints):

 ;;

 ;;   Comment on:

 ;;

 ;;   1. PAST MEDICAL HISTORY

 ;;

 ;;      a. 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 and

 ;;         occupational history since discharge from military service is

 ;;         required.

 ;;      b. History of onset of eating disorder, course, and treatment.

 ;;      c. Previous hospitalizations for parenteral nutrition or tube feeding.

 ;;      d. Periods of incapacitation (during which bedrest and treatment

 ;;         by a physician are required due to the eating disorder).

 ;;         Describe the frequency and duration.

 ;;

 ;;   2. Present Medical, Occupational and Social History - over the past

 ;;      one year.

 ;;

 ;;      a. Current status of eating disorder.

 ;;      b. Current treatment, response, side effects.

 ;;      c. Extent of time lost from work over the past 12 month period.

 ;;         If employed, identify current occupation and length of time at

 ;;         this job.

 ;;      d. Describe any social impairment over the past 12 month period.

 ;;

 ;;   3. Subjective Complaints:

 ;;

 ;;      a. Describe fully any current symptoms.

 ;;      b. 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:

 ;;

 ;;            -  Binge eating followed by self-induced vomiting

 ;;               or other measures to prevent weight gain.

 ;;

 ;;            -  Measures taken to resist weight gain when weight is already

 ;;               below expected minimum normal weight.

 ;;

 ;;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.

 ;; 

 ;;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. CAPACITY TO MANAGE FINANCIAL AFFAIRS Mental competency, for

 ;;              VA benefits purposes, refers only to the ability of the

 ;;              veteran to manage VA benefit payments in his or her own best

 ;;              interest, and not to any other subject.  Mental incompetency,

 ;;              for VA benefits purposes, means that the veteran, because

 ;;              of injury or disease, is not capable of managing benefit

 ;;              payments in his or her best interest.  In order to assist

 ;;              raters in making a legal determination as to competency,

 ;;              please address the following:

 ;;              - What is the impact of injury or disease on the veteran's ability

 ;;                to manage his or her financial affairs, including consideration

 ;;                of such things as knowing the amount of his or her VA benefit

 ;;                payment, knowing the amounts and types of bills owed monthly,

 ;;                and handling the payment prudently? Does the veteran handle

 ;;                the money and pay the bills?

 ;;

 ;;              - Based on your examination, do you believe that the veteran is

 ;;                capable of managing his or her financial affairs?

 ;;                Please provide examples to support your conclusion.

 ;;

 ;;              - If you believe a Social Work Service assessment is needed before

 ;;                you can give your opinion on the veteran's ability to manage his

 ;;                or her financial affairs, please explain why.

 ;;

 ;;      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:

 ;;

 ;;

 ;;Include your name; your credentials, (i.e., board certified psychiatrist,

 ;;licensed psychologist; psychiatry resident or psychology intern,

 ;;LCSW, or NP); and circumstances under which you performed the examination,

 ;;if applicable (i.e., under the close supervision of an attending

 ;;psychiatrist or psychologist); name of supervising psychiatrist or

 ;;psychologist, if applicable.

 ;;

 ;;

 ;;Signature:                                            Date:

 ;;

 ;;

 ;;Signature of Supervising

 ;;  Psychiatrist or Psychologist:                       Date:

 ;;END