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Routine: DVBCWEA7

DVBCWEA7.m

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  1. DVBCWEA7 ;ALB/RLC - EATING DISORDERS WKS TEXT - 1 ; 12/26/06 14:00pm
  1.  ;;2.7;AMIE;**170**;Apr 10, 1995;Build 1
  1.  ;Per VHA Directive 10-92-142, this routine should not be modified
  1.  ;
  1. TXT ;
  1.  ;;
  1.  ;;The following health care providers can perform initial examinations for
  1.  ;;Eating Disorders:
  1.  ;;a board-certified or board "eligible" psychiatrist;
  1.  ;;a licensed doctorate-level psychologist;
  1.  ;;a doctorate-level mental health provider under the close supervision of a
  1.  ;;board-certified or board eligible psychiatrist or licensed doctorate-level
  1.  ;;psychologist;
  1.  ;;a psychiatry resident under close supervision of a board-certified or
  1.  ;;board eligible psychiatrist or licensed doctorate-level psychologist;
  1.  ;;or a clinical or counseling psychologist completing a one-year internship
  1.  ;;or residency (for purposes of a doctorate-level degree) under close
  1.  ;;supervision of a board-certified or board eligible psychiatrist or licensed
  1.  ;;doctorate-level psychologist.
  1.  ;;
  1.  ;;The following health care providers can perform review examinations for
  1.  ;;Eating Disorders:
  1.  ;;a board-certified or board "eligible" psychiatrist;
  1.  ;;a licensed doctorate-level psychologist;
  1.  ;;a doctorate-level mental health provider under the close supervision of a
  1.  ;;board-certified or board eligible psychiatrist or doctorate-level
  1.  ;;psychologist;
  1.  ;;a psychiatry resident under close supervision of a board-certified or 
  1.  ;;board eligible psychiatrist or licensed doctorate-level psychologist;
  1.  ;;a clinical or counseling psychologist completing a one year internship or
  1.  ;;residency (for purposes of a doctorate-level degree) under close
  1.  ;;supervision of a board-certified or board eligible psychiatrist or licensed
  1.  ;;doctorate-level psychologist;
  1.  ;;a licensed clinical social worker (LCSW) or
  1.  ;;a nurse practitioner, a clinical nurse specialist or physician assistant,
  1.  ;;if they are clinically privileged to perform activities required for C&P
  1.  ;;mental disorder examinations, under close supervision of a board-certified
  1.  ;;or board eligible psychiatrist or licensed doctorate-level psychologist.
  1.  ;;
  1.  ;;A. Review of Medical Records:
  1.  ;;
  1.  ;;
  1.  ;;B. Medical History (Subjective Complaints):
  1.  ;;
  1.  ;;Review examination.  If this is a review examination for an already service-
  1.  ;;connected eating disorder, provide the medical and occupational history since
  1.  ;;the last medical examination.  Otherwise, follow the history requirements below.
  1.  ;;
  1.  ;;   Comment on:
  1.  ;;
  1.  ;;   1.  Onset.  Date of onset of condition, and circumstances and initial
  1.  ;;       manifestations.
  1.  ;;   2.  Course of condition since onset.
  1.  ;;   3.  Treatment.  Current treatment, response to treatment, and any side
  1.  ;;       effects.
  1.  ;;   4.  Hospitalizations or surgery.  History of related hospitalizations or
  1.  ;;       surgery, dates and locations, if known, reason or type of surgery.
  1.  ;;   5.  State number of hospitalizations required per year for parenteral
  1.  ;;       nutrition or tube feeding.
  1.  ;;   6.  Periods of incapacitation.  State whether there have been periods of
  1.  ;;       incapacitation (requiring bed rest and treatment by a physician) because
  1.  ;;       of an eating disorder.  If so, state the frequency and duration of the
  1.  ;;       episodes (in days) and the total duration of days of incapacitation
  1.  ;;       during the past 12-month period.
  1.  ;;   7.  Binge eating.  State whether there is a history of binge eating.  If
  1.  ;;       there is, state frequency and extent over the past 12-month period.
  1.  ;;   8.  Self-induced vomiting.  State if there is a history of self-induced
  1.  ;;       vomiting or other measure to prevent weight gain when weight is already
  1.  ;;       below expected minimum normal weight.  If so, state frequency and extent
  1.  ;;       over past 12-month period.
  1.  ;;   9.  Other current symptoms.  Report other current (during past 12 months)
  1.  ;;       symptoms of an eating disorder, such as amenorrhea, abdominal pain,
  1.  ;;       lethargy, cold intolerance, disturbance in perception of body shape or
  1.  ;;       size, etc., and other significant history.
  1.  ;;
  1.  ;;C. Examination (Objective Findings):
  1.  ;;
  1.  ;;   Address each of the following and fully describe:
  1.  ;;
  1.  ;;   1.  Weight-related issues.
  1.  ;; 
  1.  ;;       a.  Current weight and height.
  1.  ;;       b.  Expected minimum weight based on age, height, and body build.
  1.  ;;       c.  Pertinent weight history.
  1.  ;;       d.  Percent of weight loss or gain compared to baseline (average weight
  1.  ;;           in the 2 years preceding onset of the condition).
  1.  ;;
  1.  ;;   2.  Other significant findings on physical examination. 
  1.  ;; 
  1.  ;;D. Diagnostic and Clinical Tests
  1.  ;;
  1.  ;;   1.  Conduct psychological testing if deemed necessary.
  1.  ;;
  1.  ;;   2.  CBC, blood chemistry, EKG, renal function tests, or other studies, as
  1.  ;;       indicated.
  1.  ;;
  1.  ;;   3.  Include results of all diagnostic and clinical tests conducted in the 
  1.  ;;       examination report.
  1.  ;;
  1.  ;;E. Diagnosis:
  1.  ;;
  1.  ;;   1.  State whether the DSM-IV criteria for a diagnosis of anorexia nervosa
  1.  ;;       have been met.
  1.  ;;   2.  State whether the DSM-IV criteria for a diagnosis of bulimia nervosa
  1.  ;;       have been met.
  1.  ;;   3.  State whether the DSM-IV criteria for a diagnosis of eating disorder
  1.  ;;       not otherwise specified have been met.
  1.  ;;   4.  State any comments on the DSM-IV criteria.
  1.  ;;   5.  For each diagnosis, state effects of the condition on occupational
  1.  ;;       functioning and daily activities.
  1.  ;;   6.  Capacity to handle financial affairs.  Mental competency, for VA
  1.  ;;       benefits purposes, refers only to the ability of the veteran to manage
  1.  ;;       VA benefit payments in his or her own best interest, and not to any
  1.  ;;       other subject.  Mental incompetency, for VA benefits purposes, means
  1.  ;;       that the veteran, because of injury or disease, is not capable of
  1.  ;;       managing benefit payments in his or her own best interest.  In order to
  1.  ;;       assist raters in making a legal determination as to competency, please
  1.  ;;       address the following:
  1.  ;;
  1.  ;;         What is the impact of injury or disease on the veteran's ability to
  1.  ;;         manage his or her financial affairs, including consideration of such
  1.  ;;         things as knowing the amount of his or her VA benefit payment,
  1.  ;;         knowing the amounts and types of bills owed monthly, and handling
  1.  ;;         the payment prudently?  Does the veteran handle the money and pay the
  1.  ;;         bills himself or herself?
  1.  ;;
  1.  ;;         Based on your examination, do you believe that the veteran is capable
  1.  ;;         of managing his or her financial affairs?  Please provide examples to
  1.  ;;         support your conclusion.
  1.  ;;
  1.  ;;         If you believe a Social Work Service assessment is needed before you
  1.  ;;         can give your opinion on the veteran's ability to manage his or her
  1.  ;;         financial affairs, please explain why.
  1.  ;;
  1.  ;;Include your name; your credentials, (i.e., board certified psychiatrist,
  1.  ;;licensed psychologist; psychiatry resident or psychology intern,
  1.  ;;LCSW, or NP); and circumstances under which you performed the examination,
  1.  ;;if applicable (i.e., under the close supervision of an attending
  1.  ;;psychiatrist or psychologist); name of supervising psychiatrist or
  1.  ;;psychologist, if applicable.
  1.  ;;
  1.  ;;
  1.  ;;Signature:                                            Date:
  1.  ;;
  1.  ;;
  1.  ;;Signature of Supervising
  1.  ;;  Psychiatrist or Psychologist:                       Date:
  1.  ;;END