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Routine: DVBCWGW1

DVBCWGW1.m

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  1. DVBCWGW1 ;ALB/JFP GULF WAR GUIDELINES WKS TEXT - 1 ; 13 FEB 1998
  1.  ;;2.7;AMIE;**16**;Apr 10, 1995
  1.  ;
  1.  ;
  1. TXT ;
  1.  ;;Introduction:
  1.  ;;  Disability examinations of Gulf War veterans have unique requirements
  1.  ;;  because this group of veterans is eligible for compensation not only
  1.  ;;  for disability due to diagnosed illnesses, but also for disability
  1.  ;;  due to undiagnosed illnesses.  An undiagnosed illness is established
  1.  ;;  when findings are present that cannot be attributed to a known,
  1.  ;;  clearly defined diagnosis, after all likely diagnostic possibilities
  1.  ;;  for such abnormalities have been ruled out.  Examiners should follow
  1.  ;;  the guidelines in the "Handout of Instructions for Compensation and
  1.  ;;  Pension Examinations" but will also need to request more laboratory
  1.  ;;  tests and specialists' examinations than average in these cases.
  1.  ;;
  1.  ;;Guidelines:
  1.  ;;1.  Thoroughly review the claims file.
  1.  ;;2.  Address all conditions and symptoms specified on the examination
  1.  ;;    request and also address all additional conditions and symptoms
  1.  ;;    that you can elicit from the veteran during the examination, even
  1.  ;;    if not specified on the request form.
  1.  ;;3.  Conduct a comprehensive general medical examination, following the
  1.  ;;    AMIE General Medical Examination worksheet.  For all conditions
  1.  ;;    and symptoms which the General Medical Examination worksheet does
  1.  ;;    not address in detail, follow the appropriate additional AMIE 
  1.  ;;    worksheets, and request specialists' examinations as indicated.
  1.  ;;    Provide details about the onset, frequency, duration, and severity
  1.  ;;    of all complaints and state what precipitates and what relieves
  1.  ;;    them.
  1.  ;;4.  List all diagnosed conditions and state which symptoms, abnormal
  1.  ;;    physical findings, and abnormal laboratory test results are
  1.  ;;    associated with each.  If all symptoms, abnormal physical findings
  1.  ;;    and abnormal laboratory test results are associated with a 
  1.  ;;    diagnosed condition, additional specialist examinations for
  1.  ;;    diagnostic purposes are not needed.  Diagnosed conditions will be
  1.  ;;    handled as standard claims for service connection.  Symptom-based
  1.  ;;    "diagnoses" such as (but not limited to) myalgia, arthralgia,
  1.  ;;    headache, and diarrhea, are not considered as diagnosed conditions
  1.  ;;    for compensation purposes. 
  1.  ;;5.  However, if there are symptoms, abnormal physical findings, or
  1.  ;;    abnormal laboratory test results that have not been determined to
  1.  ;;    be part of a known clinical diagnosis, further specialist
  1.  ;;    examinations will be required to address these findings.
  1.  ;;6.  Provide the specialist with all examination reports and test
  1.  ;;    results.  Specify the symptoms, abnormal physical findings, and
  1.  ;;    abnormal laboratory test results that have not been attributed to
  1.  ;;    a known clinical diagnosis.  Request that the specialist determine
  1.  ;;    which of these, if any, can be attributed in this veteran to a
  1.  ;;    known clinical diagnosis and which, if any, cannot be attributed
  1.  ;;    in this veteran to a known clinical diagnosis.
  1.  ;;7.  After the specialists' examinations have been completed, and all
  1.  ;;    laboratory test results received, make a final report providing a
  1.  ;;    list of diagnosed conditions.  Separately list all symptoms,
  1.  ;;    abnormal physical findings, and abnormal laboratory test results
  1.  ;;    that cannot be attributed to a known clinical diagnosis. Reconcile
  1.  ;;    all differences among the examiners, by consultation or workgroup
  1.  ;;    as necessary, before the examination is returned to the regional
  1.  ;;    office.
  1.  ;;
  1.  ;;END