DVBCWP1.m

DVBCWP1 ;ALB/CMM POW, GENERAL WKS TEXT - 1 ; 7 MARCH 1997

 ;;2.7;AMIE;**12,56**;Apr 10, 1995

 ;

 ;

TXT ;

 ;;

 ;;Narrative: This is the protocol for conducting initial examinations on former 

 ;;POWs.  Approach these veterans with the greatest sensitivity because the 

 ;;POW experience likely resulted in a great deal of psychological and physical 

 ;;trauma.  Details about beatings, torture, forced marches, forced labor, diet, 

 ;;disease, brainwashing, extremes of hot and cold, and anxiety may be 

 ;;significant parts of the veteran's history; eliciting these details requires  

 ;;that one establish a trusting relationship with the veteran. Examine

 ;;veteran for each disability / disease / condition veteran is claiming 

 ;;as a consequence of the POW experience.  A former POW may be entitled 

 ;;to service connection for presumptive POW diseases; the worksheet contains

 ;;a list of these presumptive diseases.  Based on veteran's claim(s) and your

 ;;findings, please refer to and follow additional worksheets to assure

 ;;the examination  provides information adequate for rating purposes.

 ;;

 ;;

 ;;

 ;;PRESUMPTIVE POW DISABILITIES: 

 ;;

 ;;    Avitaminosis

 ;;    Beriberi (including beriberi heart disease which includes ischemic

 ;;    heart disease in a former POW who experienced localized edema 

 ;;    during captivity)

 ;;    Chronic dysentery

 ;;    Helminthiasis

 ;;    Malnutrition (including optic atrophy associated with malnutrition)

 ;;    Pellagra

 ;;    Cirrhosis of the liver

 ;;    Any other nutritional deficiency

 ;;    Psychosis

 ;;    Any of the anxiety states

 ;;    Dysthymic disorder (or depressive neurosis)

 ;;    Organic residuals of frostbite

 ;;    Post-traumatic arthritis

 ;;    Irritable bowel syndrome

 ;;    Peptic ulcer disease

 ;;    Peripheral neuropathy

 ;;

 ;;

 ;;A.  Review of Medical Records:

 ;;

 ;;    1.  Include a review of VA form 10-0048, Former POW Medical 

 ;;        History, which the veteran should have completed, prior to 

 ;;        conducting the examination.

 ;;

 ;;

 ;;    2.  Review the Social Survey.

 ;;

 ;;B.  Medical History (Subjective Complaints):  NOTE:  If the veteran 

 ;;    has had a previous protocol examination, only an interval history

 ;;    is required.

 ;;

 ;;    Comment on:

 ;;    1.  Past medical history, including childhood and adult illnesses

 ;;        and surgery.

 ;;

 ;;

 ;;    2.  Family history.

 ;;

 ;;

 ;;    3.  Social history - state civilian and military occupations, 

 ;;        including dates and locations.  Describe use of alcohol, 

 ;;        tobacco, and drugs.

 ;;

 ;;

 ;;    4.  Complete system review, commenting on all positive symptoms.  

 ;;

 ;;        a.  Describe initial symptoms, time of onset, and current 

 ;;            symptoms of all presumptive POW disabilities found.  

 ;;

 ;;

 ;;        b.  Comment on amount of weight lost as a prisoner.  Record 

 ;;            initial and release weights.

 ;;

 ;;

 ;;    5.  Describe current treatment (specify type, frequency,duration, 

 ;;        response, side effects).

 ;;

 ;;

 ;;C.  Physical Examination (Objective Findings):

 ;;

 ;;    Address each of the following and fully describe current findings:

 ;;    The examiner should incorporate all ancillary study results into 

 ;;    the final diagnoses.

 ;;    1.  VS:  Heart rate, blood pressure (If the diagnosis of hypertension 

 ;;        has not been established, take 2 or more blood pressure readings 

 ;;        on at least 3 different days.  If hypertension has been 

 ;;        diagnosed, take 2 or more blood pressure readings.), respirations, 

 ;;        height, weight, maximum weight in past year, weight change in

 ;;        past year, body build, and state of nutrition.  

 ;;

 ;;

 ;;    2.  DOMINANT HAND:  Indicate the dominant hand and how determined

 ;;        (i.e., writes, eats, combs hair, etc.).

 ;;

 ;;

 ;;    3.  POSTURE AND GAIT:  (If abnormal, describe.)

 ;;

 ;;

 ;;    4.  SKIN, INCLUDING APPENDAGES:  (If abnormal, describe appearance, 

 ;;        location, extent of lesions, and limitations to daily activity.)  

 ;;        If there are laceration or burn scars, describe location, 

 ;;        measurements (cm. x cm.), depression, type of tissue loss, 

 ;;        adherence, disfigurement, and tenderness.  For each burn scar,

 ;;        state if due to a 2nd or 3rd degree burn.  (NOTE:  If skin 

 ;;        condition or scars are disfiguring, obtain COLOR PHOTOGRAPHS 

 ;;        of affected area(s).

 ;;

 ;;

 ;;    5.  HEMIC AND LYMPHATIC:  (Describe local or generalized adenopathy, 

 ;;        tenderness, suppuration, etc.)

 ;;

 ;;

 ;;    6.  HEAD AND FACE:  Describe scars, deformities, etc.

 ;;

 ;;

 ;;    7.  EYES:  Describe external eye, pupil reaction, movements, 

 ;;        field of vision, any uncorrectable refractive error or any 

 ;;        retinopathy.

 ;;

 ;;

 ;;    8.  EARS:  Describe canals, drums, perforations, discharge.

 ;;

 ;;

 ;;    9.  NOSE, SINUSES, MOUTH AND THROAT:  Include gross dental findings.

 ;;

 ;;

 ;;   10.  NECK:  Describe lymph nodes, thyroid, etc.

 ;;

 ;;

 ;;   11.  CHEST:  Inspection, palpation, percussion, auscultation.  If 

 ;;        abnormal, describe limitations of daily living (i.e., How far

 ;;        can veteran walk, how many flights of stairs can he or she 

 ;;        climb, etc.).

 ;;

--- Routine Detail   --- with STRUCTURED ROUTINE LISTING ---DVBCWP1   5452     printed  Mar 13, 2025@20:57:42                                                                                                                                                                                                     Page 2

DVBCWP1   ;ALB/CMM POW, GENERAL WKS TEXT - 1 ; 7 MARCH 1997

 +1       ;;2.7;AMIE;**12,56**;Apr 10, 1995

 +2       ;

 +3       ;

TXT       ;

 +1       ;;

 +2       ;;Narrative: This is the protocol for conducting initial examinations on former 

 +3       ;;POWs.  Approach these veterans with the greatest sensitivity because the 

 +4       ;;POW experience likely resulted in a great deal of psychological and physical 

 +5       ;;trauma.  Details about beatings, torture, forced marches, forced labor, diet, 

 +6       ;;disease, brainwashing, extremes of hot and cold, and anxiety may be 

 +7       ;;significant parts of the veteran's history; eliciting these details requires  

 +8       ;;that one establish a trusting relationship with the veteran. Examine

 +9       ;;veteran for each disability / disease / condition veteran is claiming 

 +10      ;;as a consequence of the POW experience.  A former POW may be entitled 

 +11      ;;to service connection for presumptive POW diseases; the worksheet contains

 +12      ;;a list of these presumptive diseases.  Based on veteran's claim(s) and your

 +13      ;;findings, please refer to and follow additional worksheets to assure

 +14      ;;the examination  provides information adequate for rating purposes.

 +15      ;;

 +16      ;;

 +17      ;;

 +18      ;;PRESUMPTIVE POW DISABILITIES: 

 +19      ;;

 +20      ;;    Avitaminosis

 +21      ;;    Beriberi (including beriberi heart disease which includes ischemic

 +22      ;;    heart disease in a former POW who experienced localized edema 

 +23      ;;    during captivity)

 +24      ;;    Chronic dysentery

 +25      ;;    Helminthiasis

 +26      ;;    Malnutrition (including optic atrophy associated with malnutrition)

 +27      ;;    Pellagra

 +28      ;;    Cirrhosis of the liver

 +29      ;;    Any other nutritional deficiency

 +30      ;;    Psychosis

 +31      ;;    Any of the anxiety states

 +32      ;;    Dysthymic disorder (or depressive neurosis)

 +33      ;;    Organic residuals of frostbite

 +34      ;;    Post-traumatic arthritis

 +35      ;;    Irritable bowel syndrome

 +36      ;;    Peptic ulcer disease

 +37      ;;    Peripheral neuropathy

 +38      ;;

 +39      ;;

 +40      ;;A.  Review of Medical Records:

 +41      ;;

 +42      ;;    1.  Include a review of VA form 10-0048, Former POW Medical 

 +43      ;;        History, which the veteran should have completed, prior to 

 +44      ;;        conducting the examination.

 +45      ;;

 +46      ;;

 +47      ;;    2.  Review the Social Survey.

 +48      ;;

 +49      ;;B.  Medical History (Subjective Complaints):  NOTE:  If the veteran 

 +50      ;;    has had a previous protocol examination, only an interval history

 +51      ;;    is required.

 +52      ;;

 +53      ;;    Comment on:

 +54      ;;    1.  Past medical history, including childhood and adult illnesses

 +55      ;;        and surgery.

 +56      ;;

 +57      ;;

 +58      ;;    2.  Family history.

 +59      ;;

 +60      ;;

 +61      ;;    3.  Social history - state civilian and military occupations, 

 +62      ;;        including dates and locations.  Describe use of alcohol, 

 +63      ;;        tobacco, and drugs.

 +64      ;;

 +65      ;;

 +66      ;;    4.  Complete system review, commenting on all positive symptoms.  

 +67      ;;

 +68      ;;        a.  Describe initial symptoms, time of onset, and current 

 +69      ;;            symptoms of all presumptive POW disabilities found.  

 +70      ;;

 +71      ;;

 +72      ;;        b.  Comment on amount of weight lost as a prisoner.  Record 

 +73      ;;            initial and release weights.

 +74      ;;

 +75      ;;

 +76      ;;    5.  Describe current treatment (specify type, frequency,duration, 

 +77      ;;        response, side effects).

 +78      ;;

 +79      ;;

 +80      ;;C.  Physical Examination (Objective Findings):

 +81      ;;

 +82      ;;    Address each of the following and fully describe current findings:

 +83      ;;    The examiner should incorporate all ancillary study results into 

 +84      ;;    the final diagnoses.

 +85      ;;    1.  VS:  Heart rate, blood pressure (If the diagnosis of hypertension 

 +86      ;;        has not been established, take 2 or more blood pressure readings 

 +87      ;;        on at least 3 different days.  If hypertension has been 

 +88      ;;        diagnosed, take 2 or more blood pressure readings.), respirations, 

 +89      ;;        height, weight, maximum weight in past year, weight change in

 +90      ;;        past year, body build, and state of nutrition.  

 +91      ;;

 +92      ;;

 +93      ;;    2.  DOMINANT HAND:  Indicate the dominant hand and how determined

 +94      ;;        (i.e., writes, eats, combs hair, etc.).

 +95      ;;

 +96      ;;

 +97      ;;    3.  POSTURE AND GAIT:  (If abnormal, describe.)

 +98      ;;

 +99      ;;

 +100     ;;    4.  SKIN, INCLUDING APPENDAGES:  (If abnormal, describe appearance, 

 +101     ;;        location, extent of lesions, and limitations to daily activity.)  

 +102     ;;        If there are laceration or burn scars, describe location, 

 +103     ;;        measurements (cm. x cm.), depression, type of tissue loss, 

 +104     ;;        adherence, disfigurement, and tenderness.  For each burn scar,

 +105     ;;        state if due to a 2nd or 3rd degree burn.  (NOTE:  If skin 

 +106     ;;        condition or scars are disfiguring, obtain COLOR PHOTOGRAPHS 

 +107     ;;        of affected area(s).

 +108     ;;

 +109     ;;

 +110     ;;    5.  HEMIC AND LYMPHATIC:  (Describe local or generalized adenopathy, 

 +111     ;;        tenderness, suppuration, etc.)

 +112     ;;

 +113     ;;

 +114     ;;    6.  HEAD AND FACE:  Describe scars, deformities, etc.

 +115     ;;

 +116     ;;

 +117     ;;    7.  EYES:  Describe external eye, pupil reaction, movements, 

 +118     ;;        field of vision, any uncorrectable refractive error or any 

 +119     ;;        retinopathy.

 +120     ;;

 +121     ;;

 +122     ;;    8.  EARS:  Describe canals, drums, perforations, discharge.

 +123     ;;

 +124     ;;

 +125     ;;    9.  NOSE, SINUSES, MOUTH AND THROAT:  Include gross dental findings.

 +126     ;;

 +127     ;;

 +128     ;;   10.  NECK:  Describe lymph nodes, thyroid, etc.

 +129     ;;

 +130     ;;

 +131     ;;   11.  CHEST:  Inspection, palpation, percussion, auscultation.  If 

 +132     ;;        abnormal, describe limitations of daily living (i.e., How far

 +133     ;;        can veteran walk, how many flights of stairs can he or she 

 +134     ;;        climb, etc.).

 +135     ;;