DVBCWPA1 ;ALB/CMM POW, GENERAL WKS TEXT - 1 ; 7 MARCH 1997
;;2.7;AMIE;**79**;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:
;;
;; o Any of the anxiety states
;; o Any other nutritional deficiency
;; o Atherosclerotic heart disease, ischemic heart disease, coronary artery
;; disease and beriberi heart disease to include complications (e.g.,
;; myocardial infarction, congestive heart failure, arrhythmia).
;; o Avitaminosis
;; o Beriberi (including beriberi heart disease which includes ischemic
;; heart disease in a former POW who experienced localized edema
;; during captivity)
;; o Chronic dysentery
;; o Cirrhosis of the liver
;; o Dysthymic disorder (or depressive neurosis)
;; o Helminthiasis
;; o Hypertension and hypertensive vascular disease to include complications
;; o Irritable bowel syndrome.
;; o Malnutrition (including optic atrophy associated with malnutrition)
;; o Organic residuals of frostbite
;; o Pellagra
;; o Peptic ulcer disease
;; o Peripheral neuropathy
;; o Post-traumatic arthritis
;; o Psychosis
;; o Stroke (ischemic stroke, hemorrhagic stroke and embolic stroke)
;; to include complications
;;
;;
;;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 ---[H[J[2J[HDVBCWPA1 5933 printed Dec 13, 2024@01:53:02 Page 2
DVBCWPA1 ;ALB/CMM POW, GENERAL WKS TEXT - 1 ; 7 MARCH 1997
+1 ;;2.7;AMIE;**79**;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 ;; o Any of the anxiety states
+21 ;; o Any other nutritional deficiency
+22 ;; o Atherosclerotic heart disease, ischemic heart disease, coronary artery
+23 ;; disease and beriberi heart disease to include complications (e.g.,
+24 ;; myocardial infarction, congestive heart failure, arrhythmia).
+25 ;; o Avitaminosis
+26 ;; o Beriberi (including beriberi heart disease which includes ischemic
+27 ;; heart disease in a former POW who experienced localized edema
+28 ;; during captivity)
+29 ;; o Chronic dysentery
+30 ;; o Cirrhosis of the liver
+31 ;; o Dysthymic disorder (or depressive neurosis)
+32 ;; o Helminthiasis
+33 ;; o Hypertension and hypertensive vascular disease to include complications
+34 ;; o Irritable bowel syndrome.
+35 ;; o Malnutrition (including optic atrophy associated with malnutrition)
+36 ;; o Organic residuals of frostbite
+37 ;; o Pellagra
+38 ;; o Peptic ulcer disease
+39 ;; o Peripheral neuropathy
+40 ;; o Post-traumatic arthritis
+41 ;; o Psychosis
+42 ;; o Stroke (ischemic stroke, hemorrhagic stroke and embolic stroke)
+43 ;; to include complications
+44 ;;
+45 ;;
+46 ;;A. Review of Medical Records:
+47 ;;
+48 ;; 1. Include a review of VA form 10-0048, Former POW Medical
+49 ;; History, which the veteran should have completed, prior to
+50 ;; conducting the examination.
+51 ;;
+52 ;;
+53 ;; 2. Review the Social Survey.
+54 ;;
+55 ;;B. Medical History (Subjective Complaints): NOTE: If the veteran
+56 ;; has had a previous protocol examination, only an interval history
+57 ;; is required.
+58 ;;
+59 ;; Comment on:
+60 ;; 1. Past medical history, including childhood and adult illnesses
+61 ;; and surgery.
+62 ;;
+63 ;;
+64 ;; 2. Family history.
+65 ;;
+66 ;;
+67 ;; 3. Social history - state civilian and military occupations,
+68 ;; including dates and locations. Describe use of alcohol,
+69 ;; tobacco, and drugs.
+70 ;;
+71 ;;
+72 ;; 4. Complete system review, commenting on all positive symptoms.
+73 ;;
+74 ;; a. Describe initial symptoms, time of onset, and current
+75 ;; symptoms of all presumptive POW disabilities found.
+76 ;;
+77 ;;
+78 ;; b. Comment on amount of weight lost as a prisoner. Record
+79 ;; initial and release weights.
+80 ;;
+81 ;;
+82 ;; 5. Describe current treatment (specify type, frequency, duration,
+83 ;; response, side effects).
+84 ;;
+85 ;;
+86 ;;C. Physical Examination (Objective Findings):
+87 ;;
+88 ;; Address each of the following and fully describe current findings:
+89 ;; The examiner should incorporate all ancillary study results into
+90 ;; the final diagnoses.
+91 ;; 1. VS: Heart rate, blood pressure (If the diagnosis of hypertension
+92 ;; has not been established, take 2 or more blood pressure readings
+93 ;; on at least 3 different days. If hypertension has been
+94 ;; diagnosed, take 2 or more blood pressure readings.), respirations,
+95 ;; height, weight, maximum weight in past year, weight change in
+96 ;; past year, body build, and state of nutrition.
+97 ;;
+98 ;;
+99 ;; 2. DOMINANT HAND: Indicate the dominant hand and how determined
+100 ;; (i.e., writes, eats, combs hair, etc.).
+101 ;;
+102 ;;
+103 ;; 3. POSTURE AND GAIT: (If abnormal, describe.)
+104 ;;
+105 ;;
+106 ;; 4. SKIN, INCLUDING APPENDAGES: (If abnormal, describe appearance,
+107 ;; location, extent of lesions, and limitations to daily activity.)
+108 ;; If there are laceration or burn scars, describe location,
+109 ;; measurements (cm. x cm.), depression, type of tissue loss,
+110 ;; adherence, disfigurement, and tenderness. For each burn scar,
+111 ;; state if due to a 2nd or 3rd degree burn. (NOTE: If skin
+112 ;; condition or scars are disfiguring, obtain COLOR PHOTOGRAPHS
+113 ;; of affected area(s).
+114 ;;
+115 ;;
+116 ;; 5. HEMIC AND LYMPHATIC: (Describe local or generalized adenopathy,
+117 ;; tenderness, suppuration, etc.)
+118 ;;
+119 ;;
+120 ;; 6. HEAD AND FACE: Describe scars, deformities, etc.
+121 ;;
+122 ;;
+123 ;; 7. EYES: Describe external eye, pupil reaction, movements,
+124 ;; field of vision, any uncorrectable refractive error or any
+125 ;; retinopathy.
+126 ;;
+127 ;;
+128 ;; 8. EARS: Describe canals, drums, perforations, discharge.
+129 ;;
+130 ;;
+131 ;; 9. NOSE, SINUSES, MOUTH AND THROAT: Include gross dental findings.
+132 ;;
+133 ;;
+134 ;; 10. NECK: Describe lymph nodes, thyroid, etc.
+135 ;;
+136 ;;
+137 ;; 11. CHEST: Inspection, palpation, percussion, auscultation. If
+138 ;; abnormal, describe limitations of daily living (i.e., How far
+139 ;; can veteran walk, how many flights of stairs can he or she
+140 ;; climb, etc.).
+141 ;;
