- DVBCWPW1 ;ALB/CMM PULMONARY TB AND MYCO. DIS. WKS TEXT - 1 ; 6 MARCH 1997
- ;;2.7;AMIE;**12**;Apr 10, 1995
- ;
- ;
- TXT ;
- ;;A. Review of Medical Records:
- ;;
- ;;
- ;;
- ;;B. Medical History (Subjective Complaints):
- ;;
- ;; Comment on:
- ;; 1. Activity of pulmonary tuberculosis or other mycobacterial disease.
- ;;
- ;;
- ;; 2. Date of inactivity if it is not active.
- ;;
- ;;
- ;; 3. Identity of organism (if possible).
- ;;
- ;;
- ;;C. Physical examination (Objective Findings):
- ;;
- ;; Address each of the following and fully describe current findings:
- ;; 1. Extent of structural damage to lungs.
- ;;
- ;;
- ;; 2. If patient was hospitalized for 6 months or more, what is the
- ;; condition at the end of hospitalization?
- ;;
- ;;
- ;; 3. If patient was hospitalized for 12 months or more, what is the
- ;; condition at the end of hospitalization?
- ;;
- ;;
- ;;D. Diagnostic and Clinical Tests:
- ;;
- ;; Provide:
- ;; Pulmonary Function Tests, if indicated. When the results of
- ;; pre-bronchodilator pulmonary function tests are NORMAL, post-
- ;; bronchodilator studies are not required for VA evaluation purposes.
- ;; IN ALL OTHER CASES, post-bronchodilator studies shuld be conducted
- ;; unless contraindicated (because of allergy to medication, etc.) or
- ;; if the veteran was on bronchodilators before the test and had taken
- ;; his or her medication within a few hours of the study. An examiner
- ;; who determines that a post-bronchodilator study should not be
- ;; performed should provide an explanation of why not. If there is
- ;; a disparity between the results of different pulmonary function
- ;; tests (FEV-1, FVC, etc.), the examiner should indicate which test
- ;; result is the best indicator of the veteran's level of pulmonary
- ;; functioning.
- ;;
- ;;
- ;;E. Diagnosis:
- ;;
- ;; In reactivated cases, is this reactivation of the old disease or a
- ;; separate and distinct new infection.
- ;;
- ;;
- ;;
- ;;ADDITIONAL NOTE TO THE PHYSICIAN:
- ;;In all claims, if the disease is inactive and if the inactivity was
- ;;confirmed at a non-VA facility, obtain the name and mailing address of
- ;;the facility from the veteran so that the Regional Office may request
- ;;the report.
- ;;
- ;;
- ;;Signature: Date:
- ;;END
- --- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWPW1 2406 printed Feb 18, 2025@23:20:06 Page 2
- DVBCWPW1 ;ALB/CMM PULMONARY TB AND MYCO. DIS. WKS TEXT - 1 ; 6 MARCH 1997
- +1 ;;2.7;AMIE;**12**;Apr 10, 1995
- +2 ;
- +3 ;
- TXT ;
- +1 ;;A. Review of Medical Records:
- +2 ;;
- +3 ;;
- +4 ;;
- +5 ;;B. Medical History (Subjective Complaints):
- +6 ;;
- +7 ;; Comment on:
- +8 ;; 1. Activity of pulmonary tuberculosis or other mycobacterial disease.
- +9 ;;
- +10 ;;
- +11 ;; 2. Date of inactivity if it is not active.
- +12 ;;
- +13 ;;
- +14 ;; 3. Identity of organism (if possible).
- +15 ;;
- +16 ;;
- +17 ;;C. Physical examination (Objective Findings):
- +18 ;;
- +19 ;; Address each of the following and fully describe current findings:
- +20 ;; 1. Extent of structural damage to lungs.
- +21 ;;
- +22 ;;
- +23 ;; 2. If patient was hospitalized for 6 months or more, what is the
- +24 ;; condition at the end of hospitalization?
- +25 ;;
- +26 ;;
- +27 ;; 3. If patient was hospitalized for 12 months or more, what is the
- +28 ;; condition at the end of hospitalization?
- +29 ;;
- +30 ;;
- +31 ;;D. Diagnostic and Clinical Tests:
- +32 ;;
- +33 ;; Provide:
- +34 ;; Pulmonary Function Tests, if indicated. When the results of
- +35 ;; pre-bronchodilator pulmonary function tests are NORMAL, post-
- +36 ;; bronchodilator studies are not required for VA evaluation purposes.
- +37 ;; IN ALL OTHER CASES, post-bronchodilator studies shuld be conducted
- +38 ;; unless contraindicated (because of allergy to medication, etc.) or
- +39 ;; if the veteran was on bronchodilators before the test and had taken
- +40 ;; his or her medication within a few hours of the study. An examiner
- +41 ;; who determines that a post-bronchodilator study should not be
- +42 ;; performed should provide an explanation of why not. If there is
- +43 ;; a disparity between the results of different pulmonary function
- +44 ;; tests (FEV-1, FVC, etc.), the examiner should indicate which test
- +45 ;; result is the best indicator of the veteran's level of pulmonary
- +46 ;; functioning.
- +47 ;;
- +48 ;;
- +49 ;;E. Diagnosis:
- +50 ;;
- +51 ;; In reactivated cases, is this reactivation of the old disease or a
- +52 ;; separate and distinct new infection.
- +53 ;;
- +54 ;;
- +55 ;;
- +56 ;;ADDITIONAL NOTE TO THE PHYSICIAN:
- +57 ;;In all claims, if the disease is inactive and if the inactivity was
- +58 ;;confirmed at a non-VA facility, obtain the name and mailing address of
- +59 ;;the facility from the veteran so that the Regional Office may request
- +60 ;;the report.
- +61 ;;
- +62 ;;
- +63 ;;Signature: Date:
- +64 ;;END