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Routine: DVBCWRO1

DVBCWRO1.m

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  1. DVBCWRO1 ;ALB/ESW RESPIRATORY WKS TEXT - 1 ; 6 OCT 2000
  1.  ;;2.7;AMIE;**34**;Apr 10, 1995
  1.  ;
  1.  ;
  1. TXT ;
  1.  ;;A. Review of Medical Records:
  1.  ;;
  1.  ;;B. Medical History (Subjective Complaints):
  1.  ;;    Comment on:
  1.  ;;
  1.  ;;    1. Productive cough, sputum, hemoptysis, and/or anorexia.
  1.  ;;    2. Extent of dyspnea on exertion.
  1.  ;;    3. If veteran is asthmatic, report frequency of attacks and 
  1.  ;;       baseline functional status between attacks.
  1.  ;;    4. Treatment (type, frequency and duration including a need for 
  1.  ;;       oxygen), response, side effects.
  1.  ;;    5. Describe frequency and duration of any periods of incapacitation 
  1.  ;;       (defined as requiring bed rest and treatment by a physician).
  1.  ;;
  1.  ;;C. Physical Examination (Objective Findings):
  1.  ;;
  1.  ;;    Address each of the following as appropriate to the condition 
  1.  ;;    being examined and fully describe current findings:
  1.  ;;
  1.  ;;    1. Presence of cor pulmonale, RVH, or pulmonary hypertension.
  1.  ;;    2. Weight loss or gain.
  1.  ;;    3. For restrictive disease, describe condition underlying restrictive
  1.  ;;       disease, e.g., kyphoscoliosis, pectus excavatum, etc., unless already
  1.  ;;       of record.
  1.  ;;
  1.  ;;D. Diagnostic and Clinical Tests:
  1.  ;;Provide:
  1.  ;;
  1.  ;;1. PULMONARY FUNCTION TESTS (unless carried out within past six months and
  1.  ;;   the report is either in the claims folder or will be attached to this
  1.  ;;   examination report, e.g., PFT's were in VAMC records at your facility).
  1.  ;;   Spirometric pulmonary function testing should include FVC,FEV-1, and
  1.  ;;   the FEV-1/FVC ratio. Both pre- and post-bronchodilatation test results should
  1.  ;;   be reported. If post-bronchodilatation testing is not conducted
  1.  ;;   in a particular case, please provide an explanation of why not. A DLCO may
  1.  ;;   or may not be done routinely as part of pulmonary function testing
  1.  ;;   at a particular facility. If there is a disparity between the results of
  1.  ;;   different tests, please indicate which tests are more likely to accurately
  1.  ;;   reflect the severity of the condition.
  1.  ;;TOF
  1.  ;;     DLCO note:
  1.  ;;     If the DLCO was not done as a routine part of pulmonary function testing,
  1.  ;;     the examiner should use his or her judgment, based on the specific
  1.  ;;     condition (e.g., whether it is obstructive, interstitial, etc.) and
  1.  ;;     other available information about the condition, as to whether a DLCO test
  1.  ;;     is needed, since it is not useful in all situations. If it may provide
  1.  ;;     useful information about the severity of the condition, it should be
  1.  ;;     requested and reviewed before the examination report is submitted.
  1.  ;;     If the examiner determines that the DLCO test is not needed, a statement
  1.  ;;     as to why not (e.g., there are decreased lung volumes that would not yield
  1.  ;;     valid test results) should be included in the report. Such a statement
  1.  ;;     could avoid a remand from BVA when the test is not done. However,
  1.  ;;     in the case of a BVA remand in which the DLCO is requested, the DLCO MUST
  1.  ;;     be done unless there is a medical contraindication.
  1.  ;; 
  1.  ;;2. Chest X-ray (if no recent results available).
  1.  ;;3. Include results of all diagnostic and clinical tests conducted
  1.  ;;   in the examination report.
  1.  ;;
  1.  ;;E. Diagnosis:
  1.  ;;
  1.  ;;
  1.  ;;Signature:                             Date:
  1.  ;;END