DVBCWSC1 ;ALB/CMM INFEC, IMM, NUTRITIONSL DIS WKS TEXT - 1 ; 6 MARCH 1997
;;2.7;AMIE;**12**;Apr 10, 1995
;
;
TXT ;
;;Narrative: Many infectious diseases, immune disorders, and
;;nutritional deficiencies have acute phases at onset and
;;accompanying recurrences but leave little or no residual
;;disability beyond the acute phase. Other such conditions may
;;present with slow progression and show significant residual
;;disability. The examiner must diligently search for residual
;;disabilities upon which adjudication of the case may be made.
;;
;;A. Review of Medical Records:
;;
;;
;;
;;B. Medical History (Subjective Complaints):
;;
;; Comment on:
;; 1. Date of symptom onset.
;;
;;
;; 2. Date of diagnosis.
;;
;;
;; 3. Clinical manifestations.
;;
;;
;; 4. Treatment (type, frequency, duration, response, side effects).
;;
;;
;; 5. Disease activity (exacerbations and/or remissions)? If there
;; were exacerbations, what was the state of the veteran's health
;; between exacerbations? Frequency and duration of exacerbations.
;;
;;
;; 6. Current symptoms.
;;
;;
;;
;;C. Physical Examination (Objective Findings):
;;
;; Address each of the following and fully describe current findings:
;; 1. Is the condition still present?
;;
;;
;; 2. Current weight, nutrition. Any residuals of malnutrition,
;; vitamin deficiency?
;;
;;
;; 3. General appearance.
;;
;;
;; 4. Describe findings of all organ systems involved. See
;; appropriate examination worksheets - respiratory, joints,
;; cardiovascular, etc.
;;
;;
;;D. Diagnostic and Clinical Tests:
;;
;; 1. Include results of all diagnostic and clinical tests conducted
;; in the examination report.
;;
;; NOTE: If an infectious etiology is documented, specify the organism.
;;
;;
;;E. Diagnosis:
;;
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWSC1 2062 printed Oct 16, 2024@17:54:42 Page 2
DVBCWSC1 ;ALB/CMM INFEC, IMM, NUTRITIONSL DIS WKS TEXT - 1 ; 6 MARCH 1997
+1 ;;2.7;AMIE;**12**;Apr 10, 1995
+2 ;
+3 ;
TXT ;
+1 ;;Narrative: Many infectious diseases, immune disorders, and
+2 ;;nutritional deficiencies have acute phases at onset and
+3 ;;accompanying recurrences but leave little or no residual
+4 ;;disability beyond the acute phase. Other such conditions may
+5 ;;present with slow progression and show significant residual
+6 ;;disability. The examiner must diligently search for residual
+7 ;;disabilities upon which adjudication of the case may be made.
+8 ;;
+9 ;;A. Review of Medical Records:
+10 ;;
+11 ;;
+12 ;;
+13 ;;B. Medical History (Subjective Complaints):
+14 ;;
+15 ;; Comment on:
+16 ;; 1. Date of symptom onset.
+17 ;;
+18 ;;
+19 ;; 2. Date of diagnosis.
+20 ;;
+21 ;;
+22 ;; 3. Clinical manifestations.
+23 ;;
+24 ;;
+25 ;; 4. Treatment (type, frequency, duration, response, side effects).
+26 ;;
+27 ;;
+28 ;; 5. Disease activity (exacerbations and/or remissions)? If there
+29 ;; were exacerbations, what was the state of the veteran's health
+30 ;; between exacerbations? Frequency and duration of exacerbations.
+31 ;;
+32 ;;
+33 ;; 6. Current symptoms.
+34 ;;
+35 ;;
+36 ;;
+37 ;;C. Physical Examination (Objective Findings):
+38 ;;
+39 ;; Address each of the following and fully describe current findings:
+40 ;; 1. Is the condition still present?
+41 ;;
+42 ;;
+43 ;; 2. Current weight, nutrition. Any residuals of malnutrition,
+44 ;; vitamin deficiency?
+45 ;;
+46 ;;
+47 ;; 3. General appearance.
+48 ;;
+49 ;;
+50 ;; 4. Describe findings of all organ systems involved. See
+51 ;; appropriate examination worksheets - respiratory, joints,
+52 ;; cardiovascular, etc.
+53 ;;
+54 ;;
+55 ;;D. Diagnostic and Clinical Tests:
+56 ;;
+57 ;; 1. Include results of all diagnostic and clinical tests conducted
+58 ;; in the examination report.
+59 ;;
+60 ;; NOTE: If an infectious etiology is documented, specify the organism.
+61 ;;
+62 ;;
+63 ;;E. Diagnosis:
+64 ;;
+65 ;;
+66 ;;Signature: Date:
+67 ;;END
