DVBCWSW1 ;ALB/CMM SCARS WKS TEXT - 1 ; 6 MARCH 1997
;;2.7;AMIE;**12**;Apr 10, 1995
;
;
TXT ;
;;A. Review of Medical Records:
;;
;;
;;
;;B. Medical History (Subjective Complaints):
;;
;; 1. Type of injury or infection causing the wound or scar, its
;; date, the treatment used and the response to such treatment.
;;
;;
;; 2. Current symptoms.
;;
;;
;;C. Physical Examination (Objective Findings):
;;
;; Address each of the following and fully describe current findings
;; (for each scar):
;; 1. Location, measurements (cm. x cm.), and shape of each scar.
;;
;;
;; 2. Tenderness.
;;
;;
;; 3. Adherence.
;;
;;
;; 4. Texture.
;;
;;
;; 5. Ulceration or breakdown of skin.
;;
;;
;; 6. Elevation or depression of scar.
;;
;;
;; 7. Extent of underlying tissue loss.
;;
;;
;; 8. Inflammation, edema, or keloid formation.
;;
;;
;; 9. Color of scar compared to normal areas of skin.
;;
;;
;; 10. Disfigurement.
;;
;;
;; 11. For each burn scar, state if due to a 2nd or 3rd degree burn.
;;
;;
;; 12. Limitation of function by scar.
;;
;;
;; 13. An attachment is provided in the Handout of Instructions for
;; Compensation and Pension Examinations for plotting the
;; location of scars.
;;
;;
;;D. Diagnostic and Clinical Tests:
;;
;; 1. With disfigurement or disfiguring scar of head, face, or neck,
;; submit COLOR PHOTOGRAPHS.
;; 2. Include results of all diagnostic and clinical tests conducted
;; in the examination report.
;;
;;
;;E. Diagnosis:
;;
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWSW1 1760 printed Nov 22, 2024@17:04:20 Page 2
DVBCWSW1 ;ALB/CMM SCARS 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 ;; 1. Type of injury or infection causing the wound or scar, its
+8 ;; date, the treatment used and the response to such treatment.
+9 ;;
+10 ;;
+11 ;; 2. Current symptoms.
+12 ;;
+13 ;;
+14 ;;C. Physical Examination (Objective Findings):
+15 ;;
+16 ;; Address each of the following and fully describe current findings
+17 ;; (for each scar):
+18 ;; 1. Location, measurements (cm. x cm.), and shape of each scar.
+19 ;;
+20 ;;
+21 ;; 2. Tenderness.
+22 ;;
+23 ;;
+24 ;; 3. Adherence.
+25 ;;
+26 ;;
+27 ;; 4. Texture.
+28 ;;
+29 ;;
+30 ;; 5. Ulceration or breakdown of skin.
+31 ;;
+32 ;;
+33 ;; 6. Elevation or depression of scar.
+34 ;;
+35 ;;
+36 ;; 7. Extent of underlying tissue loss.
+37 ;;
+38 ;;
+39 ;; 8. Inflammation, edema, or keloid formation.
+40 ;;
+41 ;;
+42 ;; 9. Color of scar compared to normal areas of skin.
+43 ;;
+44 ;;
+45 ;; 10. Disfigurement.
+46 ;;
+47 ;;
+48 ;; 11. For each burn scar, state if due to a 2nd or 3rd degree burn.
+49 ;;
+50 ;;
+51 ;; 12. Limitation of function by scar.
+52 ;;
+53 ;;
+54 ;; 13. An attachment is provided in the Handout of Instructions for
+55 ;; Compensation and Pension Examinations for plotting the
+56 ;; location of scars.
+57 ;;
+58 ;;
+59 ;;D. Diagnostic and Clinical Tests:
+60 ;;
+61 ;; 1. With disfigurement or disfiguring scar of head, face, or neck,
+62 ;; submit COLOR PHOTOGRAPHS.
+63 ;; 2. Include results of all diagnostic and clinical tests conducted
+64 ;; in the examination report.
+65 ;;
+66 ;;
+67 ;;E. Diagnosis:
+68 ;;
+69 ;;
+70 ;;Signature: Date:
+71 ;;END
