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Fast Letter 07-10-07

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DEPARTMENT OF VETERANS AFFAIRS

Veterans Benefits Administration

Washington, D.C. 20420

April 24, 2007 In Reply Refer To: 211D

Fast Letter 07-10

Director (00/21)

All VA Regional Offices and Centers

 

SUBJECT: Revised Disability Examination Worksheets

 

Revised disability examination worksheets for Audio; Ear Disease; Hand, Thumb and Fingers; Feet; Mental Disorders; Eating Disorders; Esophagus and Hiatal Hernia; Intestines; and Stomach, Duodenum, and Peritoneal Adhesions have been released nationally to VA Medical Centers for C&P examiner use.

 

These worksheets are changed in the following significant ways:

 

Audio and Ear Disease

The Audio examination worksheet no longer requires frequency and duration for tinnitus. The examiner only needs to state whether tinnitus is persistent or recurrent.

On the Audio examination worksheet, the request for an opinion about the etiology of tinnitus has been removed. If an opinion about etiology is required for a specific veteran, the regional office must request it.

On the Ear Disease examination worksheet, questions have been added about history of hospitalizations, surgery, noise exposure and ear trauma.

On both examination worksheets, examiners are asked to describe effects on occupational functioning and daily activities.

 

Hand, Thumb and Fingers

Under history, questions about hospitalizations, surgery, trauma and neoplasm have been added.

Examiners are asked to describe current symptoms and effects on occupational functioning and daily activities.

On physical examination, the requirement for passive range of motion has been removed.

 

Feet

Under history, questions about neoplasm have been added.

On physical examination, all requirements for range of motion of the toes; active, passive and after repetition have been removed.

On physical examination, assessment of posture in various positions has been removed.

 

Mental Disorders and Eating Disorders

The credentials of examiners who VBA and VHA recently agreed can perform these types of examinations are listed.

On a Mental Disorders examination, the examiner is expected to select the appropriate assessment of the veteran from the list provided and support the assessment with examples.

 

Esophagus and Hiatal Hernia

Under history, questions about hospitalizations, surgery, trauma and neoplasm have been added as well as the effects of the condition on occupational functioning and daily activities.

Under diagnostic tests, if there is a history of bleeding (past 12 months) or signs of anemia, a hemoglobin/hematocrit is required.

 

Intestines

Under history, questions about hospitalizations, surgery, trauma and neoplasm have been added as well as effects of the condition on occupational functioning and daily activities.

Under history, for ulcerative colitis, the number of attacks per year has been added as a requirement.

Under diagnostic tests, if there are signs of anemia, a hemoglobin/ hematocrit is required.

 

Scars

Under history, the treatment used and response to treatment has been removed.

 

Stomach, Duodenum, and Peritoneal Adhesions

Under history, questions about hospitalizations, surgery, trauma and neoplasm have been added as well as effects of the condition on occupational functioning and daily activities.

Under diagnostic tests, if there is a recent history (past 12 months) of hematemesis, melena or signs of anemia, a hemoglobin/hematocrit is required.

 

The following worksheets will be released in approximately 8 weeks: Bones; Chronic Fatigue Syndrome; Cranial Nerves; Cushing’s Syndrome; Eye; Fibromyalgia; HIV-Related Illness; Liver, Gall Bladder, and Pancreas; Lymphatic Disorders; Nose, Sinus, Larynx, and Pharynx; and Rectum and Anus.

 

These worksheets have been changed in the following significant ways:

 

Bones

Under history, questions about hospitalizations, surgery and neoplasm have been added.

If a joint is involved, the examiner is referred to the Joint worksheet.

 

Chronic Fatigue Syndrome

Under history, a question about hospitalizations has been added.

Under history, questions about debilitating fatigue, incapacitating episodes and cognitive impairment have been added.

A cursory physical examination has been added.

 

Cranial Nerves

Under history, the question about flare-ups has been deleted.

Under history, the examiner is asked to comment on onset, course since onset and current symptoms.

Under history, questions about hospitalization, surgery, neoplasm and trauma have been added.

Under history, a question about effects on occupational functioning and daily activities has been added.

 

Cushing’s syndrome

Under history, questions about hospitalizations, surgery, and neoplasm have been added.

Under history, a question about effects on occupational functioning and daily activities has been added.

Diagnostic and Clinical tests are only to be performed if not of record or to confirm a diagnosis.

 

Eye

Under history, questions about hospitalizations, surgery, and trauma have been added.

Under history, a specific question for congestive or inflammatory glaucoma has been added.

Under physical examination, a specific question about the ability to wear a prosthesis after enucleation has been added.

 

Fibromyalgia

Under history, a question about hospitalizations has been added.

 

 

HIV-Related Illness

Under history, questions about hospitalizations, surgery and neoplasm have been added.

 

Liver, Gall Bladder, and Pancreas

Under history, a question about effects on occupational functioning and daily activities has been added.

 

Lymphatic Disorders

Under history, a question about hospitalizations and surgery has been added.

Under history, a question about effects on occupational functioning and daily activities has been added.

A focused physical examination has been added.

 

Nose, Sinus, Larynx, and Pharynx

Under history, for chronic sinusitis, a question about incapacitating and non-incapacitating episodes per year has been added.

Under history, a question about effects on occupational functioning and daily activities has been added.

Under history, questions about neoplasm have been added.

Under physical examination, the examination for larynx and pharynx has been added.

 

Rectum and Anus

Under history, questions about hospitalizations, surgery, trauma, and neoplasm have been added.

Under history, a question about effects on occupational functioning and daily activities has been added.

Under Diagnostic and Clinical tests, the examiner is asked to obtain a CBC if there is a history of bleeding, signs of anemia or chronic infection.

 

If you have any questions about this letter, please contact Vicki Milton, M.D., at (202) 273-9646 or by e-mail.

 

 

 

/S/

Bradley G. Mayes

Director

Compensation & Pension Service

 

 

USAF 1980-1986, 70% SC PTSD, 100% TDIU (P&T)

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THANKS Adora-

I dont know if my AMie Worksheet link has this update!

will sure save this info!

GRADUATE ! Nov 2nd 2007 American Military University !

When thousands of Americans faced annihilation in the 1800s Chief

Osceola's response to his people, the Seminoles, was

simply "They(the US Army)have guns, but so do we."

Sameo to us -They (VA) have 38 CFR ,38 USC, and M21-1- but so do we.

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Wow! Talk about good timing! I have an audiology C&P tomorrow morning at 09:00. The tinnitus info alone is priceless! I should definately get the SC this time.

Where can we find the new worksheet for mental disorders? I'm sure it would be very helpful for Betty's (Josephine) case to know what credentials the examiners are required to have by VA in writing.

90%, TDIU P&T

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  • HadIt.com Elder
Wow! Talk about good timing! I have an audiology C&P tomorrow morning at 09:00. The tinnitus info alone is priceless! I should definately get the SC this time.

Where can we find the new worksheet for mental disorders? I'm sure it would be very helpful for Betty's (Josephine) case to know what credentials the examiners are required to have by VA in writing.

These are all CURRENT

Index to Disability Examination Worksheets

http://www.vba.va.gov/bln/21/Benefits/exams/index.htm

USAF 1980-1986, 70% SC PTSD, 100% TDIU (P&T)

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I am also amazed at the timeliness of this of this thread.

I have a c&p 6 Jan. for hearing and tinnitus, and another for meniere's disease on the seventh.

Its amazing.

thanks Jim 501

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