Revised Disability Examination Worksheets

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Revised Disability Examination Worksheets, Fast Letter 07-10

Posted by: "Colonel Dan" colonel-dan@sbcglobal.net coloneldan1

Tue May 13, 2008 8:34 am (PDT)

Does anyone have link to the actual recent VA directive or fast letter on AO
& hypertension

I just saw this.. from April 2007


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

1. 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.

2. 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/hematocr it 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/hematocr it
is required.

3. 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.

4. 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.

5. 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