Disability Examination Worksheets
Lymphatic Disorders
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A. Review of Medical Records: B.
Medical History (Subjective Complaints):
Comment on:
- If there are exacerbations/remissions, what is the state of the veteran's health during remissions?
- Current and past treatment history including date and type of
last treatment, response, side effects.
- If malignant neoplasm, need diagnosis, date of diagnosis, dates of treatment, or if treatment ended, date of last treatment.
- Current symptoms - lymphadenopathy, bleeding tendency, gastrointestinal symptoms, constitutional symptoms.
- History of hospitalizations or surgery, reason or type of surgery, location and dates, if known.
- Effects of condition on occupational functioning and daily activities.
C. Physical Examination (Objective Findings):
Describe the residuals of each body system
affected and follow additional worksheets as appropriate. Comment on the following:
- Lymphadenopathy.
- Splenomegaly.
- Hepatomegaly, jaundice.
- Signs of bleeding.
- Signs of anemia - Presence of Pallor (nail beds, mucosal surfaces and skin), tachycardia, systolic murmur.
- Evidence of superior vena cava syndrome.
D. Diagnostic and Clinical Tests:
1. Include results of all diagnostic and clinical tests
conducted in the examination report. E. Diagnosis:
1. Is the disease active?
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Reviewed/Updated Date:
May 2, 2007
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