120 lines
3.9 KiB
Mathematica
120 lines
3.9 KiB
Mathematica
DVBCST1 ;ALB/JEH SOCIAL AND INDUSTRIAL SURVEY WKS TEXT - 1 ; 24 MAY 2004
|
|
;;2.7;AMIE;**70**;Apr 10, 1995
|
|
;
|
|
;
|
|
TXT ;
|
|
;;A. Demographic & Information and Sources
|
|
;; -------------------------------------
|
|
;;
|
|
;; 1. Note the location of the interview/exam.
|
|
;;
|
|
;; 2. List demographic data, including age, gender, marital status, and other
|
|
;; relevant data.
|
|
;;
|
|
;; 3. List service connected disabilities.
|
|
;;
|
|
;; 4. Discuss capacity to manage financial affairs (if an issue).
|
|
;;
|
|
;; 5. Verify accuracy of veteran's name, address, phone number.
|
|
;;
|
|
;; 6. List informants or sources of information, such as claims folder,
|
|
;; medical record, veteran, family members, employers, neighbors, friends,
|
|
;; physician, or other persons.
|
|
;;
|
|
;; 7. If S&I Survey is done in the community, list the collaterals residing in
|
|
;; the home, their ages and relationship to the veteran, a brief
|
|
;; description at the household appearance and overall home environment.
|
|
;;
|
|
;;
|
|
;;B. Appearance & Response to Interview
|
|
;; ----------------------------------
|
|
;;
|
|
;; 1. Appearance - Describe the veteran's size, build, general physical
|
|
;; appearance and dress, noting any distinguishing features or
|
|
;; characteristics.
|
|
;;
|
|
;; 2. Indicate if s/he was alone or interviewed with others.
|
|
;;
|
|
;; 3. Make personal observations as to attitude, openness to interview,
|
|
;; reality testing, physical or mental difficulties in communicating. Does
|
|
;; s/he find the interview stressful or threatening? Is s/he cooperative
|
|
;; and friendly or guarded and withdrawn? Observe eye contact, facial
|
|
;; expressions, and attention span during interview.
|
|
;;
|
|
;;
|
|
;;C. Disabilities
|
|
;; ------------
|
|
;;
|
|
;; 1. Include disabilities listed on Form 2507 for which the exam is
|
|
;; requested and any other complaints or conditions expressed by the
|
|
;; veteran.
|
|
;;
|
|
;; 2. List of current medications.
|
|
;;
|
|
;;
|
|
;;D. Brief Pre-Military Social History
|
|
;; ---------------------------------
|
|
;;
|
|
;; Include where the veteran was born, his/her family configuration,
|
|
;; education, etc.
|
|
;;
|
|
;;
|
|
;;E. Military History
|
|
;; ----------------
|
|
;;
|
|
;; 1. Date the veteran entered military service and branch of service.
|
|
;;
|
|
;; 2. Where s/he completed basic training.
|
|
;;
|
|
;; 3. Military occupation(s).
|
|
;;
|
|
;; 4. Primary assignments and where stationed.
|
|
;;
|
|
;; 5. Any special training received in military.
|
|
;;
|
|
;; 6. Combat experiences.
|
|
;;
|
|
;; 7. Sexual trauma while in military.
|
|
;;
|
|
;; 8. Injuries or illness incurred while in military.
|
|
;;
|
|
;; 9. If claim is for PTSD, include a detailed account of the traumatic
|
|
;; experience(s).
|
|
;;
|
|
;; 10. Relationships with peers, superiors, subordinates, etc.
|
|
;;
|
|
;;
|
|
;;F. Prisoner of War (POW) Data (if applicable)
|
|
;; --------------------------
|
|
;;
|
|
;; 1. Capture Data
|
|
;; ------------
|
|
;;
|
|
;; a. Injuries/wounds incurred when captured and any treatment received.
|
|
;;
|
|
;; b. Captors - Date and place captured.
|
|
;;
|
|
;; c. Internment - List names of camps where interred and dates of
|
|
;; internment, psychological conditions, physical conditions, methods
|
|
;; used to control prisoners.
|
|
;;
|
|
;; d. Work - Physical & psychological conditions of work.
|
|
;;
|
|
;; e. Diet - Daily meals, including types of food, quantities, regularity
|
|
;; of meals.
|
|
;;
|
|
;; f. Illnesses or Injuries incurred when captured or while imprisoned
|
|
;; and any treatment received.
|
|
;;
|
|
;; 2. Information from Veteran's Significant Other(s)
|
|
;; -----------------------------------------------
|
|
;;
|
|
;; a. The significant other's relationship to the veteran.
|
|
;;
|
|
;; b. Whether s/he knew veteran before or after capture.
|
|
;;
|
|
;; c. Any changes observed.
|
|
;;
|
|
;; d. General comments on impact of POW experience.
|
|
;;
|