CAPRI GUI User Manual

Compensation and Pension Record

Interchange (CAPRI)

Audio

Template Workflow

Patch: DVBA*2.7*150

November 2009

Department of Veterans Affairs

Office of Enterprise Development

Management & Financial Systems

November 2009

CAPRI Audio Template Workflow DVBA*2.7*150

Revision History

Initiated on 02/09/2009

Date

Description (Patch # if applicable)

Project

Manager

Technica

Writer

12/15/200

CAPRI Audio Template Workflow DVBA*2.7*150

was created based on the Audio template released with

Patch DVBA*2.7*139.

CAPRI Audio Template Workflow DVBA*2.7*150

has been updated to include changes made by patch

DVBA

*2.7*150

•

Section 2 – Replaced History screen shot,

expanded Note to Examiners, changed Tinnitus

section

•

Section 3 – Replaced Physical Exam tab screen

shot, Added Description of speech recognition

performance section

•

Section 5 – Replaced Diagnosis tab screen shot,

moved For VA purposes paragraph; added

tinnitus pop-up messages, edited Degree of

Loss,

Also:

•

Added Revision History and Preface

•

Corrected minor header and footer formatting

issues

•

Changed formatting of field description in

Heading 1 and Heading 2

REDACTE

REDA

CTED

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November 2009

CAPRI Audio Template Workflow DVBA*2.7*150

iii

Preface

Reference Numbering System

This document uses a numbering system to organize its topics into sections and to show the

reader how these topics relate to each other. For example, the information in section 1.3 is the

main topic for the third section of Chapter 1. If there were two subsections to this topic, they

would be numbered 1.3.1 and 1.3.2. A section numbered 2.3.5.4.7 would be the seventh

subsection of the fourth subsection of the fifth subsection of the third topic of Chapter 2. This

numbering system tool allows the reader to more easily follow the logic of sections that contain

several subsections.

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November 2009

CAPRI Audio Template Workflow DVBA*2.7*150

Table of Contents

Introduction .............................................................................................................. 1

1.1

Purpose ............................................................................................................................ 1

1.2

Overview ......................................................................................................................... 1

History Tab ........................................................................................................... 2

2.1

Screenshot of Audio - History Tab ............................................................................. 2

2.2

Note to Examiners .......................................................................................................... 2

2.3

Records Review .............................................................................................................. 4

2.3.1

Comments on records ................................................................................................. 4

2.4

Chief Complaint .............................................................................................................. 5

2.5

Pertinent Service History ................................................................................................ 5

2.6

History of Military, Occupational, and Recreational Noise Exposure ........................... 5

2.7

Pertinent Family and Social History, history of ear disease, head or ear trauma ........... 5

2.8

Tinnitus ........................................................................................................................... 5

2.8.1

Is there a claim for tinnitus ......................................................................................... 5

2.8.2

Is there a current complaint of tinnitus ....................................................................... 5

Physical Exam Tab ................................................................................................ 8

3.1

Screenshot of Audio - Physical Exam Tab .................................................................. 8

3.2

Puretone Threshold Testing ............................................................................................ 8

3.2.1

Measure puretone thresholds in decibels .................................................................... 8

3.2.2

Right Ear ..................................................................................................................... 8

3.2.3

Left Ear ....................................................................................................................... 9

3.2.4

Puretone thresholds should not exceed 105 decibels.................................................. 9

3.2.5

The puretone threshold at 500 Hz is not used ............................................................. 9

3.2.6

Failure to respond will be indicated with a “+” .......................................................... 9

3.2.7

Speech Recognition Score Maryland CNC Word List ............................................... 9

3.2.8

When only puretone results should be used to evaluate hearing loss ...................... 11

Tests Tab ............................................................................................................. 12

4.1

Screenshot of Audio - Tests Tab ................................................................................ 12

4.2

Report middle ear status and confirm type of loss ....................................................... 12

4.2.1

In cases where there is poor inter-test reliability ...................................................... 12

4.3

Include results of all diagnostic and clinical tests ........................................................ 12

Diagnosis Tab ...................................................................................................... 13

5.1

Screenshot of Audio - Diagnosis Tab ......................................................................... 13

5.2

Was a Medical Opinion Requested ............................................................................... 13

5.3

For VA purposes, impaired hearing is considered to be a disability ............................ 14

5.4

Audiologic Test Results Summary ............................................................................... 14

5.4.1

Side ........................................................................................................................... 14

5.4.2

Type of loss ........................................................................................................... 14

5.4.3

Additional comments on hearing loss .................................................................... 14

5.4.4

Submit ....................................................................................................................... 14

5.4.5

Summary ................................................................................................................... 15

5.5

Diagnosis ...................................................................................................................... 15

5.6

Is hearing loss present ................................................................................................... 15

5.7

Is tinnitus as likely as not a symptom associated with the hearing loss ....................... 16

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November 2009

5.8

Is there a condition, which if treated, might lead to changes in hearing ...................... 16

5.9

Is there need for medical followup for an ear or hearing problem ............................... 16

5.10

Describe Effects of the Problem on Usual Occupational Activities ............................. 16

5.11

Effect on occupation ..................................................................................................... 16

5.11.1

Resulting work problems ...................................................................................... 16

5.11.2

What effects of this disability impact on occupational activities ......................... 17

5.12

Describe the effects of the problem on usual daily activities ....................................... 17

5.13

Are there effects on usual daily activities ..................................................................... 17

5.13.1

Ambulating ........................................................................................................... 17

5.13.2

Dressing ................................................................................................................ 17

5.13.3

Feeding .................................................................................................................. 17

5.13.4

Bathing .................................................................................................................. 17

5.13.5

Driving .................................................................................................................. 17

5.13.6

Toileting ................................................................................................................ 17

5.13.7

Grooming .............................................................................................................. 17

5.13.8

Describe other effect on usual daily activities ...................................................... 17

1 Introduction

1.1

Purpose

This document provides a high level overview of the contents found on the Audio Template that

was released in CAPRI patch DVBA*2.7*150. This document serves as a workflow process guide.

1.2

Overview

The Audio Template contains the following four tabs:

•

History

•

Physical Exam

•

Tests

•

Diagnosis

A common business rule used within the Audio Template is (for all multi-line free text entry

areas the user is provided) the ability to expand the details in an additional free text memo-box

when the Details button is selected.

Figure 1.2.a: Details Button

Figure 1.2.b: Additional Free Text Memo-box

A number of questions on the Audio Template are mandatory and require a response (value)

prior to the exam being marked as completed. Some answers to questions may activate a pop-

up window with an additional

Submit

, or

button.

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November 2009

2 History Tab

2.1

Screenshot of Audio - History Tab

Figure 2.1: Audio - History Tab

2.2

Note to Examiners (Label/Button)

When the

Note to Examiners

button is selected, a pop-up window labeled

Audio: Note to

Examiners

is displayed:

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CAPRI Audio Template Workflow DVBA*2.7*150

Figure 2.1: Audio: Note to Examiners

An examination of hearing impairment must be conducted by a state-licensed audiologist and must

include a controlled speech discrimination test (specifically, the Maryland CNC recording) and a pure tone

audiometry test in a sound isolated booth that meets American National Standards Institute standards

(ANSI S3.1. 1991) for ambient noise. Measurements will be reported at the frequencies of 500, 1000,

2000, 3000, and 4000 Hz. The examination will include the following tests: Pure tone audiometry by air

conduction at 250, 500, 1000, 2000, 3000, 4000, and 8000 Hz, and by bone conduction at 250, 500,

1000, 2000, 3000, and 4000 Hz, spondee thresholds, speech recognition using the recorded Maryland

CNC Test, tympanometry and acoustic reflex tests, and, when necessary, Stenger tests. Bone conduction

thresholds are measured when the air conduction thresholds are poorer than 15dB HL. A modified

Hughson-Westlake procedure will be used with appropriate masking. A Stenger must be administered

whenever pure tone air conduction thresholds at 500, 1000, 2000, 3000, and 4000 Hz differ by 20 dB or

more between the two ears. Maximum speech recognition will be reported with the 50 word VA approved

recording of the Maryland CNC test. The starting presentation level will be 40 dB re SRT. If necessary the

starting level will be adjusted upward to obtain a level of at least 5 dB above the threshold 2000 Hz, if not

above the patient’s tolerance level. The examination will be conducted without the use of hearing aids.

Both ears must be examined for hearing impairment even if hearing loss in only one ear is at issue.

When speech recognition is 92% or less, a performance intensity function must be obtained.

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November 2009

Procedures for Obtaining a Modified Performance-Intensity Function

1. The starting level is 40 dB re: SRT (speech reception threshold). The starting level will be adjusted

upward to obtain a level at least 5 dB above the threshold at 2000 Hz, if not above the patient’s tolerance

level.

2. Present 20 words at 6 dB above and 6 dB below the starting level.

3. If recognition performance improves less than 6%, then maximum word recognition performance has

been obtained.

Example: Starting level = 50dB HL. Initial performance = 80%. Decrease level to 44 dB HL. Performance

decreases to 76%. Increase level to 56 dB HL. Performance increases to 84%. Test level for full list = 56

dB HL.

4. If performance improves by 6% or more at the first 6-dB increment then word recognition is measured

using another 25 words at an addition 6-dB increment.

Example: starting level = 50 dB HL. Initial performance = 80%. Increase level to 56 dB HL. Performance

improves to 88% (+8%). Increase level to 62 dB HL. Performance decreases to 84% (-4%). Test level for

full list = 56 dB HL.

5. A full list (50 words) is then presented at the level of maximum performance. The word

recognition performance at this level is reported as the speech recognition score. Only the best

performance for a full list (50 words) will be reported.

The Handbook of Standard Procedures and Best Practices for Audiology Compensation and Pension

Exams is available online at: http://vbaw.vba.va.gov/bl/21/rating/Medical/docs/cphandbook.pdf

(This is

a PDF file. You need ACROBAT READER to open PDF files. It is a free download.)

2.3

Records Review (Button/Read-Only Text/Action)

The

Audio: Review of Records

panel allows the user to annotate the

C File Review

and the

Medical Record Review

. For each review, one of the following associated actions may be

selected:

Reviewed

Not Requested by VARO

, or

Requested by VARO but not available

The review of records questions must be completed.

Example:

C File Review:

•

Reviewed

•

Not Requested by VARO

•

Requested by VARO but not available

Medical Record Review:

•

Reviewed

•

Not Requested by VARO

•

Requested by VARO but not available

2.3.1

Comments on records: (Label/Free Text Box)

The user may provide comments on the review of the records.

If the user closes the

Audio: Review of Records

pop-up window either without a making a C

File Review selection or having selected

Requested by VARO but not available

, then the

following instructions display in a pop-up window:

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CAPRI Audio Template Workflow DVBA*2.7*150

C File must be reviewed before submitting the report

If the user closes the

Audio: Review of Records

pop-up window either without a making a

Medical Record Review selection or having selected

Requested by VARO but not

available

, then the following instructions display in a pop-up window:

Medical Records must be reviewed before submitting the report

2.4

Chief Complaint: (Label/Free Text Box)

2.5

Pertinent Service History: (Label/Free Text Box)

2.6

History of Military, Occupational, and Recreational Noise Exposure: (Label/Free

Text Box)

2.7

Pertinent Family and Social History, history of ear disease, head or ear trauma,

etc. (Label/Free Text Box)

2.8

Tinnitus: (Section Label/Read Only Text)

At first, the Tinnitus section has only two questions enabled:

2.8.1

Is there a claim for tinnitus (verify from the examination request, i.e. 2507)?

(Yes/No) (Label/Radio Button)

2.8.2

Is there a current complaint of tinnitus? (Yes/No) (Label/Radio Button)

Figure 2.8.2: History Tab – Tinnitus Section

Depending on how these two questions are answered, other sections may be enabled.

Yes

is answered for

Is there a claim for tinnitus?

, and

Yes

is answered for

Is there a

current complaint of tinnitus?

, then these sections are enabled:

2.8.2.1

If yes, answer the following questions whether or not the condition is claimed.

(Label/Read Only Text)

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November 2009

2.8.2.2

Is tinnitus constant? (Yes/No) (Label/Radio Button)

Figure 2.8.2.2: History Tab – Tinnitus Section

This subsection has additional sections that may be enabled depending on which answer the

user selects for the

Is tinnitus constant?

question. If

Yes

is selected, then nothing further

is enabled pertaining to this question. If

is selected, then this field is enabled:

2.8.2.2.1

Is tinnitus recurrent (intermittent)? (Yes/No) (Label/Radio Button)

2.8.2.3

Date and circumstances of onset: (Label/Free Text Box)

is selected for

Is there a claim for tinnitus?

, and

Yes

is selected for

Is there a

current complaint of tinnitus?

, the same fields are enabled as if

Yes

were answered for

both questions.

Figure 2.8.2.3: History Tab – Tinnitus Section

Yes

is selected for

Is there a claim for tinnitus?

, and

is selected for

Is there a

current complaint of tinnitus?

, then the following fields are enabled:

2.8.2.4

State when veteran last experienced tinnitus: (Label/Free Text Box)

2.8.2.5

Describe the tinnitus experienced at that time: (Label/Free Text Box)

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CAPRI Audio Template Workflow DVBA*2.7*150

2.8.2.6

Description of course since onset, e.g., how frequently in a year a veteran

experiences tinnitus: (Label/Free Text Box)

Figure 2.8.2.6a: History Tab – Tinnitus Section

is selected for

Is there a claim for tinnitus?

, and

is selected for

Is there a

current complaint of tinnitus?

, then no other tinnitus questions are enabled.

Figure 2.8.2.6b: History Tab – Tinnitus Section

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3 Physical Exam Tab

3.1

Screenshot of Audio - Physical Exam Tab

Figure 3.1: Audio - Physical Exam Tab

3.2

Puretone Threshold Testing

The following sections pertain to puretone threshold testing.

3.2.1

Measure and record puretone thresholds in decibels at the indicated

frequencies (air conduction). Use numeric characters only (0 – 9) or the value “105+” as

indicated below. Non-numeric entries and entries above 105 will be treated as entries of

105. Entries below -10 will be treated as entries of -10. (Read Only Text)

3.2.2

Right Ear (Label)

3.2.2.1

500 Hz* (Label/Free Text Box)

3.2.2.2

1000 Hz (Label/Free Text Box)

3.2.2.3

2000 Hz (Label/Free Text Box)

3.2.2.4

3000 Hz (Label/Free Text Box)

3.2.2.5

4000 Hz (Label/Free Text Box)

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3.2.2.6

Average (Label/Automatic Calculation)

3.2.3

Left Ear (Label)

3.2.3.1

500 Hz* (Label/Free Text Box)

3.2.3.2

1000 Hz (Label/Free Text Box)

3.2.3.3

2000 Hz (Label/Free Text Box)

3.2.3.4

3000 Hz (Label/Free Text Box)

3.2.3.5

4000 Hz (Label/Free Text Box)

3.2.3.6

Average (Label/Automatic Calculation)

3.2.4

Puretone thresholds should not exceed 105 decibels or the tolerance level.

(Label/Read Only Text)

3.2.5

* The puretone threshold at 500 Hz is not used in calculating the puretone

threshold average for evaluation purposes but is used in determining whether or not, for

VA purposes, hearing impairment reaches the level of a disability. (Read Only Text)

3.2.6

Failure to respond will be indicated with a “+” after the maximum allowable

limit of the audiometer or the maximum permissible limit, whichever is lower (e.g. 105+).

In those circumstances where the average includes no-response at the maximum

allowable limit or the maximum limits of the audiometer, 105dB HL will be averaged.

(Read Only Text)

3.2.7

Speech Recognition Score Maryland CNC Word List (Label/Read Only Text)

3.2.7.1

% Right Ear (Label/List Box)

This field has selections that include

Could not test

Too unreliable to score

, and even

numbers ranging from

through

100

3.2.7.2

% Left Ear (Label/List Box)

This field has selections that include

Could not test

Too unreliable to score

, and even

numbers ranging from

through

100

3.2.7.3

Thresholds should not exceed 100 decibels or the tolerance level. (Label/Read

Only Text)

3.2.7.4

Description of speech recognition performance: (Label/Read Only Text)

3.2.7.5

Right Ear: (Label/List Box)

This field has selections that include

Excellent (Normal) 100 – 94%, Good 92 – 80%,

Fair 78 – 70%,

and

Poor < 70%.

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November 2009

3.2.7.6

Left Ear: (Label/List Box)

This field has selections that include

Excellent (Normal) 100 – 94%, Good 92 – 80%,

Fair 78 – 70%,

and

Poor < 70%.

3.2.7.7

Thresholds should not exceed 100 decibels or the tolerance level. (Label/Read

Only Text)

3.2.7.8

Guidance for Pausing (Label/Button)

When the

Guidance for Pausing

button is selected, a pop-up window labeled

Audio:

Pausing Guidance

is displayed:

Figure 3.2.7.8: Audio: Pausing Guidance

Pausing: Examiners should pause when necessary during speech recognition tests, in

order to give the veteran sufficient time to respond. This will ensure that the test results are

based on actual hearing loss rather than on the effects of other problems that might slow a

veteran’s response. There are a variety of problems that might require pausing, for

example, the presence of cognitive impairment. It is up to the examiner to determine when

to use pausing and the length of the pauses.

3.2.7.9

Guidance for Modified Performance-Intensity (Label/Button)

When the

Guidance for Modified Performance-Intensity

button is selected, a pop-up

window labeled

Audio: Modified Performance-Intensity Function Guidance

displayed:

Figure 3.2.7.9: Audio: Modified Performance-Intensity Function Guidance

Need for a modified performance-intensity function: The normal speech recognition

performance is 94% or better for a full (50 word) list. If speech recognition is worse than

94% after presentation of a full list, then a modified performance-intensity function must be

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CAPRI Audio Template Workflow DVBA*2.7*150

obtained to determine best performance (see Note to Examiner for description of

procedures).

When describing speech recognition performance use these terms:

Percent Correct Description

100 – 94% Excellent (Normal)

92 – 80% Good

78 – 70% Fair

Less than 70% Poor

3.2.8

When only puretone results should be used to evaluate hearing loss, the

examiner, who must be a state-licensed audiologist, should certify that language

difficulties or other problems (specify what the problems are) make the combined use of

puretone average and speech discrimination inappropriate. (Label/Free Text Box)

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4 Tests Tab

4.1

Screenshot of Audio - Tests Tab

Figure 4.1: Audio - Tests Tab

4.2

Report middle ear status and confirm type of loss. (Section Label)

4.2.1 In cases where there is poor inter-test reliability and/or positive Stenger test

results, obtain and report estimates of hearing thresholds using a combination of

behavioral testing, Stenger interference levels, and electrophysiological tests.

(Label/Free Text Box)

4.3

Include results of all diagnostic and clinical tests conducted in the examination report.

(Label/Free Text Box)

5 Diagnosis Tab

5.1

Screenshot of Audio - Diagnosis Tab

Figure 5.1: Audio - Diagnosis Tab

5.2

Was a Medical Opinion Requested? (Yes/No) (Label/Radio Button)

Yes

is selected, a pop-up window displays the following:

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November 2009

Figure 5.2: Medical Opinion Pop-up Message

Please be sure to include a Medical Opinion.

The “Manage Templates” utility found under the “Options” button at the bottom of the screen can be

used to add a Medical Opinion template.

5.3

For VA purposes, impaired hearing is considered to be a disability when the

auditory threshold in any of the frequencies 500, 1000, 2000, 3000, and 4000 Hz is

40 dB HL or greater; or when the auditory thresholds for at least three of these

frequencies are 26 dB HL or greater; or when speech recognition scores are less

than 94%. (Section Label/Read Only Text)

5.4

Audiologic Test Results Summary: (Section Label)

5.4.1

Side: (Right/Left/Bilateral) (Label/Radio Buttons)

5.4.2

Type of loss: (Label/Drop-Down Box)

The options available for this field are

Clinically normal, Hearing loss not disabling (per

38 CFR 3.385), Sensorineural, Mixed, Conductive,

and

Central.

Sensorineural

Mixed

Conductive

, or

Central

is selected, the following is enabled:

5.4.2.1

Degree of loss: (Label/Two Drop-Down Boxes)

Figure 5.4.2.1: Degree of loss

The degree of loss can be specified by selecting the upper and lower bounds of the

hearing loss from the two drop-down boxes. The options available are:

Normal (Only

available for first box), Mild (26 – 40 HL), Moderate (41 – 54 HL). Moderately

severe (55 – 69 HL). Severe (70 – 89 HL),

and

Profound (90+ HL).

5.4.3

Additional comments on hearing loss (Label/Free Text Area)

5.4.4

Submit (Label/Button/Action)

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CAPRI Audio Template Workflow DVBA*2.7*150

User must enter

Side

Type of Loss

, and

Degree of Loss

as indicated before selecting

Submit

. Otherwise, a pop-up window displays a request for any missing information.

Figure 5.4.4a: Pop-up Request – Missing Side

Figure 5.4.4b: Pop-up Request –Missing Type of Loss

Figure 5.4.4c: Pop-up Request –Missing Degree of Loss

5.4.5

Summary (populated by the submit button above) (Label/Free Text Area)

The Summary field is populated when the user clicks

Submit

5.5

Diagnosis: (Label/Free Text Box)

5.6

Is hearing loss present? (Yes/ No) (Label/Radio Buttons)

This question will be enabled only if the response is

Yes

to either question located on the

History Tab:

Is there a claim for tinnitus

Is there a current complaint of tinnitus?

(See

section 2.8)

is selected for this field, then the following message is displayed:

Figure 5.6: Tinnitus Pop-up – Regional Office

CAPRI Audio Template Workflow DVBA*2.7*150

November 2009

In this case, it will be up to the regional office to determine, based on all of the evidence of

record, whether further non-audiological examination is needed to determine the etiology of

tinnitus.

Yes

is selected for this field, then the following question becomes enabled:

5.6.1 Is tinnitus as likely as not a symptom associated with the hearing loss?

(Yes/No, it is as likely as not that tinnitus is associated with another medical

condition/Etiology of tinnitus cannot be determined on the basis of available

information without resorting to speculation) (Label/Radio Buttons)

either option other than Yes

is selected, a pop-up window displays the following:

Figure 5.7: Tinnitus Pop-up – VBA Regional Office

In this case, it will be up to the VBA regional office to determine whether further non-

audiological examination is needed, based on the review of all evidence of record.

5.7

Is there a condition, which if treated, might lead to changes in hearing threshold

levels? (Yes/No) (Label/Radio Buttons)

5.8

Is there need for medical followup for an ear or hearing problem? (Yes/No)

(Label/Radio Buttons)

5.9

Describe Effects of the Problem on Usual Occupational Activities (even if not

currently employed) (Section Label/Read Only Text)

5.10

Effect on occupation: (Label/Select Box with the following options:)

The options available for this field are:

No significant effects, Significant effects,

and

Not

employed.

If either

Significant effects

Not employed

is selected, then the following fields are

enabled:

5.10.1

Resulting work problems: (Label/Multi-Select Box)

The options available for this field are:

Assigned different duties, Increased tardiness,

Increased absenteeism,

and

Other.

Other

is selected, then the following field is enabled:

5.10.1.1

Describe other significant effects on usual occupational activities:

(Label/Free Text Box)

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CAPRI Audio Template Workflow DVBA*2.7*150

5.10.2

What effects of this disability impact on occupational activities:

(Label/Multi-Select Box)

The options available for this field are:

Memory loss, Decreased concentration,

Inappropriate behavior, Poor social interactions, Difficulty following instructions,

Decreased mobility, Decreased manual dexterity, Problems with lifting and carrying,

Difficulty reaching, Speech difficulty, Hearing difficulty, Vision difficulty, Lack of

stamina, Weakness or fatigue, Decreased strength: upper extremity, Decreased

strength: lower extremity, Urinary incontinence, Fecal incontinence, Pain,

Disfigurement,

and

Other.

5.11

Describe the effects of the problem on usual daily activities: (Section Label/Read

Only Text)

5.12

Are there effects on usual daily activities: (Yes/No) (Label/Radio Buttons)

Yes

is selected, then the following fields are enabled:

5.12.1

Ambulating: (Yes/No) (Label/Radio Buttons)

5.12.2

Dressing: (Yes/No) (Label/Radio Buttons)

5.12.3

Feeding: (Yes/No) (Label/Radio Buttons)

5.12.4

Bathing: (Yes/No) (Label/Radio Buttons)

5.12.5

Driving: (Yes/No) (Label/Radio Buttons)

5.12.6

Toileting: (Yes/No) (Label/Radio Buttons)

5.12.7

Grooming: (Yes/No) (Label/Radio Buttons)

5.12.8

Describe other effect on usual daily activities: (Label/Free Text Box)