VA Joint Range of Motion Worksheet 2012-2025 free printable template

Veteran VA Date VA Joint Range of Motion Worksheet Federal Regulations Title 38 - Pensions Bonuses Veterans Relief General Rating Formula for Spine Normal Veteran Rounded Rating 40 Unfavorable ankylosis entire cervical spine Extension 30 Flexion 15 or less or favorable ankylosis entire cervical spine Right Lateral Flexion 20 Flexion 15 to 30 or combined ROM not greater than 170 degrees or Left Lateral Flexion 20 Spasm abnormal spinal contour scoliosis reversed lordosis or kyphosis Right...

How to fill out range of motion assessment

How to fill out VA Joint Range of Motion Worksheet

1. Obtain the VA Joint Range of Motion Worksheet from your healthcare provider or the VA website.
2. Begin with the patient's identification details, such as name, Social Security number, and date of birth.
3. Specify the date of the examination.
4. Note the joints being assessed, such as the shoulder, elbow, wrist, knee, or ankle.
5. For each joint, perform range of motion measurements using a goniometer if necessary.
6. Record the measured angles for each movement (flexion, extension, abduction, adduction, etc.).
7. Indicate any pain or limitations experienced during the range of motion testing.
8. Complete any additional notes required by the worksheet pertaining to the patient's mobility or functional limitations.
9. Review the completed worksheet for accuracy and ensure all required signatures are obtained.

Who needs VA Joint Range of Motion Worksheet?

1. Veterans undergoing assessments for joint pain, injuries, or conditions affecting mobility.
2. Healthcare providers conducting evaluations for disability claims or treatment plans.
3. Physical therapists evaluating joint function for rehabilitation purposes.

People Also Ask about

What are the 4 types of range of motion?

There are three basic types of range of motion: passive, active-assistive and active, defined by the whether, and to what degree, the patient can move the joint voluntarily.

How do you document range of motion?

Documenting Knee Range of Motion If a person has 10 degrees of knee hyperextension and 130 degrees of knee flexion, it would be documented as 10-0-130. If a person has a 10 degree contracture and loss of full knee extension with 130 degrees of knee flexion, it would be documented as 0-10-130.

What are the assessments for range of motion?

A ROM assessment is most commonly used to measure movement of the ankles, knees, hips, shoulders, elbows, wrists and fingers. Measures are taken on consecutive occasions to assess any change over time. They are used to determine whether an individual's ROM is within the expected range.

What is range of motion examples?

Active range of motion is the range of motion that can be achieved when opposing muscles contract and relax, resulting in joint movement. For example, the active range of motion to allow the elbow to bend requires the biceps to contract while the triceps muscle relaxes.

What is normal range of motion for hip?

Normal hip ROM is as follows: Abduction: 0 to 45 degrees. Adduction: 45 to 0 degrees. Extension: 115 to 0 degrees.

How do you document the range of movement?

Documenting Knee Range of Motion If a person has 10 degrees of knee hyperextension and 130 degrees of knee flexion, it would be documented as 10-0-130. If a person has a 10 degree contracture and loss of full knee extension with 130 degrees of knee flexion, it would be documented as 0-10-130.

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What is VA Joint Range of Motion Worksheet?

The VA Joint Range of Motion Worksheet is a standardized form used by healthcare professionals to assess and document the range of motion in joints for veterans. It is utilized to evaluate limitations and aid in determining disability ratings.

Who is required to file VA Joint Range of Motion Worksheet?

Healthcare providers conducting evaluations for veterans who are seeking disability benefits related to joint conditions are required to file the VA Joint Range of Motion Worksheet.

How to fill out VA Joint Range of Motion Worksheet?

To fill out the VA Joint Range of Motion Worksheet, the healthcare provider must measure the joint's degrees of motion, document any pain or limitations experienced by the veteran, and complete all required sections including patient details and specific joint assessments.

What is the purpose of VA Joint Range of Motion Worksheet?

The purpose of the VA Joint Range of Motion Worksheet is to provide a comprehensive evaluation of a veteran's joint functionality, which is crucial for determining eligibility and level of compensation for service-related disabilities.

What information must be reported on VA Joint Range of Motion Worksheet?

The information that must be reported on the VA Joint Range of Motion Worksheet includes the patient's identification details, specific joints assessed, degrees of motion measured, presence of pain, any observed limitations, and relevant medical history.