VA.gov Home | Veterans Affairs

c. Achilles tendonitis or Achilles tendon rupture. If checked, indicate side affected: Right Left Both ... Wrist extension: Right: 5/5 4/5 3/5 2/5 1/5 0/5. Left: 5/5 4/5 3/5 2/5 1/5 0/5 ... Implanted automatic implantable cardioverter defibrillator (AICD) ICD code: _____ Date of diagnosis: _____ ... ................
................