| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | name(+) | 0;1 | POINTER | 2 | B | This is the name of the VIST veteran. |
| .015 | enrollment date | 7;6 | DATE-TIME | This is the date the veteran was added to the VIST roster. | ||
| .5 | referral source | 9;1 | SET OF CODES | 1:VA EYE CLINIC 2:NON-VA EYE CLINIC 3:STATE AGENCY 4:COMMUNITY AGENCY 5:VA STAFF 6:VETERANS SERVICE ORGANIZATION 7:FAMILY/FRIEND 8:SELF 9:OTHER | This is the person, organization, service or other source for the referral to the VIST program. | |
| 1 | number of dependents | 0;2 | NUMERIC | This is the number of people in addition to the veteran for whom the veteran has financial responsibility. | ||
| 1.2 | living arrangement | 7;5 | SET OF CODES | 1:ALONE 2:FAMILY 3:NURSING HOME 4:STATE VETERANS CENTER 5:UNKNOWN 6:LIVES WITH FRIEND 7:BOARD AND CARE 8:OTHER | This describes with whom the veteran resides. | |
| 1.5 | spouse's name | 13;1 | FREE TEXT | This is the name of the veteran's spouse. | ||
| 2 | dependent's name & info | 1;0 | MULTIPLE | 2040.02 | These are the names of the veteran's dependents. You can also include other information, i.e. phone numbers, etc. | |
| 2.3 | date of birth | COMPUTED | ||||
| 2.5 | age | COMPUTED | ||||
| 3 | vist eligibility | 2;1 | FREE TEXT | This describes the category of VA eligibility of the veteran. | ||
| 3.3 | period of service | COMPUTED | This is the last period of active service the veteran served. | |||
| 3.5 | va entitlement (amis) | 5;1 | SET OF CODES | 022:0% ONLY (022) 023:10% SC THRU SMC (023) 024:SC FOR BLINDNESS (024) 025:NSC PENSION A&A/HB (025) NSC:NSC PENSION ONLY OTH:NSC OTHER ELIGIBILITY | This is the category of VIST eligibility as prescribed on the VIST AMIS. | |
| 4 | eye exam date & visual status | 3;0 | MULTIPLE | 2040.04 | This is the date of the eye examination and the entry of the veteran's visual acuities and/or fields. | |
| 4.2 | eye diagnosis | 15;0 | MULTIPLE | 2040.01 | This states the diagnosis causing the veteran's visual loss. | |
| 4.5 | visual activity (amis)(+) | 7;3 | SET OF CODES | 004:NO SIGHT (004) 005:LP UP TO & INCLUDING 5/200 (005) 006:LP OF 6/200 TO 20/200 (006) 007:FIELD RESTRICTION (007) 008:NOT KNOWN (008) | This describes the veteran's degree of vision loss. | |
| 5 | general health | 4;0 | WORD-PROCESSING | This provides a summary of the veteran's general health. | ||
| 6 | vis team review date | 6;0 | MULTIPLE | 2040.06 | This is the date of the most recent VIST Review. | |
| 6.5 | vist field visit date (amis) | 10;0 | MULTIPLE | 2040.03 | This is the date of the most recent field or home visit to the veteran. | |
| 7 | vist eligible (amis)(+) | 13;2 | SET OF CODES | 001:YES (001) 002:NO - REVIEWED FOR BRC ATTENDANCE (002) 003:NO - OTHER (003) NO:NO - NOT LEGALLY BLIND I:INACTIVE | This states whether the veteran is eligible for VIST services. | |
| 8 | non vist eligible (amis) | 7;2 | SET OF CODES | 002:REVIEWED FOR BRC (002) 003:OTHER (003) | This denotes veterans not eligible for VIST Services. | |
| 8.5 | period of service (amis) | COMPUTED | This is the period of Service the veteran spent in the military. | |||
| 8.6 | period of service (amis) ii | COMPUTED | This is the AMIS field for period of service. | |||
| 8.7 | age category i | COMPUTED | This is the field denoting the age category in which the veteran is currently. | |||
| 8.9 | age category ii | COMPUTED | This is the field that denotes the age of the veteran. | |||
| 9 | major activity (amis)(+) | 7;4 | SET OF CODES | 009:EMP FOR PAY (009) 010:ENG IN TRN/SCHOOL (010) 011:VOL WORK 10HRS/WK (011) 012:RETIRED W/APPROP. ACT. (012) 013:TOO ILL OR TOO DISABLED (013) 014:NO WELL DEFINED ACT. (014) 015:NOT KNOWN (015) | This field denotes the veteran's major activities, work, school, volunteer activities, retired, too ill. | |
| 10 | county | COMPUTED | This denotes the county in which the veteran resides. | |||
| 11 | vist coordinator | 7;1 | POINTER | 200 | This is the VIST coordinator responsible for providing the veteran the VIST services. | |
| 11.5 | date veteran discharged (amis) | 14;0 | MULTIPLE | 2040.07 | This is the date a veteran was discharged from a blind rehabilitation program. | |
| 12 | *assessment | 11;0 | WORD-PROCESSING | This is an outline of the veteran's general functioning within his environment. (freetext) | ||
| 12.1 | financial and benefits info | 16;0 | WORD-PROCESSING | This indicates the veteran's financial status. | ||
| 12.2 | patient history | 17;0 | WORD-PROCESSING | This provides an outline for the veteran's family, education, military, marital and work history. (freetext) | ||
| 12.3 | activities | 18;0 | WORD-PROCESSING | This outlines the veteran's general activities within his environment. (freetext) | ||
| 12.4 | adjustment to blindness | 19;0 | WORD-PROCESSING | This summarizes the degree to which the veteran has adjusted to the loss of sight. (freetext) | ||
| 12.5 | impressions | 20;0 | WORD-PROCESSING | This outlines observations regarding the veteran's general functioning with respect to his/her vision loss. (freetext) | ||
| 13 | plan | 12;0 | WORD-PROCESSING | This states the proposed action steps to meet the presented needs. (freetext) | ||
| 14 | inactivation date | 8;0 | MULTIPLE | 2040.014 | The date after which the veteran was no longer carried on the active VIST ROSTER. |