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Ate Zip Date of birth Applied for Social Security Administration (SSA) benefits Yes No County number Case number Client identification (ID) number Members of household other than patient: Others Specify by relationship: None Spouse II. Medical history: Relevant history including surgical procedures with approximate dates: Present complaints: III. Visual and otological findings: Right eye Pterygium Cataract Corneal scars Vision Normal Impaired Blind Severe.

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How to fill out the OK 08MA080E online

The OK 08MA080E form is essential for reporting a physician's examination, particularly in the context of applying for social security benefits. This guide will provide you with comprehensive steps to efficiently complete the form online, ensuring that all necessary information is accurately recorded.

Follow the steps to successfully complete the OK 08MA080E form online.

  1. Press the ‘Get Form’ button to obtain the form and open it in the online editor.
  2. Begin by filling out the patient identification section. Provide the patient’s last name, first name, middle initial, street address, race, city, county name, date, state, zip code, date of birth, and information regarding whether they have applied for Social Security benefits.
  3. List any members of the household other than the patient, specifying relationships such as spouse, or indicate if there are none.
  4. In the medical history section, include relevant surgical procedures and approximate dates, as well as present complaints from the patient.
  5. Complete the visual and otological findings. For each eye, select the appropriate conditions (e.g., pterygium, cataract) and identify the vision status as normal, impaired, blind, or severely impaired. Repeat this for hearing evaluations for both ears.
  6. Fill out other physical findings, including height, weight, blood pressure measurements, pulse rate, and results for urinalysis.
  7. Document the clinical diagnosis by providing the primary and secondary diagnoses along with the respective ICD-9-CM codes and onset dates.
  8. Outline the plan of treatment which includes immediate orders, long-range goals, restoration plans, and a history of previous rehabilitation within the past 12 months.
  9. Specify needed care, indicating the type(s) of care required, such as skilled nursing facility care or personal care, and note any conditions requiring special management.
  10. Assess work tolerance if nursing care is not indicated, providing details on the patient’s capabilities regarding standing, walking, bending, lifting, or sedentary work.
  11. Finally, complete the examining physician’s details, including their name, address, date of examination, and ensure the physician's signature is provided.
  12. Once all sections are filled out, you have the option to save changes, download the form, print it, or share it as required.

Complete your OK 08MA080E form online today to ensure a smooth submission process.

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