DECISION SUPPORT UNIT
8th Floor, 259 Queen St, Brisbane
1st Floor Blackburn House, 199 Grenfell St, Adelaide
Intranet site: http://intranet/nat/comp/dp/Nop/dsu/dsudefault.htm
SOP Bulletin No. 99
22 December 2005
THE FOLLOWING RMA SOPS WILL TAKE EFFECT ON 28 DECEMBER, 2005
New SOPs
Guillain-Barre Syndrome
Steatohepatitis
Narcolepsy
Revocations &
Replacements
Peripheral Neuropathy
Sudden Unexpected Death (revocation of sudden
unexplained death)
Malignant Neoplasm of the Pancreas
Epileptic Seizure
Epilepsy
Dermatomyositis
Amendments
Nil
106766575
Decision Support Unit
Business Development, Monitoring and Support Section
Disability Compensation Branch
Australian Government Department of Veterans’ Affairs
Page 1 of 6
IMPORTANT OPERATIONAL FEATURES
Peripheral Neuropathy
Revocation – 41 & 42 of ‘05
Replaces 79 and 80 of '01, as
amended by 13 & 14 of ‘03
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Many of the factor and definitions in these SOPs have been reworded and restructured. The more significant changes have been listed below.
The definition has been reworded. The meaning is unchanged except for new
exclusions, namely plexus disorders (including brachial plexopathy and lumbosacral
plexopathy), hereditary neuropathies and Guillain-Barre syndrome, which now has
its own separate SOPs. Spinal cord disease now appears as a specific exclusion.
The new SOPs have no sub-factors. All factors apply to all conditions covered by
the SOP definition.
There are new causal factors for having alcohol dependence or alcohol abuse, and
for having inhalant dependence or inhalant abuse (Drug Dependence/Abuse SOPs).
The alcohol consumption factors now requires the consumption to be within the
ten years before the clinical onset.
There is a new causal factor for an inflammatory connective tissue disorder, which
includes four diseases previously covered by the systemic vasculitis factor, and
rheumatoid arthritis, which previously appeared in the systemic disease definition.
There is a new casual factor in RH only for having cutaneous contact with methyl
bromide within the thirty days before the clinical onset. Methyl bromide also
appears in the specified chemical factor, with different time requirements.
There are now factors for inhaling, ingesting or having cutaneous contact with a
chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-dioxin (TCDD), with
an associated definition. The previous factors for 2,4-dichlorophenoxyacetic acid
have been removed.
The factors for conditions no longer covered by the SOPs, i.e. plexus disorders
and Guillain-Barre syndrome have been removed.
The frostbite and nonfreezing cold injury factors have been removed. There are
SOPs for frostbite and for immersion foot, also known as trench foot. If a
neuropathy develops, for example, as a result of frostbite, the neuropathy is part
of the frostbite, and should be determined as such. The same applies to
immersion foot.
As has been the case recently, many of the new definitions for the SOP factors in
the RH and BOP SOPs are different.
Diabetes mellitus still appears in the systemic disease definition.
The drug lists have been reorganised and many additions made. Some drugs apply
for RH only.
106766575
Decision Support Unit
Business Development, Monitoring and Support Section
Disability Compensation Branch
Australian Government Department of Veterans’ Affairs
Page 2 of 6
Guillain-Barre Syndrome
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New – 53 & 54 of ‘05
These are new SOPs. Guillain-Barre syndrome was previously covered by the
peripheral neuropathy SOPs.
There are causal factors in both RH and BOP for certain infections, HIV,
Hodgkin’s and non-Hodgkin’s lymphoma, and for receiving one of the specified
vaccines, all with time requirements.
Sudden Unexpected Death
Revocation – 43 & 44 of ‘05
Replaces 99 and 100 of '96, as
amended by 185 & 186 of ’96, 18 & 19
of ’02, 49 & 50 of ‘03
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The definition has been reworded, and now specifically includes death delayed
beyond 24 hours because of life support by mechanical devices.
The RH factor for undergoing relevant service at the time of the death has been
removed.
The severe psychological stressor factor has been replaced with a factor for
experiencing a direct threat to the person’s life, where that threat would evoke
feeling of substantial distress, anger, or fear in that person. A direct threat to
the person’s life is defined in the SOP.
The physical activity factor is now physical activity greater than 5 mets within the
30 minutes before the death for RH/ immediately before the death for BOP.
A blow to the chest must now be immediately before the death for both RH and
BOP, and the definition has been reworded without change in meaning.
The drug factor now has a second component for being treated with a drug which
inhibits or blocks the cardiac hERG potassium channels. These drugs can have
cardiac arrhythmic effects. Included are drugs from a number of classes of
drugs (antibiotics, antidepressants, anti-arrhythmics), and some commonly used
drugs e.g. verapamil, phenytoin and amitriptyline.
The time requirement for these drugs and non-potassium sparing diuretics is 7
days for both RH and BOP.
106766575
Decision Support Unit
Business Development, Monitoring and Support Section
Disability Compensation Branch
Australian Government Department of Veterans’ Affairs
Page 3 of 6
Malignant Neoplasm of the Pancreas
Revocation – 45 & 46 of ‘05
Replaces 55 and 56 of '97, as
amended by 20 & 21 of ‘02
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The definition has been changed to exclude neoplasms arising from the endocrine
pancreas. However, these neoplasms are extremely rare. Primary malignant
neoplasms of the exocrine pancreas, which are the most common malignant
neoplasms of the pancreas, are included.
The previous exclusions of soft tissue sarcoma, non-Hodgkin’s and Hodgkin’s
lymphoma apply. Carcinoid tumours are now also excluded.
For both RH and BOP, there are new causal factors for using smokeless tobacco
and for being obese, with time requirements.
For RH only, there is a new causal factor for undergoing a partial gastrectomy at
least twenty years before the clinical onset.
The DDT factor has been reworded in the RH SOP and removed from the BOP
SOP.
The time requirements in the chronic pancreatitis factor have changed.
Epileptic Seizure
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There is a new causal factor in both RH and BOP for a mild head injury, with time
requirements. There is a definition of a mild head injury in the SOP.
The definition of “cerebral trauma” has been changed to require post-traumatic
amnesia to last at least thirty minutes. Shorter periods of post-traumatic
amnesia would be covered by the “mild head injury” definition.
Epilepsy
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Revocation – 47 & 48 of ‘05
Replaces 1 and 2 of '05
Revocation – 49 & 50 of ‘05
Replaces 3 and 4 of '05
The new “mild head injury” factor is in these SOPs as causal and worsening factors
in both RH and BOP, with varying time requirements.
The same change as described above under Epileptic Seizure has been made to the
“cerebral trauma” definition.
106766575
Decision Support Unit
Business Development, Monitoring and Support Section
Disability Compensation Branch
Australian Government Department of Veterans’ Affairs
Page 4 of 6
Dermatomyositis
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There is a new causal factor in both RH and BOP for having a malignant neoplasm,
other than non-melanotic malignant neoplasm of the skin, within 5 years of the
clinical onset of dermatomyositis. The word “within” here means that the clinical
onset of malignant neoplasm can occur up to five years before or after the clinical
onset of the dermatomyositis.
There is a new causal factor in RH only for becoming infected with a specified
virus in the two months before the clinical onset.
Steatohepatitis
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New – 55 & 56 of ‘05
These are new SOPs. The definition requires fatty change together with
inflammation. This is part of the spectrum of disease between mild reversible
change (fatty liver without inflammation) and severe disease (cirrhosis).
Specialist opinion will generally be required for diagnosis.
There are causal factors in both RH and BOP for consuming specified amounts of
alcohol, being obese, having diabetes mellitus, having hypertriglyceridaemia,
receiving total parental nutrition, undergoing jejunoileal bypass surgery and
experiencing rapid weight loss, with varying time requirements.
Narcolepsy
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Revocation – 51 & 52 of ‘05
Replaces 15 and 16 of '05
New – 57 & 58 of ‘05
These are new SOPs. The definition details the requirements to diagnose
excessive daytime sleepiness as narcolepsy, and includes sleep testing.
There is a RH only causal factor for having cerebral trauma within the two years
before the clinical onset.
There are causal factors in both RH and BOP for undergoing a course of
therapeutic radiation and having a specified neurological disease, with time
requirements.
106766575
Decision Support Unit
Business Development, Monitoring and Support Section
Disability Compensation Branch
Australian Government Department of Veterans’ Affairs
Page 5 of 6
Contact Officers for this bulletin:
Maureen Anderson
Dr Bev Grehan
Dr Jon Kelley
50365
48376
48412
Remember! If you are having any problems with SOPs, or SOPs in
CCPS, talk to us!
106766575
Decision Support Unit
Business Development, Monitoring and Support Section
Disability Compensation Branch
Australian Government Department of Veterans’ Affairs
Page 6 of 6