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The Statements of Principles Monitoring, Aetiology and CCPS Commentary Unit |
4th floor AMP Place, 10 Eagle St Brisbane Qld 4000.
Facsimile: 07 3223 8722.
Bob Connolly |
07 3223 8325 (Manager, Brisbane) |
Dr Bev Grehan |
07 3223 8376 |
Maureen Anderson |
08 8290 0365 (Manager, Adelaide) |
Dr Jon Kelley |
07 3223 8412 |
Duncan Cape |
07 3223 8757 |
Sue Lee |
08 8290 0227 |
Gaynor Cavanagh |
07 3223 8331 |
Bernadette McCabe |
07 3223 8393 |
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SOP BULLETIN No. 13 |
16 June, 1998
Release notes - ccps version 2.18
Version 2.18 of the Medical Knowledge Base for CCPS was released into production yesterday Monday, 15th June 1998.
This Bulletin provides a summary of the new and amended SOPs that this new version of CCPS incorporates and also details the changes to some of the existing Rulebases and Commentary.
(A)New SOPs incorporated into CCPS
Achilles tendonitis or bursitis |
This condition can be processed as a bilateral condition if required.
The only above line contention is engaging in Vigorous physical activity requiring movement of the ankle joint. This activity needs to have been done for at least
- 10 hours in operational service cases; or
- 20 hours in eligible service cases
within the 14 days before onset or worsening.
Bipolar disorder |
Suffering a Severe psychosocial stressor and Substance abuse involving alcohol are the above line contentions for this condition. In order to cause or aggravate the bipolar disorder, a severe psychosocial stressor must have occurred within the six months before the onset or worsening of the bipolar disorder.
Inflammatory bowel disease |
To investigate this condition it is necessary to identify whether the bowel disease is ulcerative colitis or Crohn's disease. There is a special diagnostic report to enable this information to be requested if necessary. The investigatory path in CCPS will be set by the ICD code selected.
The Smoking factor (which can be considered as a causal or aggravating factor) only applies if Crohn's disease is present.
The only factor which applies to ulcerative colitis is the Inability to obtain appropriate clinical management. Therefore, if the claim is in respect of ulcerative colitis which developed after VEA service, there will be no factors to investigate. This is because the inability to obtain appropriate clinical management is an aggravating factor which can only apply if the condition developed before the end of service.
Internal derangement of the knee |
With this SOP it is important to make sure the diagnosis is correct in the first instance as the term Internal Derangement of the Knee (IDK) may be used by some practitioners to describe an acute knee disorder. Acute knee disorders should be considered under the Acute Sprains/Strains SOPs (ICD Codes 840-848). The SOP for internal derangement of the knee deals only with a chronic disorder of the knee.
Jakob-Creutzfeldt disease |
Although this is a rare condition and therefore was not a priority for incorporation into CCPS, it has been included as part of a training exercise for commentary writers.
Parkinson's Disease and Parkinson's Syndrome |
The SOP for Parkinson's disease or Parkinson's syndrome has nine factors, but only the inability to obtain appropriate clinical management factor applies to both Parkinson's disease and Parkinson's syndrome. The other eight factors apply only if the condition claimed is Parkinson's syndrome. This condition is also known as secondary Parkinsonism. CCPS will display the factors to be investigated according to the ICD code selected. Thus it is important to take note of the diagnostic information displayed on the Confirm Diagnosis screen, and change the ICD code or request further diagnostic information, if required.
The definition of the lesion affecting the brainstem factor in the SOP includes a severe trauma to the head. This has been treated as a separate factor in CCPS. The drug factor and the severe trauma to the head factor are the only above line factors in CCPS.
Spasmodic torticollis |
This SOP only has the Inability to obtain appropriate clinical management as a factor and was included as a training exercise for commentary writers.
Malignant neoplasm of the thyroid gland |
It will be necessary to identify the histological type of cancer because the causal factors of Therapeutic radiation, Atomic bomb exposure, Thyroid adenoma and Goitre only apply if the malignant neoplasm of the thyroid is a papillary, follicular or anaplastic carcinoma. Papillary and follicular carcinomas account for 70% and 15% respectively of all primary thyroid cancers.
The remainder of thyroid cancers are either medullary carcinomas or the extremely rare teratoma.
NB Since this condition was prepared for incorporation into CCPS, the SOP has been amended. The effect of this amendment is to exclude medullary carcinomas from the causal factors. However, this amendment is not yet reflected in CCPS so make sure you do not accept a medullary carcinoma of the thyroid via one of the causal contentions (use the 'Make decision' facility if appropriate).
(B) Amendments to incorporated conditions following changes to the SOPs
Chronic fatigue syndrome |
Two causal factors have been added to the rulebase:
- suffering from serologically confirmed acute Epstein-Barr virus infection
- suffering from serologically confirmed acute Ross River virus infection.
Contact dermatitis |
The allergen exposure/re-exposure factors now only apply to allergic contact dermatitis. In addition, the allergen which the available clinical or serological evidence implicates as the cause of the contact dermatitis, must be identified.
Allergic contact dermatitis can be accepted via:
- any service -related exposure to the causal allergen before the onset of the dermatitis, or
- a service-related re-exposure to the causal allergen in the 5 days before the worsening of the dermatitis.
Such exposures to the causal allergen can only be service-related if they took place during operational or eligible service.
Time limits (3 days) have been introduced into the causal and aggravation paths for cutaneous exposure to an irritant.
Malignant neoplasm of the oesophagus |
The SOP amendment added undifferentiated carcinoma to the factors previously applicable only to squamous cell carcinoma. It is therefore necessary to identify whether or not the malignant neoplasm is:
- squamous cell carcinoma
- adenocarcinoma
- undifferentiated carcinoma
- other type of malignant neoplasm
There is a special diagnostic report to enable this information to be requested if necessary.
The smoking module continues to be troubled by combinations of pipe/cigar/cigarette smoking so manual conversion to one type of smoking should be used if necessary.
Rotator cuff syndrome |
SOP amendments have affected only the below line factors. The factor which dealt with occupational work with the arm has been replaced by Activities with the hand at or above the shoulder. The SOP requires that if the activities had ceased, the onset or worsening of rotator cuff syndrome must have occurred within 30 days following the cessation of the activities. Therefore rotator cuff syndrome can only be related to service activities if the onset or worsening of rotator cuff syndrome occurred during service or within 30 days after service.
There are 3 new factors - Regularly using the upper limbs for transfer, Acquired anatomical narrowing of the subacromial space and Excess laxity of the shoulder joint.
(C) Miscellaneous changes to commentary/reasons
Malignant neoplasm of the lung |
Commentary on the Confirm Diagnosis Screen and Contention Management Policy Screen has been amended. Although it is necessary to identify the histological type of the lung cancer before investigating the smoking contentions, there are circumstances where the determination of a claim should not be unduly delayed because information about the histological type of the cancer cannot be obtained. This is explained in the new commentary viewable by clicking on the Policy button attached to the Contention Management Screen.
Non melanotic malignant neoplasm of the skin |
The attachments to the reasons (where all the SOP factors are listed) have been amended to fix some editing errors.
The S.M.A.C.C unit will be happy to answer any questions about ANY OF THE ITEMS COVERED IN THIS BULLETIN AS WELL AS ABOUT ANY OTHER sop-related or ccps-related matter.