SOP Bulletin No. 105

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26 June 2006

THE FOLLOWING RMA SOPS ARE TO TAKE EFFECT ON 28 JUNE, 2006

The RMA will gazette a S196 G investigation into Shin Splints on 28 — th June 2006.  After that date claims for shin splints, as well as claims for medial tibial stress syndrome and chronic exertional compartment syndrome of the lower leg, including anterior tibial compartment syndrome, should not be determined until that investigation is complete.

IMPORTANT OPERATIONAL FEATURES

• There is an important change to the definition of osteoporosis in the BOP SOP.  The definition is now the same as in the RH SOP.  The definition requires a fracture associated with radiological evidence of prior osteoporosis or bone densitometry study results meeting the requirements.  The result now required is that the T score is -2.5 or lower.  The Z score is no longer required for this definition.  Claims for Osteoporosis which do not meet this definition should be determined “no incapacity found”.
• On 10 May 2006 the RMA declared that Osteopaenia is not a disease under the VEA.  Osteopaenia is where there is reduced bone mass, but the bone mass is not reduced sufficiently for osteoporosis to be diagnosed.  Claims for “Osteopaenia” should be investigated to see whether any other diagnoses, including Osteoporosis, can be made to answer the claim. “Osteopaenia” should be treated as “no incapacity found”.  If the degree of Osteoporosis is not sufficient to me — e — t the definition of osteoporosis in the SOP, the SOP for Osteoporosis cannot be applied.
• The SOPs have been put into the new format and many of the factors  re-worded and/or re-organised.  Only the major changes are listed here.
• There are seven new causal factors in both RH and BOP, all with dose and time requirements.  These are:

• having a BMI of less than 20
• inability to undertake physical activity greater than 3 mets
• having acquired vitamin D deficiency
• consuming more than 7.5 grams per day of vitamin A
• having a severe vitamin C deficiency
• being exposed to cadmium levels sufficient to cause renal damage
• having iron overload.

• There are now factors for a specified endocrine abnormality, a specified gastrointestinal disease and a specified autoimmune disorder with associated definitions.  The definition for the last of these is different in RH and BOP.  Th — e definitions include a number of diseases which previously appeared by disease name in factors.
• There have been a number of a — lterati — ons to the drugs table.

• These are new SOPs.  The — se SOPs finalise the formal investigation into this previously non-SOP condition.  During the investigation, claims could not be determined for this condition.  Outstanding cases may now be finalised.
• There is a causal factor in RH only for sunlight exposure.  The factor is the same factor as is in the non melanotic malignant neoplasm of the skin SOP, and inv — olves calculating how much sunlight exposure a person had as a result of service.  The factor requires only a total do — se (in hours) of sun exposure.
• The BOP SOP has only a factor for inability to obtain appropriate clinical management.

• These are new SOPs.  The — se SOPs finalise the formal investigation into this previously non-SOP condition.  During the investigation, claims could not be determined for this condition.  Outstanding cases may now be finalised.
• The definition includes retinal artery occlusion and retinal ve — in occlusion, both branch and central, where this has resulted in impaired vision.
• There are multiple causal factors in RH and BOP including factors for smoking, hypertension, diabetes, dyslipidaemia, specified drugs, being obese, trauma (which is defined) and for retinal vein occlusion only, being at least five percent dehydrated, all with time requirements.

• The atomic radiation factor has the new wording, and is now also in the BOP SOP.
• There is a new causal diagno — stic radiation factor in both RH and BOP, with different dose and time requirements.  Diagnostic radiation includes mammography.
• The hormone replacement therapy factor has different time requirements, and now includes a cessation clause.
• The contraceptive pill factor now specifies a combined contraceptive pill, and the time requirements have changed.
• There are new ca — us — al factors in both RH and BOP for:

• females breast feeding for less than 6 months RH/ 3 mon — ths BOP
• females over the age of 30 years being nulliparous
• having a first live birth or a first full-term pregnancy after the age of 30 years.

• The obesity factor now applies to males and postmenopausal females, and the time requirements have changed.
• There is new causal factor in both RH and BOP for inability to undertake physical activity, with duration and time requirements.
• The factor for a female who has not undergone oophorectomy and is nulliparous until the age of 30 years has been removed.

Remember! If you are having any problems with SOPs, or SOPs in CCPS, talk to us!