SOP Bulletin No. 112

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29th January 2007

RELEASE NOTES - CCPS VERSION 2007/01

Version 200 — 7/0 — 1 of the Medical Knowledge Base for CCPS was released into production today.  This Bu — l — letin provides a summary of the new and amended SOPs that this version of CCPS incorporates.  This Bulletin also details changes to some existing rulebases and commentary.

New SOPs incorporated into CCPS

Shin splints

• The two weight bearing factors – a sudden increase in weight bearing exercise and weight bearing exercise at a rate greater than 6 METS - will be the most commonly used.  The other causal factor, an injury resulting in excess pronation of the foot, applies only for medial tibial stress syndrome.
• The Claimant Report seeking information about Prolonged weight bearing exercise greater than 6 METS requests details of such weight bearing exercise for the six months before the first symptoms or signs of shin splints.  This reflects the requirements of the BOP SOP.  If investigating this SOP factor for a claimant who has only operational service, this part of the questionnaire should be amend to read "three months".

For information on this SoP refer to SoP Bulletin No. 108 of 2 — 8/8/06

SOP amendments incorporated into CCPS

Acute myeloid leukaemia

• The — re are 3 factors involving benzene – being exposed to benzene, cumulative exposure to benzene and exposure to AVGAS or petroleum products containing benzene'.
• Being exposed to benzene and cumulative exposure to benzene both refer to minimum concentration levels of benzene in terms of 'parts per million'; however being exposed to benzene also allows for cutaneous contact or ingestion at any concentration.  These 2 factors share a common claimant questionnaire that will enable the claimant to provide a description of when and how the exposure occurred but not specifically about concentration levels because this detail is unlikely to be known by the claimant.  If information on the concentration levels of benzene is required to test either factor, then further investigation will be required based on the description provided in the questionnaire.

For information on this SoP refer to SoP Bulletin No. 108 of 2 — 8/8/06

External burn

• In CCPS a number of factors have been grouped together as they are similar types of factors.  The thermal burn factor covers the application of heat and of friction; the radiation burn factor covers ionising radiation, radiofrequency or microwave, infrared radiation, non-ionising radiation from the use of laser, and ultrasound.  Therefore the reject reasons generated by CCPS for the radiation burn factor will prompt the decision maker to insert the particular radiation factor that has been investigated.
• Ultraviolet radiation is incorporated in CCPS as a factor on its own.
• The claimant questionnaire and medical questionnaire in the rulebase are generic for all the factors.

For information on this SoP refer to SoP Bulletin No. 108 of 2 — 8/8/06

Myelodysplastic disorder

• The — re are 2 factors involving benzene – being exposed to benzene and cumulative exposure to benzene.
• Being exposed to benzene and cumulative exposure to benzene both refer to minimum concentration levels of benzene in terms of 'parts per million'; however being exposed to benzene also allows for cutaneous contact or ingestion at any concentration.  These 2 factors share a common claimant questionnaire that will enable the claimant to provide a description of when and how the exposure occurred but not specifically about concentration levels because this detail is unlikely to be known by the claimant.  If information on the concentration levels of benzene is required to test either factor, then further investigation will be required based on the description provided in the questionnaire.

For information on this SoP refer to SoP Bulletin No. 108 of 2 — 8/8/06

Rotator cuff syndrome

• The contention repetitive or sustained activities of the affected shoulder has been placed above line in CCPS as the factor may be relevant to most military personnel, including those undertaking intense physical training or those in occupations where shoulders are routinely flexed to at least 60 degrees (such as vehicle mechanics or painters).  However, the claimant questionnaire asks for details only of those activities performed during the eight months before onset (BOP requirement allowing for 'cessation period').  If investigating an RH only case the questionnaire should be edited to refer to the five months (4 months activity plus 30 days before onset) before onset as applicable to that standard of proof.  Kattenberg principles also apply.
• Medical questionnaires have been developed to assist investigate excess laxity of the shoulder joint and dialysis-related amyloidosis as these contentions have specific clinical manifestations that require identification of the underlying disease processes.
• There is a new medical questionnaire for investigating an injury to the affected shoulder.  It may be helpful in circumstances where the LMO has first-hand knowledge of treatment for any acute injury implicated in a claim.
• Other than the medical report known as the Propagation Management Questionnaire, the medical and claimant questionnaires really only deal with one diagnosis of rotator cuff syndrome at a time.  If you have a case where you have recorded diagnoses of rotator cuff syndrome left shoulder and rotator cuff syndrome right shoulder and you wish to obtain information for both via any of these contention specific questionnaires, you will need to edit the questionnaires produced by CCPS.  For the injury and repetitive activities questionnaires, it may be simpler to duplicate the document in Word and edit it to reflect the relevant side.
• The rheumatoid arthritis and gout factors only apply if the shoulder is affected.  CCPS will test this prerequisite before propagating to the rulebase for the relevant SOP.

For information on this SoP refer to SoP Bulletin No. 108 of 2 — 8/8/06

Enhancements of CCPS rulebases and commentary

• Non-melanotic malignant neoplasm of the skin (NMMNS)
• Solar keratosis

The contention management screen (CMS) for these two conditions now includes guidance about the two UV factor requirements, as per DSU Discourse (Issue 5) recommendations.  There have been minor revisions to some hotwords shared with seborrhoeic keratosis.

Additional amendments

Amendments to the following incorporated conditions are included in this release. However, there are no noteworthy CCPS features:

• Osteoporosis (SoP Bulletin No. 110 of 7/11/06)
• Vascular dementia (SoP Bulletin No. 110 of 7/11/06)
• Seborrhoeic keratosis (minor hotword revisions)

A number of diagnostic questionnaires (including the generic questionnaire) have had a minor revision specifically to include a request for copies of specialist reports and test results when appropriate.

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