SOP Bulletin No. 149

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Rehabilitation & Entitlements Policy Group

Intranet site:  http://sharepoint/servingourcustomers/compensation/dsu

28 March, 2011

THE FOLLOWING RMA SOPS ARE TO TAKE EFFECT ON 30 MARCH, 2011

NOTEWORTHY FEATURES

• This new SOP covers a — n autoimmune disease that may develop after a streptococcal throat infection. It occurs mostly in children and is now rare in western countries.  The condition causes inflammation of the joints, heart, skin and brain, often resulting in a severe illness requiring hospitalisation. Onset is typically around three weeks after the infection.  Some symptoms may persist for months.  The chronic heart valve problems that develop in a minority of people who've had rheumatic fever are covered by the rheumatic heart disease SOP.

• Rheumatic heart disease is a sequela of acute rheumatic fever.
• There is now a more detailed and precise definition.
• In the RH SOP t — he previous onset factors for having acute rheumatic fever or a group A streptococcal infection of the throat (pharynx) or skin have been reworded but retained.  In the BOP SOP, a n — ew onset factor for group A streptococcal infection of the pharynx (but not the skin) has been added.
• Worsening factors, similar to the onset factors, have also been added.  There is one further new worsen — ing factor, covering pregnancy.

• The definition has been reworded but the SOP coverage is unchanged.
• The previous factors for craniofacial injury and disease have now been restricted to maxillofacial injury and disease.
• New onset and worsening factors have been added for: loss of teeth (as specified); having an adjacent odontogenic or ossifying fibroma; and using a mandibular repositioning device (for snoring or sleep apnoea) as specified.

• The onset factors from the old SOP have been retained, with some modifications.  The alcohol doses have been reduced from 150 kg to 110 kg for RH and from 220 kg to 150 kg for BOP.  The smoking cessation period has been increased from 10 to 20 years (RH & BOP).  The aflatoxins factor has been reworded.
• There are 13 new onset factors in the RH SOP and seven new onset factors in the BOP SOP.  These new factors cover: ionising radiation; thorotrast; type 2 diabetes; obesity; oral contraceptive pill use; gaseous vinyl chloride exposure (all RH and BOP); steatohepatitis; anabolic steroid use; immunosuppressive drugs; HIV infection; chewing betel quid or areca nut; and arsenic exposure (all RH only).

• These SOPs have been revoked and not replaced.  The RMA has concluded that metatarsalgia is not a disease or injury (it's a symptom).  T — his is the first time the RMA has revoked and not replaced a SOP.
• Metatarsalgia can be a symptom of a number of diseases or injuries, including the disease Morton's metatarsalgia, for which SOPs were recently issued (92 & 93 of '10).
• If metatarsalgia is claimed, the disease or injury that is the cause of the symptom should be established and that condition should be determined (using the app — ropriate SOP, if there is one).

# 3D echocardiogra — m of rheumatic mitral stenosis