SOP Bulletin No. 15 — 3

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Rehabilitation & Entitlements Policy Group

29 August 2011

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

THE FOLLOWING RMA SOPS TAKE EFFECT ON 31 AUGUST, 2011

NOTEWORTHY FEATURES

• Th — is new SOP covers inflammation or degeneration of the patella tendon.  This is a common cause of pain in the area just below the patella (knee cap) in younger athletes.  It is typically an over-use type injury.
• The determination of this SOP concludes the non-SOP investigation into patella tendinitis.

• Th — is new SOP covers a condition of chronic inflammation of one of the membranes that surrounds the spinal cord.  The condition can result in debilitating back pain and neurological deficits.
• Th — e determination of this SOP concludes the non-SOP investigation into arachnoiditis.
• The SOP has specific diagnostic requirements, including the need to demonstrate inflammation / scarring with imaging or at surgery, as well as appropriate clinical manifestations.

• This new S — OP covers loss of smell that is total and permanent.
• The determination of this SOP concludes the non-SOP investigation into anosmia.

• Th — is SOP replaces the acute sprain and acute strain SOP.  The determination of this SOP also concludes the non-SOP investigation into chronic sprain and chronic strain.
• The SOP covers acute sprains / strains due to a discrete injury event, as before.  It now also covers such sprains / strains that persist beyond an initial acute phase.  The SOP does not cover any form of overuse injury.

• The definition has been reworded and now specifically includes carcinoma-in-situ.
• There has been extensive reordering and rewording of the factors from the previous SOPs.  The new format ionising radiation factor replaces previous factors for atomic and therapeutic ra — diation.
• There are new RH and BOP factors for working as a painter and having neurogenic bladder dysfunction or spinal co — rd injury.
• There are new RH only factors for: heavy exposure to diesel engine exhaust; working as a hairdresser or barber; treatment with chlorporomazine; treatment with pioglitazone; and, transurethral resection for benign prostatic hyperplasia.

• The definition has been reworded and now specifically includes carcinoma-in-situ.
• The new format ionising radiation factor replaces the previous factor for a t — horotrast injection (t — horotrast was a radioactive contrast medium used with X-rays).
• There are new RH and BOP factors for: exposure to arsenic; ingesting aristolochic acid; renal stone disease; hydronephrosis; requiring dialysis or renal transplant; and, treatment with cyclophosphamide or i — f — osfamide.
• There are new RH only factors for: polycyclic aromatic hydrocarbon exposure; aromatic amine exposure; and, working as a painter.

• The definition is now more descriptive, but SOP coverage is unchanged.
• Many new onset and worsening factors have been added to both SOPs.  The BOP SOP previously had an inability factor only.
• There are new RH and BOP onset factors for smoking and for vitamin D deficiency. 
• There are new RH only onset factors for: treatment with a tumour necrosis factor alpha antagonist; vitamin D insufficiency (as opposed to deficiency); and, death of a related child. 
• There is a new BOP onset factor for symptomatic Epstein Barr virus infection (in the RH SOP there is an existing factor for infection with Epstein-Barr virus, whether symptomatic or not).
• There are new worsening factors (RH and BOP) for: smoking; onset of viral or bacterial infection as specified; treatment with drugs as specified; a range of stressors; and, a medical illness or injury as specified.  There are new RH only worsening factors for: using assisted reproductive technology (women only); being postpartum; therapeutic radiation; and, ionising radiation.

• The previous requirement in the definition for at least a 50% occlusion of a renal artery has been removed.  There still needs to be artery occlusion plus clinical manifestations (not just occlusion alone).
• The previous onset factors have been retained and also added as worsening factors (t — here were no worsening factors except inability in the previous SOPs).  Hypertension is a worsening factor in the RH SOP only.
• There are new factors (RH & BOP) for: hyperhomocysteinaemia; a dose of ionising radiation; and, a course of therapeutic radiation.
• Having a therapeutic radiation factor, when there is also an ionising radiation factor, in this SOP, the multiple sclerosis SOP and the chronic pancreatitis SOP (see below), is effectively a ”belt and braces” approach by the RMA.
• There is a new worsening only factor (RH & BOP) for being treated with an angiotensin converting enzyme (ACE) inhibitor or an angiotensin receptor blocker.

• The disease definition has been reworded, but SOP coverage is unchanged.
• The existing alcohol factor — s (RH and BOP) ha — ve been altered, with the required dose per year effectively halved.
• New factors have been added for: smoking; cholelithia — s — is (gall stones); and hypertriglyceridaemia (all RH and BOP), and for chronic renal failure (RH only).
• The previous RH only factor for acute pancreatitis has been added to the BOP SOP.
• A new ionising radiation factor, with a very high dose (10(RH)/20(BOP) sieverts) has been included, but the previous therapeutic radiation factor has also been retained.

• This SOP previously had four different factors concerning forms of ionising radiation.  They have been replaced by a single factor in the new standard format.
• Existing factors concerning Paget's disease and osteomyelitis have now been restricted to particular histological types of sarcoma.  The osteomyelitis factor was RH only but has now been included in the BOP SOP.
• There is a new RH only factor for having a bone marrow transplant.

• This SOP has been updated as part of a rolling review of older SOPs. 
• There are minor changes to the disease definition.
• There is one new factor (RH & BOP), for allergic photocontact dermatitis only, for cutaneous exposure to the causative photoallergen any time before onset.

• The previous SOP for contact dermatitis has been split, to separate the irritant and allergic forms.  Allergic contact dermatitis can be related back to past exposure to an allergen, whereas a current episode of irritant dermatitis is causally unrelated to any past exposure to the irritant.
• A similar split of the photocontact dermatitis SOPs was not considered to be needed.