SOP Bulletin No. 157

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Rehabilitation & Entitlements Policy Group

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

5 March 201 — 2

THE FOLLOWING RMA SOPS TAKE EFFECT ON 7 MARCH, 2012

NOTEWORTHY FEATURES

• The issuing of this new SOP finalises the non-SOP investigations for chronic venous insufficiency and lipodermatosclerosis.
• The SOP covers various manifestations of impaired venous blood flow, including swelling, chronic skin changes, venous leg ulcers and the later complication of lipodermatosclerosis.
• Varicose veins and DVT (deep vein thrombosis) can both give rise to this condition, but they remain covered by their own, separate SOPs.

• The definition has been altered but this does not affect the coverage of the SOP.
• Circumstances where exposure to dengue virus can occur have been listed.
• For the dengue haemorrhagic fever factor, the “priming” past infection can now be any time before (the previous requirement was that it be within 20 years).

• The smoking factors have been changed from a cigarettes per day format to a pack-year format.
• The therapeutic radiation factors have been restricted to radiation “for cancer”, but also extended to cover ulceration as well as occlusive disease.
• There are new RH and BOP factors for ionising radiation and hyperhomocysteinaemia.
• There are new RH only factors for chronic renal disease, periodontitis, depressive disorder and passive smoking.

• The SOP factors and associated definitions now provide more detail on the relevant causative chemicals and circumstances of exposure (with the addition of some new chemicals).  The previous single onset factor has been split into four.
• Worsening factors, corresponding to the onset factors, have been added.
• In the BOP SOP, the exposure window has been extended from 14 days to 6 weeks.

• The definition has been amended and now includes a reference to the possible systemic manifestations.  The definition also now includes “inflammatory bowel disease of unspecified type”.  This is a specific diagnostic entity (made in someone who has Crohn's disease or ulcerative colitis, but where it is not yet clear which type is present).
• The smoking dose, for Crohn's disease has been increased in both RH and BOP SOPs.
• There are new RH and BOP factors for: a list of drugs; transplants; and, for worsening only, recent bowel infection.
• There are new RH only factors for passive smoking (Crohn's disease only), and, for worsening only, for category 1a, 1b and 2 stressors and depressive disorder.

• There are minor changes to the definition, with no effect on SOP coverage.  The requirement remains that there be iron overload, not just the genetic abnormality. 
• This being a disorder with a genetic basis, the factors are for worsening only.
• In the alcohol factors, the doses have been reduced.
• There are new factors for Hepatitis C infection and blood transfusion overload.

• The smoking factors have been changed from a cigarettes per day format to a pack-year format.
• The therapeutic radiation factors have been restricted to radiation “for cancer”.
• There are new RH and BOP factors for ionising radiation.
• There are new RH only factors for periodontitis and passive smoking.
• Previous RH worsening factors for foot hygiene and lower limb trauma have been removed (because they don't make the underlying disease worse).

• The definitions have been revised, with no operational effect.
• The drug factor in angle-closure glaucoma now has a definitive list of drugs/drug classes.
• There has been a reorganisation and regrouping of several previous factors and an expansion of the conditions and procedures in the associated definitions.
• There are new onset factors (RH and BOP) for sympathetic ophthalmia, eye surgery (non-intraocular) and ionising radiation.
• Worsening factors, corresponding to the onset factors, have been added.