SOP Bulletin No. 66

Decision Support Unit

4 — th Floor AMP Place, 10 Eagle St Brisbane  3 — rd Floor Blackburn House, 199 Grenfell St Adelaide

Intranet site:  http://intranet/nat/comp/dp/Nop/dsu/dsudefault.htm

13 January 2003

RELEASE NOTES - CCPS VERSION 2002/12

Version 2002/12 of the Medical Knowledge Base for CCPS was released into production today.  This Bulletin 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	NIL
SOP amendments incorporated into CCPS	Atherosclerotic peripheral vascular disease Familial adenomatous polyposis Malignant neoplasm of the prostate Osteoporosis Psoriasis
Enhancements of CCPS rulebases and commentary	Reiter's syndrome, Hepatitis B, Hepatitis C and Hepatitis D Migraine and Tension-type headaches
Additional amendments - not noteworthy	Aortic stenosis Gastro-oesophageal reflux disease

New SOPs incorporated into CCPS

NIL

SOP amendments incorporated into CCPS

Atherosclerotic peripheral vascular disease

• The inability to maintain good foot hygiene and trauma to the lower limbs factors only apply if aggravation is being considered.
• The inability to undertake more than a mildly strenuous level of physical activity factor only applies for operational service cases, and only if aggravation is being considered.

For information about the SOP see SOP Bulletin No. 63 of 15/10/02

Familial adenomatous polyposis

The only RMA SOP factor for this rare genetic condition is the inability to obtain appropriate clinical management for familial adenomatous polyposis.  There are no causal factors in the SOP.

For information about the SOP see SOP Bulletin No. 62 of 9/08/02

Osteoporosis

• The new factor of an altered dietary pattern resulting in a decrease in average daily calcium intake to 600 mg/day (RH)/400 mg/day (BOP) or less requires the decreased calcium intake to be for a period of two years within the four years immediately before the onset or worsening of osteoporosis.
• It is extremely unlikely that these timing requirements could be met in relation to diet during World War 2 service (besides which, most WW2 rations provided more than 600 mg calcium per day).
• For any case to be made that diet during operational or eligible service was responsible for a post service diet with reduced calcium intake, there would need to be evidence of such a connection from an expert with relevant qualifications and experience.
• The Claimant Report provided in CCPS requests information to indicate whether or not there was a reduction in calcium intake that meets the timing requirements of the SOP.  If necessary, you may need to seek further information and dietary analysis by a nutritionist to ascertain if the 600/400 mg requirements of the SOP are satisfied.
• A Medical Report is provided in CCPS primarily to ascertain if a diet with a reduced calcium intake was adopted as treatment for another medical condition.  This questionnaire uses the milligram requirements from the RH SOP so should be amended if investigating a case with only eligible (ie non-operational) service.

• In CCPS many of the SOP factors have been grouped together based on the timing requirements specified in the SOP.  They have been given CCPS contention names of:

•      Suffering from a condition from list 1
•      Suffering from a condition from list 2

Such contention names in the reasons for decision would be meaningless to a claimant.  You should therefore consider replacing them in the reasons with a list of t — he actual conditions involved.

For information about the SOP see SOP Bulletin No. 63 of 15/10/02

Psoriasis

• The new severe psychosocial stressor factor only applies in operational service cases.
• The clinically significant anxiety disorder or a clinically significant depressive disorder factor is split into two contentions in CCPS – one dealing with anxiety disorder and the other with depressive disorder.

For information about the SOP see SOP Bulletin No. 62 of 9/08/02

Malignant Neoplasm of the Prostate

The amended definition of animal fat has been incorporated.

Enhancements of CCPS rulebases and commentary

Reiter's disease

Hepatitis B

Hepatitis C

Hepatitis D

The policy regarding infections acquired from sexual intercourse during service has been reviewed. The revised position is that any sexual intercourse to which the veteran had consented of his or her own free will during operational or eligible service cannot be considered to be causally related to service. Therefore any infection acquired from sexual intercourse during service would generally not be causally related to that service.

Migraine

Tension-type headaches

Enhanced diagnostic protocols for migraine and tension-type headaches have been incorporated, in line with the recommendations of the Decision Support Unit's monitoring report on Headaches.

Additional amendments

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

Aortic stenosis

For information about the SOP see SOP Bulletin No. 62 of 9/08/02

Gastro-oesophageal reflux disease

For information about the SOP see SOP Bulletin No. 62 of 9/08/02

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