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
12 May 2003
RELEASE NOTES - CCPS VERSION 2003/04
Version 2003/04 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.
Peripheral neuropathy |
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Cervical spondylosis Lumbar spondylosis Thoracic spondylosis |
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Lumbar spondylosis, thoracic spondylosis and osteoarthrosis Diabetes mellitus, chloracne and porphyria cutanea tarda Malignant neoplasm of the prostate Malignant neoplasm of the thyroid Commentary re service duties Solar Damage Assessment Form |
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Allergic rhinitis |
New SOPs incorporated into CCPS
- Due to unforeseen technical problems, this condition has had to be implemented into CCPS in an abridged manner. The 'above line' factors of alcohol consumption and diabetes mellitus, which apply to all types of peripheral neuropathy that are covered by the SOP, have been implemented in the usual way. The inability to obtain appropriate clinical management is also in its usual format. However, the other 'below line' factors, many of which are highly unlikely to be encountered by our veterans, have only basic rulebase support. This means the SOP limitations in relation to the type of peripheral neuropathy and timing requirements will be reflected in the commentary rather than the rulebase questions. These factors have been grouped into 4 'mega-factors' as follows:
- A specified disease causing peripheral neuropathy
This group of 18 diseases can be investigated using the system generated Medical Report (Propagation Management Questionnaire).
- A disease or a complication of a disease causing peripheral neuropathy
There is a Medical Report available in CCPS to investigate this group of diseases.
- Treatments that can cause peripheral neuropathy
This group covers the drug treatments, therapeutic radiation and mechanical ventilation support for a critical illness. There is a Medical Report in CCPS covering these.
- Events that can cause peripheral neuropathy
To assist with investigation of this group there are 6 Medical Reports and 8 Claimant Reports in Office Standard Letters in the folder DSU Investigation Letters & Reports. Rather than put all these questionnaires in CCPS where you would have to manually edit each report if not required, they have been stored in Standard Letters so you can access them when needed.
Where there are different requirements for reasonable hypothesis and balance of probability cases, you may need to edit some CRs if dealing with a claim that does not have operational service.
- Most of the 'below line' factors are limited to particular types of peripheral neuropathy. If you need to ascertain the type of peripheral neuropathy present, there is a Diagnostic Report available in CCPS that seeks this information.
- The 'reasons for decision' produced by CCPS for the below line factors will need to be extensively edited to make them meaningful. Because of the grouping of factors, it has not been possible to use self-explanatory contention names nor create detailed reasons paragraphs that cover all possible scenarios.
- Because of the simplified rulebase it is important that you either read the commentary in CCPS or consult the relevant RMA SOP for information about the SOP requirements in relation to any particular factor.
For information about the SOP see SOP Bulletin No. 52 of 13/09/01
SOP amendments incorporated into CCPS
Lumbar spondylosis
Thoracic spondylosis
The amended factors dealing with permanent ligamentous instability (PLI) have been incorporated. These factors require an injury to the relevant spine which resulted in PLI. PLI is defined for each part of the spine and requires specific radiological evidence, without which the SOP factor cannot be satisfied.
For information about the SOP see SOP Bulletin No. 65 of 25/11/02
Enhancements of CCPS rulebases and commentary
Thoracic spondylosis
Osteoarthrosis
- These SOPs have factors (Repetitive or persistent flexion, extension or twisting, kneeling or squatting and using a hand-held vibrating percussive industrial tool) which require an activity to be undertaken 'on more days than not for at least X years'. The commentary has been enhanced to provide further explanation of these terms. In essence, the period of years specified in the SOP factor is the minimum period for which the activity must be performed – the RMA has made it quite clear that more activity over a lesser period won't satisfy the SOP requirements.
(Thanks to Julie Anderson from NSW for seeking clarification of these factors.)
- In relation to establishing the required period of activity, the commentary now has a reminder to exclude service after 6.4.94 for members who enlisted on or after 22.5.86. SOP monitoring of lumbar spondylosis last year indicated an error in this area.
Diabetes mellitus, chloracne and porphyria cutanea tarda
A recent report titled 'Examination of the potential exposure of ROYAL AUSTRALIAN NAVY (RAN) personnel to polychlorinated dibenzodioxins and polychlorinated dibenzofurans via DRINKING water' has found that dioxin may have been ingested by personnel on board Army small ships and Navy ships in estuarine waters in Vietnam. Ships such as HMAS Sydney which served for substantial periods in estuarine waters in Vietnam, relied on collection of estuarine water which was then distilled for drinking. This process did not eliminate dioxin from the drinking water. CCPS commentary for the factors:
• Presence of serum 2 3 7 8-TCDD (serum dioxin) in diabetes mellitus
- Exposure to halogenated organochlorine or organobromine compounds in chloracne and
- Halogenated aromatic hydrocarbons in porphyria cutanea tarda
has been updated to incorporate this information.
Malignant neoplasm of the prostate
New information about the animal fat content of a typical “ulcer diet” has been added. This comprises:
• SOP Bulletin 69 titled Malignant Neoplasm of the Prostate – Animal Fat Factor and Ulcer Diet
- a report by Dr Ruth English titled Report on the Animal Fat Content of the Diet used for Long-Term Treatment of Peptic Ulcer Disease in the 1950s and 1960s, and
- Revised commentary in the rulebase about dietary change due to a medical condition.
Malignant neoplasm of the thyroid
Changes have made to the goitre factor so that the type of goitre needs to be identified. This is because not all the types of goitre covered by this factor are covered by the goitre SOP.
Service Duties
The commentary for 43 conditions has been revised to provide more information about job descriptions/duties, with particular reference to three areas - noise exposure, heavy lifting, and exposure to fumes and irritants. This information is based on material obtained from the Army, Navy and Airforce.
Solar Damage Assessment Form
This form has been revised. The new version is based on the version currently being used in WA, and has been developed using input from all states. The form is now less repetitive, does not ask unnecessary questions (such as where the veteran was born, and dates of service), and is more consistent with the UV risk calculator.
Additional amendments
Amendments to the following incorporated conditions are included in this release. However, there are no noteworthy CCPS features:
For information about the SOP see SOP Bulletin No. 67 of 14/01/03
Remember! If you are having any problems with SOPs, or SOPs in CCPS, talk to us!