SOP Bulletin No. 84

Decision Support Unit

8th Floor, 259 Queen St, Brisbane  3 — rd Floor, Blackburn House, 199 Grenfell St, Adelaide

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

31 May 2004

RELEASE NOTES - CCPS VERSION 2004/04

Version 2004/04 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.  Where appropriate, rulebase changes for the following conditions also take account of the principles derived from the Federal Court decision in Kattenberg.

New SOPs incorporated into CCPS	Pleural plaque
SOP amendments incorporated into CCPS	Acute pancreatitis Chronic lymphoid leukaemia Hypertension Ischaemic heart disease
Enhancements of CCPS rulebases and commentary	Anxiety Disorder & Depressive Disorder Hypertension Non melanotic malignant neoplasm of the skin Osteoarthrosis Psoriasis Spondyloses and Intervertebral disc prolapse
Additional amendments - not noteworthy	Cerebrovascular accident Myeloma

New SOPs incorporated into CCPS

Pleural plaque

For information about the SOP see SOP Bulletin No. 78 of 17/11/03

SOP amendments incorporated into CCPS

Acute pancreatitis

The alcohol factor was changed to replace 'prolonged and heavy drinking'.  For a claim under the VEA to be successful it is now necessary that:

(a)  VEA service made a material contribution to the consumption of 180 kg within a five year period and

(b)  as a result of VEA service the veteran continued to consume alcohol at the time of the clinical onset of acute pancreatitis.

In deciding whether alcohol was consumed at any particular time as a causal result of service, you must have regard to the Repatriation Commission's Guideline for claims assessors on smoking and alcohol related conditions and military service.

For information about the SOP see SOP Bulletin No. 77 of 13/10/03

Chronic lymphoid leukaemia

This incorporates the new Exposure to extremely low frequency magnetic fields factor.  As pointed out in SOP Bulletin No. 79 of 16/12/03, the dose required is a very high one.  Although service need only have made a material contribution to the dose, to achieve the minimum SOP requirement of 25 microtesla years would generally require decades of occupational exposure.  A questionnaire has been drafted to assist in obtaining evidence about exposure to extremely low frequency magnetic fields.

With cases which do not have any operational, peacekeeping or hazardous service, the system produced reasons for decision will need to be edited to remove reference to exposure to extremely low frequency magnetic fields and exposure to herbicides in Vietnam. The former is a SOP factor that applies only to reasonable hypothesis cases and the latter is a section 180A determination by the Repatriation Commission that applies only to veterans with operational service in Vietnam.

For information about the SOP see SOP Bulletin No. 79 of 16/12/03

Hypertension

The Alcohol consumption factor has been updated to include the period over which to calculate average alcohol consumption.  The rulebase for this factor has been reworked to take account of the Kattenberg principles re material contribution by service.  The rulebase structure may seem a bit unusual but a brief overview is contained in the Hotword Alcohol consumption as a factor for hypertension which is located on the Policy window for the Contention Management Screen and is also in the commentary attached to individual rulebase questions.

For information about the SOP see SOP Bulletin No. 81 of 1/03/04

Ischaemic heart disease

Changes as a result of the Federal Court decision in the case of Kattenberg have not been made to the 'Smoking Module' part of CCPS.  Therefore, in order to follow the law re 'material contribution', it has been necessary to include 3 additional contentions in the CCPS rulebase:

• Cigarette smoking - material contribution
• Cigar smoking - material contribution
• Pipe smoking - material contribution.

It will only be necessary to investigate these 'below line' contentions if a claim in respect of a smoker is unsuccessful after using the smoking module.  If the claim is still unsuccessful after the additional contentions have been investigated, care should be taken to edit the system produced reasons paragraphs to remove duplication and unnecessary paragraphs and to ensure that a sensible decision advice is provided to the claimant.  The reasons produced in successful claims should also be edited to improve the readability for the claimant.

Information on the application of the principles from the Kattenberg decision is contained in Advisory Note No 4/03.

For information about the SOP see SOP Bulletin No. 78 of 17/11/03 and No. 82 of 30/03/04.

Enhancements of CCPS rulebases and commentary

Anxiety Disorder & Depressive Disorder

The text of the Major illness or injury hotword has been altered to provide some discussion of what might constitute a "a serious illness or injury, that is life-threatening, or seriously disabling."

Hypertension

The clinically significant anxiety disorder, and the clinically significant depressive disorder contentions are now “above line”.  The Contention Management Screen commentary has been altered to draw attention to the fact that PTSD is covered by the RMA's definition of an anxiety disorder.  The obesity factor is now “below line”.

Non melanotic malignant neoplasm of the skin

A rulebase problem preventing the investigation of the cutaneous contact with polycyclic aromatic hydrocarbons factor in balance of probability cases, has now been fixed.

Osteoarthrosis

The lifting loads while bearing weight and the kneeling or squatting contentions are now “above line”.

Psoriasis

The clinically significant anxiety disorder, and the clinically significant depressive disorder contentions are now “above line”.  The Contention Management Screen commentary has been altered to draw attention to the fact that PTSD is covered by the RMA's definition of an anxiety disorder.

Spondyloses and Intervertebral disc prolapse

The text of the flying in high performance aircraft hotword has been altered to include more information about the types of aircraft which meet the RMA definition of “high performance aircraft”, but stresses that the information provided is not an exhaustive list. The new text also provides an internet link to a site containing information about all aircraft used in the RAAF.

Additional amendments

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

Cerebrovascular accident - amendment of definition of thrombocytopenia

For information about the SOP see SOP Bulletin No. 78 of 17/11/03

Myeloma

For information about the SOP see SOP Bulletin No. 78 of 17/11/03

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