SOP Bulletin No. 86

Decision Support Unit

8 — th 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

18 October 2004

THE FOLLOWING RMA SOPS ARE TO BE GAZETTED ON 20 OCTOBER, 2004

New SOPs	Nil
Revocations & Replacements	Chronic bronchitis and emphysema Rheumatoid arthritis Hodgkin's lymphoma Haemorrhoids Creutzfeldt-Jakob disease
Amendments	Deep venous thrombosis Asthma

IMPORTANT OPERATIONAL FEATURES

Chronic bronchitis and emphysema + Asthma amendment – 36 & 37 of '04

Revocation – 30 & 31 of '04 Replaces 73 and 74 of '97

• There has been major simplification of the disease definitions in this SOP.
• References to sub-types of chronic bronchitis, including asthmatic bronchitis, have been removed.  The previous requirement for evidence of cough, with sputum production, remains.
• All previous requirements for evidence of significant irreversible chronic airflow obstruction on spirometry, or diminished pulmonary gas exchange, have been removed. 
• The Asthma SOP definition has also been changed to remove the exclusion of asthmatic bronchitis.  The RMA no longer recognises asthmatic bronchitis as an entity.  If a claim is received for asthmatic bronchitis, then it should be considered whether the diagnosis is asthma, or chronic bronchitis, or both (or neither) and if appropriate, both the CB&E and the asthma SOPs should be applied.
• There are no longer sub-factors applying to certain types of chronic bronchitis only.
• The smoking dose requirements have been reduced, from 10 (RH) & 15 (BOP) pk yrs, to 5 and 10 pk yrs.
• There is a new passive smoking factor, applying to 'never' smokers only.
• There are new factors for exposure to silica dust and for inhaling smoke from combustion of biomass or fossil fuels.
• There is now a single irritants factor, applying to specified irritants only.
• Application of this SOP should now be much more straightforward.  However, claims for COAD, COPD, CAL etc should not automatically be answered using this SOP.  The underlying disease needs to be identified and spirometry results and medical advice still have an important role to play in that process.

Rheumatoid arthritis

Revocation – 32 & 33 of '04 Replaces 126 and 127 of '96

• There are six new factors (previously “inability” factor only).
• There is a new smoking factor, for clinical onset, that applies only to people who are positive for rheumatoid factor on blood testing.  This will be the case in the majority, but evidence will be required.  This factor will significantly increase the acceptance rate for this condition.
• The other new factors are for silica exposure and taking certain drugs (onset and worsening) and a smoking worsening factor.  The natural progressing of rheumatoid arthritis is to worsen over time, so evidence of worsening over and above the norm will be required to apply the worsening factors.

Hodgkin's lymphoma

Revocation – 28 & 29 of '04 Replaces 25 and 26 of '00

• The name has been changed, from Hodgkin's disease and there is a new definition – having no operational effect.
• There are three new causal factors in the RH SOP only - a new smoking factor, plus factors for rheumatoid arthritis and organ or bone marrow transplant
• The previous herbicides factor has been: expanded to a “chemicals contaminated by dioxin” factor in the RH SOP; and removed from the BOP SOP.
• The “Vietnam” factor in the RH SOP now includes consuming potable water on ships.

Haemorrhoids + DVT amendment 38 & 39 of '04

Revocation – 26 & 27 of '04 Replaces 13 and 14 of '00

• The chronic urinary obstruction factor has been removed from the BOP SOP.
• The other changes to the SOP are cosmetic.
• The definition of spinal cord injury in the DVT SOP has been amended to match the definition in the haemorrhoids SOP.

Creutzfeldt-Jakob disease

Revocation – 34 & 35 of '04 Replaces 63 and 64 of '95 as amended by 190 of '95 and 49 and 50 of '97

• The name of this SOP was previously Jakob-Creutzfeldt disease.
• Coverage has been extended to the variant form (vCJD), associated with consumption of beef from cattle affected by mad cow disease.
• There are new factors for consuming beef and for receiving blood or blood products.
• The surgery factor has been extended from neurosurgery to all surgery.

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