Current RMA Instruments
| Reasonable Hypothesis SOP | 44 of 2017 |
| Balance of Probabilities SOP | 45 of 2017 |
Changes from previous Instruments
ICD Coding:
- ICD-9-CM Codes: 487
- ICD-10-AM Codes: J09, J10, J11
Brief description
This SOP covers regular seasonal influenza as well as bird flu and swine flu. If the condition has resolved without complications then "influenza – resolved" or "No Incapacity Found" may be the appropriate diagnostic label.
Confirming the diagnosis
Sufficient evidence that the claimed condition has been caused by an influenza virus and not some other infectious agent will be required. Generally this will involve laboratory testing, but this will not always be required, depending on the indivdual circumstances.
The relevant medical specialist is an infectious diseases physician.
Additional diagnoses covered by SOP
- Animal influenza subtypes
- Avian influenza
- Bird flu
- Influenza type A, B or C
- Influenza A sub-types H1N1, H1N2, H3N2, H5N1 etc
- Swine flu
Conditions not covered by SOP
- Other viral upper respiratory tract infections
Clinical onset
This is an acute, short lived infection. Clinical onset will be at the time symptoms attributable to the particular episode of influenza virus infection first developed. Any other bouts of influenza infection represent a separate condition with a separate clinical onset.
Clinical worsening
The only worsening factor is for inability to obtain appropriate clinical management. The condition may resolve without treatment, but in a proportion of cases can be more severe, potentially requiring hospitalisation or resulting in death.