Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 201

ICD Coding

• ICD-9-CM Codes: 989.9
• ICD-10-AM Codes: T65.9

Brief description

This SOP covers the act of taking one's own life, or the act of attempting to take one's own life but where there is a non-fatal outcome.  These acts are not strictly diseases or injuries in themselves, but are given that status for DVA purposes.  They may be a consequence of an underlying disease or may result in injury.  In dealing with claims where suicide or attempted suicide is or appears to be involved, this SOP may not be the most appropriate SOP to apply to the claim, depending on the circumstances.

Confirming the diagnosis

A diagnosis of attempted suicide should be made with caution.  If an apparent suicide attempt has been made and claimed, a psychiatric report should be obtained.  Consideration should then be given to whether an underlying psychiatric condition is present that should be diagnosed in answer to the claim in addition to, or instead of, a diagnosis of attempted suicide.  Consideration should also be given to whether any injury has resulted from the suicide attempt that should be diagnosed and separately considered. 

In the event of multiple suicide attempts being made and claimed, each should generally be considered as a separate event.

Similarly for suicide or apparent suicide - consider whether there is an underlying disease or a resultant injury to be diagnosed as the cause of death and apply the relevant SOP if appropriate.

Additional diagnoses covered by SOP

• Nil

Conditions excluded from SOP

• Intentional self-harm without suicidal intent (may be covered by a separate diagnosis - other mental health SOPs may apply)
• Planned suicide attempt that is not carried out - not a disease or injury in itself (but may be a manifesation of another mental health disorder)

Clinical onset

The SOP factors do not include the usual "clinical onset" phrasing.  The time of the act (of taking or attempting to take one's own life) is the equivalent of the clinical onset for the purposes of this SOP.

Clinical worsening

The SOP has a factor for inability to obtain appropriate clinical management for attempted suicide.  It is difficult to see how this factor could apply in practice, unless the act itself was protracted (e.g. starvation, dehydration), but then the lack of appropriate treatment would most likely be deliberate rather than an inability.