DATE OF ISSUE: 24 August 2004
RMA Decision Concerning Osteoporosis, SOP 67 of 2002
Purpose
The purpose of this instruction is to notify Disability Compensation State Office staff of a decision made by the Repatriation Medical Authority (RMA) and advise the action processing staff are required to take.
Background
Departmental Instruction (DI) No. C20/04 dated 20/7/04 detailed a Specialist Medical Review Council (SMRC) decision regarding the Osteoporosis Reasonable Hypothesis SOP, 67 of 2002. That DI foreshadowed an amendment to this SOP, expected to be made by the RMA to comply with the SMRC direction.
RMA Decision
The RMA, at its August meeting, made the expected amendment to this SOP, and the amendment will be gazetted on 25 August 2004. The full changes are detailed in
Attachment 1.
The RMA also declared an investigation into osteoporosis, but the outcome will be months away.
Operational Effects
The date of effect of the RMA's decision was 21 July 2004. Because of this, the previous DI advised that certain categories of claims involving the Osteoporosis Reasonable Hypothesis SOP 67 of 2002 should be put on hold.
Action Required
The RMA amendment will be gazetted on 25 August 2004. From 25 August 2004, those claims involving the Osteoporosis Reasonable Hypothesis SOP which were put on hold should now be processed. Decisions should be made using the new Osteoporosis RH SOP, Instrument 67 of 2002 as amended by Instrument 25 of 2004. There will no longer be any requirement to put claims on hold.
The Balance of Probability SOP for Osteoporosis is unchanged. This means there are different disease definitions and different calcium factors in the Reasonable Hypothesis and Balance of Probability SOPs.
Carolyn Spiers
Branch Head
Veterans' Compensation
August 2004
Attachment 1
Changes Made to the Osteoporosis Reasonable Hypothesis SOP 67 of 2002
by Amendment 25 of 2004
Current SOP |
Amended SOP |
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Definition of disease |
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Paragraph 2 (b) (i) |
bone mineral density is 2.5 standard deviations below the mean bone mineral density of young adult sex-matched controls, and bone mineral density is 1.0 standard deviation below the mean bone mineral density of age-matched and sex-matched controls |
bone mineral density is more than 2.5 standard deviations below the mean bone mineral density of young adult sex-matched controls |
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Calcium factor |
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Paragraphs 5 (p), 5 (zf) |
having an altered dietary pattern resulting in a decrease in average daily calcium intake to 600 mg/day or less for a period of two years within the four years immediately before the clinical onset/worsening of osteoporosis; |
having an altered dietary pattern resulting in a decrease in average daily calcium intake to 400 mg/day or less, for a period of two years before age 20 years, or for a period of 7 years after that age, or the equivalent combination thereof, before the clinical onset/worsening of osteoporosis; |
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New definition for calcium factor |
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Paragraph 8 |
“or the equivalent combination” means a calculation where one year of exposure before age 20 years is equivalent to 3.5 years of exposure after age 20 years |
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