RELEASE NOTES - CCPS VERSION 2000/04

		Decision Support Unit
	4 — th Floor AMP Place, 10 Eagle St Brisbane			2 — nd Floor Blackburn House, 199 Grenfell St Adelaide.
			SOP Bulletin No. 35

8 May 2000

Version 2000/04 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.

New SOPs incorporated into CCPS	Loss of teeth Cluster headache syndrome
SOP amendments incorporated into CCPS	Anxiety disorder Aortic stenosis
Enhancements of CCPS rulebases and commentary	Acute pancreatitis Diabetes mellitus Migraine Tension-type headache Generic Diagnostic Report DSU Bulletins in the Research Library
Other changes	Plantar fasciitis Gout

New SOPs incorporated into CCPS

Loss of teeth

• The diagnostic label should be edited to specify which teeth are covered by the claim.  Advice on identifying and naming teeth, (including a colourful picture!), is contained in a Hotword in the Diagnostic Protocol.
• Because there is only one ICD code for loss of teeth (525.1), you cannot make more than one decision on loss of teeth in the one claim.  Therefore, if:

• the veteran's claim covers more than one tooth; and
• the circumstances are such that not all the teeth claimed should be accepted or not all the teeth claimed should be rejected

you should register another case to enable separate decisions to be made on the loss of specified teeth.

Cluster headache syndrome

• The Diagnostic Report is a generic 'Headache' document designed to cover the possible headache diagnoses for which there are SOPs.
• The only causal factor is trauma to the forehead, temple, or eye socket.  The other factors, including alcohol dependence, are aggravating factors and can only be considered if the clinical onset of cluster headaches occurred before the end of operational or eligible service.
• For information about the SOP see SOP Bulletin No. 28, 4 November 1999.

SOP amendments incorporated into CCPS

Anxiety disorder

• Because there are 3 types of anxiety disorder that are covered by the one SOP, you will need to specify the type of anxiety disorder on a multi-choice screen.  This will then direct the CCPS rulebase to address the SOP factors that are relevant to the type of anxiety disorder suffered by the veteran.

If required, there is a diagnostic questionnaire that will help you to obtain information on the type of anxiety disorder suffered.

• There is also a questionnaire that can be used to obtain information from a doctor about causal/aggravating factors in the veteran's case.  The time frames used in the questionnaire are those from the Reasonable Hypothesis SOP (operational service).  Therefore, if you wish to use the questionnaire and your claimant has eligible (non-operational) service only, you should edit the questionnaire ie change 'two years' to 'one year' wherever it occurs.
• For information about the SOP see SOP Bulletin No. 32, 2 February 2000.

Aortic stenosis

• There are no special CCPS features for this condition.
• For information about the SOP see SOP Bulletin No. 34, 27 March 2000.

Enhancements of CCPS rulebases and commentary

Acute pancreatitis

• The rulebase has been changed for this condition so that all contentions are consistent with more recently developed rule structures.  This has resulted in some changes to the questions, reasons, commentary and questionnaires in CCPS.

Diabetes mellitus

• The Diagnostic Report has been amended following advice from claims assessors that some LMOs are incorrectly labelling type 1 and type 2 diabetes mellitus.  The amended questionnaire includes the RMA definitions of these two types of diabetes and also seeks information about risk factors that may be relevant.

Migraine and Tension-type headache

• Each of these conditions is now linked to a new Diagnostic Report which is a generic 'Headache' document designed to cover the possible headache diagnoses for which there are SOPs.

Generic Diagnostic Report

• The generic Diagnostic Report (this is attached to all conditions that do not have a condition specific Diagnostic Report) has been amended.  The amended questionnaire includes questions about diagnosis, onset of the condition, results of investigations already conducted, any investigation still required, treatment that has been given and risk factors that may be relevant.  A copy of the amended questionnaire is at the end of this bulletin.
• If you generate the Diagnostic Report after ICD encoding the condition on CCPS, it will refer to the condition that has been coded.  If you wish the Diagnostic Report to refer to the actual disability claimed by the veteran, you should edit the diagnostic label  accordingly on the “Add  Disability” screen.

DSU Bulletins in the Research Library

• DSU Bulletins can now be accessed by subject index or bulletin number. For example, if you want to look up those bulletins dealing with SOP or CCPS changes to ischaemic heart disease, simply go to the title page, then click on the  in the Decision Support Section SOP Bulletins section, select the letter "I" in the index and scroll down.

Other changes

Changes to plantar fasciitis and gout to be included in the next MKB release

We were not able to include in this release the rulebase and commentary alterations arising from the changes to the plantar fasciitis SOP (instruments 3 & 4 of 28.1.00) nor the gout SOP (instruments 11 & 12 of 23.3.00).  Because the work on these conditions has not been completely incorporated into CCPS, the rulebase has been withdrawn from use for the time being.

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

Diagnostic Report – {+SubstituteClaimedCondition,S}

The information you provide on this form will assist in deciding eligibility for benefits under the Veterans' Entitlements Act 1986.   In the event of an appeal against a decision, this information may be provided to the Veterans' Review Board, Administrative Appeals Tribunal or Federal Court.

Veteran's Details

Surname		Given Names				DVA File Number

Report Detail

This veteran has lodged a disability claim for {+SubstituteClaimedCondition,I}.  The Department needs to establish the correct diagnosis in order to process this claim.  Could you please indicate below:

• your diagnosis or differential diagnosis for the claimed condition;
• to what extent this diagnosis has been established; and
• what further steps, if any, are needed to confirm the diagnosis.

1.What is the diagnosis / differential diagnosis for the claimed condition (indicate unknown if no relevant evidence available)?

2.To what extent has this diagnosis been established?

❏Insufficient evidence to make a diagnosis at this stage;

❏Provisional / differential diagnosis: further investigation or referral required;

❏Diagnosis confirmed on clinical grounds and/or by relevant investigation.

3.Please provide the results of any investigations which have been performed.

4.What further steps are necessary, if any, to confirm the diagnosis (please indicate specific investigations or type/s of specialist referral required)?

5.When was the clinical onset of this condition (ie: the first symptoms or signs or other evidence)?

6.What treatment has been given for this condition?

7.Are there any predisposing factors for the development of this condition?

8.Would you like to make any other comments on the diagnosis of this condition?

If you have any problems completing this form you can phone the Department and discuss the matter with one of our medical officers.

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