Factors in CCPS as at 27 April 2010 (G006)
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Important Information
- The investigation questions displayed here are based on factors that were current at the time that they were incorporated into the CCPS application.
- There may have been new instruments for this SOP condition issued after they were added to the CCPS application.
- Please ensure that you refer to and use the latest instruments for this SOP condition (ischaemic heart disease).
Current Statements of Principles
- Please refer to the Repatriation Medical Authority (RMA) Website to confirm the most recent instruments for this SOP condition (ischaemic heart disease).
- The ischaemic heart disease instruments at the RMA Website (Page 'I' [2]) will contain the latest SOP Factors.
The following ischaemic heart disease factors were last reviewed for CCPS on 27 April 2010.
A category 1A stressor
Ischaemic heart disease - A category 1A stressor Factor
RMA definition
The RMA has defined this to mean "one or more of the following severe traumatic events:
- experiencing a life-threatening event;
- being subject to a serious physical attack or assault including rape and sexual molestation; or
- being threatened with a weapon, being held captive, being kidnapped, or being tortured".
Case law
"Experiencing a severe stressor" has been the subject of Federal Court determinations and an Advisory Note. Whilst a category 1A stressor is not exactly the same there are enough similarities for the following advice to be considered:
In assessing whether a particular event is a "severe stressor" as defined, it is necessary to consider both the objective nature of the event and the veteran's subjective knowledge about the event. The authority for this approach is the Federal Court decision in Stoddart, and you should read AN02/2003 Federal Court Decision Stoddart [3].
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Severe Traumatic Event - Ischaemic Heart Disease |
 CR9142.pdf [4] |
 CR9142.docx [5] |
Last reviewed for CCPS 27 April 2010.
Preliminary questions [38928]
38968 there is some evidence that a category 1A stressor may be a factor in the development or worsening of the condition under consideration.
26976 the veteran suffered from angina or acute myocardial infarction or sudden death from ischaemic heart disease.
35945 the veteran has experienced a category 1A stressor at some time.
38969 the veteran has established the causal connection between the category 1A stressor and VEA service for ischaemic heart disease.
38970 the veteran has established the causal connection between the category 1A stressor and VEA service for the clinical onset of ischaemic heart disease.
38972 the veteran has established the causal connection between the category 1A stressor and operational service for the clinical onset of ischaemic heart disease.
or
38973 the veteran has established the causal connection between the category 1A stressor and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
38971 the veteran has established the causal connection between the category 1A stressor and VEA service for the clinical worsening of ischaemic heart disease.
38974 the veteran has established the causal connection between the category 1A stressor and operational service for the clinical worsening of ischaemic heart disease.
or
38975 the veteran has established the causal connection between the category 1A stressor and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [38972]
37340 on operational service, the veteran experienced a category 1A stressor.
38978 on operational service, the veteran experienced a category 1A stressor within the 48 hours before the clinical onset of ischaemic heart disease.
38979 the category 1A stressor that the veteran experienced within the 48 hours before the clinical onset of ischaemic heart disease, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37352 the veteran experienced the category 1A stressor because of an illness or injury which is identifiable.
38982 as a consequence of the identified illness or injury, the veteran experienced a category 1A stressor within the 48 hours before the clinical onset of the condition under consideration.
37357 the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related to operational service.
Clinical onset and eligible service [38973]
37342 on eligible service, the veteran experienced a category 1A stressor.
37343 as a causal result of eligible service, the veteran experienced a category 1A stressor.
38980 as a causal result of eligible service, the veteran experienced a category 1A stressor within the 24 hours before the clinical onset of ischaemic heart disease.
38981 the category 1A stressor that the veteran experienced within the 24 hours before the clinical onset of ischaemic heart disease, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37352 the veteran experienced the category 1A stressor because of an illness or injury which is identifiable.
38983 as a consequence of the identified illness or injury, the veteran experienced a category 1A stressor within the 24 hours before the clinical onset of the condition under consideration.
37358 the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related to eligible service.
Clinical worsening and operational service [38974]
37340 on operational service, the veteran experienced a category 1A stressor.
37341 as a causal result of operational service, the veteran experienced a category 1A stressor.
38984 as a causal result of operational service, the veteran experienced a category 1A stressor within the 48 hours before the clinical worsening of the condition under consideration.
38986 the category 1A stressor that the veteran experienced within the 48 hours before the clinical worsening of the condition under consideration, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37352 the veteran experienced the category 1A stressor because of an illness or injury which is identifiable.
38988 as a consequence of the identified illness or injury, the veteran experienced a category 1A stressor within the 48 hours before the clinical worsening of the condition under consideration.
37357 the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related to operational service.
37359 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related.
Clinical worsening and eligible service [38975]
37342 on eligible service, the veteran experienced a category 1A stressor.
37343 as a causal result of eligible service, the veteran experienced a category 1A stressor.
38985 as a causal result of eligible service, the veteran experienced a category 1A stressor within the 24 hours before the clinical worsening of the condition under consideration.
38987 the category 1A stressor that the veteran experienced within the 24 hours before the clinical worsening of the condition under consideration, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37352 the veteran experienced the category 1A stressor because of an illness or injury which is identifiable.
38989 as a consequence of the identified illness or injury, the veteran experienced a category 1A stressor within the 24 hours before the clinical worsening of the condition under consideration.
37358 the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related to eligible service.
37360 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related.
A category 1B stressor
Ischaemic heart disease - A category 1B stressor Factor
RMA definitions
The RMA has defined this to mean "one of the following severe traumatic events:
- being an eyewitness to a person being killed or critically injured;
- viewing corpses or critically injured casualties as an eyewitness;
- being an eyewitness to atrocities inflicted on another person or persons;
- killing or maiming a person; or
- being an eyewitness to or participating in, the clearance of critically injured casualties".
The RMA has also defined "an eyewitness" to mean "a person who observes an incident first hand and can give direct evidence of it. This excludes a person exposed only to media coverage of the incident".
Case law
"Experiencing a severe stressor" has been the subject of Federal Court determinations and an Advisory Note. Whilst a category 1B stressor is not exactly the same there are enough similarities for the following advice to be considered:
In assessing whether a particular event is a "severe stressor" as defined, it is necessary to consider both the objective nature of the event and the veteran's subjective knowledge about the event. The authority for this approach is the Federal Court decision in Stoddart, and you should read AN02/2003 Federal Court Decision Stoddart [3].
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Severe Traumatic Event - Ischaemic Heart Disease |
CR9142.pdf [4] |
CR9142.docx [5] |
Last reviewed for CCPS 27 April 2010.
Preliminary questions [38929]
38990 there is some evidence that a category 1B stressor may be a factor in the development or worsening of the condition under consideration.
26976 the veteran suffered from angina or acute myocardial infarction or sudden death from ischaemic heart disease.
35935 the veteran has experienced a category 1B stressor at some time.
38991 the veteran has established the causal connection between the category 1B stressor and VEA service for ischaemic heart disease.
38992 the veteran has established the causal connection between the category 1B stressor and VEA service for the clinical onset of ischaemic heart disease.
38994 the veteran has established the causal connection between the category 1B stressor and operational service for the clinical onset of ischaemic heart disease.
or
38995 the veteran has established the causal connection between the category 1B stressor and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
38993 the veteran has established the causal connection between the category 1B stressor and VEA service for the clinical worsening of ischaemic heart disease.
38996 the veteran has established the causal connection between the category 1B stressor and operational service for the clinical worsening of ischaemic heart disease.
or
38997 the veteran has established the causal connection between the category 1B stressor and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [38994]
37372 on operational service, the veteran experienced a category 1B stressor.
39000 on operational service, the veteran experienced a category 1B stressor within the 48 hours before the clinical onset of ischaemic heart disease.
39001 the category 1B stressor that the veteran experienced within the 48 hours before the clinical onset of ischaemic heart disease, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37386 the veteran experienced the category 1B stressor because of an illness or injury which is identifiable.
39004 as a consequence of the identified illness or injury, the veteran experienced a category 1B stressor within the 48 hours before the clinical onset of the condition under consideration.
37391 the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related to operational service.
Clinical onset and eligible service [38995]
37374 on eligible service, the veteran experienced a category 1B stressor.
37375 as a causal result of eligible service, the veteran experienced a category 1B stressor.
39002 as a causal result of eligible service, the veteran experienced a category 1B stressor within the 24 hours before the clinical onset of ischaemic heart disease.
39003 the category 1B stressor that the veteran experienced within the 24 hours before the clinical onset of ischaemic heart disease, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37386 the veteran experienced the category 1B stressor because of an illness or injury which is identifiable.
39005 as a consequence of the identified illness or injury, the veteran experienced a category 1B stressor within the 24 hours before the clinical onset of the condition under consideration.
37392 the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related to eligible service.
Clinical worsening and operational service [38996]
37372 on operational service, the veteran experienced a category 1B stressor.
37373 as a causal result of operational service, the veteran experienced a category 1B stressor.
39006 as a causal result of operational service, the veteran experienced a category 1B stressor within the 48 hours before the clinical worsening of the condition under consideration.
39008 the category 1B stressor that the veteran experienced within the 48 hours before the clinical worsening of the condition under consideration, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37386 the veteran experienced the category 1B stressor because of an illness or injury which is identifiable.
39010 as a consequence of the identified illness or injury, the veteran experienced a category 1B stressor within the 48 hours before the clinical worsening of the condition under consideration.
37391 the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related to operational service.
37393 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related.
Clinical worsening and eligible service [38997]
37374 on eligible service, the veteran experienced a category 1B stressor.
37375 as a causal result of eligible service, the veteran experienced a category 1B stressor.
39007 as a causal result of eligible service, the veteran experienced a category 1B stressor within the 24 hours before the clinical worsening of the condition under consideration.
39009 the category 1B stressor that the veteran experienced within the 24 hours before the clinical worsening of the condition under consideration, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37386 the veteran experienced the category 1B stressor because of an illness or injury which is identifiable.
39011 as a consequence of the identified illness or injury, the veteran experienced a category 1B stressor within the 24 hours before the clinical worsening of the condition under consideration.
37392 the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related to eligible service.
37394 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related.
A drug from the specified list
Ischaemic heart disease - A drug from the specified list Factor
The RMA has specified the following drugs:
- cocaine
- D-lysergic acid diethylamide (LSD)
- heroin
- marijuana
- phencyclidine (angel dust)
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Use of a Specified Drug |
CR9286.pdf [6] |
CR9286.docx [7] |
| Medical Report | Use of a Specified Drug |
MR9395.pdf [8] |
MR9395.docx [9] |
Preliminary questions [38926]
38953 there is some evidence that using a drug from the specified list may be a factor in the development or worsening of the condition under consideration.
38954 the veteran has established the causal connection between using a drug from the specified list and operational service for ischaemic heart disease.
38955 the veteran has established the causal connection between using a drug from the specified list and operational service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
38956 the veteran has established the causal connection between using a drug from the specified list and operational service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [38955]
38957 the veteran used a drug from the specified list on operational service.
38958 on operational service, the veteran used a drug from the specified list within the 72 hours before the clinical onset of the condition under consideration.
38960 the veteran's use of a drug from the specified list on operational service within the 72 hours before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
or
38963 the veteran's use of a drug from the specified list was due to an illness or injury which is identifiable.
38964 as a result of the identified illness or injury, the veteran used a drug from the specified list within the 72 hours before the clinical onset of the condition under consideration.
38966 the identified illness or injury, as a result of which the veteran used a drug from the specified list, is causally related to operational service.
Clinical worsening and operational service [38956]
38957 the veteran used a drug from the specified list on operational service.
38959 on operational service, the veteran used a drug from the specified list within the 72 hours before the clinical worsening of the condition under consideration.
38961 the veteran's use of a drug from the specified list on operational service within the 72 hours before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
38962 the veteran's use of a drug from the specified list on operational service within the 72 hours before the clinical worsening of the condition under consideration occurred as a causal result of operational service.
or
38963 the veteran's use of a drug from the specified list was due to an illness or injury which is identifiable.
38965 as a result of the identified illness or injury, the veteran used a drug from the specified list within the 72 hours before the clinical worsening of the condition under consideration.
38966 the identified illness or injury, as a result of which the veteran used a drug from the specified list, is causally related to operational service.
38967 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, as a result of which the veteran used a drug from the specified list, is causally related.
Acute cholinergic poisoning from exposure to an organophosphorus ester
Ischaemic heart disease - Acute cholinergic poisoning from exposure to an organophosphorus ester Factor
RMA definition
The RMA has defined acute cholinergic poisoning as:
"symptoms and signs due to the inhibition of acetylcholinesterase enzyme activity which occur within twenty-four hours following exposure. These symptoms and signs are acute paralysis, overwhelming bronchial secretions, bradycardia, gastrointestinal distress, miosis, lacrimation or diarrhoea."
For the purposes of the SoPs for Depressive Disorder, Parkinson's disease and parkinsonism, acute cholinergic poisoning is by exposure to an organophosphorus ester.
General information
Acetylcholinesterase is an enzyme that operates in the synaptic clef (the space between two nerve cells) so the next nerve impulse can be transmitted across the synaptic gap. It is sometimes abbreviated as AChE.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Acute Myocardial Infarction - Exposure to an Organophosphorus Ester |
CR9320.pdf [10] |
CR9320.docx [11] |
Preliminary questions [41525]
41526 there is some evidence that an episode of acute cholinergic poisoning from exposure to an organophosphorus ester may be a factor in the development or worsening of the condition under consideration.
41557 the veteran experienced an acute myocardial infarction.
41527 the veteran has experienced acute cholinergic poisoning from exposure to an organophosphorus ester at some time.
41528 the veteran has established the causal connection between acute cholinergic poisoning from exposure to an organophosphorus ester and VEA service for ischaemic heart disease.
41529 the veteran has established the causal connection between acute cholinergic poisoning from exposure to an organophosphorus ester and VEA service for the clinical onset of the condition under consideration.
41558 the veteran has established the causal connection between acute cholinergic poisoning from exposure to an organophosphorus ester and operational service for the clinical onset of the condition under consideration.
or
41559 the veteran has established the causal connection between acute cholinergic poisoning from exposure to an organophosphorus ester and eligible service for the clinical onset of the condition under consideration.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
41530 the veteran has established the causal connection between acute cholinergic poisoning from exposure to an organophosphorus ester and VEA service for the clinical worsening of the condition under consideration.
41563 the veteran has established the causal connection between acute cholinergic poisoning from exposure to an organophosphorus ester and operational service for the clinical worsening of the condition under consideration.
or
41564 the veteran has established the causal connection between acute cholinergic poisoning from exposure to an organophosphorus ester and eligible service for the clinical worsening of the condition under consideration.
Clinical onset and operational service [41558]
41560 the veteran experienced an episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 21 days before the clinical onset of the condition under consideration.
41561 the veteran's acute cholinergic poisoning from exposure to an organophosphorus ester within the 21 days before the clinical onset of the condition under consideration was related to the veteran's operational service.
41562 the veteran's acute cholinergic poisoning from exposure to an organophosphorus ester within the 21 days before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
Clinical onset and eligible service [41559]
41565 the veteran had an episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 14 days before the clinical onset of the condition under consideration.
41566 the episode of the veteran's acute cholinergic poisoning from exposure to an organophosphorus ester with the 14 days before the clinical onset of the condition under consideration occurred during the veteran's eligible service.
41688 the episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 14 days before the clinical onset of the condition under consideration was caused by eligible service.
41567 the episode of the veteran's acute cholinergic poisoning from exposure to an organophosphorus ester with the 14 days before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
Clinical worsening and operational service [41563]
41595 the veteran had an episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 21 days before the clinical worsening of the condition under consideration.
41597 the episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 21 days before the clinical worsening of the condition under consideration occurred during operational service.
41596 the episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 21 days before the clinical worsening of the condition under consideration was caused by operational service.
41598 the episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 21 days before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
Clinical worsening and eligible service [41564]
41599 the veteran had an episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 14 days before the clinical worsening of the condition under consideration.
41600 the episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 14 days before the clinical worsening of the condition under consideration occurred during eligible service.
41601 the episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 14 days before the clinical worsening of the condition under consideration was caused by eligible service.
41602 the episode of acute cholinergic poisoning from exposure to an organophosphorus ester within the 14 days before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
Chronic renal disease
Ischaemic heart disease - Chronic renal disease Factor
Definition
Chronic renal disease means renal injury of a sustained nature that is not reversible and leads to destruction of nephron mass and is associated with a demonstrable functional abnormality of the kidney which raises the level of creatinine. It can result from any cause of renal dysfunction of sufficient magnitude.
Signs and symptoms
Patients with mildly impaired renal function are asymptomatic. Mild to moderate renal insufficiency produces vague symptoms such as nocturia, lassitude, fatigue and decreased mental acuity. Neuromuscular features include muscular twitches, muscle cramps and convulsions. Anorexia, nausea, vomiting, stomatitis and an unpleasant taste in the mouth are nearly always present as the disease progresses. Hypertension is a feature of the advanced disease.
Establishing onset
This condition should have been specifically diagnosed if renal function tests were undertaken. However, such tests may not have been undertaken or doctors' notes and/or hospital records may have been destroyed or can no longer be obtained. Therefore, if the veteran or member gives a history of chronic renal disease at a particular time and relevant medical notes cannot be obtained, you should seek medical advice to decide whether the claimed symptoms and treatment at that time can be attributed to chronic renal disease or to some other condition.
Last reviewed for CCPS 27 April 2010.
Preliminary questions [9173]
32457 there is some evidence that chronic renal disease may be a factor in the development or worsening of the condition under consideration.
32471 the veteran has chronic renal disease.
9222 the veteran has established the causal connection between the chronic renal disease and VEA service for ischaemic heart disease.
32459 the veteran had chronic renal disease before the clinical onset of the condition under consideration.
9223 the veteran has established the causal connection between the chronic renal disease and VEA service for the clinical onset of ischaemic heart disease.
9225 the veteran has established the causal connection between the chronic renal disease and operational service for the clinical onset of ischaemic heart disease.
or
9226 the veteran has established the causal connection between the chronic renal disease and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
32461 the veteran had chronic renal disease before the clinical worsening of the condition under consideration.
9224 the veteran has established the causal connection between the chronic renal disease and VEA service for the clinical worsening of ischaemic heart disease.
9227 the veteran has established the causal connection between the chronic renal disease and operational service for the clinical worsening of ischaemic heart disease.
or
9228 the veteran has established the causal connection between the chronic renal failure and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [9225]
32467 the chronic renal disease is causally related to operational service.
Clinical onset and eligible service [9226]
32468 the chronic renal disease is causally related to eligible service.
Clinical worsening and operational service [9227]
32467 the chronic renal disease is causally related to operational service.
32469 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the chronic renal disease is causally related.
Clinical worsening and eligible service [9228]
32468 the chronic renal disease is causally related to eligible service.
32470 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the chronic renal disease is causally related.
Cigar smoking
Ischaemic heart disease - Cigar smoking Factor
If there is a history of cigar smoking it will be necessary to obtain information about:
- the quantity smoked (the number of cigars smoked per week);
- when this took place; and
- the reasons for smoking.
The evidence gathered should be as complete and accurate as possible. Information already held in departmental files, eg in previous statements and clinical notes, should not be overlooked. Conflicting evidence should be resolved.
Before a causal link between a smoking habit and service may be established, consideration must be given to Repatriation Commission Guideline CM5030 - Guideline for claims assessors on smoking and alcohol related conditions and military service [12].
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Smoking |
CRD905.pdf [13] |
CRD905.docx [14] |
| Claimant Report | Smoking |
CRV905.pdf [15] |
CRV905.docx [16] |
Preliminary questions [7883]
26916 there is some evidence that cigar smoking may be a factor in the development or worsening of the condition under consideration.
9190 the veteran has established the causal connection between the cigar smoking and VEA service for ischaemic heart disease.
7946 the veteran has established the causal connection between the cigar smoking and VEA service for the clinical onset of ischaemic heart disease.
7947 the veteran has established the causal connection between the cigar smoking and operational service for the clinical onset of ischaemic heart disease.
4921 the veteran has some period or periods of cigar smoking that are causally related to operational service.
or
7948 the veteran has established the causal connection between the cigar smoking and eligible service for the clinical onset of ischaemic heart disease.
4922 the veteran has some period or periods of cigar smoking that are causally related to eligible service.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
9191 the veteran has established the causal connection between the cigar smoking and VEA service for the clinical worsening of ischaemic heart disease.
9192 the veteran has established the causal connection between the cigar smoking and operational service for the clinical worsening of ischaemic heart disease.
33469 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the cigar smoking is causally related.
or
9193 the veteran has established the causal connection between the cigar smoking and eligible service for the clinical worsening of ischaemic heart disease.
33474 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the cigar smoking is causally related.
Clinical onset and operational service [7947]
26917 the veteran had ceased smoking cigars at the time of the clinical onset of the condition under consideration.
27818 the veteran has established the causal connection between the cigar smoking which had ceased prior to the clinical onset of ischaemic heart disease and operational service for the clinical onset of ischaemic heart disease.
26921 the veteran smoked 20 pack years of operational service cigars prior to the clinical onset of ischaemic heart disease.
or
26920 the veteran smoked 5 or more, but less than 20, pack years of operational service cigars and the clinical onset of the condition under consideration occurred within fifteen years of smoking cessation.
or
27851 the veteran smoked 5 pack years of operational service cigars before the clinical onset of ischaemic heart disease.
27850 the veteran smoked 1 or more, but less than 5, pack years of operational service cigars and the clinical onset of the condition under consideration occurred within five years of smoking cessation.
or
27848 the veteran has established the causal connection between the cigar smoking which had not ceased prior to the clinical onset of ischaemic heart disease and operational service for the clinical onset of ischaemic heart disease.
27852 the veteran smoked an average of at least 1 operational service cigar per day for at least the 1 year before the clinical onset of the condition under consideration.
or
27853 the veteran smoked at least 1 pack year of operational service cigars before the clinical onset of the condition under consideration.
Clinical onset and eligible service [7948]
26917 the veteran had ceased smoking cigars at the time of the clinical onset of the condition under consideration.
27820 the veteran has established the causal connection between the cigar smoking which had ceased prior to the clinical onset of ischaemic heart disease and eligible service for the clinical onset of ischaemic heart disease.
27302 the veteran smoked at least 5 pack years of cigars and the clinical onset of the condition under consideration occurred within five years of smoking cessation.
or
26919 the veteran smoked 5 pack years of cigars before the clinical onset of ischaemic heart disease.
26918 the veteran smoked 1 or more, but less than 5, pack years of cigars and the clinical onset of the condition under consideration occurred within three years of smoking cessation.
or
27819 the veteran has established the causal connection between the cigar smoking which had not ceased prior to the clinical onset of ischaemic heart disease and eligible service for the clinical onset of ischaemic heart disease.
7949 the veteran smoked an average of at least 1 cigar per day for at least the 1 year before the clinical onset of ischaemic heart disease.
or
27824 the veteran smoked at least 1 pack year of cigars before the clinical onset of ischaemic heart disease.
Clinical worsening and operational service [9192]
26923 the veteran had ceased smoking cigars at the time of the clinical worsening of the condition under consideration.
27821 the veteran has established the causal connection between the cigar smoking which had ceased prior to the clinical worsening of ischaemic heart disease and operational service for the clinical worsening of ischaemic heart disease.
26926 the veteran smoked at least 20 pack years of operational service cigars before the clinical worsening of ischaemic heart disease.
or
26925 the veteran smoked 5 or more, but less than 20, pack years of cigars and the clinical worsening of ischaemic heart disease occurred within fifteen years of smoking cessation.
or
27855 the veteran smoked 5 pack years of operational service cigars prior to the clinical worsening of ischaemic heart disease.
27854 the veteran smoked 1 or more, but less than 5, pack years of operational service cigars and the clinical worsening of the condition under consideration occurred within five years of smoking cessation.
or
27849 the veteran has established the causal connection between the cigar smoking which had not ceased prior to the clinical worsening of ischaemic heart disease and operational service for the clinical worsening of ischaemic heart disease.
27856 the veteran smoked an average of at least 1 operational service cigar per day for at least the 1 year before the clinical worsening of the condition under consideration.
or
27857 the veteran smoked at least 1 pack year of operational service cigars before the clinical worsening of ischaemic heart disease.
Clinical worsening and eligible service [9193]
26923 the veteran had ceased smoking cigars at the time of the clinical worsening of the condition under consideration.
27823 the veteran has established the causal connection between the cigar smoking which had ceased prior to the clinical worsening of ischaemic heart disease and eligible service for the clinical worsening of ischaemic heart disease.
27303 the veteran smoked at least 5 pack years of cigars and the clinical worsening of the condition under consideration occurred within five years of smoking cessation.
or
27825 the veteran smoked 5 pack years of cigars prior to the clinical worsening of ischaemic heart disease.
26924 the veteran smoked 1 or more, but less than 5, pack years of cigars and the clinical worsening of the condition under consideration occurred within three years of smoking cessation.
or
27822 the veteran has established the causal connection between the cigar smoking which had not ceased prior to the clinical worsening of ischaemic heart disease and eligible service for the clinical worsening of ischaemic heart disease.
9194 the veteran smoked an average of at least 1 cigar per day for at least the 1 year before the clinical worsening of ischaemic heart disease.
or
27827 the veteran smoked at least 1 pack year of cigars before the clinical worsening of ischaemic heart disease.
Cigarette smoking
Ischaemic heart disease - Cigarette smoking Factor
This factor deals with the personal use of cigarettes ie it does not include passive smoking.
If there is a history of cigarette smoking it will be necessary to obtain information about:
- the quantity smoked (either tailor-made cigarettes per day or hand-rolled cigarettes in ounces per week or a combination of both);
- when this took place; and
- the reasons for smoking.
The evidence gathered should be as complete and accurate as possible. Information already held in departmental files, eg in previous statements and clinical notes, should not be overlooked. Conflicting evidence should be resolved.
Before a causal link between a smoking habit and service may be established, consideration must be given to Repatriation Commission Guideline CM5030 - Guideline for claims assessors on smoking and alcohol related conditions and military service [12].
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Smoking |
CRD905.pdf [13] |
CRD905.docx [14] |
| Claimant Report | Smoking |
CRV905.pdf [15] |
CRV905.docx [16] |
Preliminary questions [7882]
5803 the veteran has ever smoked cigarettes.
9176 the veteran has established the causal connection between the cigarette smoking and VEA service for ischaemic heart disease.
7941 the veteran has established the causal connection between the cigarette smoking and VEA service for the clinical onset of ischaemic heart disease.
7942 the veteran has established the causal connection between the cigarette smoking and operational service for the clinical onset of ischaemic heart disease.
3116 the veteran has some period or periods of cigarette smoking that are causally related to operational service.
or
7943 the veteran has established the causal connection between the cigarette smoking and eligible service for the clinical onset of ischaemic heart disease.
3521 the veteran has some period or periods of cigarette smoking that are causally related to eligible service.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
9177 the veteran has established the causal connection between the cigarette smoking and VEA service for the clinical worsening of ischaemic heart disease.
9178 the veteran has established the causal connection between the cigarette smoking and operational service for the clinical worsening of ischaemic heart disease.
9188 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the period or periods of cigarette smoking are causally related.
or
9179 the veteran has established the causal connection between the cigarette smoking and eligible service for the clinical worsening of ischaemic heart disease.
9189 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the period or periods of cigarette smoking are causally related.
Clinical onset and operational service [7942]
26906 the veteran had ceased smoking cigarettes at the time of the clinical onset of the condition under consideration.
27801 the veteran has established the causal connection between the tobacco smoking which had ceased prior to the clinical onset of ischaemic heart disease and operational service for the clinical onset of ischaemic heart disease.
26911 the veteran smoked at least 20 pack years of operational service cigarettes before the clinical onset of ischaemic heart disease.
or
26909 the veteran smoked 5 or more, but less than 20, pack years of operational service cigarettes and the clinical onset of the condition under consideration occurred within fifteen years of smoking cessation.
or
27841 the veteran smoked 5 pack years of operational service cigarettes before the clinical onset of ischaemic heart disease.
27840 the veteran smoked 1 or more, but less than 5, pack years of operational service cigarettes and the clinical onset of the condition under consideration occurred within five years of smoking cessation.
or
27838 the veteran has established the causal connection between the tobacco smoking which had not ceased prior to the clinical onset of ischaemic heart disease and operational service for the clinical onset of ischaemic heart disease.
27842 the veteran smoked an average of at least 5 operational service cigarettes per day for at least the 1 year before the clinical onset of the condition under consideration.
or
27843 the veteran smoked at least 1 pack year of cigarettes before the clinical onset of the condition under consideration.
Clinical onset and eligible service [7943]
26906 the veteran had ceased smoking cigarettes at the time of the clinical onset of the condition under consideration.
27802 the veteran has established the causal connection between the tobacco smoking which had ceased prior to the clinical onset of ischaemic heart disease and eligible service for the clinical onset of ischaemic heart disease.
27300 the veteran smoked at least 5 pack years of cigarettes and the clinical onset of the condition under consideration occurred within five years of smoking cessation.
or
26908 the veteran smoked 5 pack years of cigarettes before the clinical onset of ischaemic heart disease.
26907 the veteran smoked 1 or more, but less than 5, pack years of cigarettes and the clinical onset of the condition under consideration occurred within three years of smoking cessation.
or
27799 the veteran has established the causal connection between the tobacco smoking which had not ceased prior to the clinical onset of ischaemic heart disease and eligible service for the clinical onset of ischaemic heart disease.
7944 the veteran smoked an average of at least 5 cigarettes per day for at least the 1 year before the clinical onset of ischaemic heart disease.
or
27805 the veteran smoked at least 1 pack year of cigarettes before the clinical onset of ischaemic heart disease.
Clinical worsening and operational service [9178]
26912 the veteran had ceased smoking cigarettes at the time of the clinical worsening of the condition under consideration.
27803 the veteran has established the causal connection between the tobacco smoking which had ceased prior to the clinical worsening of ischaemic heart disease and operational service for the clinical worsening of ischaemic heart disease.
26915 the veteran smoked at least 20 pack years of operational service cigarettes before the clinical worsening of ischaemic heart disease.
or
26914 the veteran smoked 5 or more, but less than 20, pack years of operational service cigarettes and the clinical worsening of the condition under consideration occurred within 15 years of smoking cessation.
or
27845 the veteran smoked at least 5 pack years of operational service cigarettes prior to the clinical worsening of ischaemic heart disease.
27844 the veteran smoked 1 or more, but less than 5, pack years of operational service cigarettes and the clinical worsening of the condition under consideration occurred within five years of smoking cessation.
or
27839 the veteran has established the causal connection between the tobacco smoking which had not ceased prior to the clinical worsening of ischaemic heart disease and operational service for the clinical worsening of ischaemic heart disease.
27846 the veteran smoked an average of at least 5 operational service cigarettes per day for at least the 1 year before the clinical worsening of the condition under consideration.
or
27847 the veteran smoked at least 1 pack year of cigarettes before the clinical worsening of the condition under consideration.
Clinical worsening and eligible service [9179]
26912 the veteran had ceased smoking cigarettes at the time of the clinical worsening of the condition under consideration.
27804 the veteran has established the causal connection between the tobacco smoking which had ceased prior to the clinical worsening of ischaemic heart disease and eligible service for the clinical worsening of ischaemic heart disease.
27301 the veteran smoked at least 5 pack years of cigarettes and the clinical worsening of the condition under consideration occurred within five years of smoking cessation.
or
26910 the veteran smoked at least 5 pack years of cigarettes prior to the clinical worsening of ischaemic heart disease.
26913 the veteran smoked 1 or more, but less than 5, pack years of cigarettes and the clinical worsening of the condition under consideration occurred within three years of smoking cessation.
or
27800 the veteran has established the causal connection between the tobacco smoking which had not ceased prior to the clinical worsening of ischaemic heart disease and eligible service for the clinical worsening of ischaemic heart disease.
9180 the veteran smoked an average of at least 5 cigarettes per day for at least the 1 year before the clinical worsening of ischaemic heart disease.
or
27806 the veteran smoked at least 1 pack year of cigarettes before the clinical worsening of ischaemic heart disease.
Clinically significant anxiety spectrum disorder
Ischaemic heart disease - Clinically significant anxiety spectrum disorder Factor
RMA definition
"A clinically significant anxiety spectrum disorder as specified" means one of the following disorders:
- anxiety disorder due to a general medical condition;
- generalised anxiety disorder;
- panic disorder;
- phobic anxiety;
- posttraumatic stress disorder; or
- anxiety disorder not otherwise specified,
that attract a diagnosis under DSM-IV-TR and is sufficient to warrant ongoing management. The ongoing management may involve regular visits (for example, at least monthly), to a psychiatrist, clinical psychologist or general practitioner.
Clinically significant
Generally it would be expected that if a psychiatric disorder warranted treatment then treatment would be sought. However, where treatment was not sought, a person's anxiety spectrum disorder might still meet the RMA definition of clinically significant if there was persuasive and professional evidence, based on a comprehensive clinical history, that ongoing management had been warranted.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Medical Report | Clinically Significant Anxiety Disorder - Ischaemic Heart Disease |
MR9187.pdf [17] |
MR9187.docx [18] |
Preliminary questions [26974]
26975 there is some evidence that a clinically significant anxiety spectrum disorder may be a factor in the development or worsening of the condition under consideration.
26976 the veteran suffered from angina or acute myocardial infarction or sudden death from ischaemic heart disease.
40647 the veteran has had an anxiety spectrum disorder as defined for ischaemic heart disease at some time.
40648 an anxiety spectrum disorder for ischaemic heart disease means an anxiety disorder as specified in the Statements of Principles for ischaemic heart disease.
40649 the identified illness or injury, an anxiety spectrum disorder for ischaemic heart disease, has been clinically significant at some time.
26978 the veteran has established the causal connection between a clinically significant anxiety spectrum disorder and VEA service for ischaemic heart disease.
26979 the identified illness or injury, an anxiety spectrum disorder, was clinically significant at the time of the clinical onset of the condition under consideration.
40650 the veteran has established the causal connection between a clinically significant anxiety spectrum disorder and VEA service for the clinical onset of ischaemic heart disease.
26982 the veteran has established the causal connection between a clinically significant anxiety spectrum disorder and operational service for the clinical onset of ischaemic heart disease.
or
26983 the veteran has established the causal connection between a clinically significant anxiety spectrum disorder and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
26986 the identified illness or injury, an anxiety spectrum disorder, was clinically significant at the time of the clinical worsening of the condition under consideration.
40651 the veteran has established the causal connection between a clinically significant anxiety spectrum disorder and VEA service for the clinical worsening of ischaemic heart disease.
26984 the veteran has established the causal connection between a clinically significant anxiety spectrum disorder and operational service for the clinical worsening of ischaemic heart disease.
or
26985 the veteran has established the causal connection between a clinically significant anxiety spectrum disorder and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [26982]
33438 the identified illness or injury, an anxiety spectrum disorder for ischaemic heart disease, is causally related to operational service.
Clinical onset and eligible service [26983]
33439 the identified illness or injury, an anxiety spectrum disorder for ischaemic heart disease, is causally related to eligible service.
Clinical worsening and operational service [26984]
33438 the identified illness or injury, an anxiety spectrum disorder for ischaemic heart disease, is causally related to operational service.
27405 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, an anxiety spectrum disorder for ischaemic heart disease, is causally related.
Clinical worsening and eligible service [26985]
33439 the identified illness or injury, an anxiety spectrum disorder for ischaemic heart disease, is causally related to eligible service.
27406 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, an anxiety spectrum disorder for ischaemic heart disease, is causally related.
Clinically significant depressive disorder
Ischaemic heart disease - Clinically significant depressive disorder Factor
Meaning of depressive disorder
The depressive disorder must be diagnosed by a psychiatric specialist and the report conform with the Repatriation Commission Guidelines for Psychiatric Compensation Claims [19].
Clinically significant
The ischaemic heart disease SOP requires the depressive disorder to be clinically significant for at least 5 years. The RMA has defined clinically significant as "sufficient to warrant ongoing management, which may involve regular visits (for example, at least monthly), to a psychiatrist, counsellor or general practitioner".
Generally it would be expected that if a depressive disorder warranted treatment then treatment would be sought. However, where treatment was not sought, a person's depressive disorder might still meet the definition of "clinically significant" if there was persuasive and professional evidence, based on a comprehensive clinical history, that ongoing management had been warranted. However, it is unlikely that this situation (ie of warranting ongoing management but not seeking or obtaining treatment) could have continued for 5 years.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Medical Report | Depressive Disorder |
MR9154.pdf [20] |
MR9154.docx [21] |
Preliminary questions [33430]
25245 there is some evidence that a clinically significant depressive disorder may be a factor in the development or worsening of the condition under consideration.
25246 the veteran has had depressive disorder at some time.
39978 depressive disorder means a major depressive episode, recurrent major depressive disorder, dysthymic disorder, depressive disorder not otherwise specified, substance-induced mood disorder with depressive features, or mood disorder due to a general medical condition with depressive features, or with major depressive-like episodes.
25248 the veteran's identified illness or injury was clinically significant.
33431 the veteran has established the causal connection between the depressive disorder and VEA service for ischaemic heart disease.
33432 the veteran's identified illness or injury was clinically significant for at least five years before the clinical onset of ischaemic heart disease.
38897 the veteran has established the causal connection between the depressive disorder and VEA service for the clinical onset of ischaemic heart disease.
33433 the veteran has established the causal connection between the depressive disorder and operational service for the clinical onset of ischaemic heart disease.
or
38899 the veteran has established the causal connection between the depressive disorder and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
33435 the veteran's identified illness or injury was clinically significant for at least five years before the clinical worsening of ischaemic heart disease.
38898 the veteran has established the causal connection between the depressive disorder and VEA service for the clinical worsening of ischaemic heart disease.
33434 the veteran has established the causal connection between the depressive disorder and operational service for the clinical worsening of ischaemic heart disease.
or
38900 the veteran has established the causal connection between the depressive disorder and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [33433]
25253 the identified illness or injury, which was clinically significant, is causally related to operational service.
Clinical onset and eligible service [38899]
25255 the identified illness or injury, which was clinically significant, is causally related to eligible service.
Clinical worsening and operational service [33434]
25253 the identified illness or injury, which was clinically significant, is causally related to operational service.
33436 the clinical onset of ischaemic heart disease occurred prior to that part of operational service to which the identified illness or injury, which was clinically significant, is causally related.
Clinical worsening and eligible service [38900]
25255 the identified illness or injury, which was clinically significant, is causally related to eligible service.
38901 the clinical onset of ischaemic heart disease occurred prior to that part of eligible service to which the identified illness or injury, which was clinically significant, is causally related.
Combined oral contraceptive pill
Ischaemic heart disease - Combined oral contraceptive pill Factor
The combined oral contraceptive pill contains both oestrogen and progestogen.
Oral contraceptives
Last reviewed for CCPS 27 April 2010.
Preliminary questions [33441]
25110 there is some evidence that taking the combined oral contraceptive pill may be a factor in the development of the condition under consideration.
1169 the veteran is a woman.
12789 the veteran has taken oral contraceptives containing oestrogen and progestogen.
33442 the veteran has established the causal connection between using the combined oral contraceptive pill and operational service for ischaemic heart disease.
35821 the veteran used oral contraceptives containing oestrogen and progestogen for at least the 21 days before the clinical onset of the condition under consideration.
33444 the veteran has established the causal connection between using the combined oral contraceptive pill and operational service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
35822 the veteran used oral contraceptives containing oestrogen and progestogen for at least the 21 days before the clinical worsening of the condition under consideration.
33443 the veteran has established the causal connection between using the combined oral contraceptive pill and operational service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [33444]
35801 as a causal result of operational service, the veteran used oral contraceptives containing oestrogen and progestogen for at least the 21 days before the clinical onset of the condition under consideration.
or
38902 the veteran used oral contraceptives containing oestrogen and progestogen for at least the 21 days before the clinical onset or the clinical worsening of the condition under consideration for treatment of an illness or injury which is identifiable.
33501 the veteran used oral contraceptives containing oestrogen and progestogen for treatment of the identified illness or injury for at least the 21 days before the clinical onset of the condition under consideration.
12795 the identified illness or injury, for which the veteran was treated with the combined oral contraceptive pill, is causally related to operational service.
Clinical worsening and operational service [33443]
35802 as a causal result of operational service, the veteran used oral contraceptives containing oestrogen and progestogen for at least the 21 days before the clinical worsening of the condition under consideration.
or
38902 the veteran used oral contraceptives containing oestrogen and progestogen for at least the 21 days before the clinical onset or the clinical worsening of the condition under consideration for treatment of an illness or injury which is identifiable.
33502 the veteran used oral contraceptives containing oestrogen and progestogen for treatment of the identified illness or injury for at least the 21 days before the clinical worsening of the condition under consideration.
12795 the identified illness or injury, for which the veteran was treated with the combined oral contraceptive pill, is causally related to operational service.
33503 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury for which the oral contraceptives containing oestrogen and progestogen were taken is causally related.
Diabetes mellitus
Ischaemic heart disease - Diabetes mellitus Factor
Definition
Diabetes mellitus is an endocrine disease where there is diminished insulin action. It can also be referred to as "sugar diabetes", juvenile onset diabetes, Type I diabetes, IDDM (insulin dependent diabetes mellitus), NIDDM (non insulin dependent diabetes mellitus), Type II diabetes and maturity onset diabetes.
Signs and symptoms
- Insulin dependent diabetes usually begins before the age of 40 with the abrupt onset of symptoms such as thirst, excessive urination, increased appetite and weight loss.
- Non insulin dependent diabetes usually begins in middle life or beyond, and the typical patient is overweight. The onset of symptoms is more gradual, or there may be no symptoms and diabetes is diagnosed on routine testing.
Establishing onset
If a veteran had diabetes mellitus there would be specific evidence with regard to blood sugar levels and the need for diet, weight loss, insulin or drugs to lower blood sugar levels (eg Daonil, Euglocon, Glimel, Diabinese, Rastinon, Diamicron, Minidiab, Melizide), drugs to help insulin work better (eg Diabex, Diaformin, Glucophage) and drugs to slow the digestion of carbohydrates (eg Glucobay).
Last reviewed for CCPS 27 April 2010.
Preliminary questions [7879]
489 the veteran has diabetes mellitus.
10547 the veteran has insulin dependent diabetes mellitus (type 1).
or
10548 the veteran has non-insulin dependent diabetes mellitus (type 2).
30268 the veteran has established the causal connection between the diabetes mellitus and VEA service for the condition under consideration.
3441 the veteran had the identified illness or injury before the clinical onset of the condition under consideration.
30269 the veteran has established the causal connection between this diabetes mellitus and VEA service for the clinical onset of the condition under consideration.
30282 the veteran has established the causal connection between this diabetes mellitus and operational service for the clinical onset of the condition under consideration.
or
30283 the veteran has established the causal connection between this diabetes mellitus and eligible service for the clinical onset of the condition under consideration.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
7903 the veteran had the identified illness or injury before the clinical worsening of the condition under consideration.
30270 the veteran has established the causal connection between this diabetes mellitus and VEA service for the clinical worsening of the condition under consideration.
30284 the veteran has established the causal connection between this diabetes mellitus and operational service for the clinical worsening of the condition under consideration.
or
30285 the veteran has established the causal connection between this diabetes mellitus and eligible service for the clinical worsening of the condition under consideration.
Clinical onset and operational service [30282]
17527 the identified illness or injury, a type of diabetes mellitus, is causally related to operational service.
Clinical onset and eligible service [30283]
17528 the identified illness or injury, a type of diabetes mellitus, is causally related to eligible service.
Clinical worsening and operational service [30284]
17527 the identified illness or injury, a type of diabetes mellitus, is causally related to operational service.
26450 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury is causally related.
Clinical worsening and eligible service [30285]
17528 the identified illness or injury, a type of diabetes mellitus, is causally related to eligible service.
26451 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury is causally related.
Dyslipidaemia
Ischaemic heart disease - Dyslipidaemia Factor
RMA definition of dyslipidaemia used in SoPs 2006 - present
RMA definition of dyslipidaemia used in SoPs 1998 - 2003
There are minor differences in these definitions and you will need to check that the definition is met for the particular condition being investigated (see hotwords for the conditions and relevant definition).
General information about dyslipidaemia
Lipids are naturally occurring substances consisting of fatty acids. The term dyslipidaemia describes the presence of abnormal lipid levels. Hyperlipidaemia, hypertriglyceridaemia and hypercholesterolaemia are forms of dyslipidaemia.
Signs and symptoms
Dyslipidaemia does not usually cause any symptoms although unsightly xanthomas (fatty fibrous changes in the skin associated with the formation of yellow or yellowish-brown plaques, nodules or tumours) are sometimes a feature of some lipid disorders. However, the presence of dyslipidaemia as defined by the RMA can be established only by laboratory analysis of a blood sample (usually after fasting).
Establishing onset
Only a blood test can establish the onset of dyslipidaemia and the result of such a test would normally be recorded in doctors' notes and/or hospital records. However, if these records have been destroyed or can no longer be obtained and there is a reliable history of dyslipidaemia at a particular time, this generally will be accepted, unless there is contradictory evidence. Obtain medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to dyslipidaemia rather than to some other condition.
Last reviewed for CCPS 27 April 2010.
Preliminary questions [7881]
29977 there is some evidence that dyslipidaemia may be a factor in the development or worsening of the condition under consideration.
7927 the veteran has had dyslipidaemia at some time.
7928 the veteran has established the causal connection between the dyslipidaemia and VEA service for ischaemic heart disease.
7929 the veteran had dyslipidaemia before the clinical onset of the condition under consideration.
7931 the veteran has established the causal connection between the dyslipidaemia and VEA service for the clinical onset of ischaemic heart disease.
7933 the veteran has established the causal connection between the dyslipidaemia and operational service for the clinical onset of ischaemic heart disease.
or
7934 the veteran has established the causal connection between the dyslipidaemia and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
7930 the veteran had dyslipidaemia before the clinical worsening of the condition under consideration.
7932 the veteran has established the causal connection between the dyslipidaemia and VEA service for the clinical worsening of ischaemic heart disease.
7935 the veteran has established the causal connection between the dyslipidaemia and operational service for the clinical worsening of ischaemic heart disease.
or
7936 the veteran has established the causal connection between the dyslipidaemia and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [7933]
25967 the dyslipidaemia is causally related to operational service.
Clinical onset and eligible service [7934]
25968 the dyslipidaemia is causally related to eligible service.
Clinical worsening and operational service [7935]
25967 the dyslipidaemia is causally related to operational service.
7939 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the dyslipidaemia is causally related.
Clinical worsening and eligible service [7936]
25968 the dyslipidaemia is causally related to eligible service.
7940 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the dyslipidaemia is causally related.
Exposure to phenoxy acid herbicides
Ischaemic heart disease - Exposure to phenoxy acid herbicides Factor
Phenoxy acid herbicides 2,4-dichlorophenoxyacetic acid (2,4-D) or 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) is more commonly referred to as Agent Orange.
Herbicides were not widely used in the service environment except in Vietnam, where Agent Orange (and similar products) were used to destroy vegetation.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Ischaemic Heart Disease - Exposure to Phenoxy Acid Herbicides |
CR9319.pdf [22] |
CR9319.docx [23] |
Preliminary questions [41421]
41422 there is some evidence that having inhaled, ingested or cutaneous contact with the phenoxy acid herbicides 2,4-dichlorophenoxyacetic acid (2,4-D) or 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) may be a factor in the development or worsening of the condition under consideration.
41423 the veteran inhaled, ingested or had cutaneous contact with the phenoxy acid herbicides 2,4-dichlorophenoxyacetic acid (2,4-D) or 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) at some time.
41424 the veteran has established the causal connection between exposure to phenoxy acid herbicides and operational service for ischaemic heart disease.
41434 the veteran has established the causal connection between exposure to phenoxy acid herbicides and operational service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
41426 the veteran has established the causal connection between exposure to phenoxy acid herbicides and operational service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [41434]
41427 the veteran inhaled, ingested or had cutaneous contact with the phenoxy acid herbicides 2,4-dichlorophenoxyacetic acid (2,4-D) or 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) as specified in the Statement of Principles requirements, before the clinical onset of ischaemic heart disease.
41591 operational service made a material contribution to the veteran having inhaled, ingested or having had cutaneous contact with the phenoxy acid herbicides 2,4-dichlorophenoxyacetic acid (2,4-D) or 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) as specified before the clinical onset of ischaemic heart disease.
Clinical worsening and operational service [41426]
41428 the veteran inhaled, ingested or had cutaneous contact with the phenoxy acid herbicides 2,4-dichlorophenoxyacetic acid (2,4-D) or 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) as specified in the Statement of Principles requirements, before the clinical worsening of ischaemic heart disease.
41592 operational service made a material contribution to the veteran having inhaled, ingested or having had cutaneous contact with the phenoxy acid herbicides 2,4-dichlorophenoxyacetic acid (2,4-D) or 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) as specified before the clinical worsening of ischaemic heart disease.
Exposure to TCDD (Dioxin)
Ischaemic heart disease - Exposure to TCDD (Dioxin) Factor
The chemical name for TCDD is 2,3,7,8-tetrachlorodibenzo-para-dioxin. It is commonly referred to as dioxin.
For the purposes of this SOP, the RMA defines inhaling, ingesting or having cutaneous contact with a chemical agent contaminated with TCDD as:
- decanting or spraying,
- cleaning or maintaining equipment used to apply,
- being sprayed with,
- handling or sawing timber treated with,
- being in an environment shrouded in dust from timber treated with, or
- using cutting oils contaminated with
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Exposure to a Chemical Agent Contaminated By 2,3,7,8 TCDD (Dioxin) |
CR9258.pdf [24] |
CR9258.docx [25] |
Preliminary questions [41504]
41505 there is some evidence that having inhaled, ingested or cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) may be a factor in the development or worsening of the condition under consideration.
41506 the veteran inhaled, ingested or cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) at some time.
41507 the veteran has established the causal connection between exposure to TCDD (Dioxin) and operational service for ischaemic heart disease.
41508 the veteran has established the causal connection between exposure to TCDD (Dioxin) and operational service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
41509 the veteran has established the causal connection between exposure to TCDD (Dioxin) and operational service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [41508]
41510 the veteran inhaled, ingested or had cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) as specified in the Statement of Principles requirement, before the clinical onset of ischaemic heart disease.
41593 operational service made a material contribution to the veteran having inhaled, ingested or cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) as specified before the clinical onset of ischaemic heart disease.
Clinical worsening and operational service [41509]
41511 the veteran has experienced inhalation, ingestion or had cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD), for a cumulative period of at least 1000 hours within a consecutive period of ten years before the clinical worsening of ischaemic heart disease, and where that exposure has ceased, the clinical worsening of ischaemic heart disease occurred within 25 years after cessation.
41594 operational service made a material contribution to the veteran having inhaled, ingested or cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) as specified before the clinical worsening of ischaemic heart disease.
Haematological disorder associated with a hypercoagulable state
Ischaemic heart disease - Haematological disorder associated with a hypercoagulable state Factor
This means a blood disorder which results in an abnormally increased tendency to develop blood clots.
The following list contains the conditions defined by the RMA as being haematological disorders associated with a hypercoagulable state:
- antiphospholipid antibody syndrome; or
- disseminated intravascular coagulation; or
- heparin-induced thrombocytopenia and thrombosis; or
- hyperproteinaemia; or
- hyperviscosity syndrome; or
- inherited coagulation protein disorders associated with hypercoagulability; or
- myeloproliferative disease; or
- primary or secondary polycythaemia; or
- primary or secondary thrombocytosis; or
- sickle cell disease or sickle cell trait; or
- thrombotic thrombocytopaenic purpura.
If a veteran or member had one of these haematological disorders he or she would have needed significant medical attention at some time. Such medical treatment would normally be recorded in doctors' notes and/or hospital records. However, if these records cannot be obtained, a reliable history of appropriate medical treatment at a particular time will generally be accepted, unless there is contradictory evidence. Seek medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to one of these haematological disorders rather than to some other condition.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Medical Report | Haematological Disorders Associated with a Hypercoagulable State |
MR9067.pdf [26] |
MR9067.docx [27] |
Preliminary questions [38924]
38931 there is some evidence that a haematological disorder from the specified list associated with a hypercoagulable state may be a factor in the development or worsening of the condition under consideration.
12754 the veteran has had a haematological disorder from the specified list associated with a hypercoagulable state at some time.
12755 the haematological disorder from the specified list associated with a hypercoagulable state is an illness or injury which is identifiable.
38932 the veteran has established the causal connection between the haematological disorder associated with a hypercoagulable state and operational service for ischaemic heart disease.
38935 the veteran had the identified illness or injury, a haematological disorder associated with a hypercoagulable state, at the time of the clinical onset of the condition under consideration.
38933 the veteran has established the causal connection between the haematological disorder associated with a hypercoagulable state and operational service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
38936 the veteran had the identified illness or injury, a haematological disorder associated with a hypercoagulable state, at the time of the clinical worsening of the condition under consideration.
38934 the veteran has established the causal connection between the haematological disorder associated with a hypercoagulable state and operational service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [38933]
12760 the identified illness or injury, a haematological disorder associated with a hypercoagulable state, is causally related to operational service.
Clinical worsening and operational service [38934]
12760 the identified illness or injury, a haematological disorder associated with a hypercoagulable state, is causally related to operational service.
38937 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a haematological disorder associated with a hypercoagulable state, is causally related.
Hyperhomocysteinaemia
Ischaemic heart disease - Hyperhomocysteinaemia Factor
Definition
The RMA defines hyperhomocysteinaemia to mean "a condition characterised by an excess of homocysteine in the blood".
General information
Homocysteine is an amino acid (one of the chemical compounds that forms proteins). Everyone produces it, mainly from eating animal products. Normally the substance is converted into other non-damaging amino acids. If the normal homocysteine disposal systems are faulty then homocystine can form. This homocystine can then build up in the blood and appear in the urine.
The potential artery-damaging effects of elevated total homocysteine (tHcy) levels were suggested for many years before the substance was finally recognised as a risk factor for atherosclerotic disease.
Hyperhomocystinaemia can be due to inherited enzyme defects, various dietary deficiencies (folate and vitamins B6 and B12) or chronic renal failure. In its most common form caused by deficiency of the enzyme cystathionine-beta-synthetase, affected individuals are normal at birth, but can develop lens subluxation, lengthening and weakening of long bones, and variable degrees of mental retardation. These manifest during childhood and adolescence.
The presence of hyperhomocystinaemia is demonstrated by a blood test and would be commented on in the medical records.
Last reviewed for CCPS 27 April 2010.
Preliminary questions [7887]
9381 there is some evidence that hyperhomocysteinaemia may be a factor in the development or worsening of the condition under consideration.
7987 the veteran has had hyperhomocysteinaemia at some time.
26940 the veteran has established the causal connection between the hyperhomocysteinaemia and operational service for ischaemic heart disease.
7989 the veteran had hyperhomocysteinaemia before the clinical onset of the condition under consideration.
7990 the veteran has established the causal connection between the hyperhomocysteinaemia and operational service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
26941 the veteran had hyperhomocysteinaemia before the clinical worsening of the condition under consideration.
26943 the veteran has established the causal connection between the hyperhomocysteinaemia and operational service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [7990]
7992 the hyperhomocysteinaemia is causally related to operational service.
Clinical worsening and operational service [26943]
7992 the hyperhomocysteinaemia is causally related to operational service.
26945 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the hyperhomocysteinaemia is causally related.
Hypertension
Ischaemic heart disease - Hypertension Factor
Definition
Hypertension is high blood pressure. Hypertension was also sometimes called hyperpiesia or hyperpiesis up until the 1950's. Blood pressure is usually recorded as two figures - the top figure records the systolic pressure and the lower figure records the diastolic pressure (eg 130/80 records a systolic pressure of 130 and a diastolic pressure of 80).
Note: The definition means that hypertension cannot be diagnosed on the basis of one elevated blood pressure reading. There must be a number of high readings. When treatment is given, blood pressure readings may return to normal. However, a person with 'normal' blood pressure readings can still be suffering from hypertension if he or she is undergoing treatment for hypertension.
Establishing the onset of hypertension
This disease is significant and, if it has been detected, it will have been documented by a medical officer. However, doctors' notes and hospitals' records may have been destroyed or can no longer be obtained. If this is the case, the person's statement that hypertension was detected at a particular time should generally be accepted, However, if these records cannot be obtained, a reliable history of hypertension at a particular time will generally be accepted, unless there is contradictory evidence. Obtain medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to hypertension rather than to some other condition.
Last reviewed for CCPS 27 April 2010.
Preliminary questions [7878]
317 the veteran has hypertension.
7889 the veteran has established the causal connection between the hypertension and VEA service for ischaemic heart disease.
3437 the veteran had hypertension before the clinical onset of the condition under consideration.
7890 the veteran has established the causal connection between the hypertension and VEA service for the clinical onset of ischaemic heart disease.
7895 the veteran has established the causal connection between the hypertension and operational service for the clinical onset of ischaemic heart disease.
or
7896 the veteran has established the causal connection between the hypertension and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
7894 the veteran had hypertension before the clinical worsening of the condition under consideration.
7893 the veteran has established the causal connection between the hypertension and VEA service for the clinical worsening of ischaemic heart disease.
7897 the veteran has established the causal connection between the hypertension and operational service for the clinical worsening of ischaemic heart disease.
or
7898 the veteran has established the causal connection between the hypertension and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [7895]
334 the hypertension is causally related to operational service.
Clinical onset and eligible service [7896]
934 the hypertension is causally related to eligible service.
Clinical worsening and operational service [7897]
334 the hypertension is causally related to operational service.
7899 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the hypertension is causally related.
Clinical worsening and eligible service [7898]
934 the hypertension is causally related to eligible service.
7900 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the hypertension is causally related.
Hypothyroidism
Ischaemic heart disease - Hypothyroidism Factor
General information
Hypothyroidism is characterised by a reduction in circulating thyroid hormones and is reversible by thyroid hormone replacement therapy so that a normal thyroid state (euthyroid) is attained and hypothyroidism is no longer present. Subclinical hypothyroidism is an asymptomatic condition which occurs when there are normal levels of thyroid hormone in the blood but a high level of thyroid stimulating hormone (TSH) is detected; this condition is a precursor to hypothyroidism.
Primary hypothyroidism, the most common form, results in a shrunken fibrotic thyroid gland. Iatrogenic hypothyroidism, following radioactive iodine therapy or surgery for hyperthyroidism, is the second most common form of hypothyroidism. Drugs used to treat hyperthyroidism (anti-thyroid drugs eg propylthiouracil and methimazole) can cause hypothyroidism, as can drugs containing iodine, such as amiodarone (an anti-arrhythmic drug). Severe iodine deficiency in certain countries may lead to hypothryoidism. Secondary and tertiary hypothyroidism are not common and occur when there is disease of the pituitary gland or hypothalamus respectively.
Hypothyroidism is also known as myxoedema.
Signs and symptoms
- fatigue, excessive sleepiness;
- depression;
- dull facial expression, drooping eyelids and slowness of speech;
- cold intolerance;
- weight gain;
- increased cholesterol levels;
- sparse, coarse, dry hair and coarse, scaly, dry, thick skin;
- forgetfulness and decreased concentration with a gradual change in personality;
- puffiness and periorbital swelling;
- cardiomyopathy.
Establishing onset
Onset is subtle and blood testing is required to confirm the diagnosis. If a person was known to have hypothyroidism this would be recorded in doctors' notes and/or hospital records. However, if these records have been destroyed or can no longer be obtained and there is a reliable history of hypothyroidism at a particular time, this generally will be accepted, unless there is contradictory evidence. Obtain medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to hypothyroidism rather than to some other condition.
Last reviewed for CCPS 27 April 2010.
Preliminary questions [9174]
21952 there is some evidence that hypothyroidism may be a factor in the development or worsening of the condition under consideration.
8806 the veteran has had hypothyroidism at some time.
9450 hypothyroidism means a disease state characterised by a reduction in circulating thyroid hormones.
9233 the veteran has established the causal connection between the hypothyroidism and VEA service for ischaemic heart disease.
9234 the veteran had the identified illness or injury, a type of hypothyroidism, before the clinical onset of the condition under consideration.
9236 the veteran has established the causal connection between the hypothyroidism and VEA service for the clinical onset of ischaemic heart disease.
9238 the veteran has established the causal connection between the hypothyroidism and operational service for the clinical onset of ischaemic heart disease.
or
9239 the veteran has established the causal connection between the hypothyroidism and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
9235 the veteran had the identified illness or injury, a type of hypothyroidism, before the clinical worsening of the condition under consideration.
9237 the veteran has established the causal connection between the hypothyroidism and VEA service for the clinical worsening of ischaemic heart disease.
9240 the veteran has established the causal connection between the hypothyroidism and operational service for the clinical worsening of ischaemic heart disease.
or
9241 the veteran has established the causal connection between the hypothyroidism and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [9238]
8811 the identified illness or injury, a type of hypothyroidism, is causally related to operational service.
Clinical onset and eligible service [9239]
8812 the identified illness or injury, a type of hypothyroidism, is causally related to eligible service.
Clinical worsening and operational service [9240]
8811 the identified illness or injury, a type of hypothyroidism, is causally related to operational service.
9242 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a type of hypothyroidism, is causally related.
Clinical worsening and eligible service [9241]
8812 the identified illness or injury, a type of hypothyroidism, is causally related to eligible service.
9243 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a type of hypothyroidism, is causally related.
Immersion in an atmosphere with a visible tobacco smoke haze
Ischaemic heart disease - Immersion in an atmosphere with a visible tobacco smoke haze Factor
"Visible tobacco smoke haze" is not defined in the SoP but it means tobacco smoke is present to the point where such smoke is obviously hanging in the air about and around the veteran or member.
Information about the scope and nature of various service occupations is also contained in:
Physical requirements, duties, and workplace hazards of specific military occupations
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Being in an Atmosphere with a Visible Tobacco Smoke Haze |
CRD901.pdf [28] |
CRD901.docx [29] |
| Claimant Report | Being in an Atmosphere with a Visible Tobacco Smoke Haze |
CRV901.pdf [30] |
CRV901.docx [31] |
Preliminary questions [7885]
25962 there is some evidence that being in an atmosphere with a visible smoke haze may be a factor in the development or worsening of the condition under consideration.
4925 the veteran has been in an atmosphere with a visible tobacco smoke haze.
4926 the veteran has been in an atmosphere with a visible tobacco smoke haze in an enclosed space.
7956 the veteran has established the causal connection between being in an atmosphere with a visible tobacco smoke haze and VEA service for ischaemic heart disease.
9206 the veteran has established the causal connection between being in an atmosphere with a visible tobacco smoke haze and VEA service for the clinical onset of ischaemic heart disease.
7957 the veteran has established the causal connection between being in an atmosphere with a visible tobacco smoke haze and operational service for the clinical onset of ischaemic heart disease.
or
7958 the veteran has established the causal connection between being in an atmosphere with a visible tobacco smoke haze and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
9207 the veteran has established the causal connection between being in an atmosphere with a visible tobacco smoke haze and VEA service for the clinical worsening of ischaemic heart disease.
9208 the veteran has established the causal connection between being in an atmosphere with a visible tobacco smoke haze and operational service for the clinical worsening of ischaemic heart disease.
or
9209 the veteran has established the causal connection between being in an atmosphere with a visible tobacco smoke haze and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [7957]
7960 the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 1000 hours.
7961 the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 1000 hours before the clinical onset of the condition under consideration.
25964 where the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 1000 hours before the clinical onset of the condition under consideration, the last exposure to that atmosphere occurred more than 5 years before the clinical onset of the condition under consideration.
33418 operational service made a material contribution to the requirements of the reasonable hypothesis Statement of Principles for being in an atmosphere with a visible tobacco smoke haze in an enclosed space before the clinical onset of the condition under consideration.
7962 the veteran being in an atmosphere with a visible tobacco smoke haze in an enclosed space on operational service before the clinical onset of the condition under consideration, which made a material contribution to the requirements of the reasonable hypothesis Statement of Principles for the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
Clinical onset and eligible service [7958]
7967 the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours.
25963 the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours before the clinical onset of the condition under consideration.
25965 where the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours before the clinical onset of the condition under consideration, the last exposure to that atmosphere occurred more than 5 years before the clinical onset of the condition under consideration.
33421 eligible service made a material contribution to the requirements of the balance of probabilities Statement of Principles for being in an atmosphere with a visible tobacco smoke haze in an enclosed space before the clinical onset of the condition under consideration.
7966 the veteran being in an atmosphere with a visible tobacco smoke haze in an enclosed space on eligible service before the clinical onset of the condition under consideration, which made a material contribution to the requirements of the balance of probabilities Statement of Principles for the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
Clinical worsening and operational service [9208]
7960 the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 1000 hours.
18464 the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 1000 hours before the clinical worsening of the condition under consideration.
9215 where the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 1000 hours before the clinical worsening of the condition under consideration, the last exposure to that atmosphere occurred more than 5 years before the clinical worsening of the condition under consideration.
25969 the veteran being in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 1000 hours commenced after the clinical onset of the condition under consideration.
33423 operational service made a material contribution to the requirements of the reasonable hypothesis Statement of Principles for being in an atmosphere with a visible tobacco smoke haze in an enclosed space before the clinical worsening of the condition under consideration.
9217 the veteran being in an atmosphere with a visible tobacco smoke haze in an enclosed space on operational service before the clinical worsening of the condition under consideration, which made a material contribution to the requirements of the reasonable hypothesis Statement of Principles for the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
Clinical worsening and eligible service [9209]
7967 the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours.
9214 the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours before the clinical worsening of the condition under consideration.
9216 where the veteran was in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours before the clinical worsening of the condition under consideration, the last exposure to that atmosphere occurred more than 5 years before the clinical worsening of the condition under consideration.
25966 the veteran being in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours commenced after the clinical onset of the condition under consideration.
33425 eligible service made a material contribution to the requirements of the balance of probabilities Statement of Principles for being in an atmosphere with a visible tobacco smoke haze in an enclosed space before the clinical worsening of the condition under consideration.
9218 the veteran being in an atmosphere with a visible tobacco smoke haze in an enclosed space on eligible service before the clinical worsening of the condition under consideration, which made a material contribution to the requirements of the balance of probabilities Statement of Principles for the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
Inability to obtain appropriate clinical management for ischaemic heart disease
Ischaemic heart disease - Inability to obtain appropriate clinical management for ischaemic heart disease Factor
Ischaemic heart disease usually presents initially as angina or as a heart attack and emergency medical treatment may be required to prevent possible death.
Treatment can include medications, such as aspirin, anti-platelet and anti-coagulants to inhibit blood clot formation, clot-dissolving drugs, nitroglycerin (vasodilator), ACE inhibitors and Beta blockers.
Surgery may be required: angiography to x-ray the coronary arteries using a dye inserted via a catheter; angioplasty where a balloon is inserted via a catheter to push open the blocked artery; or a stent is inserted during the angioplasty to permanently keep the artery open; and coronary artery by-pass graft.
Advice may be given to modify lifestyle risk factors such as smoking, diet, excess weight and exercise.
Inability to obtain appropriate clinical managementLast reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Medical Report | Inability to Obtain Appropriate Clinical Management |
GQACM.pdf [32] |
GQACM.docx [33] |
Preliminary questions [7888]
11109 the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7066 there is some evidence that an inability to obtain appropriate clinical management for the condition under consideration may be a factor in the worsening of the condition under consideration.
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
7378 the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration.
11234 the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration.
11235 the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration.
or
11236 the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration.
Clinical worsening and operational service [11235]
7384 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service.
21084 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service, as a causal result of operational service.
7387 the veteran's inability to obtain appropriate clinical management for the condition under consideration during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.
or
7389 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.
7390 the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service.
7392 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.
Clinical worsening and eligible service [11236]
7385 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service.
7386 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service, as a causal result of eligible service.
7388 the veteran's inability to obtain appropriate clinical management for the condition under consideration during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.
or
7389 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.
7391 the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service.
7393 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.
Inability to undertake any physical activity greater than 3 METs
Ischaemic heart disease - Inability to undertake any physical activity greater than 3 METs Factor
RMA definition
The RMA defines this as "the presence of an incapacity which prevents any physical activity greater than 3 METS, where a "MET" is a unit of measurement of the level of physical exertion. 1 MET = 3.5 ml of oxygen/kg of body weight per minute or, 1.0 kcal/kg of body weight per hour, or resting metabolic rate. (A MET approximates to the energy required to rest quietly in bed. A 70 kg man would use about 3 METs when walking at 4 km per hour.)"
Note:
- The factor requirements are a severe test of a limited capacity for exertion. The MET ratings for common activities provides guidance for considering whether or not certain activities meet the RMA definition.
- The incapacity must be due a physical inability with a generalised rather than localised effect on the level of physical activity able to be undertaken.
- Lifestyle choices, lack of opportunity, or medical conditions with only narrow restrictions do not constitute an incapacity – eg the person with adhesive capsulitis may not be able to work as a mechanic or play golf, but can readily engage in other activities where the level of energy expended is greater than 3 METs; similarly, the person with osteoarthrosis of the knees can undertake upper arm activities and/or swimming at levels easily exceeding 3 METs.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Inability to Undertake Physical Activity |
CR9147.pdf [34] |
CR9147.docx [35] |
| Medical Report | Inability to Undertake Physical Activity |
MR9045.pdf [36] |
MR9045.docx [37] |
Preliminary questions [7886]
33534 there is some evidence that an inability to undertake any physical activity greater than 3 METs may be a factor in the development or worsening of the condition under consideration.
33535 the veteran has been unable to undertake any physical activity greater than 3 METs for at least 5 years at some time.
33536 the veteran was unable to undertake any physical activity greater than 3 METs for at least 5 years as a result of an illness or injury which is identifiable.
7970 the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and VEA service for ischaemic heart disease.
7973 the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and VEA service for the clinical onset of ischaemic heart disease.
7976 the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and eligible service for the clinical onset of ischaemic heart disease.
or
7975 the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and operational service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
7974 the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and VEA service for the clinical worsening of ischaemic heart disease.
9219 the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and eligible service for the clinical worsening of ischaemic heart disease.
or
7977 the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and operational service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [7975]
33499 the identified illness or injury made a material contribution to the veteran's inability to undertake any physical activity greater than 3 METs for at least the five years before the clinical onset of the condition under consideration.
33538 the identified illness or injury which prevented the veteran from undertaking any physical activity greater than 3 METs is causally related to operational service.
Clinical onset and eligible service [7976]
7979 the identified illness or injury made a material contribution to the veteran's inability to undertake any physical activity greater than 3 METs for at least seven years.
7984 the identified illness or injury made a material contribution to the veteran's inability to undertake any physical activity greater than 3 METs for at least the seven years before the clinical onset of the condition under consideration.
33537 the identified illness or injury which prevented the veteran from undertaking any physical activity greater than 3 METs is causally related to eligible service.
Clinical worsening and operational service [7977]
33500 the identified illness or injury made a material contribution to the veteran's inability to undertake any physical activity greater than 3 METs after the clinical onset and for at least the five years before the clinical worsening of the condition under consideration.
33538 the identified illness or injury which prevented the veteran from undertaking any physical activity greater than 3 METs is causally related to operational service.
33539 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from undertaking any physical activity greater than 3 METs is causally related.
Clinical worsening and eligible service [9219]
7979 the identified illness or injury made a material contribution to the veteran's inability to undertake any physical activity greater than 3 METs for at least seven years.
9220 the identified illness or injury made a material contribution to the veteran's inability to undertake any physical activity greater than 3 METs after the clinical onset and for at least the seven years before the clinical worsening of the condition under consideration.
33537 the identified illness or injury which prevented the veteran from undertaking any physical activity greater than 3 METs is causally related to eligible service.
33540 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from undertaking any physical activity greater than 3 METs is causally related.
Inhaling or having cutaneous contact with nitroglycerine and nitroglycol
Ischaemic heart disease - Inhaling or having cutaneous contact with nitroglycerine and nitroglycol Factor
This factor only applies to reasonable hypothesis cases. In addition, it is a requirement of the SOP that the last inhalation or contact occurred not more than 14 days before the onset or worsening of ischaemic heart disease. Therefore, for ischaemic heart disease to be related to any exposure during operational service, the onset or worsening of the heart disease would need to have occurred during, or within 2 weeks after, that service.
General information
Products containing nitroglycerine or nitroglycol include double and triple base gun propellants and gelatinous explosives such as gelignite.
Exposure to nitroglycerine or nitroglycol by Australian Defence Force personnelAdditional information may also be found in Physical requirements, duties, and workplace hazards of specific military occupations.
Last review for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Inhaling or having cutaneous contact with products containing nitroglycerine or nitroglycol |
CR9108.pdf [38] |
CR9108.docx [39] |
Preliminary questions [24619]
24620 there is some evidence that experiencing inhalation of or cutaneous contact with products containing nitroglycerine or nitroglycol may be a factor in the development or worsening of the condition under consideration.
26962 the veteran has established the causal connection between experiencing inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol and VEA service for ischaemic heart disease.
24624 the veteran has established the causal connection between experiencing inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol and operational service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
26964 the veteran has established the causal connection between experiencing inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol and operational service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [24624]
24626 the clinical onset of the condition under consideration occurred during operational service or within the 14 days following a period of operational service.
26961 the veteran has experienced inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol at some time.
24635 the veteran experienced inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol on operational service.
24627 during operational service the veteran experienced inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol each day for at least 20 days within a consecutive period of 30 days.
24628 during operational service the veteran experienced inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol each day for at least 20 days within a consecutive period of 30 days before the clinical onset of the condition under consideration, where the last exposure occurred not more than 14 days before the clinical onset.
33541 the veteran's inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol each day for at least 20 days within a consecutive period of 30 days before the clinical onset of the condition under consideration, on operational service, where the last exposure occurred not more than 14 days before the clinical onset, was due to the veteran's serious default, wilful act or serious breach of discipline.
Clinical worsening and operational service [26964]
26966 the clinical worsening of the condition under consideration occurred during operational service or within the 14 days following a period of operational service.
26961 the veteran has experienced inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol at some time.
24635 the veteran experienced inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol on operational service.
24627 during operational service the veteran experienced inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol each day for at least 20 days within a consecutive period of 30 days.
26967 during operational service, the veteran experienced inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol each day for at least 20 days within a consecutive period of 30 days before the clinical worsening of the condition under consideration, where the last exposure occurred not more than 14 days before the clinical worsening.
26968 the clinical onset of the condition under consideration occurred before the veteran's inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol on operational service made a material contribution to the requirements of the Statement of Principles for the condition under consideration.
33542 the veteran's inhalation of, or cutaneous contact with, products containing nitroglycerine or nitroglycol each day for at least 20 days within a consecutive period of 30 days before the clinical worsening of the condition under consideration, on operational service, where the last exposure occurred not more than 14 days before the clinical worsening, was due to the veteran's serious default, wilful act or serious breach of discipline.
Morbid obesity
Ischaemic heart disease - Morbid obesity Factor
"BMI" means body mass index and is calculated as follows:
BMI = W/H2 where:
W is the person's weight in kilograms; and
H is the person's height in metres.
(For Imperial weights and measures, BMI = wt. in lbs/ (ht in inches2) x 703.1).
Establishing the presence of morbid obesity
While efforts should be made to obtain details of the veteran's height and weight, if it is just not possible to obtain specific height/weight measurements, a medical comment that the veteran or member was morbidly obese will be sufficient. Details of any ongoing, medically prescribed drug therapy for weight reduction or any surgical intervention for weight reduction should be obtained.
If height/weight measurements can be obtained, the BMI formula should be applied.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Obesity or Increased Waist to Hip Ratio |
CR9288.pdf [40] |
CR9288.docx [41] |
| Medical Report | Obesity or Increased Waist to Hip Ratio |
MR9397.pdf [42] |
MR9397.docx [43] |
Preliminary questions [38915]
38198 there is some evidence that morbid obesity may be a factor in the development or worsening of the condition under consideration.
9004 the veteran has a history of morbid obesity.
38916 the veteran has been morbidly obese for at least five years at some time.
38917 the veteran has established the causal connection between morbid obesity and VEA service for ischaemic heart disease.
38918 the veteran has established the causal connection between morbid obesity and VEA service for the clinical onset of ischaemic heart disease.
38920 the veteran has established the causal connection between morbid obesity and operational service for the clinical onset of ischaemic heart disease.
or
38921 the veteran has established the causal connection between morbid obesity and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
38919 the veteran has established the causal connection between morbid obesity and VEA service for the clinical worsening of ischaemic heart disease.
38922 the veteran has established the causal connection between morbid obesity and operational service for the clinical worsening of ischaemic heart disease.
or
38923 the veteran has established the causal connection between morbid obesity and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [38920]
33414 the veteran was morbidly obese for at least five years before the clinical onset of the condition under consideration.
9005 the morbid obesity is causally related to operational service.
Clinical onset and eligible service [38921]
28048 the veteran was morbidly obese for at least five years within the 15 years before the clinical onset of the condition under consideration.
9006 the morbid obesity is causally related to eligible service.
Clinical worsening and operational service [38922]
33416 the veteran was morbidly obese for at least five years before the clinical worsening of the condition under consideration.
9005 the morbid obesity is causally related to operational service.
9009 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the morbid obesity is causally related.
Clinical worsening and eligible service [38923]
28049 the veteran was morbidly obese for at least five years within the 15 years before the clinical worsening of the condition under consideration.
9006 the morbid obesity is causally related to eligible service.
9010 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the morbid obesity is causally related.
Obesity or increased waist to hip ratio
Ischaemic heart disease - Obesity or increased waist to hip ratio Factor
This covers 2 factors:
- Being obese
- Having a waist to hip circumference ratio exceeding 1.0 (for men) and 0.9 (for women)
Morbid obesity is covered under a separate contention.
Establishing the presence of obesity or being overweight
If it is not possible to obtain specific height/weight or waist/hip measurements, a medical comment that the veteran or member was obese or met the required circumference ratio will be sufficient. If height/weight or waist/hip measurements can be obtained, the BMI formula or circumference ratio should be applied.
Waist to hip circumference ratio
This ratio is calculated by dividing the waist measurement by the hip measurement e.g. 120 cm ÷ 100 cm = 1.2.
Whereas the Body Mass Index (BMI) measures total body fat, the waist to hip circumference ratio measures the distribution of body fat. Fat stored around the waist poses a greater health risk than fat stored on the hips. This distribution of body fat is commonly referred to as being an “apple” shape as opposed to a “pear” shape where fat is stored below the waist on hips, thighs and buttocks. The apple shape is predominantly a male phenomenon, although women are more prone to develop an apple shape in mid-life, particularly after menopause.
While efforts should be made to obtain details of the veteran's waist and hip measures, if it is just not possible to obtain specific waist/hip measurements, a medical comment that the veteran or member met this circumference ratio will be sufficient.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title |
PDF Format |
Word Format |
|---|---|---|---|
| Claimant Report | Obesity or Increased Waist to Hip Ratio |
CR9288.pdf [40] |
CR9288.docx [41] |
| Medical Report | Obesity or Increased Waist to Hip Ratio |
MR9397.pdf [42] |
MR9397.docx [43] |
Preliminary questions [7880]
38903 the veteran was overweight or obese for at least five years at some time.
38904 the veteran has established the causal connection between being overweight or obese and VEA service for ischaemic heart disease.
38905 the veteran has established the causal connection between being overweight or obese and VEA service for the clinical onset of ischaemic heart disease.
38906 the veteran has established the causal connection between being overweight or obese and operational service for the clinical onset of ischaemic heart disease.
or
38908 the veteran has established the causal connection between being overweight or obese and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
38907 the veteran has established the causal connection between being overweight or obese and VEA service for the clinical worsening of ischaemic heart disease.
38909 the veteran has established the causal connection between being overweight or obese and operational service for the clinical worsening of ischaemic heart disease.
or
38910 the veteran has established the causal connection between being overweight or obese and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [38906]
33413 the veteran was overweight or obese for at least five years before the clinical onset of the condition under consideration.
38911 the veteran being overweight or obese was caused by operational service.
Clinical onset and eligible service [38908]
22359 the veteran was overweight or obese for at least 5 years within the 15 years before the clinical onset of the condition under consideration.
38912 the veteran being overweight or obese was caused by eligible service.
Clinical worsening and operational service [38909]
33415 the veteran was overweight or obese for at least 5 years before the clinical worsening of the condition under consideration.
38913 the veteran being overweight or obese for at least 5 years commenced after the clinical onset of the condition under consideration.
38911 the veteran being overweight or obese was caused by operational service.
Clinical worsening and eligible service [38910]
22360 the veteran was overweight or obese for at least 5 years within the 15 years before the clinical worsening of the condition under consideration.
38913 the veteran being overweight or obese for at least 5 years commenced after the clinical onset of the condition under consideration.
38912 the veteran being overweight or obese was caused by eligible service.
Pipe smoking
Ischaemic heart disease - Pipe smoking Factor
If there is a history of pipe smoking it will be necessary to obtain information about:
- the quantity smoked (ascertain tobacco smoked per week in grams or ounces; 1 ounce = 28 grams);
- when this took place; and
- the reasons for smoking.
The evidence gathered should be as complete and accurate as possible. Information already held in departmental files, eg in previous statements and clinical notes, should not be overlooked. Conflicting evidence should be resolved.
Before a causal link between a smoking habit and service may be established, consideration must be given to Repatriation Commission Guideline CM5030 - Guideline for claims assessors on smoking and alcohol related conditions and military service [12].
NB The SOP factor dealing with pipe smoking covers only the smoking of tobacco. It does not include non-tobacco products such as marijuana or hashish. This is because the RMA SOP factors refer to "cigarettes or the equivalent thereof in other tobacco products".
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Smoking |
CRD905.pdf [13] |
CRD905.docx [14] |
| Claimant Report | Smoking |
CRV905.pdf [15] |
CRV905.docx [16] |
Preliminary questions [7884]
26927 there is some evidence that pipe smoking may be a factor in the development or worsening of the condition under consideration.
9198 the veteran has established the causal connection between the pipe smoking and VEA service for ischaemic heart disease.
7951 the veteran has established the causal connection between the pipe smoking and VEA service for the clinical onset of ischaemic heart disease.
7952 the veteran has established the causal connection between the pipe smoking and operational service for the clinical onset of ischaemic heart disease.
4911 the veteran has some period or periods of pipe smoking that are causally related to operational service.
or
7953 the veteran has established the causal connection between the pipe smoking and eligible service for the clinical onset of ischaemic heart disease.
4913 the veteran has some period or periods of pipe smoking that are causally related to eligible service.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
9199 the veteran has established the causal connection between the pipe smoking and VEA service for the clinical worsening of ischaemic heart disease.
9200 the veteran has established the causal connection between the pipe smoking and operational service for the clinical worsening of ischaemic heart disease.
33483 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the pipe smoking is causally related.
or
9201 the veteran has established the causal connection between the pipe smoking and eligible service for the clinical worsening of ischaemic heart disease.
33488 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the pipe smoking is causally related.
Clinical onset and operational service [7952]
26928 the veteran had ceased smoking pipe tobacco at the time of the clinical onset of the condition under consideration.
27828 the veteran has established the causal connection between the pipe smoking which had ceased prior to the clinical onset of ischaemic heart disease and operational service for the clinical onset of ischaemic heart disease.
26933 the veteran smoked at least 20 pack years of operational service pipe tobacco before the clinical onset of the condition under consideration.
or
26931 the veteran smoked 5 or more, but less than 20, pack years of operational service pipe tobacco and the clinical onset of the condition under consideration occurred within fifteen years of smoking cessation.
or
27861 the veteran smoked 5 pack years of operational service pipe tobacco before the clinical onset of ischaemic heart disease.
27860 the veteran smoked 1 or more, but less than 5, pack years of pipe tobacco and the clinical onset of ischaemic heart disease occurred within five years of smoking cessation.
or
27858 the veteran has established the causal connection between the pipe smoking which had not ceased prior to the clinical onset of ischaemic heart disease and operational service for the clinical onset of ischaemic heart disease.
27862 the veteran smoked an average of at least 5 grams of pipe tobacco per day for at least the 1 year before the clinical onset of the condition under consideration.
or
27863 the veteran smoked at least 1 pack year of operational service pipe tobacco before the clinical onset of the condition under consideration.
Clinical onset and eligible service [7953]
26928 the veteran had ceased smoking pipe tobacco at the time of the clinical onset of the condition under consideration.
27830 the veteran has established the causal connection between the pipe smoking which had ceased prior to the clinical onset of ischaemic heart disease and eligible service for the clinical onset of ischaemic heart disease.
27304 the veteran smoked at least 5 pack years of pipe tobacco and the clinical onset of the condition under consideration occurred within five years of smoking cessation.
or
26930 the veteran smoked 5 pack years of pipe tobacco before the clinical onset of ischaemic heart disease.
26929 the veteran smoked 1 or more, but less than 5, pack years of pipe tobacco and the clinical onset of ischaemic heart disease occurred within three years of smoking cessation.
or
27829 the veteran has established the causal connection between the pipe smoking which had not ceased prior to the clinical onset of ischaemic heart disease and eligible service for the clinical onset of ischaemic heart disease.
7954 the veteran smoked an average of at least 5 grams of pipe tobacco per day for at least the 1 year before the clinical onset of ischaemic heart disease.
or
27834 the veteran smoked at least 1 pack year of pipe tobacco before the clinical onset of ischaemic heart disease.
Clinical worsening and operational service [9200]
26934 the veteran had ceased smoking pipe tobacco at the time of the clinical worsening of the condition under consideration.
27831 the veteran has established the causal connection between the pipe smoking which had ceased prior to the clinical worsening of ischaemic heart disease and operational service for the clinical worsening of ischaemic heart disease.
27052 the veteran smoked at least 20 pack years of pipe tobacco before the clinical worsening of the condition under consideration.
or
26936 the veteran smoked 5 or more, but less than 20, pack years of pipe tobacco and the clinical worsening of ischaemic heart disease occurred within fifteen years of smoking cessation.
or
27865 the veteran smoked 5 pack years of operational service pipe tobacco before the clinical worsening of ischaemic heart disease.
27864 the veteran smoked 1 or more, but less than 5, pack years of pipe tobacco and the clinical worsening of the condition under consideration occurred within five years of smoking cessation.
or
27859 the veteran has established the causal connection between the pipe smoking which had not ceased prior to the clinical worsening of ischaemic heart disease and operational service for the clinical worsening of ischaemic heart disease.
27866 the veteran smoked an average of at least 5 grams of operational service pipe tobacco per day for at least the 1 year before the clinical worsening of the condition under consideration.
or
27867 the veteran smoked at least 1 pack year of operational service pipe tobacco before the clinical worsening of the condition under consideration.
Clinical worsening and eligible service [9201]
26934 the veteran had ceased smoking pipe tobacco at the time of the clinical worsening of the condition under consideration.
27833 the veteran has established the causal connection between the pipe smoking which had ceased prior to the clinical worsening of ischaemic heart disease and eligible service for the clinical worsening of ischaemic heart disease.
27305 the veteran smoked at least 5 pack years of pipe tobacco and the clinical worsening of the condition under consideration occurred within five years of smoking cessation.
or
27836 the veteran smoked 5 pack years of pipe tobacco before the clinical worsening of ischaemic heart disease.
26935 the veteran smoked 1 or more, but less than 5, pack years of pipe tobacco and the clinical worsening of the condition under consideration occurred within three years of smoking cessation.
or
27832 the veteran has established the causal connection between the pipe smoking which had not ceased prior to the clinical worsening of ischaemic heart disease and eligible service for the clinical worsening of ischaemic heart disease.
9202 the veteran smoked an average of at least 5 grams of pipe tobacco per day for at least the 1 year before the clinical worsening of ischaemic heart disease.
or
27837 the veteran smoked at least 1 pack year of pipe tobacco before the clinical worsening of ischaemic heart disease.
Smoking tobacco products - material contribution
Ischaemic heart disease - Smoking tobacco products - material contribution Factor
Smoking and CCPS
Smoking cigarettes, cigars or pipe tobacco due to VEA service need only have made a material contribution to the minimum smoking requirements specified in the SOP (refer Kattenberg v Repatriation Commission [2002] FCA 412). It has not been possible to make changes to the smoking module in CCPS to take account of this, but for many cases this is of no consequence because service-related smoking alone is sufficient to meet the SOP requirements. However, for smoking cases that do not succeed under the CCPS smoking module, there is a contention:
-
Smoking tobacco products - material contribution
This contention covers all types of smoking – cigarettes, pipe and cigars - with rulebase questions to ascertain whether or not VEA service made a material contribution to the SOP requirements. This may entail addressing issues that have already been covered in the smoking module because it has not been possible to isolate specific facts established within that module.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Smoking |
CRD905.pdf [13] |
CRD905.docx [14] |
| Claimant Report | Smoking |
CRV905.pdf [15] |
CRV905.docx [16] |
Preliminary questions [33596]
30303 the veteran has smoked cigarettes, cigars or pipe tobacco at some time.
33597 the veteran has established the causal connection between smoking tobacco products and VEA service for the condition under consideration.
33598 the veteran has established the causal connection between smoking tobacco products and VEA service for the clinical onset of the condition under consideration.
33600 the veteran has established the causal connection between smoking tobacco products and operational service for the clinical onset of the condition under consideration.
or
33601 the veteran has established the causal connection between smoking tobacco products and eligible service for the clinical onset of the condition under consideration.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
33599 the veteran has established the causal connection between smoking tobacco products and VEA service for the clinical worsening of the condition under consideration.
33602 the veteran has established the causal connection between smoking tobacco products and operational service for the clinical worsening of the condition under consideration.
33454 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the smoking is causally related.
or
33603 the veteran has established the causal connection between smoking tobacco products and eligible service for the clinical worsening of the condition under consideration.
33459 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the smoking is causally related.
Clinical onset and operational service [33600]
34228 the veteran had ceased smoking tobacco products at the time of the clinical onset of the condition under consideration.
33604 the veteran has established the causal connection between the tobacco smoking which had ceased prior to the clinical onset of ischaemic heart disease and operational service for the clinical onset of the condition under consideration.
33612 the veteran smoked at least 20 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of ischaemic heart disease.
33456 smoking as a causal result of operational service made a material contribution to 20 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of the condition under consideration.
or
33614 the veteran smoked 5 or more, but less than 20, pack years of cigarettes or the equivalent thereof in other tobacco products and the clinical onset of the condition under consideration occurred within fifteen years of smoking cessation.
33446 where the clinical onset of the condition under consideration occurred within fifteen years of smoking cessation, smoking as a causal result of operational service made a material contribution to 5 pack years of cigarettes or the equivalent thereof in other tobacco products.
or
33615 the veteran smoked 1 or more, but less than 5, pack years of cigarettes or the equivalent thereof in other tobacco products and the clinical onset of the condition under consideration occurred within five years of smoking cessation.
33447 where the clinical onset of the condition under consideration occurred within five years of smoking cessation, smoking as a causal result of operational service made a material contribution to 1 pack year of cigarettes or the equivalent thereof in other tobacco products.
or
33605 the veteran has established the causal connection between the tobacco smoking which had not ceased prior to the clinical onset of ischaemic heart disease and operational service for the clinical onset of the condition under consideration.
33621 the veteran smoked an average of at least 5 cigarettes per day or the equivalent thereof in other tobacco products for at least the 1 year before the clinical onset of the condition under consideration.
33448 smoking as a causal result of operational service made a material contribution to an average of at least five cigarettes per day or the equivalent thereof in other tobacco products for at least the 1 year before the clinical onset of the condition under consideration.
or
33617 the veteran smoked a minimum of 1 pack year of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of the condition under consideration.
33449 smoking as a causal result of operational service made a material contribution to 1 pack year of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of the condition under consideration.
Clinical onset and eligible service [33601]
34228 the veteran had ceased smoking tobacco products at the time of the clinical onset of the condition under consideration.
33606 the veteran has established the causal connection between the tobacco smoking which had ceased prior to the clinical onset of ischaemic heart disease and eligible service for the clinical onset of the condition under consideration.
33618 the veteran smoked a minimum of 5 pack years of cigarettes or the equivalent thereof in other tobacco products and the clinical onset of the condition under consideration occurred within five years of smoking cessation.
33450 where the clinical onset of the condition under consideration occurred within five years of smoking cessation, smoking as a causal result of eligible service made a material contribution to 5 pack years of cigarettes or the equivalent thereof in other tobacco products.
or
33620 the veteran smoked a minimum of 1, but less than 5, pack years of cigarettes or the equivalent thereof in other tobacco products and the clinical onset of the condition under consideration occurred within three years of smoking cessation.
33451 where the clinical onset of the condition under consideration occurred within three years of smoking cessation, smoking as a causal result of eligible service made a material contribution to 1 pack year of cigarettes or the equivalent thereof in other tobacco products.
or
33607 the veteran has established the causal connection between the tobacco smoking which had not ceased prior to the clinical onset of ischaemic heart disease and eligible service for the clinical onset of the condition under consideration.
33621 the veteran smoked an average of at least 5 cigarettes per day or the equivalent thereof in other tobacco products for at least the 1 year before the clinical onset of the condition under consideration.
33630 smoking as a causal result of eligible service made a material contribution to an average of at least five cigarettes per day or the equivalent thereof in other tobacco products for at least the 1 year before the clinical onset of the condition under consideration.
or
33617 the veteran smoked a minimum of 1 pack year of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of the condition under consideration.
33452 smoking as a causal result of eligible service made a material contribution to 1 pack year of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of the condition under consideration.
Clinical worsening and operational service [33602]
34229 the veteran had ceased smoking tobacco products at the time of the clinical worsening of the condition under consideration.
33608 the veteran has established the causal connection between the tobacco smoking which had ceased prior to the clinical worsening of ischaemic heart disease and operational service for the clinical worsening of the condition under consideration.
33623 the veteran smoked a minimum of 20 pack years of cigarettes or the equivalent thereof in other tobacco products after the clinical onset of the condition under consideration and before its clinical worsening.
34230 smoking as a causal result of operational service made a material contribution to 20 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of the condition under consideration.
or
33625 the veteran smoked 5 or more, but less than 20, pack years of cigarettes or the equivalent thereof in other tobacco products and the clinical worsening of the condition under consideration occurred within fifteen years of smoking cessation.
34224 the veteran's smoking of 5 or more, but less than 20, pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of the condition under consideration took place after the clinical onset of ischaemic heart disease.
33710 where the clinical worsening of the condition under consideration occurred within fifteen years of smoking cessation, smoking as a causal result of operational service made a material contribution to 5 pack years of cigarettes or the equivalent thereof in other tobacco products.
or
33627 the veteran smoked 1 or more, but less than 5, pack years of cigarettes or the equivalent thereof in other tobacco products and the clinical worsening of the condition under consideration occurred within five years of smoking cessation.
34225 the veteran's smoking of 1 or more, but less than 5, pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of the condition under consideration took place after the clinical onset of ischaemic heart disease.
33453 where the clinical worsening of the condition under consideration occurred within five years of smoking cessation, smoking as a causal result of operational service made a material contribution to 1 pack year of cigarettes or the equivalent thereof in other tobacco products.
or
33609 the veteran has established the causal connection between the tobacco smoking which had not ceased prior to the clinical worsening of ischaemic heart disease and operational service for the clinical worsening of the condition under consideration.
33628 the veteran smoked an average of at least 5 cigarettes per day or the equivalent thereof in other tobacco products after the clinical onset of the condition under consideration and for at least the 1 year before the clinical worsening of the condition under consideration.
33455 smoking as a causal result of operational service made a material contribution to an average of at least five cigarettes per day or the equivalent thereof in other tobacco products for at least the 1 year before the clinical worsening of the condition under consideration.
or
33629 the veteran smoked a minimum of 1 pack year of cigarettes or the equivalent thereof in other tobacco products after the clinical onset of the condition under consideration and before its clinical worsening.
33711 smoking as a causal result of operational service made a material contribution to 1 pack year of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of the condition under consideration.
Clinical worsening and eligible service [33603]
34229 the veteran had ceased smoking tobacco products at the time of the clinical worsening of the condition under consideration.
33610 the veteran has established the causal connection between the tobacco smoking which had ceased prior to the clinical worsening of ischaemic heart disease and eligible service for the clinical worsening of the condition under consideration.
33631 the veteran smoked a minimum of 5 pack years of cigarettes or the equivalent thereof in other tobacco products and the clinical worsening of the condition under consideration occurred within five years of smoking cessation.
34226 the veteran's smoking of a minimum of 5 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of the condition under consideration took place after the clinical onset of ischaemic heart disease.
33457 where the clinical worsening of the condition under consideration occurred within five years of smoking cessation, smoking as a causal result of eligible service made a material contribution to 5 pack years of cigarettes or the equivalent thereof in other tobacco products.
or
33633 the veteran smoked at least 1, but less than 5, pack years of cigarettes or the equivalent thereof in other tobacco products and the clinical worsening of the condition under consideration occurred within three years of smoking cessation.
34227 the veteran's smoking of at least 1, but less than 5, pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of the condition under consideration took place after the clinical onset of ischaemic heart disease.
33458 where the clinical worsening of the condition under consideration occurred within three years of smoking cessation, smoking as a causal result of eligible service made a material contribution to 1 pack year of cigarettes or the equivalent thereof in other tobacco products.
or
33611 the veteran has established the causal connection between the tobacco smoking which had not ceased prior to the clinical worsening of ischaemic heart disease and eligible service for the clinical worsening of the condition under consideration.
33628 the veteran smoked an average of at least 5 cigarettes per day or the equivalent thereof in other tobacco products after the clinical onset of the condition under consideration and for at least the 1 year before the clinical worsening of the condition under consideration.
33460 smoking as a causal result of eligible service made a material contribution to an average of at least five cigarettes per day or the equivalent thereof in other tobacco products for at least the 1 year before the clinical worsening of the condition under consideration.
or
33629 the veteran smoked a minimum of 1 pack year of cigarettes or the equivalent thereof in other tobacco products after the clinical onset of the condition under consideration and before its clinical worsening.
33461 smoking as a causal result of eligible service made a material contribution to 1 pack year of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of the condition under consideration.
The death of a significant other
Traumatic death of a significant other
RMA definitions
"Traumatic death" means death due to homicide, suicide, an accident, or other violent or traumatic circumstances;
"a significant other" means a person who has a close family bond or a close personal relationship and is important or influential in one's life.
Last reviewed for CCPS 27 April 2010.
Preliminary questions [38930]
37447 there is some evidence that the death of a significant other may be a factor in the development or worsening of the condition under consideration.
26976 the veteran suffered from angina or acute myocardial infarction or sudden death from ischaemic heart disease.
37448 the veteran has experienced the death of a significant other at some time.
39012 the veteran has established the causal connection between the death of a significant other and VEA service for ischaemic heart disease.
39013 the veteran has established the causal connection between the death of a significant other and VEA service for the clinical onset of ischaemic heart disease.
39015 the veteran has established the causal connection between the death of a significant other and operational service for the clinical onset of ischaemic heart disease.
or
39016 the veteran has established the causal connection between the death of a significant other and eligible service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
39014 the veteran has established the causal connection between the death of a significant other and VEA service for the clinical worsening of ischaemic heart disease.
39017 the veteran has established the causal connection between the death of a significant other and operational service for the clinical worsening of ischaemic heart disease.
or
39018 the veteran has established the causal connection between the death of a significant other and eligible service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [39015]
39019 the veteran experienced the death of a significant other within the 12 months before the clinical onset of the condition under consideration.
39023 the death of the veteran's significant other within the 12 months before the clinical onset of the condition under consideration was related to the veteran's operational service.
39027 the death of the veteran's significant other within the 12 months before the clinical onset of the condition under consideration, which was related to the veteran's operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
Clinical onset and eligible service [39016]
39020 the veteran experienced the death of a significant other within the six months before the clinical onset of the condition under consideration.
39024 the death of the veteran's significant other within the six months before the clinical onset of the condition under consideration was related to the veteran's eligible service.
39028 the death of the veteran's significant other within the six months before the clinical onset of the condition under consideration, which was related to the veteran's eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
Clinical worsening and operational service [39017]
39021 the veteran experienced the death of a significant other after the clinical onset of the condition under consideration and within the 12 months before its clinical worsening.
39025 the death of the veteran's significant other within the 12 months before the clinical worsening of the condition under consideration was related to the veteran's operational service.
39029 the death of the veteran's significant other within the 12 months before the clinical worsening of the condition under consideration, which was related to the veteran's operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
Clinical worsening and eligible service [39018]
39022 the veteran experienced the death of a significant other after the clinical onset of the condition under consideration and within the six months before its clinical worsening.
39026 the death of the veteran's significant other within the six months before the clinical worsening of the condition under consideration was related to the veteran's eligible service.
39030 the death of the veteran's significant other within the six months before the clinical worsening of the condition under consideration, which was related to the veteran's eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
Therapeutic radiation to the mediastinum or the chest wall overlying the heart
Ischaemic heart disease - Therapeutic radiation to the mediastinum or the chest wall overlying the heart Factor
The mediastinum is that area of the central part of the chest cavity between the right and left lungs. It contains the heart and its pericardium, the bases of the great vessels, the trachea and bronchi, oesophagus, thymus, lymph nodes, thoracic duct, phrenic and vagus nerves and other structures and tissues.
The chest wall is that part of the body surrounding the chest cavity and includes the skin, muscles, bones, nerves, blood vessels and membranes.
The heart is located in the middle of chest cavity, slightly to the left of centre.
Seek medical advice if you are not sure if a particular area constitutes the chest wall region overlying the heart.
Therapeutic radiationLast reviewed for CCPS 27 April 2010.
Preliminary questions [26989]
26990 there is some evidence that therapeutic radiation involving the mediastinum or the chest wall region overlying the heart may be a factor in the development or worsening of the condition under consideration.
26991 the veteran has undergone a course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart at some time.
26994 the veteran underwent a course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart as treatment for an illness or injury which is identifiable.
26992 the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and VEA service for the condition under consideration.
33440 the veteran underwent a course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart for treatment of the identified illness or injury before the clinical onset of the condition under consideration.
26993 the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and VEA service for the clinical onset of the condition under consideration.
26997 the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and operational service for the clinical onset of the condition under consideration.
or
26998 the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and eligible service for the clinical onset of the condition under consideration.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
26995 the veteran underwent a course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart for treatment of the identified illness or injury before the clinical worsening of the condition under consideration.
26996 the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and VEA service for the clinical worsening of the condition under consideration.
26999 the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and operational service for the clinical worsening of the condition under consideration.
or
27000 the veteran has established the causal connection between the therapeutic radiation involving the mediastinum or the chest wall region overlying the heart and eligible service for the clinical worsening of the condition under consideration.
Clinical onset and operational service [26997]
27004 the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to operational service.
Clinical onset and eligible service [26998]
27005 the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to eligible service.
Clinical worsening and operational service [26999]
27004 the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to operational service.
27006 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related.
Clinical worsening and eligible service [27000]
27005 the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related to eligible service.
27007 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, for which the course of therapeutic radiation involving the mediastinum or the chest wall region overlying the heart was undergone, is causally related.
Using amphetamines
Ischaemic heart disease - Using amphetamines Factor
Amphetamines or amphetamine-like compounds are defined by the RMA as meaning one of the following drugs:
- 3,4-methylenedioxymethamphetamine (ecstasy);
- dextroamphetamine;
- ephedrine;
- methamphetamine;
- methylphenidate (Ritalin);
- phendimetrazine;
- phentermine;
- phenylpropanolamine; or
- pseudoephedrine.
Amphetamines are drugs that stimulate the CNS. Although they can be used as medications such as Ritalin for ADHD, in anti-epileptic preparations, in cold and flu preparations and in appetite suppressants, they are mostly used in illegal drugs. Street names include 'speed', 'crystal meth', 'base', 'ice', 'shabu' and 'ecstasy'.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Use of Amphetamines or Amphetamine-like Compounds |
CR9285.pdf [44] |
CR9285.docx [45] |
| Medical Report | Use of Amphetamines or Amphetamine-like Compounds |
MR9394.pdf [46] |
MR9394.docx [47] |
Preliminary questions [38925]
38938 there is some evidence that using amphetamines may be a factor in the development or worsening of the condition under consideration.
38939 the veteran has established the causal connection between using amphetamines and operational service for ischaemic heart disease.
38940 the veteran has established the causal connection between using amphetamines and operational service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
38941 the veteran has established the causal connection between using amphetamines and operational service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [38940]
38942 the veteran used amphetamines or amphetamine-like compounds on operational service.
38943 on operational service, the veteran used amphetamines or amphetamine-like compounds within the 24 hours before the clinical onset of the condition under consideration.
38945 the veteran's use of amphetamines or amphetamine-like compounds on operational service within the 24 hours before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
or
38948 the veteran's use of amphetamines or amphetamine-like compounds was due to an illness or injury which is identifiable.
38949 as a result of the identified illness or injury, the veteran used amphetamines or amphetamine-like compounds within the 24 hours before the clinical onset of the condition under consideration.
38951 the identified illness or injury, as a result of which the veteran used amphetamines or amphetamine-like compounds, is causally related to operational service.
Clinical worsening and operational service [38941]
38942 the veteran used amphetamines or amphetamine-like compounds on operational service.
38944 on operational service, the veteran used amphetamines or amphetamine-like compounds within the 24 hours before the clinical worsening of the condition under consideration.
38946 the veteran's use of amphetamines or amphetamine-like compounds on operational service within the 24 hours before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
38947 the veteran's use of amphetamines or amphetamine-like compounds on operational service within the 24 hours before the clinical worsening of the condition under consideration occurred as a causal result of operational service.
or
38948 the veteran's use of amphetamines or amphetamine-like compounds was due to an illness or injury which is identifiable.
38950 as a result of the identified illness or injury, the veteran used amphetamines or amphetamine-like compounds within the 24 hours before the clinical worsening of the condition under consideration.
38951 the identified illness or injury, as a result of which the veteran used amphetamines or amphetamine-like compounds, is causally related to operational service.
38952 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, as a result of which the veteran used amphetamines or amphetamine-like compounds, is causally related.
Using nonsteroidal anti-inflammatory drugs
Ischaemic heart disease - Using nonsteroidal anti-inflammatory drugs Factor
There are many anti-inflammatory drugs that do not contain steroids. Most commonly they are treatment for arthritic conditions but may also be used for muscle strains associated with sporting injuries. Although aspirin is a non-steroidal anti-inflammatory drug (NSAID), it is excluded from this SOP factor. Examples of NSAIDs (other than aspirin) include:
- Phenylbutazone (Butazolidine - BTZ)
- Indomethacin (Indocid, Hicin, Indomed)
- Naproxen (Naprosyn, Naprogesic)
- Ibuprofen (Brufen, Nurofen, Rafen)
- Piroxicam (Feldene, Fensaid, Mobilis)
- Ketoprofen (Orudis, Oruvail)
- Sulindac (Clusinol, Clinoril)
- Tenoxicam (Tilcotil)
- Diclofenac sodium (Voltaren, Fenac)
- Celecoxib (Celebrex)
- Rofecoxib (Vioxx).
These are usually prescribed medications, but some, such as Nurofen and Naprogesic, are available without a doctor's prescription.
Last reviewed for CCPS 27 April 2010.
Investigative Documents
| Type | Title | PDF Format | Word Format |
|---|---|---|---|
| Claimant Report | Nonsteroidal Anti-Inflammatory Drugs (Excluding Aspirin) |
CR9287.pdf [48] |
CR9287.docx [49] |
| Medical Report | Treatment with NSAIDs (Excluding Aspirin) |
MR9396.pdf [50] |
MR9396.docx [51] |
Preliminary questions [38927]
39031 there is some evidence that a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, may be a factor in the development or worsening of the condition under consideration.
39032 the veteran has used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days at some time.
39033 the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days for treatment of an illness or injury which is identifiable.
39034 the veteran has established the causal connection between using a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, and VEA service for ischaemic heart disease.
39035 the veteran has established the causal connection between using a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, and VEA service for the clinical onset of ischaemic heart disease.
39038 the veteran has established the causal connection between using a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs and eligible service for the clinical onset of ischaemic heart disease.
or
39037 the veteran has established the causal connection between using a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, and operational service for the clinical onset of ischaemic heart disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
39036 the veteran has established the causal connection between using a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, and VEA service for the clinical worsening of ischaemic heart disease.
39040 the veteran has established the causal connection between using a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs and eligible service for the clinical worsening of ischaemic heart disease.
or
39039 the veteran has established the causal connection between using a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, and operational service for the clinical worsening of ischaemic heart disease.
Clinical onset and operational service [39037]
39041 for treatment of the identified illness or injury, the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days before the clinical onset of ischaemic heart disease.
39043 where, for treatment of the identified illness or injury the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days, the last dose of the drug was taken within the seven days before the clinical onset of ischaemic heart disease.
39045 the identified illness or injury, for treatment of which the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days, is causally related to operational service.
Clinical onset and eligible service [39038]
39047 for treatment of the identified illness or injury, the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days.
39048 for treatment of the identified illness or injury, the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days before the clinical onset of ischaemic heart disease.
39050 where, for treatment of the identified illness or injury the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days, the last dose of the drug was taken within the seven days before the clinical onset of ischaemic heart disease.
39052 the identified illness or injury, for treatment of which the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days, is causally related to eligible service.
Clinical worsening and operational service [39039]
39042 for treatment of the identified illness or injury, the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days before the clinical worsening of ischaemic heart disease.
39044 where, for treatment of the identified illness or injury the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days, the last dose of the drug was taken within the seven days before the clinical worsening of ischaemic heart disease.
39045 the identified illness or injury, for treatment of which the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days, is causally related to operational service.
39046 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, for treatment of which the veteran used a drug belonging to the nonsteroidal anti-inflammatory class of drugs, excluding aspirin, for a continuous period of at least 7 days, is causally related.
Clinical worsening and eligible service [39040]
39047 for treatment of the identified illness or injury, the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days.
39049 for treatment of the identified illness or injury, the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days before the clinical worsening of ischaemic heart disease.
39051 where, for treatment of the identified illness or injury the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days, the last dose of the drug was taken within the seven days before the clinical worsening of ischaemic heart disease.
39052 the identified illness or injury, for treatment of which the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days, is causally related to eligible service.
39053 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, for treatment of which the veteran used a drug belonging to the selective cyclo-oxygenase 2 inhibitor class of drugs for a continuous period of at least 7 days, is causally related.
Links
[1] https://clik.dva.gov.au/user/login?destination=comment/reply/63689%23comment-form
[2] http://www.rma.gov.au/SOP/alpha_ind/i.htm
[3] https://clik.dva.gov.au/compensation-and-support-reference-library/advisory-notes/2003/an02-federal-court-decision-stoddart
[4] https://clik.dva.gov.au/system/files/media/CR9142_0.pdf
[5] https://clik.dva.gov.au/system/files/media/CR9142_1.docx
[6] https://clik.dva.gov.au/system/files/media/CR9286.pdf
[7] https://clik.dva.gov.au/system/files/media/CR9286.docx
[8] https://clik.dva.gov.au/system/files/media/MR9395.pdf
[9] https://clik.dva.gov.au/system/files/media/MR9395.docx
[10] https://clik.dva.gov.au/system/files/media/CR9320.pdf
[11] https://clik.dva.gov.au/system/files/media/CR9320.docx
[12] https://clik.dva.gov.au/compensation-and-support-reference-library/commission-guidelines/cm5030-guideline-claims-assessors-smoking-and-alcohol-related-conditions-and-military-service
[13] https://clik.dva.gov.au/system/files/media/CRD905_6.pdf
[14] https://clik.dva.gov.au/system/files/media/CRD905_5.docx
[15] https://clik.dva.gov.au/system/files/media/CRV905_6.pdf
[16] https://clik.dva.gov.au/system/files/media/CRV905_8.docx
[17] https://clik.dva.gov.au/system/files/media/MR9187.pdf
[18] https://clik.dva.gov.au/system/files/media/MR9187.docx
[19] https://clik.dva.gov.au/compensation-and-support-reference-library/commission-guidelines/cm7014-mrcc181-guidelines-psychiatric-compensation-claims
[20] https://clik.dva.gov.au/system/files/docs/MR9154.pdf
[21] https://clik.dva.gov.au/system/files/docs/MR9154.docx
[22] https://clik.dva.gov.au/system/files/media/CR9319_0.pdf
[23] https://clik.dva.gov.au/system/files/media/CR9319_1.docx
[24] https://clik.dva.gov.au/system/files/media/CR9258.pdf
[25] https://clik.dva.gov.au/system/files/media/CR9258.docx
[26] https://clik.dva.gov.au/system/files/media/MR9067.pdf
[27] https://clik.dva.gov.au/system/files/media/MR9067.docx
[28] https://clik.dva.gov.au/system/files/media/CRD901.pdf
[29] https://clik.dva.gov.au/system/files/media/CRD901_0.docx
[30] https://clik.dva.gov.au/system/files/media/CRV901.pdf
[31] https://clik.dva.gov.au/system/files/media/CRV901.docx
[32] https://clik.dva.gov.au/system/files/media/GQACM_13.pdf
[33] https://clik.dva.gov.au/system/files/media/GQACM_13.docx
[34] https://clik.dva.gov.au/system/files/media/CR9147.pdf
[35] https://clik.dva.gov.au/system/files/media/CR9147.docx
[36] https://clik.dva.gov.au/system/files/media/MR9045.pdf
[37] https://clik.dva.gov.au/system/files/media/MR9045.docx
[38] https://clik.dva.gov.au/system/files/media/CR9108.pdf
[39] https://clik.dva.gov.au/system/files/media/CR9108.docx
[40] https://clik.dva.gov.au/system/files/media/CR9288.pdf
[41] https://clik.dva.gov.au/system/files/media/CR9288.docx
[42] https://clik.dva.gov.au/system/files/media/MR9397.pdf
[43] https://clik.dva.gov.au/system/files/media/MR9397.docx
[44] https://clik.dva.gov.au/system/files/media/CR9285.pdf
[45] https://clik.dva.gov.au/system/files/media/CR9285.docx
[46] https://clik.dva.gov.au/system/files/media/MR9394.pdf
[47] https://clik.dva.gov.au/system/files/media/MR9394.docx
[48] https://clik.dva.gov.au/system/files/media/CR9287_0.pdf
[49] https://clik.dva.gov.au/system/files/media/CR9287.docx
[50] https://clik.dva.gov.au/system/files/media/MR9396_0.pdf
[51] https://clik.dva.gov.au/system/files/media/MR9396.docx