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Porphyria Cutanea Tarda M003

Last amended 
Thursday, June 3, 2021
Current RMA Instruments
Reasonable Hypothesis SOP [1]
69 of 2021
Balance of Probabilities SOP [2]
70 of 2021
Changes from previous Instruments

SOP Bulletin 222 [3]

ICD Coding
  • ICD-9-CM Codes: 277.1
  • ICD-10-AM Codes: E80.1
Brief description

This is predominantly a skin ("cutanea") disease, caused by a deficiency of a liver enzyme involved in the metabolism of porphyrin.  This leads to an excess of porphyrins in the blood ("porphyria"). The term ‘tarda’ refers to the typically late onset of the condition.  Porphyrins are photosensitising when transported to the skin and cause skin damage on exposure to light.  The condition can be familial (hereditary) or acquired.

Confirming the diagnosis

This diagnosis is based on the clinical presentation, laboratory screening for total porphyrin levels in either plasma or urine, and then specific testing, including porphyrin fractionation, if the screening test is positive.

The relevant medical specialist is a dermatologist.

Additional diagnoses covered by SOP
  • chemical, symptomatic, or toxic porphyria
Conditions excluded from SOP
  • Erythropoietic protoporphyria#
  • Hepatoerythropoietic porphyria#
  • Hereditary coproporphyria#
  • X-linked protoporphyria#
  • other porphyrias#

# non-SOP condition

Clinical onset

Porphyria cutanea tarda (PCT) is generally a disease of adults. It usually presents in mid or later life.  The usual major manifesation is chronic blistering of the skin.  Other manifestations include skin fragility, scarring, and hyper- and hypopigmentation affecting sun-exposed areas.  Liver involvement/damage is also common.

Clinical worsening

PCT is a readily treatable condition with a good prognosis.  Relapses may occur following successful treatment.  Phlebotomy (drawing blood) and hydroxychloroquine therapy and the main forms of treatment.

 

 

Rulebase for porphyria cutanea tarda

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Alcohol dependence or alcohol abuse

Porphyria cutanea tarda - Alcohol dependence or alcohol abuse Factor

Last reviewed for CCPS 18 May 2001.

Preliminary questions [7717]

8610 [5] there is some evidence that alcohol dependence or alcohol abuse may be a factor in the development or worsening of the condition under consideration.

25223 [5] the veteran has had alcohol dependence or alcohol abuse at some time.

7719 — the veteran has established the causal connection between the alcohol dependence or alcohol abuse and operational service for porphyria cutanea tarda.

8958 [6] the veteran was suffering from alcohol dependence or alcohol abuse and consuming alcohol at the time of the clinical onset of the condition under consideration.

7721 — the veteran has established the causal connection between the alcohol dependence or alcohol abuse and operational service for the clinical onset of porphyria cutanea tarda.

or

[7]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]8959

the veteran was suffering from alcohol dependence or alcohol abuse and consuming alcohol at the time of the clinical worsening of the condition under consideration.

7722 — the veteran has established the causal connection between the alcohol dependence or alcohol abuse and operational service for the clinical worsening of porphyria cutanea tarda.

Clinical onset and operational service [7721]

26519 — the alcohol dependence or alcohol abuse is causally related to operational service. [10]

Clinical worsening and operational service [7722]

26519 — the alcohol dependence or alcohol abuse is causally related to operational service. [11]

[12]23760

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the alcohol dependence or alcohol abuse is causally related. [13]

Alcoholic liver disease

Porphyria cutanea tarda - Alcoholic liver disease Factor

Last reviewed for CCPS 18 May 2001.

Preliminary questions [7729]

7730 [14] there is some evidence that alcoholic liver disease may be a factor in the development or worsening of the condition under consideration.

24417 [14] the veteran has suffered from alcoholic liver disease at some time.

26653 [15] the alcoholic liver disease is an illness which is identifiable.

7736 — the veteran has established the causal connection between the alcoholic liver disease and VEA service for porphyria cutanea tarda.

[16]22930

the veteran was suffering from the identified illness or injury, a type of alcoholic liver disease, at the time of the clinical onset of the condition under consideration.

7737 — the veteran has established the causal connection between the alcoholic liver disease and VEA service for the clinical onset of porphyria cutanea tarda.

7739 — the veteran has established the causal connection between the alcoholic liver disease and operational service for the clinical onset of porphyria cutanea tarda.

or

7742 — the veteran has established the causal connection between the alcoholic liver disease and eligible service for the clinical onset of porphyria cutanea tarda.

or

[17]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]7733

the veteran was suffering from the identified illness or injury, a type of alcoholic liver disease, at the time of the clinical worsening of the condition under consideration.

7738 — the veteran has established the causal connection between the alcoholic liver disease and VEA service for the clinical worsening of porphyria cutanea tarda.

7744 — the veteran has established the causal connection between the alcoholic liver disease and operational service for the clinical worsening of porphyria cutanea tarda.

or

7745 — the veteran has established the causal connection between the alcoholic liver disease and eligible service for the clinical worsening of porphyria cutanea tarda.

Clinical onset and operational service [7739]

22934 — the identified illness or injury, a type of alcoholic liver disease, is causally related to operational service. [18] [19]

Clinical onset and eligible service [7742]

22935 — the identified illness or injury, a type of alcoholic liver disease, is causally related to eligible service. [20] [19]

Clinical worsening and operational service [7744]

22934 — the identified illness or injury, a type of alcoholic liver disease, is causally related to operational service. [21] [19]

[22]7747

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 alcoholic liver disease, is causally related.

Clinical worsening and eligible service [7745]

22935 — the identified illness or injury, a type of alcoholic liver disease, is causally related to eligible service. [23] [19]

[24]7740

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 alcoholic liver disease, is causally related. [25]

Cirrhosis of the liver

Porphyria cutanea tarda - Cirrhosis of the liver Factor

Last reviewed for CCPS 18 May 2001.

Preliminary questions [7727]

7784 [26] there is some evidence that cirrhosis of the liver may be a factor in the development or worsening of the condition under consideration.

22586 [26] the veteran has had cirrhosis of the liver at some time.

7785 — the veteran has established the causal connection between the cirrhosis of the liver and VEA service for porphyria cutanea tarda.

30235 [27] the veteran had cirrhosis of the liver before the clinical onset of the condition under consideration.

7786 — the veteran has established the causal connection between the cirrhosis of the liver and VEA service for the clinical onset of porphyria cutanea tarda.

30503 — the veteran has established the causal connection between the cirrhosis of the liver and operational service for the clinical onset of porphyria cutanea tarda.

or

30504 — the veteran has established the causal connection between the cirrhosis of the liver and eligible service for the clinical onset of porphyria cutanea tarda.

or

[28]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]30502

the veteran was suffering from cirrhosis of the liver before the clinical worsening of the condition under consideration.

7787 — the veteran has established the causal connection between the cirrhosis of the liver and VEA service for the clinical worsening of the condition under consideration.

30505 — the veteran has established the causal connection between the cirrhosis of the liver and operational service for the clinical worsening of porphyria cutanea tarda.

or

30506 — the veteran has established the causal connection between the cirrhosis of the liver and eligible service for the clinical worsening of porphyria cutanea tarda.

Clinical onset and operational service [30503]

22588 — the cirrhosis of the liver is causally related to operational service. [29] [30]

Clinical onset and eligible service [30504]

22589 — the cirrhosis of the liver is causally related to eligible service. [31] [30]

Clinical worsening and operational service [30505]

22588 — the cirrhosis of the liver is causally related to operational service. [32] [30]

[33]30507

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the cirrhosis of the liver is causally related.

Clinical worsening and eligible service [30506]

22589 — the cirrhosis of the liver is causally related to eligible service. [34] [30]

[35]30508

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the cirrhosis of the liver is causally related. [36]

Haemochromatosis

Porphyria cutanea tarda - Haemochromatosis Factor

Last reviewed for CCPS 18 May 2001.

Preliminary questions [20511]

21960 [37] there is some evidence that haemochromatosis may be a factor in the development or worsening of the condition under consideration.

8677 [37] the veteran has haemochromatosis.

20644 — the veteran has established the causal connection between the haemochromatosis and VEA service for the condition under consideration.

20651 [38] the veteran was suffering from haemochromatosis at the time of the clinical onset of the condition under consideration.

20645 — the veteran has established the causal connection between the haemochromatosis and VEA service for the clinical onset of the condition under consideration.

20647 — the veteran has established the causal connection between the haemochromatosis and operational service for the clinical onset of the condition under consideration.

or

20648 — the veteran has established the causal connection between the haemochromatosis and eligible service for the clinical onset of the condition under consideration.

or

[39]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]20652

the veteran was suffering from haemochromatosis at the time of the clinical worsening of the condition under consideration.

20646 — the veteran has established the causal connection between the haemochromatosis and VEA service for the clinical worsening of the condition under consideration.

20649 — the veteran has established the causal connection between the haemochromatosis and operational service for the clinical worsening of the condition under consideration.

or

20650 — the veteran has established the causal connection between the haemochromatosis and eligible service for the clinical worsening of the condition under consideration.

Clinical onset and operational service [20647]

10698 — the haemochromatosis is causally related to operational service. [40] [41]

Clinical onset and eligible service [20648]

10699 — the haemochromatosis is causally related to eligible service. [42] [41]

Clinical worsening and operational service [20649]

10698 — the haemochromatosis is causally related to operational service. [43] [41]

[44]21000

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the haemochromatosis is causally related.

Clinical worsening and eligible service [20650]

10699 — the haemochromatosis is causally related to eligible service. [45] [41]

[46]21001

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the haemochromatosis is causally related. [47]

Haemodialysis

Porphyria cutanea tarda - Haemodialysis Factor

Last reviewed for CCPS 18 May 2001.

Preliminary questions [30486]

30541 [48] there is some evidence that undergoing haemodialysis may be a factor in the development of the condition under consideration.

14932 [48] the veteran has undergone haemodialysis at some time.

14933 [49] the veteran has undergone haemodialysis for treatment of an illness or injury which is identifiable.

[50]30542

for the identified illness or injury, the veteran underwent haemodialysis for the one year immediately before the clinical onset of the condition under consideration. [51]

30543 — the veteran has established the causal connection between the haemodialysis and VEA service for the clinical onset of porphyria cutanea tarda.

30544 — the veteran has established the causal connection between the haemodialysis and operational service for the clinical onset of porphyria cutanea tarda.

or

30545 — the veteran has established the causal connection between the haemodialysis and eligible service for the clinical onset of porphyria cutanea tarda.

Clinical onset and operational service [30544]

14942 — the identified illness or injury, for which haemodialysis was undergone, is causally related to operational service. [52] [53]

Clinical onset and eligible service [30545]

14943 — the identified illness or injury, for which haemodialysis was undergone, is causally related to eligible service. [54] [53]

Halogenated aromatic hydrocarbons

Porphyria cutanea tarda - Halogenated aromatic hydrocarbons Factor

Last reviewed for CCPS 18 May 2001.

Investigative Documents

Claimant Report - Halogenated Aromatic Hydrocarbons [CR9025]

Preliminary questions [7706]

[55]8609

there is some evidence that halogenated aromatic hydrocarbons may be a factor in the development or worsening of the condition under consideration.

7707 — the veteran has established the causal connection between the halogenated aromatic hydrocarbons and VEA service for porphyria cutanea tarda.

7709 — the veteran has established the causal connection between the halogenated aromatic hydrocarbons and VEA service for the clinical onset of porphyria cutanea tarda.

7672 — the veteran has established the causal connection between the halogenated aromatic hydrocarbons and operational service for the clinical onset of porphyria cutanea tarda.

or

7703 — the veteran has established the causal connection between the halogenated aromatic hydrocarbons and eligible service for the clinical onset of porphyria cutanea tarda.

or

7334 [56] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

7710 — the veteran has established the causal connection between the halogenated aromatic hydrocarbons and VEA service for the clinical worsening of porphyria cutanea tarda.

7705 — the veteran has established the causal connection between the halogenated aromatic hydrocarbons and operational service for the clinical worsening of porphyria cutanea tarda.

or

7711 — the veteran has established the causal connection between the halogenated aromatic hydrocarbons and eligible service for the clinical worsening of porphyria cutanea tarda.

Clinical onset and operational service [7672]

[9]7712

on operational service, the veteran inhaled , ingest or cutaneously absorb a halogenated aromatic hydrocarbon within the ten years immediately before the clinical onset of the condition under consideration.

[57]7713

the inhalation, ingestion or cutaneous absorption of a halogenated aromatic hydrocarbon on operational service within the ten years immediately 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 [7703]

[58]7714

on eligible service, the veteran inhaled , ingest or cutaneously absorb a halogenated aromatic hydrocarbon within the one year immediately before the clinical onset of the condition under consideration.

[59]7716

in the course of eligible service duties, the veteran inhaled , ingest or cutaneously absorb a halogenated aromatic hydrocarbon within the one year immediately before the clinical onset of the condition under consideration.

[60]7741

the inhalation, ingestion or cutaneous absorption of a halogenated aromatic hydrocarbon on eligible service within the one year immediately 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 [7705]

[58]7743

on operational service, the veteran inhaled , ingest or cutaneously absorb a halogenated aromatic hydrocarbon within the ten years immediately before the clinical worsening of the condition under consideration.

[61]7746

in the course of operational service duties, the veteran inhaled , ingest or cutaneously absorb a halogenated aromatic hydrocarbon within the ten years immediately before the clinical worsening of the condition under consideration.

[62]7748

the inhalation, ingestion or cutaneous absorption of a halogenated aromatic hydrocarbon on operational service within the ten years immediately 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 [7711]

[58]30496

on eligible service, the veteran inhaled , ingest or cutaneously absorb a halogenated aromatic hydrocarbon within the one year immediately before the clinical worsening of the condition under consideration.

[63]30497

in the course of eligible service duties, the veteran inhaled , ingest or cutaneously absorb a halogenated aromatic hydrocarbon within the one year immediately before the clinical worsening of the condition under consideration.

[64]30498

the inhalation, ingestion or cutaneous absorption of a halogenated aromatic hydrocarbon on eligible service within the one year immediately before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline. [58]

Hepatic haemosiderosis

Porphyria cutanea tarda - Hepatic haemosiderosis Factor

Last reviewed for CCPS 18 May 2001.

Preliminary questions [30485]

30526 [65] there is some evidence that hepatic haemosiderosis may be a factor in the development or worsening of the condition under consideration.

30527 [65] the veteran has suffered from hepatic haemosiderosis at some time.

30528 — the veteran has established the causal connection between the hepatic haemosiderosis and VEA service for porphyria cutanea tarda.

30529 [66] the veteran was suffering from hepatic haemosiderosis at the time of the clinical onset of the condition under consideration.

30530 — the veteran has established the causal connection between the hepatic haemosiderosis and VEA service for the clinical onset of porphyria cutanea tarda.

30533 — the veteran has established the causal connection between the hepatic haemosiderosis and operational service for the clinical onset of porphyria cutanea tarda.

or

30534 — the veteran has established the causal connection between the hepatic haemosiderosis and eligible service for the clinical onset of porphyria cutanea tarda.

or

[67]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]30531

the veteran was suffering from hepatic haemosiderosis at the time of the clinical worsening of the condition under consideration.

30532 — the veteran has established the causal connection between the hepatic haemosiderosis and VEA service for the clinical worsening of porphyria cutanea tarda.

30535 — the veteran has established the causal connection between the hepatic haemosiderosis and operational service for the clinical worsening of porphyria cutanea tarda.

or

30536 — the veteran has established the causal connection between the hepatic haemosiderosis and eligible service for the clinical worsening of porphyria cutanea tarda.

Clinical onset and operational service [30533]

30537 — the hepatic haemosiderosis is causally related to operational service. [68] [69]

Clinical onset and eligible service [30534]

30538 — the hepatic haemosiderosis is causally related to eligible service. [70] [69]

Clinical worsening and operational service [30535]

30537 — the hepatic haemosiderosis is causally related to operational service. [71] [69]

[72]30539

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the hepatic haemosiderosis is causally related.

Clinical worsening and eligible service [30536]

30538 — the hepatic haemosiderosis is causally related to eligible service. [73] [69]

[74]30540

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the hepatic haemosiderosis is causally related. [75]

Hepatitis

Porphyria cutanea tarda - Hepatitis Factor

Last reviewed for CCPS 18 May 2001.

Preliminary questions [7726]

8611 [76] there is some evidence that hepatitis may be a factor in the development or worsening of the condition under consideration.

2295 [76] the veteran has suffered from hepatitis at some time.

7779 [77] the hepatitis is an illness which is identifiable.

7781 — the veteran has established the causal connection between the hepatitis and VEA service for porphyria cutanea tarda.

[78]4631

the veteran was suffering from the identified illness or injury, a type of hepatitis, at the time of the clinical onset of the condition under consideration.

7782 — the veteran has established the causal connection between the hepatitis and VEA service for the clinical onset of porphyria cutanea tarda.

30490 — the veteran has established the causal connection between the hepatitis and operational service for the clinical onset of porphyria cutanea tarda.

or

30491 — the veteran has established the causal connection between the hepatitis and eligible service for the clinical onset of porphyria cutanea tarda.

or

[79]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]7708

the veteran was suffering from the identified illness or injury, a type of hepatitis, at the time of the clinical worsening of the condition under consideration.

7783 — the veteran has established the causal connection between the hepatitis and VEA service for the clinical worsening of porphyria cutanea tarda.

30492 — the veteran has established the causal connection between the hepatitis and operational service for the clinical worsening of porphyria cutanea tarda.

or

30493 — the veteran has established the causal connection between the hepatitis and eligible service for the clinical worsening of porphyria cutanea tarda.

Clinical onset and operational service [30490]

2299 — the identified illness or injury, a type of hepatitis, is causally related to operational service. [80] [81]

Clinical onset and eligible service [30491]

2301 — the identified illness or injury, a type of hepatitis, is causally related to eligible service. [82] [81]

Clinical worsening and operational service [30492]

2299 — the identified illness or injury, a type of hepatitis, is causally related to operational service. [83] [81]

[84]30494

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 hepatitis, is causally related.

Clinical worsening and eligible service [30493]

2301 — the identified illness or injury, a type of hepatitis, is causally related to eligible service. [85] [81]

[86]30495

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 hepatitis, is causally related. [87]

Inability to obtain appropriate clinical management for porphyria cutanea tarda

Porphyria cutanea tarda - Inability to obtain appropriate clinical management for porphyria cutanea tarda Factor

Last reviewed for CCPS 18 May 2001.

Investigative Documents

Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM]

Preliminary questions [32596]

11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.

[88]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 [56] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]7378

the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.

7379 [89] 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]

[90]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.

[91]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.

[92]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

[58]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. [93] [94]

[95]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]

[96]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.

[97]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.

[98]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

[58]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. [93] [94]

[99]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. [100]

Infection with the human immunodeficiency virus (HIV)

Porphyria cutanea tarda - Infection with the human immunodeficiency virus (HIV) Factor

Last reviewed for CCPS 18 May 2001.

Preliminary questions [28118]

21948 [101] there is some evidence that infection with human immunodeficiency virus (HIV) may be a factor in the development or worsening of the condition under consideration.

2464 [101] the veteran has been infected with the human immunodeficiency virus (HIV).

28120 — the veteran has established the causal connection between the infection with HIV and VEA service for the condition under consideration.

28121 [102] the veteran was infected with human immunodeficiency virus (HIV) at the time of the clinical onset of the condition under consideration.

28122 — the veteran has established the causal connection between the infection with HIV and VEA service for the clinical onset of the condition under consideration.

28125 — the veteran has established the causal connection between the infection with HIV and operational service for the clinical onset of the condition under consideration.

or

28126 — the veteran has established the causal connection between the infection with HIV and eligible service for the clinical onset of the condition under consideration.

or

[103]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]28123

the veteran was infected with human immunodeficiency virus (HIV) at the time of the clinical worsening of the condition under consideration.

28124 — the veteran has established the causal connection between the infection with HIV and VEA service for the clinical worsening of the condition under consideration.

28127 — the veteran has established the causal connection between the infection with HIV and operational service for the clinical worsening of the condition under consideration.

or

28128 — the veteran has established the causal connection between the infection with HIV and eligible service for the clinical worsening of the condition under consideration.

Clinical onset and operational service [28125]

2466 — the human immunodeficiency virus (HIV) infection is causally related to operational service. [104] [105]

Clinical onset and eligible service [28126]

7788 — the human immunodeficiency virus (HIV) infection is causally related to eligible service. [106] [105]

Clinical worsening and operational service [28127]

2466 — the human immunodeficiency virus (HIV) infection is causally related to operational service. [107] [105]

[108]20786

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the human immunodeficiency virus (HIV) infection is causally related.

Clinical worsening and eligible service [28128]

7788 — the human immunodeficiency virus (HIV) infection is causally related to eligible service. [109] [105]

[110]20787

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the human immunodeficiency virus (HIV) infection is causally related. [111]

Oral oestrogen therapy

Porphyria cutanea tarda - Oral oestrogen therapy Factor

Last reviewed for CCPS 18 May 2001.

Preliminary questions [30484]

30509 [112] there is some evidence that oral oestrogen therapy may be a factor in the development or worsening of the condition under consideration.

30510 [112] the veteran has undergone a course of oral oestrogen therapy at some time.

30513 — the veteran has established the causal connection between the oral oestrogen therapy and VEA service for porphyria cutanea tarda.

35807 [113] the veteran has undergone a course of oral oestrogen therapy for the 30 days immediately before the clinical onset of the condition under consideration.

30515 — the veteran has established the causal connection between the oral oestrogen therapy and VEA service for the clinical onset of porphyria cutanea tarda.

30518 — the veteran has established the causal connection between the oral oestrogen therapy and operational service for the clinical onset of porphyria cutanea tarda.

or

30519 — the veteran has established the causal connection between the oral oestrogen therapy and eligible service for the clinical onset of porphyria cutanea tarda.

or

[114]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]35808

the veteran has undergone a course of oral oestrogen therapy for the 30 days immediately before the clinical worsening of the condition under consideration.

30517 — the veteran has established the causal connection between the oral oestrogen therapy and VEA service for the clinical worsening of porphyria cutanea tarda.

30520 — the veteran has established the causal connection between the oral oestrogen therapy and operational service for the clinical worsening of porphyria cutanea tarda.

or

30521 — the veteran has established the causal connection between the oral oestrogen therapy and eligible service for the clinical worsening of porphyria cutanea tarda.

Clinical onset and operational service [30518]

[115]35809

as a causal result of operational service, the veteran underwent a course of oral oestrogen therapy for the 30 days immediately before the clinical onset of the condition under consideration.

or

[116]30512

the veteran was undergoing a course of oral oestrogen therapy for treatment of an illness or injury which is identifiable.

[117]30514

for treatment of the identified illness or injury, the veteran was undergoing a course of oral oestrogen therapy for the 30 days immediately before the clinical onset of the condition under consideration.

30522 — the identified illness or injury for which the course of oral oestrogen therapy was undergone is causally related to operational service. [118] [119]

Clinical onset and eligible service [30519]

[120]35810

as a causal result of eligible service, the veteran underwent a course of oral oestrogen therapy for the 30 days immediately before the clinical onset of the condition under consideration.

or

[121]30512

the veteran was undergoing a course of oral oestrogen therapy for treatment of an illness or injury which is identifiable.

[117]30514

for treatment of the identified illness or injury, the veteran was undergoing a course of oral oestrogen therapy for the 30 days immediately before the clinical onset of the condition under consideration.

30523 — the identified illness or injury for which the course of oral oestrogen therapy was undergone is causally related to eligible service. [118] [119]

Clinical worsening and operational service [30520]

[122]35811

as a causal result of operational service, the veteran underwent a course of oral oestrogen therapy for the 30 days immediately before the clinical worsening of the condition under consideration.

or

[123]30512

the veteran was undergoing a course of oral oestrogen therapy for treatment of an illness or injury which is identifiable.

[117]30516

for treatment of the identified illness or injury, the veteran was undergoing a course of oral oestrogen therapy for the 30 days immediately before the clinical worsening of the condition under consideration.

30522 — the identified illness or injury for which the course of oral oestrogen therapy was undergone is causally related to operational service. [124] [119]

[125]30524

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 oral oestrogen therapy was undergone is causally related.

Clinical worsening and eligible service [30521]

[126]35812

as a causal result of eligible service, the veteran underwent a course of oral oestrogen therapy for the 30 days immediately before the clinical worsening of the condition under consideration.

or

[127]30512

the veteran was undergoing a course of oral oestrogen therapy for treatment of an illness or injury which is identifiable.

[117]30516

for treatment of the identified illness or injury, the veteran was undergoing a course of oral oestrogen therapy for the 30 days immediately before the clinical worsening of the condition under consideration.

30523 — the identified illness or injury for which the course of oral oestrogen therapy was undergone is causally related to eligible service. [124] [119]

[128]30525

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 oral oestrogen therapy was undergone is causally related. [129]

Porphyrin-generating hepatocellular tumour

Porphyria cutanea tarda - Porphyrin-generating hepatocellular tumour Factor

Last reviewed for CCPS 18 May 2001.

Preliminary questions [30487]

30546 [130] there is some evidence that a porphyrin-generating hepatocellular tumour may be a factor in the development of the condition under consideration.

30547 [130] the veteran has suffered from a porphyrin-generating hepatocellular tumour at some time.

30548 [131] the veteran was suffering from a porphyrin-generating hepatocellular tumour at the time of the clinical onset of the condition under consideration. [132]

30500 — the porphyrin-generating hepatocellular tumour that the veteran was suffering from at the time of the clinical onset of the condition under consideration is an illness which is identifiable. [Default true]

30549 — the veteran has established the causal connection between the porphyrin-generating hepatocellular tumour and VEA service for the clinical onset of porphyria cutanea tarda.

30550 — the veteran has established the causal connection between the porphyrin-generating hepatocellular tumour and operational service for the clinical onset of porphyria cutanea tarda.

or

30551 — the veteran has established the causal connection between the porphyrin-generating hepatocellular tumour and eligible service for the clinical onset of porphyria cutanea tarda.

Clinical onset and operational service [30550]

30552 — the identified illness or injury, a porphyrin-generating hepatocellular tumour, is causally related to operational service. [133] [134]

Clinical onset and eligible service [30551]

30553 — the identified illness or injury, a porphyrin-generating hepatocellular tumour, is causally related to eligible service. [135] [134]

Sun exposure within 5 days before clinical worsening of porphyria cutanea tarda

Porphyria cutanea tarda - Sun exposure within 5 days before clinical worsening of porphyria cutanea tarda Factor

Last reviewed for CCPS 18 May 2001.

Investigative Documents

Medical Report - Worsening - [GQWRS]

Preliminary questions [7728]

[136]30499

there is some evidence that sun exposure may be a factor in the worsening of the condition under consideration.

7334 [56] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]7793

the affected area of skin was exposed to sunlight within the five days immediately before the clinical worsening of the condition under consideration.

7790 — the veteran has established the causal connection between the sun exposure and VEA service for the clinical worsening of porphyria cutanea tarda.

7791 — the veteran has established the causal connection between the sun exposure and operational service for the clinical worsening of porphyria cutanea tarda.

or

7792 — the veteran has established the causal connection between the sun exposure and eligible service for the clinical worsening of porphyria cutanea tarda.

Clinical worsening and operational service [7791]

[137]7795

on operational service, the affected area of skin was exposed to sunlight within the five days immediately before the clinical worsening of the condition under consideration.

[138]7798

as a causal result of operational service, the affected area of skin was exposed to sunlight within the five days immediately before the clinical worsening of the condition under consideration.

[139]30612

the operational service-related exposure of the affected area of skin to sunlight in the 5 days immediately before the clinical worsening of porphyria cutanea tarda occurred after the clinical onset of porphyria cutanea tarda.

Clinical worsening and eligible service [7792]

[140]7796

on eligible service, the affected area of skin was exposed to sunlight within the five days immediately before the clinical worsening of the condition under consideration.

[141]7797

as a causal result of eligible service, the affected area of skin was exposed to sunlight within the five days immediately before the clinical worsening of the condition under consideration.

[142]30613

the eligible service-related exposure of the affected area of skin to sunlight in the 5 days immediately before the clinical worsening of porphyria cutanea tarda occurred after the clinical onset of porphyria cutanea tarda. [143]

Treatment with a drug or a class of drugs from list 1

Porphyria cutanea tarda - Treatment with a drug or a class of drugs from list 1 Factor

Last reviewed for CCPS 18 May 2001.

Investigative Documents

Medical Report - Drug Treatment - Porphyria Cutanea Tarda [MR9255]

Clinical worsening and operational service [30488]

[144]30554

there is some evidence that treatment with a drug or a class of drugs from list 1 may be a factor in the worsening of the condition under consideration.

30555 [145] the veteran has been treated with a drug or a class of drugs from list 1 at some time.

[146]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]30556

the veteran was treated with a drug or a class of drugs from list 1 for an illness or injury which is identifiable.

[147]30557

the identified illness or injury is a condition for which treatment with a drug or a class of drugs from list 1 can be ceased or substituted.

[148]30558

for the identified illness or injury, the veteran was being treated with a drug or a class or drugs from list 1, which was unable to be ceased or substituted, at the time of the clinical worsening of the condition under consideration.

30560 — the identified illness or injury, for which treatment with a drug or a class of drugs from list 1 was given, is causally related to operational service. [149]

[150]30561

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 treatment with a drug or a class of drugs from list 1 was given, is causally related. [151]

Treatment with a drug or a class of drugs from list 2

Porphyria cutanea tarda - Treatment with a drug or a class of drugs from list 2 Factor

Last reviewed for CCPS 18 May 2001.

Investigative Documents

Medical Report - Drug Treatment - Porphyria Cutanea Tarda [MR9255]

Preliminary questions [30489]

[144]30562

there is some evidence that treatment with a drug or a class of drugs from list 2 may be a factor in the worsening of the condition under consideration.

30563 [152] the veteran has been treated with a drug or a class of drugs from list 2 at some time.

[153]7334

the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[8]7335

the condition under consideration permanently worsened.

[9]30564

the veteran was treated with a drug or a class of dugs from list 2 for an illness or injury which is identifiable.

[154]30565

the identified illness or injury is a condition for which treatment with a drug or a class of drugs from list 2 can be ceased or substituted.

[155]30566

for the identified illness or injury, the veteran was being treated with a drug or a class of drugs from list 2, which was unable to be ceased or substituted, at the time of the clinical worsening of the condition under consideration.

30567 — the veteran has established the causal connection between the drug or class of drugs from list 2 and VEA service for the clinical worsening of porphyria cutanea tarda.

30568 — the veteran has established the causal connection between the drug or class of drugs from list 2 and operational service for the clinical worsening of porphyria cutanea tarda.

or

30569 — the veteran has established the causal connection between the drug or class of drugs from list 2 and eligible service for the clinical worsening of porphyria cutanea tarda.

Clinical worsening and operational service [30568]

30570 — the identified illness or injury, for which treatment with a drug or a class of drugs from list 2 was given, is causally related to operational service. [156] [157]

[158]30571

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 treatment with a drug or a class of drugs from list 2 was given, is causally related.

Clinical worsening and eligible service [30569]

30572 — the identified illness or injury, for which treatment with a drug or a class of drugs from list 2 was given, is causally related to eligible service. [159] [157]

[160]30573

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 treatment with a drug or a class of drugs from list 2 was given, is causally related. [161]


Source URL (modified on 18/06/2021 - 1:37pm): https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/n-p/porphyria-cutanea-tarda-m003-e801

Links
[1] http://www.rma.gov.au/assets/SOP/2021/f6b57ca8e1/069.pdf
[2] http://www.rma.gov.au/assets/SOP/2021/e25df436a1/070.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20222.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/64015%23comment-form
[5] https://clik.dva.gov.au/ccpsj008rc-2
[6] clikpopup://CCPS/Alcohol dependence or alcohol abuse and consuming alcohol at onset of porphyria cutanea tarda
[7] clikpopup://CCPS/5reject8958
[8] clikpopup://CCPS/Reject/OnsetAfterService
[9] clikpopup://CCPS/Reject/NoPermanentWorsening
[10] clikpopup://CCPS/5reject8959
[11] clikpopup://CCPS/reject26519No
[12] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to operational service which alcohol dependence or alcohol abuse is causally related
[13] clikpopup://CCPS/5reject23760
[14] https://clik.dva.gov.au/ccpsk010rc-14
[15] clikpopup://CCPS/Alcoholic liver disease is an illness or injury
[16] clikpopup://CCPS/reject26653No
[17] clikpopup://CCPS/reject22930No
[18] clikpopup://CCPS/reject7733No
[19] clikpopup://CCPS/reject22934,22935No
[20] clikpopup://CCPS/reject22935No
[21] clikpopup://CCPS/reject22934No
[22] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to operational service to which alcoholic liver disease is causally related
[23] clikpopup://CCPS/reject7747No
[24] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to eligible service to which alcoholic liver disease is causally related
[25] clikpopup://CCPS/reject7740No
[26] https://clik.dva.gov.au/ccpsk010rc-9
[27] https://clik.dva.gov.au/7727-cirrhosis-liver
[28] clikpopup://CCPS/reject30235No
[29] clikpopup://CCPS/reject30502No
[30] clikpopup://CCPS/reject22588,22589No
[31] clikpopup://CCPS/reject22589No
[32] clikpopup://CCPS/reject22588No
[33] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to operational service which cirrhosis of the liver is causally related
[34] clikpopup://CCPS/reject30507No
[35] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to eligible service which cirrhosis of the liver is causally related
[36] clikpopup://CCPS/reject30508No
[37] https://clik.dva.gov.au/ccpsj017rc-19
[38] clikpopup://CCPS/Hemochromatosis at onset of porphyria cutanea tarda
[39] clikpopup://CCPS/reject20651No
[40] clikpopup://CCPS/reject20652No
[41] clikpopup://CCPS/reject10698,10699No
[42] clikpopup://CCPS/reject10699No
[43] clikpopup://CCPS/reject10698No
[44] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to operational service to which haemochromatosis is causally related
[45] clikpopup://CCPS/reject21000No
[46] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to eligible service to which haemochromatosis is causally related
[47] clikpopup://CCPS/reject21001No
[48] https://clik.dva.gov.au/ccpsn027rc-5
[49] clikpopup://CCPS/Haemodialysis treatment for treatment of identifiable illness
[50] clikpopup://CCPS/reject14933No
[51] clikpopup://CCPS/reject30542No
[52] clikpopup://CCPS/reject14942No
[53] clikpopup://CCPS/reject14942,14943No
[54] clikpopup://CCPS/reject14943No
[55] https://clik.dva.gov.au/ccpsclaimant-168
[56] https://clik.dva.gov.au/node/72167
[57] clikpopup://CCPS/reject7712No
[58] clikpopup://CCPS/rejectwilful
[59] clikpopup://CCPS/reject7714No
[60] clikpopup://CCPS/reject7716No
[61] clikpopup://CCPS/reject7743No
[62] clikpopup://CCPS/reject7746No
[63] clikpopup://CCPS/reject30496No
[64] clikpopup://CCPS/reject30497No
[65] https://clik.dva.gov.au/ccpsm003rc-14
[66] clikpopup://CCPS/Hepatic haemosiderosis at onset of porphyria cutanea tarda
[67] clikpopup://CCPS/reject30529No
[68] clikpopup://CCPS/reject30531No
[69] clikpopup://CCPS/reject30537,30538No
[70] clikpopup://CCPS/reject30538No
[71] clikpopup://CCPS/reject30537No
[72] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to operational service which hepatic haemosiderosis is causally related
[73] clikpopup://CCPS/reject30539No
[74] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to eligible service which hepatic haemosiderosis is causally related
[75] clikpopup://CCPS/reject30540No
[76] https://clik.dva.gov.au/ccpsm003rc-4
[77] clikpopup://CCPS/Hepatitis is an illness which is identifiable
[78] clikpopup://CCPS/reject7779No
[79] clikpopup://CCPS/reject4631No
[80] clikpopup://CCPS/reject7708No
[81] clikpopup://CCPS/reject2299,2301No
[82] clikpopup://CCPS/reject2301No
[83] clikpopup://CCPS/reject2299No
[84] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to operational service to which hepatitis is causally related
[85] clikpopup://CCPS/reject30494No
[86] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to eligible service to which hepatitis is causally related
[87] clikpopup://CCPS/reject30495No
[88] https://clik.dva.gov.au/ccpsother-31
[89] clikpopup://CCPS/Porphyria cutanea tarda/ACM - contributed to worsening
[90] clikpopup://CCPS/ACM/NoContribution
[91] clikpopup://CCPS/ACM/NotOpService
[92] clikpopup://CCPS/ACM/NotOperDuties
[93] clikpopup://CCPS/ACM/NoIllness
[94] clikpopup://CCPS/reject7390,7391No
[95] clikpopup://CCPS/Porphyria cutanea tarda/ACM - onset prior to operational service
[96] clikpopup://CCPS/ACM/OnsetFailOper
[97] clikpopup://CCPS/ACM/NotEligService
[98] clikpopup://CCPS/ACM/NotEligDuties
[99] clikpopup://CCPS/Porphyria cutanea tarda/ACM - onset prior to eligible service
[100] clikpopup://CCPS/ACM/OnsetFailElig
[101] https://clik.dva.gov.au/ccpsj006rc-5
[102] clikpopup://CCPS/Infected with HIV at onset of porphyria cutanea tarda
[103] https://clik.dva.gov.au/reasons-decision-238
[104] clikpopup://CCPS/reject28123No
[105] clikpopup://CCPS/reject2466,7788No
[106] clikpopup://CCPS/reject7788No
[107] clikpopup://CCPS/reject2466No
[108] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to operational service which HIV is causally related
[109] clikpopup://CCPS/reject20786No
[110] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to eligible service which HIV is causally related
[111] clikpopup://CCPS/reject20787No
[112] https://clik.dva.gov.au/ccpsm003rc-13
[113] clikpopup://CCPS/Oral oestrogen therapy for the 30 days before the onset of PCT
[114] clikpopup://CCPS/reject35807No
[115] clikpopup://CCPS/reject35808No
[116] clikpopup://CCPS/reject35809No
[117] clikpopup://CCPS/reject30512No
[118] clikpopup://CCPS/reject30514No
[119] clikpopup://CCPS/reject30522,30523No
[120] clikpopup://CCPS/Due to el service had oral oestrogen therapy for the 30 days before the onset of PCT
[121] clikpopup://CCPS/reject35810No
[122] clikpopup://CCPS/Due to op service had oral oestrogen therapy for the 30 days before the worsening of PCT
[123] clikpopup://CCPS/reject35811No
[124] clikpopup://CCPS/reject30516No
[125] clikpopup://CCPS/Onset of PCT prior to operational service which oral oestrogen therapy is causally related
[126] clikpopup://CCPS/reject30524No
[127] clikpopup://CCPS/reject35812No
[128] clikpopup://CCPS/Onset of PCT prior to eligible service which oral oestrogen therapy is causally related
[129] clikpopup://CCPS/reject30525No
[130] https://clik.dva.gov.au/ccpsm003rc-10
[131] clikpopup://CCPS/A porphyrin-generating hepatocellular tumour at onset of porphyria cutanea tarda
[132] clikpopup://CCPS/reject30548No
[133] clikpopup://CCPS/reject30552No
[134] clikpopup://CCPS/reject30552,30553No
[135] clikpopup://CCPS/reject30553No
[136] https://clik.dva.gov.au/ccpsother-1
[137] clikpopup://CCPS/reject7793No
[138] clikpopup://CCPS/reject7795No
[139] clikpopup://CCPS/reject7798No
[140] clikpopup://CCPS/reject30612No
[141] clikpopup://CCPS/reject7796No
[142] clikpopup://CCPS/reject7797No
[143] clikpopup://CCPS/reject30613No
[144] https://clik.dva.gov.au/ccpsmedical-119
[145] https://clik.dva.gov.au/ccpsm003rc-9
[146] clikpopup://CCPS/reject30555No
[147] clikpopup://CCPS/reject30556No
[148] clikpopup://CCPS/reject30557Yes
[149] clikpopup://CCPS/reject30558No
[150] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to operational service which treatment with a drug or class of drugs from list 1 is causally related
[151] clikpopup://CCPS/reject30561No
[152] https://clik.dva.gov.au/standard-commentary-180
[153] clikpopup://CCPS/reject30563No
[154] clikpopup://CCPS/reject30564No
[155] clikpopup://CCPS/reject30565Yes
[156] clikpopup://CCPS/reject30566No
[157] clikpopup://CCPS/reject30570,30572No
[158] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to operational service which treatment with drug or class of drugs from list 2 is causally related
[159] clikpopup://CCPS/reject30571No
[160] clikpopup://CCPS/Onset of porphyria cutanea tarda prior to eligible service which treatment with drug or class of drugs from list 2 is causally related
[161] clikpopup://CCPS/reject30573No