Reasonable Hypothesis SOP [1] | 11 of 2020 |
Balance of Probabilities SOP [2] | 12 of 2020 |
SOP Bulletin 213 [3]
Multiple sclerosis is an immune-mediated demyelinating disease of the central nervous system, typically affecting young to middle aged adults. It causes a range of symptoms, such as muscle weakness, numbness and changes in vision. The course of the disease is highly variable, but there are often episodes (attacks) of symptoms with partial or complete recovery periods in between.
The diagnosis can be relatively straightforward in people who present with typical symptoms and have characteristic MRI findings. In such people the diagnosis may be made at the time of the first attack. In others the diagnosis can be difficult and may be delayed. A range of addition investigations may be performed, particularly to rule out other causes for the presentation. Specialist diagnosis will be routine for this condition.
The relevant medical specialist is a neurologist.
# Non-SOP condition
The most common presentation is a young adult with one or more distinct episodes of central nervous system dysfunction, with at least partial recovery. Motor symptoms can include weakness, visual changes, gait disturbance and balance problems. Sensory symptoms (e.g. numbness) tend to involve the face and limbs. Diagnois requires both clinical manifestations and imaging findings, but onset may be backdatable to when just clinical manifestations, or just radiological changes (found incidentally) were first noted.
The condition can follow a relapsing/remitting course, or be progressive. The tendency is for a relapsing pattern in the early years, then a progressive decline later on. The rate of worsening is slow in most patients. Worsening may be evidenced by an increase in the frequency or severity of relapses, or an increase in the rate of progression. Disease modifying therapy is now available for multiple sclerosis.
Place holder node for Rulebase for multiple sclerosis
Multiple sclerosis - Inability to obtain appropriate clinical management for multiple sclerosis Factor
Last reviewed for CCPS 20 December 2002.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [16008] 11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7334 [6] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 [9] 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] or 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. [14] [15] Clinical worsening and eligible service [11236] or 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. [14] [15]
Multiple sclerosis - Infection with Epstein-Barr virus Factor
Last reviewed for CCPS 20 December 2002.
Preliminary questions [32053]
32012 [22] there is some evidence that being infected with Epstein-Barr virus may be a factor in the development of the condition under consideration.
10921 [23] the veteran has been infected with Epstein-Barr virus at some time. the veteran was infected with Epstein-Barr virus before the clinical onset of the condition under consideration. [25]
32055 — the veteran has established the causal connection between being infected with Epstein-Barr virus and operational service for the clinical onset of the condition under consideration.
Clinical onset and operational service [32055]
32013 — being infected with Epstein-Barr virus is causally related to operational service. [26]
Multiple sclerosis - Inhaling or having cutaneous contact with organic solvents Factor
Last reviewed for CCPS 20 December 2002.
Investigative Documents
Claimant Report - Exposure to Organic Solvents - Multiple Sclerosis [CR9211] Preliminary questions [32052]
32059 — the veteran has established the causal connection between experiencing inhalation of, or cutaneous contact with, organic solvents and operational service for the clinical onset of the condition under consideration.
Clinical onset and operational service [32059]
32060 [28] the veteran experienced inhalation of, or cutaneous contact with, organic solvents on more days than not during a continuous 12 month period before the clinical onset of the condition under consideration. operational service made a material contribution to the veteran's inhalation of, or cutaneous contact with, organic solvents on more days than not during a continuous 12 month period before the clinical onset of the condition under consideration. [30]
Links
[1] http://www.rma.gov.au/assets/SOP/2020/011.pdf
[2] http://www.rma.gov.au/assets/SOP/2020/012.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20213.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63876%23comment-form
[5] https://clik.dva.gov.au/ccpsother-31
[6] https://clik.dva.gov.au/node/69280
[7] clikpopup://CCPS/Reject/OnsetAfterService
[8] clikpopup://CCPS/Reject/NoPermanentWorsening
[9] clikpopup://CCPS/Multiple sclerosis/ACM %C2%96 contributed to worsening
[10] clikpopup://CCPS/ACM/NoContribution
[11] clikpopup://CCPS/ACM/NotOpService
[12] clikpopup://CCPS/ACM/NotOperDuties
[13] clikpopup://CCPS/rejectwilful
[14] clikpopup://CCPS/ACM/NoIllness
[15] clikpopup://CCPS/reject7390,7391No
[16] clikpopup://CCPS/Multiple sclerosis/ACM %C2%96 onset prior to operational service
[17] clikpopup://CCPS/ACM/OnsetFailOper
[18] clikpopup://CCPS/ACM/NotEligService
[19] clikpopup://CCPS/ACM/NotEligDuties
[20] clikpopup://CCPS/Multiple sclerosis/ACM %C2%96 onset prior to eligible service
[21] clikpopup://CCPS/ACM/OnsetFailElig
[22] https://clik.dva.gov.au/ccpsb006rc-2
[23] clikpopup://CCPS/Infected with Epstein-Barr virus at some time
[24] clikpopup://CCPS/reject10921No
[25] clikpopup://CCPS/reject22487No
[26] clikpopup://CCPS/reject32013No
[27] https://clik.dva.gov.au/ccpsclaimant-98
[28] https://clik.dva.gov.au/32052-experiencing-inhalation-or-cutaneous-contact-organic-solvents
[29] clikpopup://CCPS/reject32060No
[30] clikpopup://CCPS/reject32058No