Reasonable Hypothesis SOP [1] | 108 of 2015 |
Balance of Probabilities SOP [2] | 109 of 2015 |
SOP Bulletin 185 [3]
ICD-9-CM: 386.0
ICD-10-AM: H81.0
This is a progressive disease of the labyrinth of the inner ear with manifestations of rotational spinning (vertigo), fluctuating hearing loss, tinnitus and nausea and vomiting.
Also known as Meniere’s syndrome, endolymphatic hydrops, labyrinthine hydrops.
Note that Meniere’s disease is bilateral in 10-50% of cases.
To confirm the diagnosis there needs to be an opinion from an Ear nose and throat (ENT) surgeon. Normal practice is to consider that Meniere’s disease is present when there is episodic vertigo in addition to sensorineural hearing loss and tinnitus or fullness in the ears.
The relevant medical specialist is an Ear nose and throat (ENT) surgeon.
Meniere’s syndrome
labyrinthine hydrops
endolymphatic hydrops
Lermoyez’s syndrome – variant of Meniere’s disease
labyrinthinitis#
vertigo of central origin#
vertigo as a symptom#
vestibular Schwannoma* - acoustic neuroma
migraine*
transient ischaemic attack* - cerebrovascular accident
multiple sclerosis* - acoustic neuroma
* another SOP applies - the SOP has the same name unless otherwise specified
# non-SOP condition
The assessment of the clinical onset begins with the confirmed diagnosis, then goes back in time to the first onset of reliable clinical symptoms and signs which are pathognomonic of Meniere’s disease.
For an aggravation to be relevant, there must be a clinical worsening out of keeping with the natural history of the underlying pathology and it is difficult to ascertain whether Meniere’s disease has clinically worsened since the course of Meniere’s disease varies in different individuals. According to Dinces (2015) “some patients have marked hearing fluctuation and progressive hearing loss with infrequent vestibular symptoms; some have severe and frequent vertigo with only mild auditory symptoms; and some manifest both auditory and vestibular symptoms in equal measure” and “approximately two thirds of patients experience vertigo attacks in clusters, while one third have sporadic attacks” and “the frequency of vertigo episodes may decline over time”.
Dinces, E. 2015, ‘Meniere disease’, UpToDate, 9 July, http://www.uptodate.com/contents/meniere-disease [4]
Note that though there is an aetiological factor for a severe traumatic brain injury, the SOP itself does not include vertigo of a central origin, so the traumatic brain injury must have caused a disruption of the inner ear’s labyrinth rather than a central brain lesion.
Place holder node for Rulebase for Meniere's disease
Meniere's disease - Head injury Factor
Last reviewed for CCPS 24 May 2007.
Investigative Documents
Claimant Report - Head Injury - Meniere's Disease [CR9277] [6] Medical Report - Head Injury - Meniere's Disease [MR9374] Preliminary questions [37030]
37039 [8] the veteran has had a head injury as defined in the Statements of Principles for Meniere's disease at some time. 37036 — the veteran has established the causal connection between the head injury and VEA service for the clinical onset of Meniere's disease. 37037 — the veteran has established the causal connection between the head injury and operational service for the clinical onset of Meniere's disease. or 37038 — the veteran has established the causal connection between the head injury and eligible service for the clinical onset of Meniere's disease. Clinical onset and operational service [37037] or
37048 [13] as a consequence of the identified illness or injury, the veteran had a head injury as defined in the Statements of Principles for Meniere's disease before the clinical onset of Meniere's disease. 37050 — the identified illness or injury, which caused the head injury as defined in the Statements of Principles for Meniere's disease, is causally related to operational service. [14] [15] Clinical onset and eligible service [37038] or
37049 [20] as a consequence of the identified illness or injury, the veteran had a head injury as defined in the Statements of Principles for Meniere's disease within the 20 years before the clinical onset of Meniere's disease. [21]
37051 — the identified illness or injury, which caused the head injury as defined in the Statements of Principles for Meniere's disease, is causally related to eligible service. [22] [15]
Meniere's disease - Inability to obtain appropriate clinical management for Meniere's disease Factor
Last reviewed for CCPS 24 May 2007.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [12150] 11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7334 [24] 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 [27] 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. [31] [32] 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. [31] [32]
Meniere's disease - Otitis media Factor
Last reviewed for CCPS 24 May 2007.
Preliminary questions [37031]
37033 [39] there is some evidence that otitis media may be a factor in the development of the condition under consideration.
37052 [40] the veteran has had otitis media at some time.
37053 [41] the veteran has had otitis media of side and site of the body at some time. the veteran had otitis media of side and site of the body before the clinical onset of the condition under consideration. [43]
37055 — the veteran has established the causal connection between otitis media and operational service for the clinical onset of Meniere's disease.
Clinical onset and operational service [37055]
37056 — the veteran's otitis media of side and site of the body is causally related to operational service. [44]
Meniere's disease - Otosyphilis Factor
Last reviewed for CCPS 24 May 2007.
Preliminary questions [37032]
37034 [45] there is some evidence that otosyphilis may be a factor in the development of the condition under consideration.
37057 [45] the veteran has had otosyphilis at some time.
37058 [46] the veteran's otosyphilis affected side and site of the body. the veteran had otosyphilis affecting side and site of the body before the clinical onset of the condition under consideration. [48]
37061 — the veteran has established the causal connection between otosyphilis and VEA service for the clinical onset of Meniere's disease.
37062 — the veteran has established the causal connection between otosyphilis and operational service for the clinical onset of Meniere's disease.
or
37063 — the veteran has established the causal connection between otosyphilis and eligible service for the clinical onset of Meniere's disease.
Clinical onset and operational service [37062]
37064 — the veteran's otosyphilis affecting side and site of the body is causally related to operational service. [49] [50]
Clinical onset and eligible service [37063]
37065 — the veteran's otosyphilis affecting side and site of the body is causally related to eligible service. [51] [50]
Links
[1] http://www.rma.gov.au/SOP/15/108.pdf
[2] http://www.rma.gov.au/SOP/15/109.pdf
[3] https://clik.dva.gov.au/system/files/media/Bull185.pdf
[4] http://www.uptodate.com/contents/meniere-disease?source=search_result&search=meniere%27s&selectedTitle=1%7E29
[5] https://clik.dva.gov.au/user/login?destination=comment/reply/63840%23comment-form
[6] https://clik.dva.gov.au/ccpsclaimant-163
[7] https://clik.dva.gov.au/ccpsf013rc-1
[8] https://clik.dva.gov.au/37030-head-injury
[9] https://clik.dva.gov.au/reasons-decision-55
[10] clikpopup://CCPS/reject37040No
[11] clikpopup://CCPS/reject37041No
[12] clikpopup://CCPS/rejectwilful
[13] clikpopup://CCPS/Head injury due to illness or injury before onset of Meniere's disease
[14] clikpopup://CCPS/reject37048No
[15] clikpopup://CCPS/reject37050,37051No
[16] clikpopup://CCPS/Head injury for Meniere's disease on El service
[17] clikpopup://CCPS/reject37042No
[18] clikpopup://CCPS/reject37043No
[19] clikpopup://CCPS/reject37044No
[20] clikpopup://CCPS/Head injury due to illness or injury in 20 years before onset of Meniere's disease
[21] clikpopup://CCPS/reject37049No
[22] clikpopup://CCPS/reject37051No
[23] https://clik.dva.gov.au/ccpsother-31
[24] https://clik.dva.gov.au/node/69466
[25] clikpopup://CCPS/Reject/OnsetAfterService
[26] clikpopup://CCPS/Reject/NoPermanentWorsening
[27] clikpopup://CCPS/Meniere's disease/ACM - contributed to worsening
[28] clikpopup://CCPS/ACM/NoContribution
[29] clikpopup://CCPS/ACM/NotOpService
[30] clikpopup://CCPS/ACM/NotOperDuties
[31] clikpopup://CCPS/ACM/NoIllness
[32] clikpopup://CCPS/reject7390,7391No
[33] clikpopup://CCPS/Meniere's disease/ACM - onset prior to operational service
[34] clikpopup://CCPS/ACM/OnsetFailOper
[35] clikpopup://CCPS/ACM/NotEligService
[36] clikpopup://CCPS/ACM/NotEligDuties
[37] clikpopup://CCPS/Meniere's disease/ACM - onset prior to eligible service
[38] clikpopup://CCPS/ACM/OnsetFailElig
[39] https://clik.dva.gov.au/ccpsf013rc
[40] clikpopup://CCPS/Otitis media at some time
[41] clikpopup://CCPS/Otitis media of affected ear
[42] clikpopup://CCPS/reject37053No
[43] clikpopup://CCPS/reject37054No
[44] clikpopup://CCPS/reject37056No
[45] https://clik.dva.gov.au/ccpsf013rc-0
[46] clikpopup://CCPS/Otosyphilis of affected ear
[47] clikpopup://CCPS/reject37058No
[48] clikpopup://CCPS/reject37060No
[49] clikpopup://CCPS/reject37064No
[50] clikpopup://CCPS/reject37064,37065No
[51] clikpopup://CCPS/reject37065No