Reasonable hypothesis SOP [1] | 48 of 2020 as amended |
Balance of Probabilities SOP [1] | 49 of 2020 as amended |
SOP Bulletin 215 [2]
SOP Bulletin 223 [3]
SOP Bulletin 230 [4]
Diabetes mellitus is a metabolic disorder characterised by high blood sugar levels. Most cases of diabetes mellitus can be classified as either type 1 or type 2. Type 1 diabetes (5 to 10% of cases) results from the destruction of insulin secreting cells in the pancreas. Type 2 diabetes (90 to 95% of cases) is due to resistance to the action of insulin by target tissues +/- some deficiency of insulin production. Most patients with type 2 diabetes are obese.
Diagnosis requires confirmation by blood testing, for either plasma glucose level or HbA1c level, as specified in the SOP definition.
The relevant medical specialist is an endocrinologist or general physician. The diagnosis can be confirmed by a general practitioner.
There are factors in the SOP that apply only to type 1 or type 2 diabetes, so information on the type of diabetes is required to apply those factors.
# non-SOP condition
Clinical onset will be when the diagnosis is first confirmed by blood testing. This is a threshold diagnosis. A glucose level that is elevated but below the threshold does not establish clinical onset.
The normal clinical course varies. Type 2 diabetes may resolve with weight loss. The more usual course is for slow progression of disease with the eventual development of complications or associated secondary diseases.
If there is a history of cigar smoking it will be necessary to obtain information about:
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 [7].
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [8] | CRD905.docx [9] |
Claimant Report | Smoking | CRV905.pdf [10] | CRV905.docx [11] |
26916 there is some evidence that cigar smoking may be a factor in the development or worsening of the condition under consideration.
10548 the veteran has non-insulin dependent diabetes mellitus (type 2).
28304 the veteran has established the causal connection between the cigar smoking and VEA service for diabetes mellitus.
28305 the veteran has established the causal connection between the cigar smoking and VEA service for the clinical onset of diabetes mellitus.
28307 the veteran has established the causal connection between the cigar smoking and operational service for the clinical onset of diabetes mellitus.
or
28308 the veteran has established the causal connection between the cigar smoking and eligible service for the clinical onset of diabetes mellitus.
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.
28306 the veteran has established the causal connection between the cigar smoking and VEA service for the clinical worsening of diabetes mellitus.
28310 the veteran has established the causal connection between the cigar smoking and operational service for the clinical worsening of diabetes mellitus.
or
28309 the veteran has established the causal connection between the cigar smoking and eligible service for the clinical worsening of diabetes mellitus.
28206 the veteran smoked at least 10 pack years of cigars before the clinical onset of the condition under consideration and, where smoking had ceased, the clinical onset of the condition under consideration occurred within 10 years of cessation.
4921 the veteran has some period or periods of cigar smoking that are causally related to operational service.
28207 the veteran smoked at least 10 pack years of cigars before the clinical onset of the condition under consideration and, where smoking had ceased, the clinical onset of the condition under consideration occurred within 5 years of cessation.
4922 the veteran has some period or periods of cigar smoking that are causally related to eligible service.
28208 the veteran smoked at least 10 pack years of cigars before the clinical worsening of the condition under consideration and, where smoking had ceased, the clinical worsening of the condition under consideration occurred within 10 years of cessation.
4921 the veteran has some period or periods of cigar smoking that are causally related to operational service.
9196 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the period or periods of cigar smoking are causally related.
28211 the veteran smoked at least 10 pack years of cigars before the clinical worsening of the condition under consideration and, where smoking had ceased, the clinical worsening of the condition under consideration occurred within 5 years of cessation.
4922 the veteran has some period or periods of cigar smoking that are causally related to eligible service.
9197 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the period or periods of cigar smoking are causally related.
This factor deals with the personal use of cigarettes, i.e. it does not include passive smoking.
If there is a history of cigarette smoking it will be necessary to obtain information about:
The evidence gathered should be as complete and accurate as possible. Information already held in departmental files, e.g. 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 [7].
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [12] | CRD905.docx [13] |
Claimant Report | Smoking | CRV905.pdf [14] | CRV905.docx [15] |
10548 the veteran has non-insulin dependent diabetes mellitus (type 2).
5803 the veteran has ever smoked cigarettes.
10588 the veteran has established the causal connection between the cigarette smoking and VEA service for diabetes mellitus.
10589 the veteran has established the causal connection between the cigarette smoking and VEA service for the clinical onset of diabetes mellitus.
10591 the veteran has established the causal connection between the cigarette smoking and operational service for the clinical onset of diabetes mellitus.
or
10592 the veteran has established the causal connection between the cigarette smoking and eligible service for the clinical onset of diabetes mellitus.
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.
10590 the veteran has established the causal connection between the cigarette smoking and VEA service for the clinical worsening of diabetes mellitus.
10593 the veteran has established the causal connection between the cigarette smoking and operational service for the clinical worsening of diabetes mellitus.
or
10594 the veteran has established the causal connection between the cigarette smoking and eligible service for the clinical worsening of diabetes mellitus.
10595 the veteran smoked at least 10 pack years of cigarettes before the clinical onset of the condition under consideration and, where smoking had ceased, the clinical onset of the condition under consideration occurred within 10 years of cessation.
3116 the veteran has some period or periods of cigarette smoking that are causally related to operational service.
10596 the veteran smoked at least 10 pack years of cigarettes before the clinical onset of the condition under consideration and, where smoking had ceased, the clinical onset of the condition under consideration occurred within 5 years of cessation.
3521 the veteran has some period or periods of cigarette smoking that are causally related to eligible service.
10597 the veteran smoked at least 10 pack years of cigarettes before the clinical worsening of the condition under consideration and, where smoking had ceased, the clinical worsening of the condition under consideration occurred within 10 years of cessation.
3116 the veteran has some period or periods of cigarette smoking that are causally related to operational service.
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.
10598 the veteran smoked at least 10 pack years of cigarettes before the clinical worsening of the condition under consideration and, where smoking had ceased, the clinical worsening of the condition under consideration occurred within 5 years of cessation.
3521 the veteran has some period or periods of cigarette smoking that are causally related to eligible service.
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.
Cirrhosis of the liver is sometimes referred to as hepatic cirrhosis. It is characterised by diffuse interlacing bands of fibrous tissue typically dividing the hepatic parenchyma into micronodular or macronodular areas.
There may be no clinical signs as onset is often insidious. A firm, nodular liver may be an early sign of disease; the liver may be either enlarged, normal, or decreased in size. Non-specific symptoms may include fatigue and weakness. Eventually the clinical manifestations of hepatocellular dysfunction and portal hypertension ensue, including progressive jaundice, bleeding from gastroesophageal varices, ascites, and encephalopathy. The abrupt onset of one of these complications may be the first event prompting the patient to seek medical attention. However, routine tests of liver function may be quite normal in cirrhosis. The diagnosis may be based on clinical features together with laboratory findings and can be confirmed by liver biopsy.
The condition may well have been present for some time before it was noted as it can be symptomless and the veteran or member may not have sought medical attention. Once identified a veteran or member would have needed significant medical attention at that time. It would be expected that such medical treatment would be recorded in doctors' notes and/or hospital records. However, if these records cannot be obtained, a reliable history of cirrhosis of the liver 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 cirrhosis of the liver rather than to some other condition.
7784 there is some evidence that cirrhosis of the liver may be a factor in the development or worsening of the condition under consideration.
10548 the veteran has non-insulin dependent diabetes mellitus (type 2).
22586 the veteran has had cirrhosis of the liver at some time.
33823 the veteran has established the causal connection between the cirrhosis of the liver and VEA service for diabetes mellitus.
33825 the veteran had cirrhosis of the liver at the time of the clinical onset of the condition under consideration.
33824 the veteran has established the causal connection between the cirrhosis of the liver and VEA service for the clinical onset of diabetes mellitus.
33828 the veteran has established the causal connection between the cirrhosis of the liver and operational service for the clinical onset of diabetes mellitus.
or
33829 the veteran has established the causal connection between the cirrhosis of the liver and eligible service for the clinical onset of diabetes mellitus.
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.
33826 the veteran had cirrhosis of the liver at the time of the clinical worsening of the condition under consideration.
33827 the veteran has established the causal connection between the cirrhosis of the liver and VEA service for the clinical worsening of diabetes mellitus.
33831 the veteran has established the causal connection between the cirrhosis of the liver and operational service for the clinical worsening of diabetes mellitus.
or
33830 the veteran has established the causal connection between the cirrhosis of the liver and eligible service for the clinical worsening of diabetes mellitus.
22588 the cirrhosis of the liver is causally related to operational service.
22589 the cirrhosis of the liver is causally related to eligible service.
22588 the cirrhosis of the liver is causally related to operational service.
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.
22589 the cirrhosis of the liver is causally related to eligible service.
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.
Gestational diabetes is defined by the RMA as "carbohydrate intolerance of variable severity with onset or first recognition during pregnancy". Gestational diabetes may also be referred to as GDM (gestational diabetes mellitus), GCI (gestational carbohydrate intolerance) or, sometimes, Type III diabetes.
A number of mainly hormonal factors act during pregnancy to increase blood sugar levels. While in most cases, women with normal pancreatic function can maintain blood sugar levels within the normal range during pregnancy, a small percentage of women are unable to do this and develop gestational diabetes. Following delivery, carbohydrate tolerance may return to normal.
If a veteran or member developed gestational diabetes this fact would have been recorded during the pregnancy in doctors' notes and/or hospital records. However, these records may have been destroyed or can no longer be obtained. Therefore, if there is a reliable history of appropriate medical treatment at a particular time, this generally will be accepted, unless there is contradictory evidence. Seek medical advice if it is unclear whether the claimed treatment at that time can be attributed to gestational diabetes rather than to some other condition.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Gestational Diabetes - Diabetes Mellitus | MR9052.pdf [16] | MR9052.docx [17] |
10604 there is some evidence that gestational diabetes may be a factor in the development of the condition under consideration.
8240 the veteran has been pregnant at some time.
10606 the veteran has established the causal connection between the gestational diabetes and VEA service for the clinical onset of diabetes mellitus.
10607 the veteran has established the causal connection between the gestational diabetes and operational service for the clinical onset of diabetes mellitus.
or
10608 the veteran has established the causal connection between the gestational diabetes and eligible service for the clinical onset of diabetes mellitus.
8245 the veteran became pregnant during operational service.
8246 the veteran became pregnant during operational service, as a causal result of operational service.
10601 the veteran's pregnancy as a causal result of operational service resulted in gestational diabetes.
10605 the veteran's pregnancy as a causal result of operational service resulted in gestational diabetes before the clinical onset of the condition under consideration.
10871 the veteran's pregnancy as a causal result of operational service which resulted in gestational diabetes before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
8247 the veteran became pregnant during eligible service.
8248 the veteran became pregnant during eligible service, as a causal result of eligible service.
10826 the veteran's pregnancy as a causal result of eligible service resulted in gestational diabetes.
10827 the veteran's pregnancy as a causal result of eligible service resulted in gestational diabetes before the clinical onset of the condition under consideration.
10872 the veteran's pregnancy on eligible service which resulted in gestational diabetes before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
Hepatitis C means the presence of anti-HCV on serologic testing.
Formerly it was included in the group known as non-A non-B hepatitis, and it is unrelated to other types of hepatitis.
Hepatitis C can be asymptomatic and the first sign may well be the detection of hepatitis C antibodies (anti-HCV) in the blood. Fatigue rather than jaundice is the main symptom for this condition. As the disease becomes chronic and cirrhosis of the liver develops then complications of cirrhosis become evident.
It is quite possible for a veteran or member to be unaware at the time that he or she had been infected with the hepatitis C virus (HCV). However, if there is a reliable history of appropriate symptoms prior to diagnosis of hepatitis C, this generally will be accepted, unless there is contradictory evidence. In other cases, the clinical onset of hepatitis C will be the time when evidence of hepatitis C antibodies or hepatitis C virus is detected. Seek medical advice if the clinical onset of hepatitis C is unclear.
33841 there is some evidence that hepatitis C may be a factor in the development or worsening of the condition under consideration.
10548 the veteran has non-insulin dependent diabetes mellitus (type 2).
2794 the veteran has hepatitis C.
33835 the veteran has established the causal connection between hepatitis C and operational service for diabetes mellitus.
33836 the veteran was suffering from hepatitis C before the clinical onset of diabetes mellitus.
33837 the veteran has established the causal connection between hepatitis C and operational service for the clinical onset of diabetes mellitus.
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.
33838 the veteran was suffering from hepatitis C before the clinical worsening of diabetes mellitus.
33839 the veteran has established the causal connection between hepatitis C and operational service for the clinical worsening of diabetes mellitus.
2799 the hepatitis C is causally related to operational service.
2799 the hepatitis C is causally related to operational service.
33840 the clinical onset of diabetes mellitus occurred prior to that part of operational service to which the hepatitis C is causally related.
Appropriate clinical management of diabetes mellitus may involve management of diet and treatment with insulin or other drugs to control plasma glucose levels. Monitoring of plasma glucose levels is essential.
Inability to obtain appropriate clinical management
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Inability to Obtain Appropriate Clinical Management | GQACM.pdf [18] | GQACM.docx [19] |
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.
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.
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.
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:
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Inability to Undertake Physical Activity | CR9147.pdf [20] | CR9147.docx [21] |
Medical Report | Inability to Undertake Physical Activity | MR9045.pdf [22] | MR9045.docx [23] |
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.
10548 the veteran has non-insulin dependent diabetes mellitus (type 2).
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.
33843 the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and VEA service for diabetes mellitus.
33844 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 diabetes mellitus.
33846 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 diabetes mellitus.
or
33847 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 diabetes mellitus.
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.
33845 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 diabetes mellitus.
33849 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 diabetes mellitus.
or
33848 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 diabetes mellitus.
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.
33850 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 10 years.
33851 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 10 years immediately 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.
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.
33850 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 10 years.
33852 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 10 years immediately 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.
"Being infected with a Coxsackie B virus" is defined by the RMA to mean:
Coxsackie B is one of a heterogeneous group of viruses of the genus Enterovirus, that in humans has a tendency to affect the meninges (membranes that envelope the brain and spinal cord) and occasionally the cerebrum (brain), but which can cause a wide spectrum of clinical illness.
After an incubation period of 3 to 6 days, patients present with an acute onset of fever, malaise, and headache. Many cases include upper respiratory symptoms, and some cases include vomiting and nausea. Symptoms often last 3-4 days and most resolve in a week.
Whether or not a person has been infected with Coxsackie B virus can only be determined by isolation of the virus which may be found in oral secretions, stool, blood and cerebrospinal fluid.
10603 there is some evidence that infection with Coxsackie B virus may be a factor in the development or worsening of the condition under consideration.
10547 the veteran has insulin dependent diabetes mellitus (type 1).
10563 the veteran has been infected with Coxsackie B virus at some time.
10564 the veteran has established the causal connection between the Coxsackie B virus and operational service for diabetes mellitus.
10571 the veteran was infected with Coxsackie B virus before the clinical onset of the condition under consideration.
10567 the veteran has established the causal connection between the Coxsackie B virus and operational service for the clinical onset of diabetes mellitus.
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.
10572 the veteran was infected with Coxsackie B virus before the clinical worsening of the condition under consideration.
10569 the veteran has established the causal connection between the Coxsackie B virus and operational service for the clinical worsening of diabetes mellitus.
10573 on operational service, the veteran was infected with Coxsackie B virus before the clinical onset of the condition under consideration.
10867 the infection with Coxsackie B virus on operational service before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
28194 on operational service, the veteran was infected with Coxsackie B virus before the clinical worsening of the condition under consideration.
28195 as a causal result of operational service, the veteran was infected with Coxsackie B virus before the clinical worsening of the condition under consideration.
28197 the infection with Coxsackie B virus on operational service before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
The diabetes mellitus SOP includes a factor of 'being obese'. This term is defined in the SOP. The RMA has also issued a SOP for morbid obesity. If there is a history of "being obese" but the claim for diabetes mellitus does not succeed via this factor, you will be asked to consider whether there is a history of morbid obesity, as this is an extreme form of obesity.
In this Statement of Principles the Repatriation Medical Authority has defined being obese as meaning "an increase in body weight by way of fat accumulation which results in a Body Mass Index (BMI) of 30 or greater.
The measurement used to define "being obese" is the Body Mass Index (BMI).
W is the person’s weight in kilograms and
H is the person’s height in metres.
If it is not possible to obtain specific height/weight measurements, a medical comment that the veteran or member was obese will be sufficient. If height/weight measurements can be obtained, the BMI formula should be applied.
A history of obesity may be documented in the evidence. However, the veteran or member may not have sought medical attention and the condition may not have been recorded in medical records. In addition, doctors' and hospitals' records may have been destroyed or can no longer be obtained.
Therefore, a statement by the veteran about his or her weight at a particular time will generally be accepted, unless there is contradictory evidence. This weight can then be used to calculate whether the veteran was obese at that time.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Obesity | CR9230.pdf [24] | CR9230.docx [25] |
Medical Report | Obesity | MR9305.pdf [26] | MR9305.docx [27] |
10548 the veteran has non-insulin dependent diabetes mellitus (type 2).
587 the veteran has a history of obesity.
10577 the veteran has established the causal connection between the obesity and VEA service for diabetes mellitus.
10578 the veteran has established the causal connection between the obesity and VEA service for the clinical onset of diabetes mellitus.
10580 the veteran has established the causal connection between the obesity and operational service for the clinical onset of diabetes mellitus.
or
10581 the veteran has established the causal connection between the obesity and eligible service for the clinical onset of diabetes mellitus.
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.
10579 the veteran has established the causal connection between the obesity and VEA service for the clinical worsening of diabetes mellitus.
10582 the veteran has established the causal connection between the obesity and operational service for the clinical worsening of diabetes mellitus.
or
10583 the veteran has established the causal connection between the obesity and eligible service for the clinical worsening of diabetes mellitus.
28202 the obesity was present for at least five years.
33976 the obesity was present for at least five years before the clinical onset of the condition under consideration.
591 the obesity was caused by operational service.
or
9004 the veteran has a history of morbid obesity.
33979 the morbid obesity was present for at least five years before the clinical onset of the condition under consideration.
9005 the morbid obesity is causally related to operational service.
33978 the obesity was present for at least ten years.
10584 the obesity was present for at least ten years before the clinical onset of the condition under consideration.
3407 the obesity was caused by eligible service.
or
9004 the veteran has a history of morbid obesity.
10586 the morbid obesity was present for at least ten years before the clinical onset of the condition under consideration.
9006 the morbid obesity is causally related to eligible service.
28202 the obesity was present for at least five years.
33977 the obesity was present for at least five years before the clinical worsening of the condition under consideration.
591 the obesity was caused by operational service.
17309 the clinical onset of the condition under consideration occurred prior to that part of operational service which caused the obesity.
or
9004 the veteran has a history of morbid obesity.
33980 the morbid obesity was present 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.
33978 the obesity was present for at least ten years.
10585 the obesity was present for at least ten years before the clinical worsening of the condition under consideration.
3407 the obesity was caused by eligible service.<
17310 the clinical onset of the condition under consideration occurred prior to that part of eligible service which caused the obesity.
or
9004 the veteran has a history of morbid obesity.
10587 the morbid obesity was present for at least ten 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.
If there is a history of pipe smoking it will be necessary to obtain information about:
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 [7].
Note: 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".
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [12] | CRD905.docx [13] |
Claimant Report | Smoking | CRV905.pdf [14] | CRV905.docx [15] |
26927 there is some evidence that pipe smoking may be a factor in the development or worsening of the condition under consideration.
10548 the veteran has non-insulin dependent diabetes mellitus (type 2).
28319 the veteran has established the causal connection between the pipe smoking and VEA service for diabetes mellitus.
28320 the veteran has established the causal connection between the pipe smoking and VEA service for the clinical onset of diabetes mellitus.
28323 the veteran has established the causal connection between the pipe smoking and operational service for the clinical onset of diabetes mellitus.
or
28324 the veteran has established the causal connection between the pipe smoking and eligible service for the clinical onset of diabetes mellitus.
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.
28321 the veteran has established the causal connection between the pipe smoking and VEA service for the clinical worsening of diabetes mellitus.
28322 the veteran has established the causal connection between the pipe smoking and operational service for the clinical worsening of diabetes mellitus.
or
28325 the veteran has established the causal connection between the pipe smoking and eligible service for the clinical worsening of diabetes mellitus.
28214 the veteran smoked at least 10 pack years of pipe tobacco before the clinical onset of the condition under consideration and, where smoking had ceased, the clinical onset of the condition under consideration occurred within 10 years of cessation.
4911 the veteran has some period or periods of pipe smoking that are causally related to operational service.
28213 the veteran smoked at least 10 pack years of pipe tobacco before the clinical onset of the condition under consideration and, where smoking had ceased, the clinical onset of the condition under consideration occurred within 5 years of cessation.
4913 the veteran has some period or periods of pipe smoking that are causally related to eligible service.
28212 the veteran smoked at least 10 pack years of pipe tobacco before the clinical worsening of the condition under consideration and, where smoking had ceased, the clinical worsening of the condition under consideration occurred within 10 years of cessation.
4911 the veteran has some period or periods of pipe smoking that are causally related to operational service.
9204 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the period or periods of pipe smoking are causally related.
28215 the veteran smoked at least 10 pack years of pipe tobacco before the clinical worsening of the condition under consideration and, where smoking had ceased, the clinical worsening of the condition under consideration occurred within 5 years of cessation.
4913 the veteran has some period or periods of pipe smoking that are causally related to eligible service.
9205 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the period or periods of pipe smoking are causally related.
Being pregnant refers to the physical state of a female from the time of conception to parturition (birth or abortion). Hence, a pregnancy exists at any time there is a developing embryo or foetus in the body. A pregnancy may or may not continue to full term, which is approximately 267 days.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Pregnancy | CR9027.pdf [28] | CR9027.docx [29] |
10611 there is some evidence that pregnancy 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.
8240 the veteran has been pregnant at some time.
10613 the veteran has established the causal connection between the pregnancy and VEA service for the clinical worsening of diabetes mellitus.
10614 the veteran has established the causal connection between the pregnancy and operational service for the clinical worsening of diabetes mellitus.
or
10615 the veteran has established the causal connection between the pregnancy and eligible service for the clinical worsening of diabetes mellitus.
8245 the veteran became pregnant during operational service.
8246 the veteran became pregnant during operational service, as a causal result of operational service.
10612 at the time of the clinical worsening of the condition under consideration the veteran was pregnant as a causal result of operational service.
26890 the clinical onset of the condition under consideration occurred before the veteran became pregnant on operational service, as a causal result of operational service.
10873 the veteran's pregnancy during operational service before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
8247 the veteran became pregnant during eligible service.
8248 the veteran became pregnant during eligible service, as a causal result of eligible service.
10825 at the time of the clinical worsening of the condition under consideration the veteran was pregnant as a causal result of eligible service.
26893 the clinical onset of the condition under consideration occurred before the veteran became pregnant on eligible service, as a causal result of eligible service.
10874 the veteran's pregnancy during eligible service before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
Serum 2,3,7,8-TCDD is defined by the RMA as meaning "2,3,7,8-tetrachlorodibenzo-para-dioxin as measured from an appropriately derived blood sample".
Note: Testing is no longer required to measure serum dioxin levels after changes to these factors in the SOPs issued on 13 July 2011. The new factors only require inhaling, ingesting or having cutaneous contact with the chemical agent over specified time frames. There are now also clinical worsening factors available.
Requirements for RH SOP are now:
inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD),
Requirements for BOP SOP are now:
Note: The Rulebase has not been updated to reflect these changes as yet, so you may need to use the override or 'make' facility to record your decision if a new factor applies in the case you are assessing.
28281 there is some evidence that the presence of serum 2,3,7,8-TCDD may be a factor in the development of the condition under consideration.
28283 the veteran has established the causal connection between the presence of serum 2,3,7,8-TCDD and VEA service for the clinical onset of diabetes mellitus.
28284 the veteran has established the causal connection between the presence of serum 2,3,7,8-TCDD and operational service for the clinical onset of diabetes mellitus.
or
28285 the veteran has established the causal connection between the presence of serum 2,3,7,8-TCDD and eligible service for the clinical onset of diabetes mellitus.
28287 the veteran had a serum 2,3,7,8-TCDD level of at least 10 ppt at the time of the clinical onset of the condition under consideration as a causal result of operational service.
28288 the serum 2,3,7,8-TCDD level of at least 10 ppt on operational service at the time of the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
28291 the veteran had a serum 2,3,7,8-TCDD level of at least 20 ppt at the time of the clinical onset of the condition under consideration as a causal result of eligible service.
28293 the serum 2,3,7,8-TCDD level of at least 20 ppt on eligible service at the time of the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
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.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [12] | CRD905.docx [13] |
Claimant Report | Smoking | CRV905.pdf [14] | CRV905.docx [15] |
10548 the veteran has non-insulin dependent diabetes mellitus (type 2).
30303 the veteran has smoked cigarettes, cigars or pipe tobacco at some time.
33781 the veteran has established the causal connection between smoking tobacco products and VEA service for diabetes mellitus.
33782 the veteran has established the causal connection between smoking tobacco products and VEA service for the clinical onset of diabetes mellitus.
33784 the veteran has established the causal connection between smoking tobacco products and operational service for the clinical onset of diabetes mellitus.
or
33785 the veteran has established the causal connection between smoking tobacco products and eligible service for the clinical onset of diabetes mellitus.
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.
33783 the veteran has established the causal connection between smoking tobacco products and VEA service for the clinical worsening of diabetes mellitus.
33787 the veteran has established the causal connection between smoking tobacco products and operational service for the clinical worsening of diabetes mellitus.
or
33786 the veteran has established the causal connection between smoking tobacco products and eligible service for the clinical worsening of diabetes mellitus.
33788 the veteran smoked at least 10 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of diabetes mellitus and, where smoking had ceased, the clinical onset of the condition under consideration occurred within 10 years of cessation.
33789 smoking as a causal result of operational service made a material contribution to the Statement of Principles requirements for the clinical onset of diabetes mellitus.
33790 the veteran smoked at least 10 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of diabetes mellitus and, where smoking had ceased, the clinical onset of the condition under consideration occurred within 5 years of cessation.
33791 smoking as a causal result of eligible service made a material contribution to the Statement of Principles requirements for the clinical onset of diabetes mellitus.
33792 the veteran smoked at least 10 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of diabetes mellitus and, where smoking had ceased, the clinical worsening of the condition under consideration occurred within 10 years of cessation.
34221 the veteran's smoking of at least 10 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 diabetes mellitus.
33803 smoking as a causal result of operational service made a material contribution to the Statement of Principles requirements for the clinical worsening of diabetes mellitus.
33454 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the smoking is causally related.
33793 the veteran smoked at least 10 pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of diabetes mellitus and, where smoking had ceased, the clinical worsening of the condition under consideration occurred within 5 years of cessation.
34221 the veteran's smoking of at least 10 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 diabetes mellitus.
33805 smoking as a causal result of eligible service made a material contribution to the Statement of Principles requirements for the clinical worsening of diabetes mellitus.
33459 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the smoking is causally related.
The following conditions have been grouped together as they have the same CCPS rulebase structure.
28220 there is some evidence that suffering from one of the specified conditions may be a factor in the development or worsening of the condition under consideration.
28221 the veteran has suffered from one of the specified conditions for diabetes mellitus at some time.
10617 the veteran has suffered from acute pancreatitis at some time.
or
1360 the veteran has had chronic pancreatitis at some time.
or
196 the veteran has malignant neoplasm of the pancreas.
or
10673 the veteran has had cystic fibrosis at some time.
or
8677 the veteran has haemochromatosis.
or
622 the veteran has had Cushing's syndrome at some time.
or
10714 the veteran has had acromegaly at some time.
or
31142 the veteran has suffered from phaeochromocytoma at some time.
28222 the veteran has established the causal connection between suffering from one of the specified conditions for diabetes mellitus and VEA service for diabetes mellitus.
28223 the veteran was suffering from the identified illness or injury, a condition specified for diabetes mellitus, before the clinical onset of the condition under consideration.
28224 the veteran has established the causal connection between suffering from one of the specified conditions for diabetes mellitus and VEA service for the clinical onset of diabetes mellitus.
28230 the veteran has established the causal connection between suffering from one of the specified conditions for diabetes mellitus and operational service for the clinical onset of diabetes mellitus.
or
28229 the veteran has established the causal connection between suffering from one of the specified conditions for diabetes mellitus and eligible service for the clinical onset of diabetes mellitus.
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.
28226 the veteran was suffering from the identified illness or injury, a condition specified for diabetes mellitus, before the clinical worsening of the condition under consideration.
28225 the veteran has established the causal connection between suffering from one of the specified conditions for diabetes mellitus and VEA service for the clinical worsening of diabetes mellitus.
28227 the veteran has established the causal connection between suffering from one of the specified conditions for diabetes mellitus and operational service for the clinical worsening of diabetes mellitus.
or
28228 the veteran has established the causal connection between suffering from one of the specified conditions for diabetes mellitus and eligible service for the clinical worsening of diabetes mellitus.
Clinical onset and operational service [28230]
28231 the identified illness or injury, a condition specified for diabetes mellitus, is causally related to operational service.
Clinical onset and eligible service [28229]
28232 the identified illness or injury, a condition specified for diabetes mellitus, is causally related to eligible service.
Clinical worsening and operational service [28227]
28231 the identified illness or injury, a condition specified for diabetes mellitus, is causally related to operational service.
28234 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a condition specified for diabetes mellitus, is causally related.
Clinical worsening and eligible service [28228]
28232 the identified illness or injury, a condition specified for diabetes mellitus, is causally related to eligible service.
28233 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a condition specified for diabetes mellitus, is causally related.
Surgery to the pancreas usually involves resection (removal by cutting) of all or part of the pancreas. Surgery may be undertaken because of pancreatic infection, a pancreatic pseudocyst, stricture of the pancreatic duct, pain relief in chronic pancreatitis, and pancreatic cancer. Pancreatic surgery may also be required following severe blunt or penetrating trauma to the pancreas.
There may be reference to pancreatic debridement (cutting away damaged or infected tissue), distal pancreatectomy, Whipple operation (pancreatoduodenectomy), pancreaticojejunostomy or total pancreatectomy.
If a veteran or member had undergone surgery to the pancreas this would be recorded in doctors' notes and/or hospital records. However, these records may have been destroyed or can no longer be obtained. Therefore, if there is a reliable history of pancreatic surgery at a particular time, this generally will be accepted, unless there is contradictory evidence. Seek medical advice if it is unclear whether the claimed history of surgery to the pancreas is medically feasible.
10656 there is some evidence that surgery to the pancreas may be a factor in the development or worsening of the condition under consideration.
10657 the veteran has undergone surgery to the pancreas at some time.
10659 the veteran underwent surgery to the pancreas for treatment of an illness or injury which is identifiable.
10658 the veteran has established the causal connection between the surgery to the pancreas and VEA service for diabetes mellitus.
10666 for treatment of the identified illness or injury, the veteran underwent surgery to the pancreas before the clinical onset of the condition under consideration.
10660 the veteran has established the causal connection between the surgery to the pancreas and VEA service for the clinical onset of diabetes mellitus.
10662 the veteran has established the causal connection between the surgery to the pancreas and operational service for the clinical onset of diabetes mellitus.
or
10663 the veteran has established the causal connection between the surgery to the pancreas and eligible service for the clinical onset of diabetes mellitus.
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.
28532 for treatment of the identified illness or injury, the veteran underwent surgery to the pancreas before the clinical worsening of the condition under consideration.
10661 the veteran has established the causal connection between the surgery to the pancreas and VEA service for the clinical worsening of diabetes mellitus.
10664 the veteran has established the causal connection between the surgery to the pancreas and operational service for the clinical worsening of diabetes mellitus.
or
10665 the veteran has established the causal connection between the surgery to the pancreas and eligible service for the clinical worsening of diabetes mellitus.
10668 the identified illness or injury for which surgery to the pancreas was undergone is causally related to operational service.
10669 the identified illness or injury for which surgery to the pancreas was undergone is causally related to eligible service.
10668 the identified illness or injury for which surgery to the pancreas was undergone is causally related to operational service.
10670 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 surgery to the pancreas was undergone is causally related.
10669 the identified illness or injury for which surgery to the pancreas was undergone is causally related to eligible service.
10671 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 surgery to the pancreas was undergone is causally related.
A drug reported to have caused hyperglycaemia is defined by the RMA as meaning "a drug reported to have caused hyperglycaemia in the published peer-reviewed medical literature". Peer-reviewed medical literature means published in peer-reviewed medical journals.
Relevant drugs can be identified from:
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Treatment with a Drug causing Hyperglycaemia - Diabetes Mellitus | MR9213.pdf [30] | MR9213.docx [31] |
28243 there is some evidence that treatment with a drug reported to have caused hyperglycaemia may be a factor in the development or worsening of the condition under consideration.
28244 the veteran has been treated with a drug reported to have caused hyperglycaemia at some time.
28248 the veteran was treated with a drug reported to have caused hyperglycaemia for an illness or injury which is identifiable.
28245 the identified illness or injury for which the veteran was treated with a drug reported to have caused hyperglycaemia, is a condition for which the drug cannot be ceased or substituted.
28246 the veteran has established the causal connection between the treatment with a drug reported to have caused hyperglycaemia and VEA service for diabetes mellitus.
28258 the veteran was being treated with a drug reported to have caused hyperglycaemia for the identified illness or injury, for which the drug cannot be ceased or substituted, at the time of the clinical onset of the condition under consideration.
28247 the veteran has established the causal connection between the treatment with a drug reported to have caused hyperglycaemia and VEA service for the clinical onset of diabetes mellitus.
28252 the veteran has established the causal connection between the treatment with a drug reported to have caused hyperglycaemia and operational service for the clinical onset of diabetes mellitus.
or
28253 the veteran has established the causal connection between the treatment with a drug reported to have caused hyperglycaemia and eligible service for the clinical onset of diabetes mellitus.
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.
28249 the veteran was being treated with a drug reported to have caused hyperglycaemia for the identified illness or injury, for which the drug cannot be ceased or substituted, at the time of the clinical worsening of the condition under consideration.
28250 the veteran has established the causal connection between the treatment with a drug reported to have caused hyperglycaemia and VEA service for the clinical worsening of diabetes mellitus.
28251 the veteran has established the causal connection between the treatment with a drug reported to have caused hyperglycaemia and operational service for the clinical worsening of diabetes mellitus.
or
28254 the veteran has established the causal connection between the treatment with a drug reported to have caused hyperglycaemia and eligible service for the clinical worsening of diabetes mellitus.
28259 the identified illness or injury for which the veteran was being treated with a drug reported to have caused hyperglycaemia is causally related to operational service.
28260 the identified illness or injury for which the veteran was being treated with a drug reported to have caused hyperglycaemia is causally related to eligible service.
28259 the identified illness or injury for which the veteran was being treated with a drug reported to have caused hyperglycaemia is causally related to operational service.
28261 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 veteran was being treated with a drug reported to have caused hyperglycaemia is causally related.
28260 the identified illness or injury for which the veteran was being treated with a drug reported to have caused hyperglycaemia is causally related to eligible service.
28262 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 veteran was being treated with a drug reported to have caused hyperglycaemia is causally related.
Immunosuppressive drugs are defined by the RMA as meaning "drugs or agents capable of suppressing immune system responses".
If a veteran or member had undergone organ transplantation, he or she must have been treated with immunosuppressive drugs (and, at least initially, this would have been at least on a daily basis). However, the converse is not necessarily true ie treatment with immunosuppressive drugs does not necessarily mean that the person has undergone organ transplantation. If a person had undergone organ transplantation, this would be recorded in doctors' notes and/or hospital records. However, these records may have been destroyed or can no longer be obtained. Therefore, if there is a reliable history of organ transplantation at a particular time, this generally will be accepted, unless there is contradictory evidence.
10791 there is some evidence that immunosuppressive drugs taken for an organ transplantation may be a factor in the development or worsening of the condition under consideration.
2365 the veteran has had an organ transplantation at some time.
10792 the organ transplantation required the veteran to be treated with immunosuppressive drugs. [Default true]
10793 the organ transplantation requiring the veteran to be treated with immunosuppressive drugs was for treatment of an illness or injury which is identifiable. [Default true]
10794 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and VEA service for diabetes mellitus.
28264 as a consequence of the identified illness or injury, the veteran was being treated with immunosuppressive drugs for organ transplantation at the time of the clinical onset of the condition under consideration.
10795 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and VEA service for the clinical onset of diabetes mellitus.
10797 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and operational service for the clinical onset of diabetes mellitus.
or
10798 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and eligible service for the clinical onset of diabetes mellitus.
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.
10802 as a consequence of the identified illness or injury, the veteran was being treated with immunosuppressive drugs for organ transplantation at the time of the clinical worsening of the condition under consideration.
10796 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and VEA service for the clinical worsening of diabetes mellitus.
10799 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and operational service for the clinical worsening of diabetes mellitus.
or
10800 the veteran has established the causal connection between the treatment with immunosuppressive drugs for organ transplantation and eligible service for the clinical worsening of diabetes mellitus.
2371 the identified illness or injury for which the organ transplant was given is causally related to operational service.
10264 the identified illness or injury for which the organ transplant was given is causally related to eligible service.
2371 the identified illness or injury for which the organ transplant was given is causally related to operational service.
10803 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury which required the organ transplantation is causally related.
10264 the identified illness or injury for which the organ transplant was given is causally related to eligible service.
10804 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury which required the organ transplantation is causally related.
Pentamidine injections (Pentacarinat) are used in the treatment of rare infections such as pneumocystis carinii pneumonia (PCP) - particularly due to AIDS, and leishmaniasis. Pentamidine can permanently destroy beta cells of the pancreas. For PCP the usual dose is once daily by IV injection for 14 days. For leishmaniasis the usual dose is 3 times a week to a maximum of 10 injections.
28237 there is some evidence that treatment with pentamidine may be a factor in the development or worsening of the condition under consideration.
10979 the veteran has been treated with pentamidine at some time.
10747 the veteran was treated with pentamidine for an illness or injury which is identifiable.
10748 the veteran has established the causal connection between the treatment with pentamidine and VEA service for diabetes mellitus.
28238 the veteran was treated with pentamidine for the identified illness or injury within the two years immediately before the clinical onset of the condition under consideration.
10749 the veteran has established the causal connection between the treatment with pentamidine and VEA service for the clinical onset of diabetes mellitus.
10753 the veteran has established the causal connection between the treatment with pentamidine and operational service for the clinical onset of diabetes mellitus.
or
10754 the veteran has established the causal connection between the treatment with pentamidine and eligible service for the clinical onset of diabetes mellitus.
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.
28239 the veteran was treated with pentamidine for the identified illness or injury within the two years immediately before the clinical worsening of the condition under consideration.
10750 the veteran has established the causal connection between the treatment with pentamidine and VEA service for the clinical worsening of diabetes mellitus.
10755 the veteran has established the causal connection between the treatment with pentamidine and operational service for the clinical worsening of diabetes mellitus.
or
10756 the veteran has established the causal connection between the treatment with pentamidine and eligible service for the clinical worsening of diabetes mellitus.
28240 the identified illness or injury for which the treatment with pentamidine was given is causally related to operational service.
28241 the identified illness or injury for which the treatment with pentamidine was given is causally related to eligible service.
28240 the identified illness or injury for which the treatment with pentamidine was given is causally related to operational service.
10763 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 treatment with pentamidine was given is causally related.
28241 the identified illness or injury for which the treatment with pentamidine was given is causally related to eligible service.
10764 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 treatment with pentamidine was given is causally related.
[This information was provided in September 1999 by the Medical Services Section, Canberra]
The chemical TCDD (or more correctly, 2,3,7,8-tetrachlorodibenzo-p-dioxin) is an unwanted by-product of the manufacture of 2,4,5-T (2,4,5 trichlorophenoxyacetic acid). Unfortunately, 2,4,5-T manufactured during the 1950s and 1960s was contaminated with TCDD.
The first conflict in which TCDD-contaminated herbicides were used was the Korean War. No use of these chemicals was made in World war Two, or during the occupation of Japan following World war Two.
The use that was made in Korea was very small. In general, Korea had very little vegetation that was suitable for the use of herbicides. It is believed that the use was confined to U.S. personnel. There is no known record of any Australian using TCDD -contaminated herbicide in Korea.
The chemicals were again used in the Malayan emergency. In Malaya, they were used by British troops, but there is no record of Australians using the herbicides. There is no record of the chemicals being used in Borneo during the confrontation with Indonesia.
The chemicals were used extensively in Vietnam by US forces, and by forces associated with the Army of the Republic of Vietnam (ARVN) or South Vietnam. The use by Australian troops during the Vietnam conflict was very restricted. Use of the chemical began prior to the arrival of Australian forces in Vietnam.
Use of the chemicals in Vietnam was suspended in 1970, and there has been no use of the chemicals since that time in any operational deployment.
The use of TCDD-contaminated herbicides by Australian personnel in Vietnam was very restricted, and is confined to two specific events.
The first event, (described in the First Report (November 1982) of the Senate’s Standing Committee on Science and the Environment report into ‘Pesticides and the Health of Australian Vietnam Veterans’) was in December of 1967 and January of 1968.
At that time, the Australian army tested various herbicides. The personnel who are known to be directly involved in this testing are Mr G A Lugg and Major E S Holt. No other personnel were involved in this particular application of 2,4,5-T. They sprayed a minute amount (20mls) of 2,4,5-T. As a result of these tests, the Australian army concluded that there were other herbicides that were superior to 2,4,5-T, and decided to make no further use of the chemical.
The second incident (described in the Final Report of the Evatt ‘Royal Commission on the Use and Effects of Chemical Agents on Australian Personnel in Vietnam’ (July 1985) of the Senate Standing Committee on Science and the Environment) occurred on July 28 1968.
At that time, the Australian Task Force had run out of the herbicide that they usually used. As part of Operation Santa Fe, it was decided to destroy an enemy garden near the village of Thua Tich.
The hygiene officer, Major J C Rhodes, decided to use some supplies of Agent Orange that had been obtained from US sources. He participated in the mission himself, and there were three other personnel on the helicopter (one pilot and two gunners). The helicopter flew two sorties. There were also a number of field hygiene personnel who mixed the herbicides earlier in the day. National Office has a list of those individuals (10 personnel) who were members of the Field Hygiene Company on that day.
There are no other recorded incidents of Australian personnel using dioxin-contaminated herbicides. Neither of the recorded incidents described above, would satisfy the conditions set down in the Statement of Principles.
The Australian armed forces probably used 2,4,5-T during the 1950s and 1960s in Australia, as the chemical was in widespread civilian use at that time. As far as operational deployments are concerned, the available evidence is that the Australian armed forces choose to use other herbicides.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Work Involving 2,3,7,8-TCDD (dioxin) Contaminated Herbicides | CR9178.pdf [32] | CR9178.docx [33] |
28266 there is some evidence that exposure to 2,3,7,8-TCDD contaminated herbicides may be a factor in the development of the condition under consideration.
28268 the veteran has established the causal connection between the exposure to 2,3,7,8-TCDD contaminated herbicides and VEA service for the clinical onset of diabetes mellitus.
28269 the veteran has established the causal connection between the exposure to 2,3,7,8-TCDD contaminated herbicides and operational service for the clinical onset of diabetes mellitus.
or
28270 the veteran has established the causal connection between the exposure to 2,3,7,8-TCDD contaminated herbicides and eligible service for the clinical onset of diabetes mellitus.
28271 on operational service, the veteran undertook work involving 2,3,7,8-TCDD contaminated herbicides.
28272 the veteran undertook work involving 2,3,7,8-TCDD contaminated herbicides on more days than not during a period of at least six months before the clinical onset of the condition under consideration.
28273 operational service made a material contribution to the veteran's work involving 2,3,7,8-TCDD contaminated herbicides on more days than not during a period of at least six months before the clinical onset of the condition under consideration.
28275 as a causal result of eligible service duties, the veteran undertook work involving 2,3,7,8-TCDD contaminated herbicides.
28276 the veteran undertook work involving 2,3,7,8-TCDD contaminated herbicides on more days than not during a period of at least two years before the clinical onset of the condition under consideration.
28278 eligible service made a material contribution to the veteran's work involving 2,3,7,8-TCDD contaminated herbicides on more days than not during a period of at least two years before the clinical onset of the condition under consideration.
Links
[1] http://www.rma.gov.au/sops/condition/diabetes-mellitus
[2] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20215.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20223.pdf
[4] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20230.pdf
[5] https://clik.dva.gov.au/user/login?destination=comment/reply/63478%23comment-form
[6] http://www.rma.gov.au/SOP/alpha_ind/d.htm
[7] https://clik.dva.gov.au/compensation-and-support-reference-library/commission-guidelines/cm5030-guideline-claims-assessors-smoking-and-alcohol-related-conditions-and-military-service
[8] https://clik.dva.gov.au/system/files/media/CRD905_6.pdf
[9] https://clik.dva.gov.au/system/files/media/CRD905_5.docx
[10] https://clik.dva.gov.au/system/files/media/CRV905_6.pdf
[11] https://clik.dva.gov.au/system/files/media/CRV905_8.docx
[12] https://clik.dva.gov.au/system/files/media/CRD905_7.pdf
[13] https://clik.dva.gov.au/system/files/media/CRD905_6.docx
[14] https://clik.dva.gov.au/system/files/media/CRV905_7.pdf
[15] https://clik.dva.gov.au/system/files/media/CRV905_9.docx
[16] https://clik.dva.gov.au/system/files/media/MR9052.pdf
[17] https://clik.dva.gov.au/system/files/media/MR9052.docx
[18] https://clik.dva.gov.au/system/files/media/GQACM_16.pdf
[19] https://clik.dva.gov.au/system/files/media/GQACM_16.docx
[20] https://clik.dva.gov.au/system/files/media/CR9147.pdf
[21] https://clik.dva.gov.au/system/files/media/CR9147.docx
[22] https://clik.dva.gov.au/system/files/media/MR9045.pdf
[23] https://clik.dva.gov.au/system/files/media/MR9045.docx
[24] https://clik.dva.gov.au/system/files/media/CR9230_7.pdf
[25] https://clik.dva.gov.au/system/files/media/CR9230_7.docx
[26] https://clik.dva.gov.au/system/files/media/MR9305_8.pdf
[27] https://clik.dva.gov.au/system/files/media/MR9305_8.docx
[28] https://clik.dva.gov.au/system/files/media/CR9027.pdf
[29] https://clik.dva.gov.au/system/files/media/CR9027.docx
[30] https://clik.dva.gov.au/system/files/media/MR9213.pdf
[31] https://clik.dva.gov.au/system/files/media/MR9213.docx
[32] https://clik.dva.gov.au/system/files/media/CR9178.pdf
[33] https://clik.dva.gov.au/system/files/media/CR9178.docx