Reasonable Hypothesis SOP [1] | 65 of 2019 |
Balance of Probabilities SOP [1] | 66 of 2019 |
SOP Bulletin 209 [2]
Irritable bowel syndrome (IBS) is a common, functional gastrointestinal disorder, characterised by chronic abdominal pain and altered bowel habit, in the absence of any organic cause.
The diagnosis of IBS requires the fulfillment of symptom-based diagnostic criteria and an evaluation to exclude underlying organic disease. There needs to be recurrent abdominal pain, on average, at least one day per week in the last three months, where the pain is associated with at least two of the following (1) defecation, (2) a change in stool frequency, or (3) a change in stool form (appearance).
Testing that is appropriate to the circumstances and presenting symptoms in the individual should be undertaken, to exclude organic disease (such as coeliac disease, diverticular disease, cancer or inflammatory bowel disease). Any "alarm features" features such as rectal bleeding, unexplained weight loss, nocturnal or progressive pain signify a need for more extensive investigation, usually including endoscopy/colonoscopy.
The relevant medical specialist is a gastroenterologist.
* another SOP applies
Once the diagnositc criteria in the SOP have been fulfilled the clinical onset can be backdated to when the relevant symptoms commenced.
Clinical worsening of IBS would be evidenced by an increase in the severity or frequency of symptoms. The condition has a chronic course. Symptoms can generally be controlled with diet or lifestyle modifications or medications.
In the SOP for irritable bowel syndrome the RMA has defined a specified psychiatric condition to mean:
(a) a psychiatric condition with features of anxiety, including:
(i) generalised anxiety disorder, ICD code 300.02; or
(ii) panic disorder, ICD code 300.01; or
(iii) adjustment disorder with features of anxiety, ICD code 309.24, 309.28, 309.3, 309.4, or 309.9; or
iv) post traumatic stress disorder, ICD code 309.81; or
(b) a psychiatric condition with depressive features, including:
(i) major depressive disorder, ICD code 296.2 or 296.3; or
(ii) neurotic depression, ICD code 300.4; or
(iii) other depressive disorders, ICD code 311; or
(iv) adjustment disorder with depressed mood, ICD code 309.0, 309.1, 309.4 or 309.28;
(b) (i)-(iii) above are covered by the SOP for depressive disorder.
The conditions named above are not the only psychiatric conditions with features of anxiety or depression. It is possible that a person may have a psychiatric condition with features of anxiety or depression other than the examples listed by the RMA eg anxiety disorder not otherwise specified (ICD 300.00) and obsessive-compulsive disorder (ICD 300.3). Obtain medical advice if the evidence is not clear if a diagnosed psychiatric condition has features of anxiety or depression.
21822 the veteran has suffered from a specified psychiatric condition at some time.
25643 the specified psychiatric condition is an illness or injury which is identifiable.
690 the veteran has established the causal connection between the psychiatric condition, and VEA service for irritable bowel syndrome.
21823 the veteran was suffering from the identified illness or injury, a specified psychiatric condition, within the six months immediately before the clinical onset of irritable bowel syndrome.
21806 the veteran has established the causal connection between the psychiatric condition and VEA service for the clinical onset of irritable bowel syndrome.
21808 the veteran has established the causal connection between the psychiatric condition and operational service for the clinical onset of irritable bowel syndrome.
or
21809 the veteran has established the causal connection between the psychiatric condition and eligible service for the clinical onset of irritable bowel syndrome.
or
21804 the clinical onset of the veteran's irritable bowel syndrome occurred after the end of the veteran's last period of VEA service.
21805 the veteran's irritable bowel syndrome permanently worsened.
21824 the veteran was suffering from the identified illness or injury, a specified psychiatric condition, within the six months immediately before the clinical worsening of irritable bowel syndrome.
21807 the veteran has established the causal connection between the psychiatric condition and VEA service for the clinical worsening of irritable bowel syndrome.
21810 the veteran has established the causal connection between the psychiatric condition and operational service for the clinical worsening of irritable bowel syndrome.
or
21811 the veteran has established the causal connection between the psychiatric condition and eligible service for the clinical worsening of irritable bowel syndrome.
6024 the identified illness or injury, a psychiatric condition, is causally related to operational service.
6026 the identified illness or injury, a psychiatric condition, is causally related to eligible service.
6024 the identified illness or injury, a psychiatric condition, is causally related to operational service.
21859 the clinical onset of irritable bowel syndrome occurred prior to that part of operational service to which the identified illness or injury, a psychiatric condition, is causally related.
6026 the identified illness or injury, a psychiatric condition, is causally related to eligible service.
21860 the clinical onset of irritable bowel syndrome occurred prior to that part of eligible service to which the identified illness or injury, a psychiatric condition, is causally related.
Diarrhoea is the acute onset of the passage of frequent loose watery motions accompanied by a marked urgency to defaecate. For diarrhoea to be a factor in the development of irritable bowel syndrome it must be an acute illness, caused by an infective organism, and of sufficient severity to warrant medical attention, or in the absence of medical intervention, lasting at least four days.
Type | Title | PDF Format | Word Format |
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Claimant Report | An Episode of Severe Diarrhoea |
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Medical Report | An Episode of Severe Diarrhoea |
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692 the veteran has had an episode of severe diarrhoea at some time.
21826 the veteran has suffered from an episode of diarrhoea which required medical intervention at some time.
or
21827 the veteran has suffered from an episode of diarrhoea which lasted for four days at some time.
22282 the veteran has had an episode of severe diarrhoea which was due to an infective organism at some time.
21825 the veteran has established the causal connection between the episode of severe diarrhoea and VEA service for irritable bowel syndrome.
21836 the veteran suffered from an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical onset of irritable bowel syndrome.
21830 the veteran has established the causal connection between the episode of severe diarrhoea and VEA service for the clinical onset of irritable bowel syndrome.
21832 the veteran has established the causal connection between the episode of severe diarrhoea and operational service for the clinical onset of irritable bowel syndrome.
or
21833 the veteran has established the causal connection between the episode of severe diarrhoea and eligible service for the clinical onset of irritable bowel syndrome.
or
21804 the clinical onset of the veteran's irritable bowel syndrome occurred after the end of the veteran's last period of VEA service.
21805 the veteran's irritable bowel syndrome permanently worsened.
21837 the veteran suffered from an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical worsening of irritable bowel syndrome.
21831 the veteran has established the causal connection between the episode of severe diarrhoea and VEA service for the clinical worsening of irritable bowel syndrome.
21834 the veteran has established the causal connection between the episode of severe diarrhoea and operational service for the clinical worsening of irritable bowel syndrome.
or
21835 the veteran has established the causal connection between the episode of severe diarrhoea and eligible service for the clinical worsening of irritable bowel syndrome.
22421 on operational service, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical onset of irritable bowel syndrome.
22422 on eligible service, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical onset of irritable bowel syndrome.
22427 on eligible service, as a causal result of eligible service duties, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical onset of irritable bowel syndrome.
22424 on operational service, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical worsening of irritable bowel syndrome.
22425 on operational service, as a causal result of operational service duties, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical worsening of irritable bowel syndrome.
25639 the clinical onset of irritable bowel syndrome occurred prior to the episode of severe diarrhoea due to an infective organism on operational service.
22423 on eligible service, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical worsening of irritable bowel syndrome.
22426 on eligible service, as a causal result of eligible service duties, the veteran suffered an episode of severe diarrhoea due to an infective organism within the six months immediately before the clinical worsening of irritable bowel syndrome.
25640 the clinical onset of irritable bowel syndrome occurred prior to the episode of severe diarrhoea due to an infective organism on eligible service.
Prisoners of war are identified on the client data base.
The veteran's statement of service will also record the fact that he was a prisoner of war.
The Repatriation Commission has defined a prisoner of war as a veteran who has been confined in a camp, building, prison or other restrictive area as a prisoner of the enemy, even if the confinement was for only a few hours.
30034 there is some evidence that having been a prisoner of war may be a factor in the development of the condition under consideration.
292 the veteran was a prisoner of war at some time.
25485 the veteran was a prisoner of war before the clinical onset of the condition under consideration.
In the case of irritable bowel syndrome appropriate clinical management may include:
After the exclusion of any underlying pathology, routine general physical examinations, and stool examinations for occult blood should be regularly undertaken.
Further information about irritable bowel syndrome can be found in its Diagnostic Criteria contained in the Research module of CCPS.
Inability to obtain appropriate clinical management
Type | Title | PDF Format | Word Format |
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Medical Report | Inability to Obtain Appropriate Clinical Management | ![]() | ![]() |
21841 there is some evidence that an inability to obtain appropriate clinical management for irritable bowel syndrome, may be a factor in the worsening of the condition under consideration.
21804 the clinical onset of the veteran's irritable bowel syndrome occurred after the end of the veteran's last period of VEA service.
21805 the veteran's irritable bowel syndrome permanently worsened.
21842 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome at some time.
21843 the inability to obtain appropriate clinical management for irritable bowel syndrome contributed to the clinical worsening of irritable bowel syndrome.
21845 the veteran has established the causal connection between the inability to obtain appropriate clinical management for irritable bowel syndrome, and VEA service for the clinical worsening of irritable bowel syndrome.
21846 the veteran has established the causal connection between the inability to obtain appropriate clinical management for irritable bowel syndrome, and operational service for the clinical worsening of irritable bowel syndrome.
or
21847 the veteran has established the causal connection between the inability to obtain appropriate clinical management for irritable bowel syndrome, and eligible service for the clinical worsening of irritable bowel syndrome.
21848 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome during operational service.
21849 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome during operational service, as a causal result of operational service duties.
21853 the veteran's inability to obtain appropriate clinical management for irritable bowel syndrome during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.
or
21850 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome because of an illness or injury which is identifiable.
21851 the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for irritable bowel syndrome is causally related to operational service.
21852 the clinical onset of irritable bowel syndrome 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 irritable bowel syndrome is causally related.
21854 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome during eligible service.
21855 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome during eligible service, as a causal result of eligible service duties.
21856 the veteran's inability to obtain appropriate clinical management for irritable bowel syndrome during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.
or
21850 the veteran was unable to obtain appropriate clinical management for irritable bowel syndrome because of an illness or injury which is identifiable.
21857 the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for irritable bowel syndrome is causally related to eligible service.
21858 the clinical onset of irritable bowel syndrome 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 irritable bowel syndrome is causally related.
Links
[1] http://www.rma.gov.au/sops/condition/irritable-bowel-syndrome
[2] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20209_0.pdf
[3] https://clik.dva.gov.au/user/login?destination=comment/reply/63683%23comment-form
[4] http://www.rma.gov.au/SOP/alpha_ind/i.htm
[5] https://clik.dva.gov.au/system/files/media/CR9078.pdf
[6] https://clik.dva.gov.au/system/files/media/CR9078.docx
[7] https://clik.dva.gov.au/system/files/media/MR9112.pdf
[8] https://clik.dva.gov.au/system/files/media/MR9112.docx
[9] https://clik.dva.gov.au/system/files/media/GQACM_16.pdf
[10] https://clik.dva.gov.au/system/files/media/GQACM_16.docx