Reasonable Hypothesis SOP [1] | 11 of 2023 |
Balance of Probabilities SOP [2] | 12 of 2023 |
SOP Bulletin 235 [3]
ICD-10-AM codes: M47.01, M47.02, M47.03, M47.11, M47.12, M47.13, M47.21, M47.22, M47.23, M47.81, M47.82, M47.83, M47.91, M47.92, M47.93 or M50.3
Cervical spondylosis is a degenerative disease affecting the vertebrae, intervertebral discs and facet joints (zygapophyseal joints) of the cervical spine. The cervical spine includes all cervical vertebra from C1 to C7 as well as the cervico-thoracic junction (C7/T1).
The diagnosis requires both clinical manifestations (symptoms and signs) and evidence of relevant bone/joint pathology (osteophytes, disc space narrowing, facet joint degeneration). A diagnosis that is based on imaging (X-ray, CT, MRI) evidence is required for the SOP to apply (see further comments below).
The relevant medical specialist is an orthopaedic surgeon, neuro/spinal surgeon, or rheumatologist.
* another SOP applies - the SOP has the same name unless otherwise specified
# non-SOP condition
The cervical spondylosis SOP includes a condition-specific defintion of clinical onset (thoracolumbar spondylosis is the only other SOP with such a definition).
It is likely that clinical onset will predate the first imaging evidence of degenerative change. This will be a matter of medical judgement, based on the relevant associated symptoms. Neck pain is a non-specific symptom, with other possible causes. The nature and pattern of the symptoms (location, temporal connection, persistence etc.) needs to be consistent with a degenerative origin. Difficulties in assessing onset may arise where a prior acute neck injury, or surgery (e.g. for a disc prolapse) has occurred and symptoms have persisted subsequently. The time to develop clinically apparent spondylosis post injury is variable and dependent on factors such as the nature and extent of the injury and age. Most commonly, spondylosis onset following a joint injury occurs between ages 40 and 50. Onset may be as soon as 5 years post injury, particularly if of older age at the time of injury, but is more likely to be 10 years or more (and up to several decades later), particularly if the injury occurred at a young age (<25). The clinical onset will not be at the time of an initiating trauma/injury. The degeneration takes time to develop following a trauma.
Imaging evidence of joint degeneration does not establish a clinical onset, as clinical manifestations from the degeneration are also required. An attempt should be made to backdate onset to before the time of first imaging evidence, based on the clinical picture and medical advice. However, in the case of a prior injury or joint disorder, in the absence of a change in symptoms, and where a diagnosis of spondylosis has been made, date of first imaging showing degeneration may provide the only available marker for the time of clinical onset.
The natural history of cervical spondylosis is for the degenerative changes to slowly progress and worsen. The symptoms may fluctuate over time and may improve in some cases. Conventional medical therapy and operative treatment may alleviate symptoms but will not slow or reverse the condition.
In exceptional circumstances the diagnosis may be made without imaging, in a person > 50 years, with typical clinical manifestations, and in whom imaging cannot reasonably be undertaken or obtained.
In the factors that can contribute to spondylosis, the RMA specifies the following spinal conditions:
These conditions can result in abnormal distribution of loading forces through the spine. Seek medical advice if unsure if the particular spinal condition fits within the parameters of the RMA definition.
Scoliosis is sometimes a result of diseases of the central nervous system (eg polio, muscular dystrophy), congenital defects of the spine, or uneven leg length.
Necrosis of bone can result from exposure to ionising radiation.
Paget's disease of the spine may result in a vertebral deformity.
Type |
Title |
PDF Format |
Word Format |
---|---|---|---|
Medical Report | A Specified Spinal Condition for Spondylosis | MR9279.pdf [6] | MR9279.docx [7] |
9593 there is some evidence that a condition from the specified list of spinal conditions may be a factor in the development or worsening of the condition under consideration.
9594 the veteran has had a condition from the specified list of spinal conditions at some time.
35550 the veteran's condition from the specified list of spinal conditions affected side and site of the body.
35551 a condition from the specified list of spinal conditions means scoliosis, spondylolisthesis, retrospondylolisthesis, a deformity of a vertebra, a deformity of a joint of a vertebra or necrosis of bone.
35552 the veteran has established the causal connection between the identified illness or injury, a condition from the specified list of spinal conditions, and VEA service for the condition under consideration.
35559 the veteran had the identified illness or injury, a condition of side and site of the body from the specified list of spinal conditions, before the clinical onset of the condition under consideration.
35553 the veteran has established the causal connection between the identified illness or injury, a condition from the specified list of spinal conditions, and VEA service for the clinical onset of the condition under consideration.
35555 the veteran has established the causal connection between the identified illness or injury, a condition from the specified list of spinal conditions, and operational service for the clinical onset of the condition under consideration.
or
35556 the veteran has established the causal connection between the identified illness or injury, a condition from the specified list of spinal conditions, and eligible service for the clinical onset of the condition under consideration.
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.
35560 the veteran had the identified illness or injury, a condition of side and site of the body from the specified list of spinal conditions, before the clinical worsening of the condition under consideration.
35554 the veteran has established the causal connection between the identified illness or injury, a condition from the specified list of spinal conditions, and VEA service for the clinical worsening of the condition under consideration.
35557 the veteran has established the causal connection between the identified illness or injury, a condition from the specified list of spinal conditions, and operational service for the clinical worsening of the condition under consideration.
or
35558 the veteran has established the causal connection between the identified illness or injury, a condition from the specified list of spinal conditions, and eligible service for the clinical worsening of the condition under consideration.
35561 the identified illness or injury, a condition of side and site of the body from the specified list of spinal conditions, is causally related to operational service.
35562 the identified illness or injury, a condition of side and site of the body from the specified list of spinal conditions, is causally related to eligible service.
35561 the identified illness or injury, a condition of side and site of the body from the specified list of spinal conditions, is causally related to operational service.
35563 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 of side and site of the body from the specified list of spinal conditions, is causally related.
35562 the identified illness or injury, a condition of side and site of the body from the specified list of spinal conditions, is causally related to eligible service.
35564 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 of side and site of the body from the specified list of spinal conditions, is causally related.
The SOPs for cervical, lumbar and thoracic spondyloses include factors for “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 spondylosis 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).
The BMI = W/H2 and where:
W is the person’s weight in kilograms and
H is the person’s height in metres".
(For Imperial weights and measures, BMI = wt. in lbs/(ht in inches2) x 703.1).
This definition excludes weight gain not resulting from fat deposition such as gross oedema, peritoneal or pleural effusion, or muscle hypertrophy. "Being obese" develops when energy intake is in excess of expenditure for a sustained period of time.
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 [8] | CR9230.docx [9] |
Medical Report | Obesity | MR9305.pdf [10] | MR9305.docx [11] |
17512 there is some evidence that obesity may be a factor in the development or worsening of the condition under consideration.
587 the veteran has a history of obesity.
25529 the veteran has been obese for a period of at least 10 years at some time.
25530 the veteran has established the causal connection between the long term obesity and VEA service for the condition under consideration.
8661 the veteran has established the causal connection between the long term obesity and VEA service for the clinical onset of the condition under consideration.
8663 the veteran has established the causal connection between the long term obesity and operational service for the clinical onset of the condition under consideration.
or
8664 the veteran has established the causal connection between the long term obesity and eligible service for the clinical onset of the condition under consideration.
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.
25531 the veteran has established the causal connection between the long term obesity and VEA service for the clinical worsening of the condition under consideration.
25533 the veteran has established the causal connection between the long term obesity and operational service for the clinical worsening of the condition under consideration.
or
25532 the veteran has established the causal connection between the long term obesity and eligible service for the clinical worsening of the condition under consideration.
8665 the veteran was obese for at least 10 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.
24666 the veteran was morbidly obese for at least 10 years before the clinical onset of the condition under consideration.
9005 the morbid obesity is causally related to operational service.
8666 the veteran was obese for at least 10 years within the 25 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.
24667 the veteran was morbidly obese for at least 10 years within the 25 years before the clinical onset of the condition under consideration.
9006 the morbid obesity is causally related to eligible service.
25534 the veteran was obese for at least 10 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.
24668 the veteran was morbidly obese for at least 10 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.
25535 the veteran was obese for at least 10 years within the 25 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.
24669 the veteran was morbidly obese for at least 10 years within the 25 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.
This factor in the Statement of Principles for cervical spondylosis requires carrying loads of at least:
15 kilograms for operational service cases, 25 kilograms for eligible service cases, on the head while upright.
To give perspective to a weight of 15 kilograms, 6 reams of A4 paper 80 gsm weighs just less than 15 kilograms.
It is unlikely that service in the Australian military involved carrying such weights on the head - the carrying of loads on the head is more common in countries such as Ghana.
A submission made to the RMA in October 2000 indicated that the new “ballistic” helmet combined with night vision equipment that is worn by armoured vehicle crewman and aircrew, weighed just over 3 kg.
Advice has also been received that the Alpha Military Aircrew Helmet weighs approximately 2 kilograms (advice from Elix-Comet, contacts for Helmet Integrated Systems Ltd).
Physical requirements, duties, and workplace hazards of specific military occupations
Type |
Title |
PDF Format |
Word Format |
---|---|---|---|
Claimant Report | Carrying loads on the head | CR9206.pdf [12] | CR9206.docx [13] |
32142 there is some evidence that carrying loads on the head may be a factor in the development or worsening of the condition under consideration.
32143 the veteran has established the causal connection between carrying loads on the head and VEA service for the condition under consideration.
32144 the veteran has established the causal connection between carrying loads on the head and VEA service for the clinical onset of the condition under consideration.
32146 the veteran has established the causal connection between carrying loads on the head and operational service for the clinical onset of the condition under consideration.
or
32147 the veteran has established the causal connection between carrying loads on the head and eligible service for the clinical onset of the condition under consideration.
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.
32145 the veteran has established the causal connection between carrying loads on the head and VEA service for the clinical worsening of the condition under consideration.
32148 the veteran has established the causal connection between carrying loads on the head and operational service for the clinical worsening of the condition under consideration.
or
32149 the veteran has established the causal connection between carrying loads on the head and eligible service for the clinical worsening of the condition under consideration.
32150 the veteran carried loads of at least 15 kg on the head while upright to a cumulative total of at least 72,000 kg within any 10 year period.
32152 the veteran carried loads of at least 15 kg on the head while upright to a cumulative total of at least 72,000 kg within any 10 year period before the clinical onset of the condition under consideration.
32153 operational service made a material contribution to the veteran carrying loads of at least 15 kg on the head while upright to a cumulative total of at least 72,000 kg within any 10 year period before the clinical onset of the condition under consideration.
32151 the veteran carried loads of at least 25 kg on the head while upright to a cumulative total of at least 120,000 kg within any 10 year period.
32155 the veteran carried loads of at least 25 kg on the head while upright to a cumulative total of at least 120,000 kg within any 10 year period before the clinical onset of the condition under consideration.
32161 the clinical onset of the condition under consideration occurred within the 25 years following the 10 year period during which the veteran carried loads of at least 25 kg on the head while upright to a cumulative total of at least 120,000 kg.
32157 eligible service made a material contribution to the SOP requirements for carrying loads on the head before the clinical onset of the condition under consideration.
32150 the veteran carried loads of at least 15 kg on the head while upright to a cumulative total of at least 72,000 kg within any 10 year period.
34003 the veteran carried loads of at least 15 kg on the head while upright to a cumulative total of at least 72,000 kg within any 10 year period before the clinical worsening of the condition under consideration.
32159 the accumulation within any 10 year period of at least 72,000 kg from carrying loads of at least 15 kg on the head while upright commenced after the clinical onset of the condition under consideration.
32154 operational service made a material contribution to the veteran carrying loads of at least 15 kg on the head while upright to a cumulative total of at least 72,000 kg within any 10 year period before the clinical worsening of the condition under consideration.
32151 the veteran carried loads of at least 25 kg on the head while upright to a cumulative total of at least 120,000 kg within any 10 year period.
32156 the veteran carried loads of at least 25 kg on the head while upright to a cumulative total of at least 120,000 kg within any 10 year period before the clinical worsening of the condition under consideration.
32162 the clinical worsening of the condition under consideration occurred within the 25 years following the 10 year period during which the veteran carried loads of at least 25 kg on the head while upright to a cumulative total of at least 120,000 kg.
32160 the accumulation within any 10 year period of at least 120,000 kg from carrying loads of at least 25 kg on the head while upright commenced after the clinical onset of the condition under consideration.
32158 eligible service made a material contribution to the SOP requirements for carrying loads on the head before the clinical worsening of the condition under consideration.
A cervical intervertebral disc prolapse is a protrusion, herniation or rupture of an intervertebral disc of the cervical spine, causing local pain and stiffness, and may include pain and paraesthesia radiating into the upper limbs.
The cervical spine is the neck extending from the base of the skull down to the start of the rib cage (C1 to C7). The intervertebral discs lie between the adjacent surfaces of the bodies of the vertebrae in the spine, each disc being a highly elastic tissue mass which is compressed between the vertebral surfaces. Degenerative changes gradually cause fragmentation of the nucleus pulposus (soft gelatinous material under tension) and softening of the annulus fibrosus (the periphery of the disc). A portion of the nucleus may protrude through a rent or tear in the softened annulus and may impinge on the adjacent nerve roots or the spinal cord itself.The protrusion may be episodic and may continue intermittently over a period of months or years.In the final stage of the pathological changes commonly described as prolapsed intervertebral disc, the defective disc is replaced by fibrous tissue.
Disc protrusion may occur at any time in adult life.Classically the onset is sudden following a history of spinal strain, and is clearly defined. The pain may be aggravated by coughing or sneezing. Characteristically the symptoms may fluctuate in intensity, or appear intermittently. Paraesthesia, often described as a sensation of "pins and needles" often occurs at some time in the affected limb, and a degree of muscle wasting is often noted.
In some cases there is no prior history of strain or trauma, and the neck pain may begin gradually and not radiate to a limb. The acute symptoms usually subside in a few weeks and recovery from symptoms may occur though the disc protrusion remains. Recurrence of symptoms is common and may occur at frequent intervals.
Intervertebral disc prolapse may be demonstrated by plain X-rays, myelography (X-ray of the spinal cord after injection of a contrast medium), CT (computerised tomography) scan or MRI (magnetic resonance imaging).
Type |
Title |
PDF Format |
Word Format |
---|---|---|---|
Medical Report | Intervertebral Disc Prolapse | MR9113.pdf [14] | MR9113.docx [15] |
22444 the condition under consideration has been accepted on the basis of an intervertebral disc prolapse.
22445 the veteran has had an intervertebral disc prolapse of side and site of the body at some time.
26444 intervertebral disc prolapse means protrusion, herniation or rupture of an intervertebral disc of the cervical, thoracic or lumbar spine, causing local pain and stiffness.
22447 the condition under consideration is at the level of the identified illness or injury.
26445 the veteran has established the causal connection between the intervertebral disc prolapse and VEA service for the condition under consideration.
22446 the veteran had the identified illness or injury before the clinical onset of the condition under consideration at the level of the intervertebral disc prolapse.
22448 the veteran has established the causal connection between the intervertebral disc prolapse and VEA service for the clinical onset of the condition under consideration.
22449 the veteran has established the causal connection between the intervertebral disc prolapse and operational service for the clinical onset of the condition under consideration.
or
22450 the veteran has established the causal connection between the intervertebral disc prolapse and eligible service for the clinical onset of the condition under consideration.
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.
26446 the veteran had the identified illness or injury before the clinical worsening of the condition under consideration at the level of the intervertebral disc prolapse.
26447 the veteran has established the causal connection between the intervertebral disc prolapse and VEA service for the clinical worsening of the condition under consideration.
26448 the veteran has established the causal connection between the intervertebral disc prolapse and operational service for the clinical worsening of the condition under consideration.
or
26449 the veteran has established the causal connection between the intervertebral disc prolapse and eligible service for the clinical worsening of the condition under consideration.
22451 the identified illness or injury is causally related to operational service.
22452 the identified illness or injury is causally related to eligible service.
22451 the identified illness or injury is causally related to operational service.
26450 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury is causally related.
22452 the identified illness or injury is causally related to eligible service.
26451 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury is causally related.
The RMA has defined a depositional joint disease as gout, pseudogout, haemochromatosis, Wilson's disease or ochronosis.
8667 there is some evidence that a depositional joint disease may be a factor in the development or worsening of the condition under consideration.
8668 the veteran has had a depositional joint disease at some time.
1894 the veteran has gout.
or
8676 the veteran has pseudogout.
or
8677 the veteran has haemochromatosis.
or
8678 the veteran has Wilson's disease.
or
8679 the veteran has had ochronosis at some time.
9600 the identified illness or injury, a depositional joint disease, occurred in side and site of the body.
26422 the veteran has established the causal connection between the depositional joint disease and VEA service for the condition under consideration.
25539 the veteran had the identified illness or injury, a depositional joint disease in side and site of the body, before the clinical onset of the condition under consideration.
9602 the veteran has established the causal connection between the depositional joint disease and VEA service for the clinical onset of the condition under consideration.
9603 the veteran has established the causal connection between the depositional joint disease and operational service for the clinical onset of the condition under consideration.
or
9604 the veteran has established the causal connection between the depositional joint disease and eligible service for the clinical onset of the condition under consideration.
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.
25540 the veteran had the identified illness or injury, a depositional joint disease in side and site of the body, before the clinical worsening of the condition under consideration.
26423 the veteran has established the causal connection between the depositional joint disease and VEA service for the clinical worsening of the condition under consideration.
26424 the veteran has established the causal connection between the depositional joint disease and operational service for the clinical worsening of the condition under consideration.
or
26425 the veteran has established the causal connection between the depositional joint disease and eligible service for the clinical worsening of the condition under consideration.
26426 the identified illness or injury, a depositional joint disease in side and site of the body, is causally related to operational service.
26427 the identified illness or injury, a depositional joint disease in side and site of the body, is causally related to eligible service.
26426 the identified illness or injury, a depositional joint disease in side and site of the body, is causally related to operational service.
25544 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a depositional joint disease in side and site of the body, is causally related.
26427 the identified illness or injury, a depositional joint disease in side and site of the body, is causally related to eligible service.
25545 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a depositional joint disease in side and site of the body, is causally related.
The RMA has defined 'high performance aircraft' as meaning "an aircraft capable of routinely sustaining a positive G force of four or more".
The first planes that were "high performance" or "high G" were the fighter planes introduced during World War II, such as Spitfires or Hurricanes. The wearing of anti G suits (to prevent loss of consciousness) became commonplace after WW2, and if worn by the aircrew, is a good indicator that the aircraft was liable to pull high positive Gs in common flight profiles. However, anti G suits would not be worn in heavy bombers, transport, helicopters etc, indicating that sustaining G forces was not an expected part of that aircraft flight profile.
With WW2 aircraft anti-G suits were not necessarily available. In these circumstances it may be necessary to look at the role of the aircraft (were they used in a fighter combat role), or if the aircraft had a number of roles, the role of the claimant (what type of missions did they fly).
The following aircraft may be considered "high performance aircraft". NOTE: this is not an exhaustive list.
Trainers
The following aircraft are not considered "high performance aircraft". NOTE: this is not an exhaustive list.
For aircraft not covered in these lists, the following site lists all RAAF/RAN aircraft:
http://en.wikipedia.org/wiki/List_of_aircraft_of_t... [16]
Information may also be available from the RAAF. If you need to check whether specific aircraft were capable of routinely sustaining +4G, submit a request through DocTracker and the Single Access Mechanism (SAM) group will endeavour to obtain the information.
Any relevant information obtained about additional aircraft should be forwarded to DVA's Decision Support Unit so that CCPS commentary may be updated.
· Exposure to positive G forces of 4 or more
· Physical requirements, duties, and workplace hazards of specific military occupations
Type |
Title |
PDF Format |
Word Format |
---|---|---|---|
Claimant Report | Flying in high performance aircraft | CR9207.pdf [17] | CR9207.docx [18] |
32117 there is some evidence that flying in high performance aircraft may be a factor in the development or worsening of the condition under consideration.
32119 the veteran has established the causal connection between flying in high performance aircraft and VEA service for the condition under consideration.
32120 the veteran has established the causal connection between flying in high performance aircraft and VEA service for the clinical onset of the condition under consideration.
32122 the veteran has established the causal connection between flying in high performance aircraft and operational service for the clinical onset of the condition under consideration.
or
32123 the veteran has established the causal connection between flying in high performance aircraft and eligible service for the clinical onset of the condition under consideration.
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.
32121 the veteran has established the causal connection between flying in high performance aircraft and VEA service for the clinical worsening of the condition under consideration.
32124 the veteran has established the causal connection between flying in high performance aircraft and operational service for the clinical worsening of the condition under consideration.
or
32125 the veteran has established the causal connection between flying in high performance aircraft and eligible service for the clinical worsening of the condition under consideration.
32126 the veteran flew in high performance aircraft for a cumulative total of at least 500 hours within any 10 year period.
32128 the veteran flew in high performance aircraft for a cumulative total of at least 500 hours within any 10 year period before the clinical onset of the condition under consideration.
32132 operational service made a material contribution to the veteran's flying in high performance aircraft for a cumulative total of at least 500 hours within any 10 year period before the clinical onset of the condition under consideration.
32127 the veteran flew in high performance aircraft for a cumulative total of at least 1000 hours within any 10 year period.
32129 the veteran flew in high performance aircraft for a cumulative total of at least 1000 hours within any 10 year period before the clinical onset of the condition under consideration.
32138 the clinical onset of the condition under consideration occurred within the 25 years following the 10 year period during which the veteran flew in high performance aircraft for a cumulative total of at least 1000 hours.
32134 eligible service made a material contribution to the SOP requirements for flying in high performance aircraft before the clinical onset of the condition under consideration.
32126 the veteran flew in high performance aircraft for a cumulative total of at least 500 hours within any 10 year period.
32130 the veteran flew in high performance aircraft for a cumulative total of at least 500 hours within any 10 year period before the clinical worsening of the condition under consideration.
32140 the accumulation of at least 500 hours flying in high performance aircraft within any 10 year period commenced after the clinical onset of the condition under consideration.
32135 operational service made a material contribution to the veteran's flying in high performance aircraft for a cumulative total of at least 500 hours within any 10 year period before the clinical worsening of the condition under consideration.
32127 the veteran flew in high performance aircraft for a cumulative total of at least 1000 hours within any 10 year period.
32131 the veteran flew in high performance aircraft for a cumulative total of at least 1000 hours within any 10 year period before the clinical worsening of the condition under consideration.
32139 the clinical worsening of the condition under consideration occurred within the 25 years following the 10 year period during which the veteran flew in high performance aircraft for a cumulative total of at least 1000 hours.
32141 the accumulation of at least 1000 hours flying in high performance aircraft within any 10 year period commenced after the clinical onset of the condition under consideration.
32137 eligible service made a material contribution to the SOP requirements for flying in high performance aircraft before the clinical worsening of the condition under consideration.
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.
Cervical spondylosis is a degenerative disease where gradual worsening is part of the normal course of the disease process. Appropriate clinical management for cervical spondylosis would include anti-inflammatory drugs to reduce pain and inflammation, and if clinically indicated, X-rays, CT (computerised tomography) scan or MRI (magnetic resonance imaging). Physiotherapy and exercise may be recommended, but surgery would be uncommon.
Inability to obtain appropriate clinical management
Type |
Title |
PDF Format |
Word Format |
---|---|---|---|
Medical Report | Inability to Obtain Appropriate Clinical Management | GQACM.pdf [19] | GQACM.docx [20] |
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.
The RMA has defined inflammatory joint disease to mean:
Conditions such as chondromalacia patellae, Paget's disease, osteoporosis, meniscal or ligament damage are not inflammatory joint disease.
8657 there is some evidence that an inflammatory joint disease may be a factor in the development or worsening of the condition under consideration.
8636 the veteran has had an inflammatory joint disease at some time.
20034 the veteran has had Reiter's syndrome at some time.
or
20035 the veteran has had psoriatic arthropathy at some time.
or
20036 the veteran has had ankylosing spondylitis at some time.
or
20038 the veteran has had rheumatoid arthritis at some time.
or
25493 the veteran has had arthritis associated with Crohn's disease at some time.
or
25494 the veteran has had arthritis associated with ulcerative colitis at some time.
8637 the identified illness or injury, an inflammatory joint disease, affected side and site of the body.
9584 the veteran has established the causal connection between the inflammatory joint disease and VEA service for the condition under consideration.
8639 the veteran had the identified illness or injury, an inflammatory joint disease in side and site of the body, before the clinical onset of the condition under consideration.
26403 the veteran has established the causal connection between the inflammatory joint disease and VEA service for the clinical onset of the condition under consideration.
9585 the veteran has established the causal connection between the inflammatory joint disease and operational service for the clinical onset of the condition under consideration.
or
9586 the veteran has established the causal connection between the inflammatory joint disease and eligible service for the clinical onset of the condition under consideration.
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.
25487 the veteran had the identified illness or injury, an inflammatory joint disease in side and site of the body, before the clinical worsening of the condition under consideration.
26404 the veteran has established the causal connection between the inflammatory joint disease and VEA service for the clinical worsening of the condition under consideration.
26405 the veteran has established the causal connection between the inflammatory joint disease and operational service for the clinical worsening of the condition under consideration.
or
26406 the veteran has established the causal connection between the inflammatory joint disease and eligible service for the clinical worsening of the condition under consideration.
26407 the identified illness or injury, an inflammatory joint disease in side and site of the body, is causally related to operational service.
26408 the identified illness or injury, an inflammatory joint disease in side and site of the body, is causally related to eligible service.
26407 the identified illness or injury, an inflammatory joint disease in side and site of the body, is causally related to operational service.
25491 the clinical onset of the condition under consideration occurred prior to that part of the operational service to which the identified illness or injury, an inflammatory joint disease in side and site of the body, is causally related.
26408 the identified illness or injury, an inflammatory joint disease in side and site of the body, is causally related to eligible service.
25492 the clinical onset of the condition under consideration occurred prior to that part of the eligible service to which the identified illness or injury, an inflammatory joint disease in side and site of the body, is causally related.
In the Statement of Principles for osteoarthritis the RMA has defined intra-articular fracture to mean "a fracture involving the articular surface of a joint".
This type of fracture involves the cartilaginous articular surface of one of the bones of a joint or of the vertebral bodies or facet joints of the spine. The articular surface refers to the area of bone involved in the joint, i.e. opposing the other bone(s).
If a person had an intra-articular fracture he or she would have needed significant medical attention at that time. X-ray evidence would have been obtained to demonstrate the presence of a fracture involving the cartilaginous articular surface of one of the bones of the joint. Such medical treatment would normally be recorded in doctors' notes and/or hospital records. However, if these records have been destroyed or can no longer be obtained and there is a reliable history of an intra-articular fracture at a particular time, this generally will 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 an intra-articular fracture rather than to some other condition.
8658 there is some evidence that an intra-articular fracture may be a factor in the development or worsening of the condition under consideration.
4572 the veteran has had an intra-articular fracture at some time.
2485 the veteran has had an intra-articular fracture of side and site of the body at some time.
8829 intra-articular fracture means a fracture involving the articular surface of a joint.
26409 the veteran has established the causal connection between the intra-articular fracture and VEA service for the condition under consideration.
25514 the veteran had the identified illness or injury, an intra-articular fracture of side and site of the body, before the clinical onset of the condition under consideration.
9590 the veteran has established the causal connection between the identified illness or injury, an intra-articular fracture, and VEA service for the clinical onset of the condition under consideration.
9591 the veteran has established the causal connection between the intra-articular fracture and operational service for the clinical onset of the condition under consideration.
or
9592 the veteran has established the causal connection between the intra-articular fracture and eligible service for the clinical onset of the condition under consideration.
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.
25516 the veteran had the identified illness or injury, an intra-articular fracture of side and site of the body, before the clinical worsening of the condition under consideration.
26410 the veteran has established the causal connection between the intra-articular fracture and VEA service for the clinical worsening of the condition under consideration.
26411 the veteran has established the causal connection between the intra-articular fracture and operational service for the clinical worsening of the condition under consideration.
or
26412 the veteran has established the causal connection between the intra-articular fracture and eligible service for the clinical worsening of the condition under consideration.
26413 the identified illness or injury, an intra-articular fracture of side and site of the body, is causally related to operational service.
26414 the identified illness or injury, an intra-articular fracture of side and site of the body, is causally related to eligible service.
Clinical worsening and operational service [26411]
26413 the identified illness or injury, an intra-articular fracture of side and site of the body, is causally related to operational service.
25519 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, an intra-articular fracture of side and site of the body, is causally related.
26414 the identified illness or injury, an intra-articular fracture of side and site of the body, is causally related to eligible service.
25520 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, an intra-articular fracture of side and site of the body, is causally related.
The RMA has defined septic arthritis as "the bacterial infection of a joint resulting in inflammation within that joint".
There are many bacterial infections which can result in septic arthritis, such as tuberculosis, gonorrhoea or infection with staphylococcus aureus ('golden staph'); however the incidence of septic arthritis in all of them is fairly low. Most cases of septic arthritis arise from trauma or follow surgical operations.
Where a joint is involved:
Acute joint pain [most often the knee, followed by the shoulder, wrist, hip, phalanges, and elbow] and stiffness. On examination, the joint is warm, tender, and swollen with evidence of effusion. Other signs of infection [eg, fever, chills, or leukocytosis] usually are present. Diagnosis is by analysis of fluid aspirated from the joint and/or blood cultures. The condition is most often treated with antibiotics.
Vertebral osteomyelitis usually has an insidious onset and a gradually progressive back pain unrelieved by rest, heat or analgesics, and worsened by movement. Fever typically is minimal or absent. Diagnosis is by blood cultures but usually biopsy of the infected bone is required. Treatment usually involves bed rest and an appropriate antimicrobial agent. Surgery may be required.
Acute bacterial arthritis is a medical emergency; the joint may be destroyed if not promptly treated.
If a veteran or member had septic arthritis significant medical attention would have been sought. Such medical treatment would normally be recorded in the medical documents.
26453 there is some evidence that septic arthritis in side and site of the body may be a factor in the development or worsening of the condition under consideration.
25497 the veteran has had septic arthritis at some time.
25498 the veteran has had septic arthritis in side and site of the body at some time.
25499 septic arthritis means the bacterial infection of a joint resulting in inflammation within that joint.
26454 the veteran has established the causal connection between the septic arthritis and VEA service for the condition under consideration.
26516 the veteran had the identified illness or injury, a type of septic arthritis in side and site of the body, before the clinical onset of the condition under consideration.
26455 the veteran has established the causal connection between the septic arthritis and VEA service for the clinical onset of the condition under consideration.
26457 the veteran has established the causal connection between the septic arthritis and operational service for the clinical onset of the condition under consideration.
or
26458 the veteran has established the causal connection between the septic arthritis and eligible service for the clinical onset of the condition under consideration.
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.
26517 the veteran had the identified illness or injury, a type of septic arthritis in side and site of the body, before the clinical worsening of the condition under consideration.
26456 the veteran has established the causal connection between the septic arthritis and VEA service for the clinical worsening of the condition under consideration.
26459 the veteran has established the causal connection between the septic arthritis and operational service for the clinical worsening of the condition under consideration.
or
26460 the veteran has established the causal connection between the septic arthritis and eligible service for the clinical worsening of the condition under consideration.
26461 the identified illness or injury, a type of septic arthritis in side and site of the body, is causally related to operational service.
26462 the identified illness or injury, a type of septic arthritis in side and site of the body, is causally related to eligible service.
26461 the identified illness or injury, a type of septic arthritis in side and site of the body, is causally related to operational service.
26509 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a type of septic arthritis in side and site of the body, is causally related.
26462 the identified illness or injury, a type of septic arthritis in side and site of the body, is causally related to eligible service.
26510 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a type of septic arthritis in side and site of the body, is causally related.
The cervical spine is the area of the neck extending from the base of the skull down to the start of the rib cage, which approximates the level of the shoulders.
Trauma means any type of discrete physical injury [such as a hit, blow, knock, twisting, bending or crushing injury] to the neck, and specifically includes G-force induced injury. It also includes penetrating injuries to the cervical spine as may occur with projectiles such as bullets and shrapnel. Trauma does not include activities such as carrying heavy packs or weight lifting in the gym unless a specific injury occurred during the performance of such activities, eg slipping or falling while carrying a pack.
Type |
Title |
PDF Format |
Word Format |
---|---|---|---|
Claimant Report | Trauma to the Spine | CR9083.pdf [21] | CR9083.docx [22] |
Medical Report | Trauma to the Spine | MR9047.pdf [23] | MR9047.docx [24] |
9580 the condition under consideration has been accepted on the basis of trauma.
26436 the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles.
9612 the veteran has established the causal connection between the trauma and VEA service for the condition under consideration.
9620 the veteran has established the causal connection between the trauma and VEA service for the clinical onset of the condition under consideration.
9622 the veteran has established the causal connection between the trauma and operational service for the clinical onset of the condition under consideration.
or
9623 the veteran has established the causal connection between the trauma and eligible service for the clinical onset of the condition under consideration.
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.
9621 the veteran has established the causal connection between the trauma and VEA service for the clinical worsening of the condition under consideration.
9624 the veteran has established the causal connection between the trauma and operational service for the clinical worsening of the condition under consideration.
or
9625 the veteran has established the causal connection between the trauma and eligible service for the clinical worsening of the condition under consideration.
16924 on operational service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles.
9626 on operational service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least seven days except for where specified medical intervention occurred.
26437 on operational service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least seven days except for where specified medical intervention occurred, before the clinical onset of the condition under consideration.
9629 the trauma to side and site of the body, 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.
or
9631 the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles because of an illness or injury which is identifiable.
20129 as a consequence of the identified illness or injury, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least seven days except for where specified medical intervention occurred.
26438 as a consequence of the identified illness or injury, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least seven days except for where specified medical intervention occurred, before the clinical onset of the condition under consideration.
9632 the identified illness or injury, which caused the trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, is causally related to operational service.
26439 on eligible service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles.
9627 on eligible service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least ten days except for where specified medical intervention occurred.
9628 as a causal result of eligible service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least ten days except for where specified medical intervention occurred.
26440 as a causal result of eligible service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least ten days except for where specified medical intervention occurred, within the 25 years before the clinical onset of the condition under consideration.
9630 the trauma to side and site of the body, on eligible service, within the 25 years before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
or
9631 the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles because of an illness or injury which is identifiable.
26441 as a consequence of the identified illness or injury, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least ten days except for where specified medical intervention occurred.
26442 as a consequence of the identified illness or injury, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least ten days except for where specified medical intervention occurred, within the 25 years before the clinical onset of the condition under consideration.
9633 the identified illness or injury, which caused the trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, is causally related to eligible service.
16924 on operational service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles.
9626 on operational service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least seven days except for where specified medical intervention occurred.
20132 as a causal result of operational service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least seven days except for where specified medical intervention occurred.
9634 as a causal result of operational service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least seven days except for where specified medical intervention occurred, before the clinical worsening of the condition under consideration.
9637 the trauma to side and site of the body, 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.
or
9631 the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles because of an illness or injury which is identifiable.
20129 as a consequence of the identified illness or injury, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least seven days except for where specified medical intervention occurred.
20131 as a consequence of the identified illness or injury, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least seven days except for where specified medical intervention occurred, before the clinical worsening of the condition under consideration.
9632 the identified illness or injury, which caused the trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, is causally related to operational service.
9639 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, which caused the trauma to side and site of the body as defined in the reasonable hypothesis Statement of Principles, is causally related.
26439 on eligible service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles.
9627 on eligible service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least ten days except for where specified medical intervention occurred.
9628 as a causal result of eligible service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least ten days except for where specified medical intervention occurred.
9635 as a causal result of eligible service, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least ten days except for where specified medical intervention occurred, within the 25 years before the clinical worsening of the condition under consideration.
9638 the trauma to side and site of the body, on eligible service, within the 25 years before the clinical worsening of the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
9631 the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles because of an illness or injury which is identifiable.
26441 as a consequence of the identified illness or injury, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least ten days except for where specified medical intervention occurred.
26443 as a consequence of the identified illness or injury, the veteran had a trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, which lasted for a period of at least ten days except for where specified medical intervention occurred, within the 25 years before the clinical worsening of the condition under consideration.
9633 the identified illness or injury, which caused the trauma to side and site of the body that caused the development of symptoms as defined in the Statement of Principles, is causally related to eligible service.
9640 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, which caused the trauma to side and site of the body as defined in the balance of probabilities Statement of Principles, is causally related.
Links
[1] http://www.rma.gov.au/assets/SOP/2023/acff4f8b15/011.pdf
[2] http://www.rma.gov.au/assets/SOP/2023/aee69d3e48/012.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20235.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63354%23comment-form
[5] http://www.rma.gov.au/SOP/alpha_ind/c.htm
[6] https://clik.dva.gov.au/system/files/media/MR9279_1.pdf
[7] https://clik.dva.gov.au/system/files/media/MR9279_1.docx
[8] https://clik.dva.gov.au/system/files/media/CR9230_6.pdf
[9] https://clik.dva.gov.au/system/files/media/CR9230_6.docx
[10] https://clik.dva.gov.au/system/files/media/MR9305_6.pdf
[11] https://clik.dva.gov.au/system/files/media/MR9305_6.docx
[12] https://clik.dva.gov.au/system/files/media/CR9206.pdf
[13] https://clik.dva.gov.au/system/files/media/CR9206.docx
[14] https://clik.dva.gov.au/system/files/media/MR9113.pdf
[15] https://clik.dva.gov.au/system/files/media/MR9113.docx
[16] http://en.wikipedia.org/wiki/List_of_aircraft_of_the_RAAF
[17] https://clik.dva.gov.au/system/files/media/CR9207_0.pdf
[18] https://clik.dva.gov.au/system/files/media/CR9207_0.docx
[19] https://clik.dva.gov.au/system/files/media/GQACM_16.pdf
[20] https://clik.dva.gov.au/system/files/media/GQACM_16.docx
[21] https://clik.dva.gov.au/system/files/media/CR9083.pdf
[22] https://clik.dva.gov.au/system/files/media/CR9083.docx
[23] https://clik.dva.gov.au/system/files/media/MR9047.pdf
[24] https://clik.dva.gov.au/system/files/media/MR9047.docx