Consolidated RH SOP [1] | 100 of 2023 |
Consolidated BOP SOP [2] | 101 of 2023 |
This is a collection of psychiatric disorders with anxiety as a significant clinical manifestation. It covers endogenous anxiety disorders but not those reactive anxiety type psychiatric disorders such as posttraumatic stress disorder and adjustment disorder with anxious mood and not the specific phobias or panic disorders.
Confirming the diagnosis
A report from a specialist psychiatrist that conforms with the Repatriation Commission Guidelines for Psychiatric Compensation Claims [4] is required for diagnosis. The diagnosis is made with reference to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
* another SOP applies - the SOP has the same name unless otherwise specified
# Non-SOP condition
The clinical onset of an anxiety disorder will be when the required level of clinical features necessary to meet the diagnostic criteria were first fulfilled, which may be some time after relevant symptoms first developed - i.e., if initially some anxiety symptoms were present, but they were insufficient to meet the diagnostic criteria (e.g. less than the three of six symptoms required for generalised anxiety disorder were present), then the anxiety disorder had not had its clinical onset at that point. Where the criteria require a minimum duration of symptoms confirmation of the diagnosis can only occur once that duration requirement has been met, but the clinical onset can then be retrospectively assessed as being at the start of the period from when the required symptoms were first present.
Symptoms of generalised anxiety disorder tend to be chronic and to wax and wane over time. Symptoms may fluctuate between meeting diagnostic criteria and being below the threshold for diagnosis. Rates of full remission are very low. A range of treatment options are available and the effectiveness of treatment varies between types and between individuals. For anxiety disorder due to another medical condition the course generally follows the course of the underlying illness.
The RMA has defined this to mean "one or more of the following severe traumatic events:
(a) experiencing a life-threatening event;
(b) being subject to a serious physical attack or assault including rape and sexual molestation; or
(c) being threatened with a weapon, being held captive, being kidnapped, or being tortured".
"Experiencing a severe stressor" has been the subject of Federal Court determinations and an Advisory Note. Whilst a category 1A stressor is not exactly the same there are enough similarities for the following advice to be considered:
In assessing whether a particular event is a "severe stressor" as defined, it is necessary to consider both the objective nature of the event and the veteran's subjective knowledge about the event. The authority for this approach is the Federal Court decision in Stoddart, and you should read AN02/2003 Federal Court Decision Stoddart [7].
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
35945 the veteran has experienced a category 1A stressor at some time.
37331 the veteran has established the causal connection between the category 1A stressor and VEA service for the condition under consideration.
37332 the veteran has established the causal connection between the category 1A stressor and VEA service for the clinical onset of the condition under consideration.
37334 the veteran has established the causal connection between the category 1A stressor and operational service for the clinical onset of the condition under consideration.
or
37335 the veteran has established the causal connection between the category 1A stressor 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.
37333 the veteran has established the causal connection between the category 1A stressor and VEA service for the clinical worsening of the condition under consideration.
37336 the veteran has established the causal connection between the category 1A stressor and operational service for the clinical worsening of the condition under consideration.
or
37337 the veteran has established the causal connection between the category 1A stressor and eligible service for the clinical worsening of the condition under consideration.
37340 on operational service, the veteran experienced a category 1A stressor.
37344 on operational service, the veteran experienced a category 1A stressor within the five years before the clinical onset of the condition under consideration.
37348 the category 1A stressor that the veteran experienced within the five years before the clinical onset of the condition under consideration, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37352 the veteran experienced the category 1A stressor because of an illness or injury which is identifiable.
37353 as a consequence of the identified illness or injury, the veteran experienced a category 1A stressor within the five years before the clinical onset of the condition under consideration.
37357 the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related to operational service.
37342 on eligible service, the veteran experienced a category 1A stressor.
37343 as a causal result of eligible service, the veteran experienced a category 1A stressor.
37346 as a causal result of eligible service, the veteran experienced a category 1A stressor within the two years before the clinical onset of the condition under consideration.
37349 the category 1A stressor that the veteran experienced within the two years before the clinical onset of the condition under consideration, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37352 the veteran experienced the category 1A stressor because of an illness or injury which is identifiable.
37355 as a consequence of the identified illness or injury, the veteran experienced a category 1A stressor within the two years before the clinical onset of the condition under consideration.
37358 the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related to eligible service.
37340 on operational service, the veteran experienced a category 1A stressor.
37341 as a causal result of operational service, the veteran experienced a category 1A stressor.
37345 as a causal result of operational service, the veteran experienced a category 1A stressor after the clinical onset of the condition under consideration and within the five years before its clinical worsening.
37350 the category 1A stressor that the veteran experienced within the five years before the clinical worsening of the condition under consideration, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37352 the veteran experienced the category 1A stressor because of an illness or injury which is identifiable.
37354 as a consequence of the identified illness or injury, the veteran experienced a category 1A stressor after the clinical onset of the condition under consideration and within the five years before its clinical worsening.
37357 the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related to operational service.
37359 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related.
37342 on eligible service, the veteran experienced a category 1A stressor.
37343 as a causal result of eligible service, the veteran experienced a category 1A stressor.
37347 as a causal result of eligible service, the veteran experienced a category 1A stressor after the clinical onset of the condition under consideration and within the two years before its clinical worsening.
37351 the category 1A stressor that the veteran experienced within the two years before the clinical worsening of the condition under consideration, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37352 the veteran experienced the category 1A stressor because of an illness or injury which is identifiable.
37356 as a consequence of the identified illness or injury, the veteran experienced a category 1A stressor after the clinical onset of the condition under consideration and within the two years before its clinical worsening.
37358 the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related to eligible service.
37360 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, as a consequence of which the veteran experienced a category 1A stressor, is causally related.
The RMA has defined this to mean "one of the following severe traumatic events:
(a) being an eyewitness to a person being killed or critically injured;
(b) viewing corpses or critically injured casualties as an eyewitness;
(c) being an eyewitness to atrocities inflicted on another person or persons;
(d) killing or maiming a person; or
(e) being an eyewitness to or participating in, the clearance of critically injured casualties".
The RMA has also defined "an eyewitness" to mean "a person who observes an incident first hand and can give direct evidence of it. This excludes a person exposed only to media coverage of the incident".
"Experiencing a severe stressor" has been the subject of Federal Court determinations and an Advisory Note. Whilst a category 1B stressor is not exactly the same there are enough similarities for the following advice to be considered:
In assessing whether a particular event is a "severe stressor" as defined, it is necessary to consider both the objective nature of the event and the veteran's subjective knowledge about the event. The authority for this approach is the Federal Court decision in Stoddart, and you should read AN02/2003 Federal Court Decision Stoddart [7].
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
35935 the veteran has experienced a category 1B stressor at some time.
37363 the veteran has established the causal connection between the category 1B stressor and VEA service for the condition under consideration.
37364 the veteran has established the causal connection between the category 1B stressor and VEA service for the clinical onset of the condition under consideration.
37366 the veteran has established the causal connection between the category 1B stressor and operational service for the clinical onset of the condition under consideration.
or
37367 the veteran has established the causal connection between the category 1B stressor 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.
37365 the veteran has established the causal connection between the category 1B stressor and VEA service for the clinical worsening of the condition under consideration.
37368 the veteran has established the causal connection between the category 1B stressor and operational service for the clinical worsening of the condition under consideration.
or
37369 the veteran has established the causal connection between the category 1B stressor and eligible service for the clinical worsening of the condition under consideration.
37372 on operational service, the veteran experienced a category 1B stressor.
37376 on operational service, the veteran experienced a category 1B stressor within the five years before the clinical onset of the condition under consideration.
37380 the category 1B stressor that the veteran experienced within the five years before the clinical onset of the condition under consideration, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37386 the veteran experienced the category 1B stressor because of an illness or injury which is identifiable.
37387 as a consequence of the identified illness or injury, the veteran experienced a category 1B stressor within the five years before the clinical onset of the condition under consideration.
37391 the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related to operational service.
37374 on eligible service, the veteran experienced a category 1B stressor.
37375 as a causal result of eligible service, the veteran experienced a category 1B stressor.
37378 as a causal result of eligible service, the veteran experienced a category 1B stressor within the two years before the clinical onset of the condition under consideration.
37381 the category 1B stressor that the veteran experienced within the two years before the clinical onset of the condition under consideration, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37386 the veteran experienced the category 1B stressor because of an illness or injury which is identifiable.
37389 as a consequence of the identified illness or injury, the veteran experienced a category 1B stressor within the two years before the clinical onset of the condition under consideration.
37392 the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related to eligible service.
37372 on operational service, the veteran experienced a category 1B stressor.
37373 as a causal result of operational service, the veteran experienced a category 1B stressor.
37377 as a causal result of operational service, the veteran experienced a category 1B stressor after the clinical onset of the condition under consideration and within the five years before its clinical worsening.
37382 the category 1B stressor that the veteran experienced within the five years before the clinical worsening of the condition under consideration, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37386 the veteran experienced the category 1B stressor because of an illness or injury which is identifiable.
37388 as a consequence of the identified illness or injury, the veteran experienced a category 1B stressor after the clinical onset of the condition under consideration and within the five years before its clinical worsening.
37391 the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related to operational service.
37393 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related.
37374 on eligible service, the veteran experienced a category 1B stressor.
37375 as a causal result of eligible service, the veteran experienced a category 1B stressor.
37379 as a causal result of eligible service, the veteran experienced a category 1B stressor after the clinical onset of the condition under consideration and within the two years before its clinical worsening.
37383 the category 1B stressor that the veteran experienced within the two years before the clinical worsening of the condition under consideration, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37386 the veteran experienced the category 1B stressor because of an illness or injury which is identifiable.
37390 as a consequence of the identified illness or injury, the veteran experienced a category 1B stressor after the clinical onset of the condition under consideration and within the two years before its clinical worsening.
37392 the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related to eligible service.
37394 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, as a consequence of which the veteran experienced a category 1B stressor, is causally related.
"A category 2 stressor" means one or more of the following negative life events, the effects of which are chronic in nature and cause the person to feel on-going distress, concern or worry [emphasis added]:
37405 there is some evidence that a category 2 stressor may be a factor in the development or worsening of the condition under consideration.
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
37395 the veteran has experienced a category 2 stressor at some time.
37396 the veteran has established the causal connection between the category 2 stressor and VEA service for the condition under consideration.
37397 the veteran has established the causal connection between the category 2 stressor and VEA service for the clinical onset of the condition under consideration.
37399 the veteran has established the causal connection between the category 2 stressor and operational service for the clinical onset of the condition under consideration.
or
37400 the veteran has established the causal connection between the category 2 stressor 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.
37398 the veteran has established the causal connection between the category 2 stressor and VEA service for the clinical worsening of the condition under consideration.
37401 the veteran has established the causal connection between the category 2 stressor and operational service for the clinical worsening of the condition under consideration.
or
37402 the veteran has established the causal connection between the category 2 stressor and eligible service for the clinical worsening of the condition under consideration.
37406 on operational service, the veteran experienced a category 2 stressor.
37408 as a causal result of operational service, the veteran experienced a category 2 stressor.
37410 as a causal result of operational service, the veteran experienced a category 2 stressor within the one year before the clinical onset of the condition under consideration.
37414 the category 2 stressor that the veteran experienced within the one year before the clinical onset of the condition under consideration, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37420 the veteran experienced the category 2 stressor because of an illness or injury which is identifiable.
37421 as a consequence of the identified illness or injury, the veteran experienced a category 2 stressor within the one year before the clinical onset of the condition under consideration.
37425 the identified illness or injury, as a consequence of which the veteran experienced a category 2 stressor, is causally related to operational service.
37407 on eligible service, the veteran experienced a category 2 stressor.
37409 as a causal result of eligible service, the veteran experienced a category 2 stressor.
37412 as a causal result of eligible service, the veteran experienced a category 2 stressor within the six months before the clinical onset of the condition under consideration.
37415 the category 2 stressor that the veteran experienced within the six months before the clinical onset of the condition under consideration, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37420 the veteran experienced the category 2 stressor because of an illness or injury which is identifiable.
37422 as a consequence of the identified illness or injury, the veteran experienced a category 2 stressor within the six months before the clinical onset of the condition under consideration.
37426 the identified illness or injury, as a consequence of which the veteran experienced a category 2 stressor, is causally related to eligible service.
37406 on operational service, the veteran experienced a category 2 stressor.
37408 as a causal result of operational service, the veteran experienced a category 2 stressor.
37411 as a causal result of operational service, the veteran experienced a category 2 stressor after the clinical onset of the condition under consideration and within the one year before its clinical worsening.
37416 the category 2 stressor that the veteran experienced within the one year before the clinical worsening of the condition under consideration, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37420 the veteran experienced the category 2 stressor because of an illness or injury which is identifiable.
37423 as a consequence of the identified illness or injury, the veteran experienced a category 2 stressor after the clinical onset of the condition under consideration and within the one year before its clinical worsening.
37425 the identified illness or injury, as a consequence of which the veteran experienced a category 2 stressor, is causally related to operational service.
37427 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, as a consequence of which the veteran experienced a category 2 stressor, is causally related.
37407 on eligible service, the veteran experienced a category 2 stressor.
37409 as a causal result of eligible service, the veteran experienced a category 2 stressor.
37413 as a causal result of eligible service, the veteran experienced a category 2 stressor after the clinical onset of the condition under consideration and within the six months before its clinical worsening.
37417 the category 2 stressor that the veteran experienced within the six months before the clinical worsening of the condition under consideration, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
or
37420 the veteran experienced the category 2 stressor because of an illness or injury which is identifiable.
37424 as a consequence of the identified illness or injury, the veteran experienced a category 2 stressor after the clinical onset of the condition under consideration and within the six months before its clinical worsening.
37426 the identified illness or injury, as a consequence of which the veteran experienced a category 2 stressor, is causally related to eligible service.
37428 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, as a consequence of which the veteran experienced a category 2 stressor, is causally related.
In the SOPs for anxiety disorder, among others, the RMA has defined "a clinically significant psychiatric condition" to mean "any Axis 1 disorder of mental health that attracts a diagnosis under DSM-IV-TR which is sufficient to warrant ongoing management, which may involve regular visits (for example, at least monthly), to a psychiatrist, clinical psychologist or general practitioner".
Axis 1 covers clinical disorders, for example, substance-related disorders, mood disorders, anxiety disorders (including PTSD), depressive disorders, bipolar disorder, and schizophrenia.
Generally it would be expected that if a psychiatric disorder warranted treatment then treatment would be sought. However, where treatment was not sought, a person's psychiatric disorder might still meet the RMA definition if there was persuasive and professional evidence, based on a comprehensive clinical history, that ongoing management had been warranted.
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
1709 the veteran has had a psychiatric condition at some time.
6058 psychiatric condition means any Axis 1 disorder of mental health that attracts a diagnosis under DSM-IV-TR. [Default true]
26043 the identified illness or injury, a psychiatric condition, has been clinically significant at some time.
6013 the veteran has established the causal connection between the clinically significant psychiatric condition and VEA service for the condition under consideration.
6017 the veteran has established the causal connection between the clinically significant psychiatric condition and VEA service for the clinical onset of the condition under consideration.
6020 the veteran has established the causal connection between the clinically significant psychiatric condition and eligible service for the clinical onset of the condition under consideration.
or
6019 the veteran has established the causal connection between the clinically significant psychiatric condition and operational 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.
6018 the veteran has established the causal connection between the clinically significant psychiatric condition and VEA service for the clinical worsening of the condition under consideration.
6022 the veteran has established the causal connection between the clinically significant psychiatric condition and eligible service for the clinical worsening of the condition under consideration.
or
6021 the veteran has established the causal connection between the clinically significant psychiatric condition and operational service for the clinical worsening of the condition under consideration.
6023 the identified illness or injury, a psychiatric condition, was clinically significant within the ten years before the clinical onset of the condition under consideration.
26044 the identified illness or injury, a clinically significant psychiatric condition, is causally related to operational service.
6025 the identified illness or injury, a psychiatric condition, was clinically significant within the five years before the clinical onset of the condition under consideration.
26045 the identified illness or injury, a clinically significant psychiatric condition, is causally related to eligible service.
6027 the identified illness or injury, a psychiatric condition, was clinically significant within the ten years before the clinical worsening of the condition under consideration.
26044 the identified illness or injury, a clinically significant psychiatric condition, is causally related to operational service.
6029 the clinical onset of the veteran's condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a clinically significant psychiatric condition, is causally related.
6028 the identified illness or injury, a psychiatric condition, was clinically significant within the five years before the clinical worsening of the condition under consideration.
26045 the identified illness or injury, a clinically significant psychiatric condition, is causally related to eligible service.
6030 the clinical onset of the veteran's condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a clinically significant psychiatric condition, is causally related.
This SOP factor only applies for anxiety disorder due to a general medical condition where the general medical condition is a direct physiological cause of the anxiety.
The SOP condition anxiety disorder covers the following three conditions:
The psychiatrist who diagnosed the anxiety disorder would have taken a history of when relevant symptoms began, even if the veteran had not sought medical attention until symptoms had persisted for some time. Seek medical advice if it is unclear whether the symptoms claimed to be due to anxiety disorder at a particular time were actually due to that disorder.
30035 there is some evidence that an endocrine, cardiovascular, respiratory, metabolic, infectious, or neurological disorder may be a factor in the development of the condition under consideration.
30033 the condition under consideration is anxiety disorder due to a general medical condition.
38885 the veteran's endocrine, cardiovascular, respiratory, metabolic, infectious or neurological disorder was a direct physiological cause of anxiety at the time of the clinical onset of the condition under consideration.
30012 the veteran's endocrine, cardiovascular, respiratory, metabolic, infectious or neurological disorder, which was a direct physiological cause of anxiety at the time of the clinical onset of the condition under consideration, is an illness or injury which is identifiable.
30015 the veteran has established the causal connection between the endocrine, cardiovascular, respiratory, metabolic, infectious, or neurological disorder and VEA service for the clinical onset of the condition under consideration.
30018 the veteran has established the causal connection between the endocrine, cardiovascular, respiratory, metabolic, infectious, or neurological disorder and operational service for the clinical onset of the condition under consideration.
or
30019 the veteran has established the causal connection between the endocrine, cardiovascular, respiratory, metabolic, infectious, or neurological disorder and eligible service for the clinical onset of the condition under consideration.
30022 the identified illness or injury, an endocrine, cardiovascular, respiratory, metabolic, infectious, or neurological disorder that was a direct physiological cause of the condition under consideration, is causally related to operational service.
30023 the identified illness or injury, an endocrine, cardiovascular, respiratory, metabolic, infectious, or neurological disorder that was a direct physiological cause of the condition under consideration, is causally related to eligible service.
A medical condition as specified means an endocrine, cardiovascular, respiratory, metabolic, infectious, or neurological condition, that causes symptoms consistent with anxiety, panic attacks, obsessions or compulsions, as a direct physiological consequence of the condition.
Direct physiological consequence of the medical condition means, for example, that the medical condition causes an excess or deficiency of a hormone, metabolite or electrolyte that impacts on brain function, or alternatively, directly effects neurological function. Examples include:
38886 there is some evidence that a medical condition as specified 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.
38887 the veteran has had a medical condition as specified at some time.
38889 the veteran had the medical condition as specified at the time of the clinical worsening of the condition under consideration.
38888 the medical condition as specified at the time of the clinical worsening of the condition under consideration is an illness or injury which is identifiable.
38890 the veteran has established the causal connection between the medical condition as specified and VEA service for the clinical worsening of the condition under consideration.
38891 the veteran has established the causal connection between the medical condition as specified and operational service for the clinical worsening of the condition under consideration.
or
38892 the veteran has established the causal connection between the medical condition as specified and eligible service for the clinical worsening of the condition under consideration.
38893 the identified illness or injury, a medical condition as specified, is causally related to operational service.
38895 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a medical condition as specified, is causally related.
38894 the identified illness or injury, a medical condition as specified, is causally related to eligible service.
38896 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a medical condition as specified, is causally related.
The SoP factor is 'having a medical illness or injury which is life-threatening or which results in serious physical or cognitive disability'. The RMA has not defined this factor.
Whether a condition is life-threatening can be a difficult assessment, particularly where cancer has been diagnosed in the past but is currently causing little, if any, incapacity – for example a man with cancer of the prostate that attracts only 10 points under GARP for urinary problems. It can be argued that cancer of any type (except perhaps skin) is always a serious disease, but in this case it is clearly not a serious physical or cognitive disability. But is it "life-threatening"? An assessment in terms of the Life-Expectancy table in GARP can help. The phrase "normal, or near normal, five year survival" used in table 14.2 of GARP means that statistically there is little chance of dying from the disease in the next five years. It doesn't mean the person will remain disease free, but if the person is disease free at five years after diagnosis or staging then there is little prospect of disease recurrence. To a certain extent "life-threatening" is also a matter of perspective. An 80 year old with low grade prostate cancer does not have a life threatening disease. A 50 year old with aggressive prostate cancer does.
37289 there is some evidence that a serious medical illness or injury may be a factor in the development or worsening of the condition under consideration.
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
37310 the veteran has had a serious medical illness or injury at some time.
37311 a serious medical illness or injury means a medical illness or injury which is life-threatening or which results in serious physical or cognitive disability.
37303 the veteran has established the causal connection between the serious medical illness or injury and VEA service for the condition under consideration.
37304 the veteran has established the causal connection between the serious medical illness or injury and VEA service for the clinical onset of the condition under consideration.
37307 the veteran has established the causal connection between the serious medical illness or injury and eligible service for the clinical onset of the condition under consideration.
or
37306 the veteran has established the causal connection between the serious medical illness or injury and operational 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.
37305 the veteran has established the causal connection between the serious medical illness or injury and VEA service for the clinical worsening of the condition under consideration.
37309 the veteran has established the causal connection between the serious medical illness or injury and eligible service for the clinical worsening of the condition under consideration.
or
37308 the veteran has established the causal connection between the serious medical illness or injury and operational service for the clinical worsening of the condition under consideration.
37312 the veteran had the identified illness or injury, a serious medical illness or injury, within the five years before the clinical onset of the condition under consideration.
37316 the identified illness or injury, a serious medical illness or injury, is causally related to operational service.
37313 the veteran had the identified illness or injury, a serious medical illness or injury, within the two years before the clinical onset of the condition under consideration.
37317 the identified illness or injury, a serious medical illness or injury, is causally related to eligible service.
37314 the veteran had the identified illness or injury, a serious medical illness or injury, after the clinical onset of the condition under consideration and within the five years before its clinical worsening.
37316 the identified illness or injury, a serious medical illness or injury, is causally related to operational service.
37318 the clinical onset of the veteran's condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a serious medical illness or injury, is causally related.
37315 the veteran had the identified illness or injury, a serious medical illness or injury, after the clinical onset of the condition under consideration and within the two years before its clinical worsening.
37317 the identified illness or injury, a serious medical illness or injury, is causally related to eligible service.
37319 the clinical onset of the veteran's condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a serious medical illness or injury, is causally related.
Note: it is the "significant other" who has to experience the category 1A stressor.
"A significant other" means a person who has a close family bond or a close personal relationship and is important or influential in one's life.
The RMA has defined a "a category 1A stressor" to mean "one or more of the following severe traumatic events:
37470 there is some evidence that having a significant other who experiences a category 1A stressor may be a factor in the development or worsening of the condition under consideration.
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
35925 the veteran has a significant other who experienced a category 1A stressor at some time.
37471 the veteran has established the causal connection between the veteran's significant other experiencing a category 1A stressor and VEA service for the condition under consideration.
37472 the veteran has established the causal connection between the veteran's significant other experiencing a category 1A stressor and VEA service for the clinical onset of the condition under consideration.
37474 the veteran has established the causal connection between the veteran's significant other experiencing a category 1A stressor and operational service for the clinical onset of the condition under consideration.
or
37475 the veteran has established the causal connection between the veteran's significant other experiencing a category 1A stressor 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.
37473 the veteran has established the causal connection between the veteran's significant other experiencing a category 1A stressor and VEA service for the clinical worsening of the condition under consideration.
37476 the veteran has established the causal connection between the veteran's significant other experiencing a category 1A stressor and operational service for the clinical worsening of the condition under consideration.
or
37477 the veteran has established the causal connection between the veteran's significant other experiencing a category 1A stressor and eligible service for the clinical worsening of the condition under consideration.
37478 the veteran's significant other experienced the category 1A stressor within the two years before the clinical onset of the condition under consideration.
37482 the category 1A stressor experienced by the veteran's significant other within the two years before the clinical onset of the condition under consideration is related to the veteran's operational service.
37486 the category 1A stressor experienced by the veteran's significant other within the two years before the clinical onset of the condition under consideration, which was related to the veteran's operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
37480 the veteran's significant other experienced the category 1A stressor within the one year before the clinical onset of the condition under consideration.
37484 the category 1A stressor experienced by the veteran's significant other within the one year before the clinical onset of the condition under consideration is related to the veteran's eligible service.
37488 the category 1A stressor experienced by the veteran's significant other within the one year before the clinical onset of the condition under consideration, which was related to the veteran's eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
37479 the veteran's significant other experienced the category 1A stressor after the clinical onset of the condition under consideration and within the two years before its clinical worsening.
37483 the category 1A stressor experienced by the veteran's significant other within the two years before the clinical worsening of the condition under consideration is related to the veteran's operational service.
37487 the category 1A stressor experienced by the veteran's significant other within the two years before the clinical worsening of the condition under consideration, which was related to the veteran's operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
37481 the veteran's significant other experienced the category 1A stressor after the clinical onset of the condition under consideration and within the one year before its clinical worsening.
37485 the category 1A stressor experienced by the veteran's significant other within the one year before the clinical worsening of the condition under consideration is related to the veteran's eligible service.
37489 the category 1A stressor experienced by the veteran's significant other within the one year before the clinical worsening of the condition under consideration, which was related to the veteran's eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
The RMA has defined chronic pain as meaning "continuous or almost continuous pain, which may or may not be ameliorated by analgesic medication and which is of a level to cause interference with usual work or leisure activities or activities of daily living."
There are several factors that can cause chronic pain:
A pain management plan may include medications, physiotherapy, chiropractic therapy, counselling and psychotherapy, hypnosis, acupuncture, exercise, electrical stimulation and surgery.
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
26047 the veteran has had chronic pain of at least three months duration at some time.
26048 the veteran's chronic pain of at least three months duration was materially contributed by an illness or injury which is identifiable.
26049 the veteran has established the causal connection between the chronic pain and VEA service for the condition under consideration.
26051 the veteran has established the causal connection between the chronic pain and VEA service for the clinical onset of the condition under consideration.
26054 the veteran has established the causal connection between the chronic pain and operational service for the clinical onset of the condition under consideration.
or
26055 the veteran has established the causal connection between the chronic pain 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.
26053 the veteran has established the causal connection between the chronic pain and VEA service for the clinical worsening of the condition under consideration.
26056 the veteran has established the causal connection between the chronic pain and operational service for the clinical worsening of the condition under consideration.
or
26057 the veteran has established the causal connection between the chronic pain and eligible service for the clinical worsening of the condition under consideration.
26050 the identified illness or injury made a material contribution to the chronic pain of at least three months duration at the time of the clinical onset of the condition under consideration.
26058 the identified illness or injury that contributed to the veteran's chronic pain of at least three months duration is causally related to operational service.
37320 the identified illness or injury made a material contribution to chronic pain of at least six months duration.
37321 the identified illness or injury made a material contribution to the chronic pain of at least six months duration at the time of the clinical onset of the condition under consideration.
26059 the identified illness or injury that contributed to the veteran's chronic pain of at least six months duration is causally related to eligible service.
26052 the identified illness or injury made a material contribution to the chronic pain of at least three months duration at the time of the clinical worsening of the condition under consideration.
26058 the identified illness or injury that contributed to the veteran's chronic pain of at least three months duration is causally related to operational service.
26060 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury that caused the veteran to suffer chronic pain of at least three months duration is causally related.
37320 the identified illness or injury made a material contribution to chronic pain of at least six months duration.
37322 the identified illness or injury made a material contribution to the chronic pain of at least six months duration at the time of the clinical worsening of the condition under consideration.
26059 the identified illness or injury that contributed to the veteran's chronic pain of at least six months duration is causally related to eligible service.
26061 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury that caused the veteran to suffer chronic pain of at least six months duration is causally related.
Epilepsy means a chronic neurological disorder characterised by two or more epileptic seizures.
Epilepsy consists of chronic, recurrent, paroxysmal changes in function of the nervous system caused by abnormalities in the electrical activity in the brain. Each episode of neurological dysfunction is termed a seizure. A seizure may be partial, involving only isolated muscle groups and may be accompanied by alteration of consciousness or awareness of the environment, or generalised and accompanied by severe muscle contractions, loss of consciousness and incontinence. Status epilepticus is associated with a high mortality rate.
If there have been at least two seizures, more than 24 hours apart, which were not due to an acute (short term) precipitating cause, the clinical onset of epilepsy is when the first of those seizures occurred, even if there was a gap of decades between them. However, a diagnosis of epilepsy can only be made when the second of those seizures occurred.
If a person had epilepsy he or she would have needed significant medical attention at that time. Status epilepticus would be considered to be a medical emergency and possibly life-threatening. 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 epilepsy 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 epilepsy rather than to some other condition.
38868 there is some evidence that epilepsy may be a factor in the development or worsening of the condition under consideration.
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
22981 the veteran has suffered from epilepsy at some time.
38870 the veteran has established the causal connection between epilepsy and VEA service for the condition under consideration.
38877 the veteran had epilepsy at the time of the clinical onset of the condition under consideration.
38871 the veteran has established the causal connection between epilepsy and VEA service for the clinical onset of the condition under consideration.
38873 the veteran has established the causal connection between epilepsy and operational service for the clinical onset of the condition under consideration.
or
38874 the veteran has established the causal connection between epilepsy 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.
38878 the veteran had epilepsy at the time of the clinical worsening of the condition under consideration.
38872 the veteran has established the causal connection between epilepsy and VEA service for the clinical worsening of the condition under consideration.
38875 the veteran has established the causal connection between epilepsy and operational service for the clinical worsening of the condition under consideration.
or
38876 the veteran has established the causal connection between epilepsy and eligible service for the clinical worsening of the condition under consideration.
38879 the veteran's epilepsy is causally related to operational service.
38880 the veteran's epilepsy is causally related to eligible service.
38879 the veteran's epilepsy is causally related to operational service.
38881 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the veteran's epilepsy is causally related.
38880 the veteran's epilepsy is causally related to eligible service.
38882 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the veteran's epilepsy is causally related.
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.
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
8625 the condition under consideration has been accepted on the basis of the veteran's prisoner of war status.
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.
Appropriate clinical management for an anxiety disorder may include psychotherapy - usually cognitive-behavioural therapy - and medications such as antidepressants and tranquillisers (e.g. benzodiazepines like diazepam or Valium).
In the case of anxiety disorder due to a general medical condition, appropriate management includes treatment of the underlying medical condition which has caused the anxiety disorder.
Inability to obtain appropriate clinical management
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.
In the Statements of Principles for Personality Disorder, "severe childhood abuse" means:
where such serious harm or neglect has been perpetrated by a parent, a care provider, an adult who works with or around that child, or any other adult in contact with that child.
It would be difficult for a person with VEA service to meet the requirements of the Statement of Principles factors for either the onset, or clinical worsening of this condition as the person would need to have received the childhood abuse on service, before the age of 16 years, and for this to be related to their service.
The report from a specialist psychiatrist that conforms with the Repatriation Commission Guidelines for Psychiatric Compensation Claims [8] would include a full statement about events (either prior, during or after service) described by the person that may be related to the claimed psychiatric condition.
If there is a reference to severe childhood abuse during VEA service, before the age of 16, such abuse would generally be well documented in the person's medical records, if it was reported, although you may need to specifically request to see the psychological records. There may also be additional special investigative material if this involved a disciplinary hearing, or prosecution of other service personnel.
41513 there is some evidence the veteran's severe childhood abuse may be a factor in the onset of the condition under consideration.
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
41514 the veteran has established the causal connection between severe childhood abuse and VEA service for the clinical onset of anxiety disorder.
41515 the veteran has established the causal connection between severe childhood abuse and operational service for the clinical onset of anxiety disorder.
or
41516 the veteran has established the causal connection between severe childhood abuse and eligible service for the clinical onset of anxiety disorder.
40500 on operational service, the veteran experienced severe childhood abuse.
41589 on operational service, the veteran experienced severe childhood abuse before the clinical onset of the condition under consideration.
40501 on eligible service, the veteran experienced severe childhood abuse.
40503 as a causal result of eligible service, the veteran experienced severe childhood abuse.
41590 as a causal result of eligible service, the veteran experienced severe childhood abuse within the 30 years before the clinical onset of the condition under consideration.
"A significant other" means "a person who has a close family bond or a close personal relationship and is important or influential in one's life".
The nature of the death of the significant other can be traumatic or not.
37447 there is some evidence that the death of a significant other may be a factor in the development or worsening of the condition under consideration.
30028 the condition under consideration is generalised anxiety disorder or anxiety disorder not otherwise specified.
30014 the condition under consideration is generalised anxiety disorder.
or
30029 the condition under consideration is anxiety disorder not otherwise specified.
37448 the veteran has experienced the death of a significant other at some time.
37449 the veteran has established the causal connection between the death of a significant other and VEA service for the condition under consideration.
37450 the veteran has established the causal connection between the death of a significant other and VEA service for the clinical onset of the condition under consideration.
37452 the veteran has established the causal connection between the death of a significant other and operational service for the clinical onset of the condition under consideration.
or
37453 the veteran has established the causal connection between the death of a significant other 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.
37451 the veteran has established the causal connection between the death of a significant other and VEA service for the clinical worsening of the condition under consideration.
37454 the veteran has established the causal connection between the death of a significant other and operational service for the clinical worsening of the condition under consideration.
or
37455 the veteran has established the causal connection between the death of a significant other and eligible service for the clinical worsening of the condition under consideration.
37456 the veteran experienced the death of a significant other within the two years before the clinical onset of the condition under consideration.
37460 the death of the veteran's significant other within the two years before the clinical onset of the condition under consideration was related to the veteran's operational service.
37464 the death of the veteran's significant other within the two years before the clinical onset of the condition under consideration, which was related to the veteran's operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
37457 the veteran experienced the death of a significant other within the one year before the clinical onset of the condition under consideration.
37461 the death of the veteran's significant other within the one year before the clinical onset of the condition under consideration was related to the veteran's eligible service.
37465 the death of the veteran's significant other within the one year before the clinical onset of the condition under consideration, which was related to the veteran's eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
37458 the veteran experienced the death of a significant other after the clinical onset of the condition under consideration and within the two years before its clinical worsening.
37462 the death of the veteran's significant other within the two years before the clinical worsening of the condition under consideration was related to the veteran's operational service.
37466 the death of the veteran's significant other within the two years before the clinical worsening of the condition under consideration, which was related to the veteran's operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.
37459 the veteran experienced the death of a significant other after the clinical onset of the condition under consideration and within the one year before its clinical worsening.
37463 the death of the veteran's significant other within the one year before the clinical worsening of the condition under consideration was related to the veteran's eligible service.
37467 the death of the veteran's significant other within the one year before the clinical worsening of the condition under consideration, which was related to the veteran's eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.
Links
[1] http://www.rma.gov.au/assets/SOP/2023/be4fcd2b63/100.pdf
[2] http://www.rma.gov.au/assets/SOP/2023/d573c63c12/101.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20239_0.pdf
[4] http://auth-clik.dvastaff.dva.gov.au/compensation-and-support-reference-library/commission-guidelines/cm7014-mrcc181-guidelines-psychiatric-compensation-claims
[5] https://clik.dva.gov.au/user/login?destination=comment/reply/63276%23comment-form
[6] http://www.rma.gov.au/SOP/alpha_ind/a.htm
[7] https://clik.dva.gov.au/compensation-and-support-reference-library/advisory-notes/2003/an02-federal-court-decision-stoddart
[8] https://clik.dva.gov.au/compensation-and-support-reference-library/commission-guidelines/cm7014-mrcc181-guidelines-psychiatric-compensation-claims