Reasonable Hypothesis [1] | 43 of 2022 |
Balance of Probabilities [2] | 44 of 2022 |
SOP Bulletin 230 [3]
This is a condition where excessive accumulation of fat in the body results in a body mass index (BMI) of 40 kg/m2 or higher, in adults. Note that there is a different criterion for persons aged 18 years or younger (see SOP definition).
The diagnosis is made by calculating the person's BMI from their height and weight. Note that the SOP definition previously specified a current BMI, but that requirement has been removed. If a person's BMI has been at or over the threshold in the past, but the current BMI is below the threshold, then the SOP may still be applicable. Examples may include: where a person has undergone bariatric surgery for morbid obesity; and, where a person's BMI has fluctuated above and below the threshold and is currently slightly below. In cases where the BMI is not currently at or above the threshold at the time a claim is made the individual circumstances should be considered and medical advice sought as to whether a morbid obesity diagnosis is warranted.
Body mass index = [Mass in kg] divided by [height in metres, squared] = (kg/m2).
The World Health Organisation Body Mass Index charts referred to in the SOP definition, for persons aged 18 years or younger, are linked below.
WHO BMI girls [4]
WHO BMI boys [5]
Clinical onset of morbid obesity is when the person first reached the BMI threshold. If a person's weight subsequently fluctuated below and then back above the threshold, that will not represent a new clinical onset in most circumstances (unless there has been a substantial decrease in BMI and that decrease was maintained for a significant period of time).
Clinical worsening may be evidenced by a significant increase in weight, beyond the normal weight trajectory or pattern for that person.
Place holder node for Rulebase for morbid obesity
Morbid obesity - Binge-eating disorder Factor
Last reviewed for CCPS 17 December 2003.
Investigative Documents
Medical Report - Binge Eating Disorder - Morbid Obesity [MR9308] Preliminary questions [33367]
21735 [9] the veteran has suffered from a binge eating disorder at some time. 21737 — the binge eating disorder is an illness which is identifiable. [Default true]
33397 — the veteran has established the causal connection between the binge eating disorder and VEA service for the clinical onset of morbid obesity.
33398 — the veteran has established the causal connection between the binge eating disorder and operational service for the clinical onset of morbid obesity.
or
33399 — the veteran has established the causal connection between the binge eating disorder and eligible service for the clinical onset of morbid obesity.
Clinical onset and operational service [33398]
21741 — the identified illness or injury, a binge eating disorder, is causally related to operational service. [12] [13]
Clinical onset and eligible service [33399]
21742 — the identified illness or injury, a binge eating disorder, is causally related to eligible service. [14] [13]
Morbid obesity - Excessive caloric intake Factor
Last reviewed for CCPS 17 December 2003.
Investigative Documents
Claimant Report - Excessive caloric intake that cannot be compensated by physical activity - Morbid Obesity [CR9233] Preliminary questions [33365]
33375 [16] the veteran had a caloric intake that was excessive for energy needs and which could not be compensated by physical activity for the year immediately before the clinical onset of morbid obesity. 33376 — the veteran has established the causal connection between the excessive caloric intake and VEA service for the clinical onset of morbid obesity. 33379 — the veteran has established the causal connection between the excessive caloric intake and operational service for the clinical onset of morbid obesity. or 33380 — the veteran has established the causal connection between the excessive caloric intake and eligible service for the clinical onset of morbid obesity. Clinical onset and operational service [33379] or
33382 — the identified illness or injury, which materially contributed to the caloric intake that was excessive for energy needs and which could not be compensated by physical activity, is causally related to operational service. [19] Clinical onset and eligible service [33380] or
33385 — the identified illness or injury, which materially contributed to the caloric intake that was excessive for energy needs and which could not be compensated by physical activity, is causally related to eligible service. [22] [23]
Morbid obesity - Hypercortisolism Factor
Last reviewed for CCPS 17 December 2003.
Preliminary questions [33368]
22369 [24] there is some evidence that hypercortisolism may be a factor in the development of the condition under consideration.
21743 — the veteran has suffered from hypercortisolism at some time.
622 [25] the veteran has had Cushing's syndrome at some time.
or
21744 [26] the veteran has suffered from corticoadrenal overactivity at some time.
33400 [27] the veteran was suffering from the identified illness or injury, a type of hypercortisolism, at the time of the clinical onset of morbid obesity. [28]
33401 — the veteran has established the causal connection between the hypercortisolism and VEA service for the clinical onset of morbid obesity.
33402 — the veteran has established the causal connection between the hypercortisolism and operational service for the clinical onset of morbid obesity.
or
33403 — the veteran has established the causal connection between the hypercortisolism and eligible service for the clinical onset of morbid obesity.
Clinical onset and operational service [33402]
21749 — the identified illness or injury, a type of hypercortisolism, is causally related to operational service. [29] [30]
Clinical onset and eligible service [33403]
21750 — the identified illness or injury, a type of hypercortisolism, is causally related to eligible service. [31] [30]
Morbid obesity - Hypothalamic disorder causing hyperphagia Factor
Last reviewed for CCPS 17 December 2003.
Investigative Documents
Medical Report - Hypothalamic Disorder - Morbid Obesity [MR9309] Preliminary questions [33370]
21764 [33] the veteran has suffered from a hypothalamic disorder at some time. the veteran has suffered from a hypothalamic disorder which caused hyperphagia at some time. 21766 — the hypothalamic disorder which caused hyperphagia is an illness or injury which is identifiable. [Default true]
33409 — the veteran has established the causal connection between the hypothalamic disorder which caused hyperphagia and VEA service for the clinical onset of morbid obesity.
33410 — the veteran has established the causal connection between the hypothalamic disorder which caused hyperphagia and operational service for the clinical onset of morbid obesity.
or
33411 — the veteran has established the causal connection between the hypothalamic disorder which caused hyperphagia and eligible service for the clinical onset of morbid obesity.
Clinical onset and operational service [33410]
21771 — the identified illness or injury, a hypothalamic disorder which caused hyperphagia, is causally related to operational service. [37] [38]
Clinical onset and eligible service [33411]
21772 — the identified illness or injury, a hypothalamic disorder which caused hyperphagia, is causally related to eligible service. [39] [38]
Morbid obesity - Hypothyroidism Factor
Last reviewed for CCPS 17 December 2003.
Preliminary questions [33369]
22370 [40] there is some evidence that hypothyroidism may be a factor in the development of the condition under consideration.
8806 [40] the veteran has had hypothyroidism at some time.
9450 — hypothyroidism means a disease state characterised by a reduction in circulating thyroid hormones. [Default true]
33404 [41] the veteran was suffering from the identified illness or injury, a type of hypothyroidism, at the time of the clinical onset of morbid obesity. [42]
33405 — the veteran has established the causal connection between the hypothyroidism and VEA service for the clinical onset of morbid obesity.
33406 — the veteran has established the causal connection between the hypothyroidism and operational service for the clinical onset of morbid obesity.
or
33407 — the veteran has established the causal connection between the hypothyroidism and eligible service for the clinical onset of morbid obesity.
Clinical onset and operational service [33406]
8811 — the identified illness or injury, a type of hypothyroidism, is causally related to operational service. [43] [44]
Clinical onset and eligible service [33407]
8812 — the identified illness or injury, a type of hypothyroidism, is causally related to eligible service. [45] [44]
Morbid obesity - Inability to obtain appropriate clinical management for morbid obesity Factor
Last reviewed for CCPS 17 December 2003.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [33371] 11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7334 [47] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 [50] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration. 11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration. 11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration. or 11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration. Clinical worsening and operational service [11235] or 7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [55] [56] Clinical worsening and eligible service [11236] or 7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [55] [56]
Morbid obesity - Treatment with a drug as specified for morbid obesity Factor
Last reviewed for CCPS 17 December 2003.
Investigative Documents
Medical Report - Drug Treatment as a Cause of Morbid Obesity [MR9307] Preliminary questions [33366]
33387 [64] the veteran has undergone treatment with a drug as specified for morbid obesity at some time. the drug specified for morbid obesity with which the veteran was being treated, was able to be ceased or substituted. the veteran underwent treatment with the drug as specified for morbid obesity, which drug could not be ceased or substituted, at the time of the clinical onset of morbid obesity. the treatment with the drug as specified for morbid obesity at the time of the clinical onset of morbid obesity, which drug could not be ceased or substituted, was for an illness or injury which is identifiable. [68]
33391 — the veteran has established the causal connection between the treatment with a drug as specified for morbid obesity and VEA service for the clinical onset of morbid obesity.
33392 — the veteran has established the causal connection between the treatment with a drug as specified for morbid obesity and operational service for the clinical onset of morbid obesity.
or
33393 — the veteran has established the causal connection between the treatment with a drug as specified for morbid obesity and eligible service for the clinical onset of morbid obesity.
Clinical onset and operational service [33392]
33394 — the identified illness or injury, for which the veteran underwent treatment with a drug as specified for morbid obesity, which drug could not be ceased or substituted, is causally related to operational service. [69] [70]
Clinical onset and eligible service [33393]
33395 — the identified illness or injury, for which the veteran underwent treatment with a drug as specified for morbid obesity, which drug could not be ceased or substituted, is causally related to eligible service. [71] [70]
Links
[1] http://www.rma.gov.au/assets/SOP/2022/8e87e59341/043.pdf
[2] http://www.rma.gov.au/assets/SOP/2022/d3a364d4c7/044.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20230.pdf
[4] https://clik.dva.gov.au/system/files/media/WHO%20BMI%20girls.pdf
[5] https://clik.dva.gov.au/system/files/media/WHO%20BMI%20boys.pdf
[6] http://www.rma.gov.au/sops/condition/obesity
[7] https://clik.dva.gov.au/user/login?destination=comment/reply/63864%23comment-form
[8] https://clik.dva.gov.au/ccpsmedical-65
[9] https://clik.dva.gov.au/ccpsc031rc-18
[10] clikpopup://CCPS/reject21735No
[11] clikpopup://CCPS/reject33396No
[12] clikpopup://CCPS/reject21741No
[13] clikpopup://CCPS/reject21741,21742No
[14] clikpopup://CCPS/reject21742No
[15] https://clik.dva.gov.au/ccpsclaimant-90
[16] https://clik.dva.gov.au/33365-excessive-caloric-intake-0
[17] clikpopup://CCPS/reject33375No
[18] clikpopup://CCPS/reject33377No
[19] clikpopup://CCPS/reject33382No
[20] clikpopup://CCPS/El service contributed to a caloric intake that was excessive for energy and not compensated by physical activity for the year immediately before clinical onset of morbid obesity
[21] clikpopup://CCPS/reject33383No
[22] clikpopup://CCPS/reject33385No
[23] clikpopup://CCPS/reject33382,33385No
[24] https://clik.dva.gov.au/ccpsc031rc-14
[25] https://clik.dva.gov.au/ccpsg009rc-36
[26] https://clik.dva.gov.au/ccpsc031rc-6
[27] clikpopup://CCPS/Veteran suffering ill/inj, a type of hypercortisolism, at time of clinical onset of morbid obesity
[28] clikpopup://CCPS/reject33400No
[29] clikpopup://CCPS/reject21749No
[30] clikpopup://CCPS/reject21749,21750No
[31] clikpopup://CCPS/reject21750No
[32] https://clik.dva.gov.au/ccpsmedical-208
[33] https://clik.dva.gov.au/ccpsc031rc-5
[34] clikpopup://CCPS/reject21764No
[35] clikpopup://CCPS/reject21765No
[36] clikpopup://CCPS/reject33408No
[37] clikpopup://CCPS/reject21771No
[38] clikpopup://CCPS/reject21771,21772No
[39] clikpopup://CCPS/reject21772No
[40] https://clik.dva.gov.au/ccpsf040rc-7
[41] clikpopup://CCPS/Veteran suffering ill/inj, a type of hypothyroidism, at time of clinical onset of morbid obesity
[42] clikpopup://CCPS/reject33404No
[43] clikpopup://CCPS/reject8811No
[44] clikpopup://CCPS/reject8811,8812No
[45] clikpopup://CCPS/reject8812No
[46] https://clik.dva.gov.au/ccpsother-31
[47] https://clik.dva.gov.au/node/71418
[48] clikpopup://CCPS/Reject/OnsetAfterService
[49] clikpopup://CCPS/Reject/NoPermanentWorsening
[50] clikpopup://CCPS/Morbid obesity/ACM - contributed to worsening
[51] clikpopup://CCPS/ACM/NoContribution
[52] clikpopup://CCPS/ACM/NotOpService
[53] clikpopup://CCPS/ACM/NotOperDuties
[54] clikpopup://CCPS/rejectwilful
[55] clikpopup://CCPS/ACM/NoIllness
[56] clikpopup://CCPS/reject7390,7391No
[57] clikpopup://CCPS/Morbid obesity/ACM - onset prior to operational service
[58] clikpopup://CCPS/ACM/OnsetFailOper
[59] clikpopup://CCPS/ACM/NotEligService
[60] clikpopup://CCPS/ACM/NotEligDuties
[61] clikpopup://CCPS/Morbid obesity/ACM - onset prior to eligible service
[62] clikpopup://CCPS/ACM/OnsetFailElig
[63] https://clik.dva.gov.au/ccpsmedical-25
[64] https://clik.dva.gov.au/ccpsc031rc-15
[65] clikpopup://CCPS/reject33387No
[66] clikpopup://CCPS/reject33388Yes
[67] clikpopup://CCPS/reject33389No
[68] clikpopup://CCPS/reject33390No
[69] clikpopup://CCPS/reject33394No
[70] clikpopup://CCPS/reject33394,33395No
[71] clikpopup://CCPS/reject33395No