Reasonable Hypothesis SOP [1] | 17 of 2023 |
Balance of Probabilities SOP [2] | 18 of 2023 |
SOP Bulletin 235 [3]
ICD-10-AM Codes: J41, J42, J43, J44
This SOP covers: chronic bronchitis (with or without obstruction); emphysema; and persistent airflow limitation. The terminology in this field can be given different meanings in different settings and can be confusing. There are a range of other lung diseases that can present in a similar way, that are not covered by this SOP. Symptoms and clincial findings require careful evaluation and diagnosis can be difficult.
A diagnosis of chronic bronchitis requires evidence of chronic cough with sputum production.
A diagnosis of emphysema will generally be made based on spirometry showing persistent airflow limitation, or a high resolution CT lung scan showing the disease, or other specific lung function studies, reported by a respiratory physician.
Accurate diagnosis of persistent airflow limitation requires maximal effort post bronchodilator spirometry, with repeatable results obtained on calibrated equipment. This generally means respiratory function testing undertaken at a respiratory laboratory.
Note: persistent airflow limitation is not generally diagnosed as a separate condition if it is an integral manifestation of another diagnosed respiratory disease. See further comments, below.
The relevant medical specialist is a respiratory physician. A report froma respiratory physician should be obtained where possible to establish the correct diagnosis.
* another SOP applies
# non-SOP condition
The clinical onset depends on the type of disease.
The normal course of chronic obstructive pulmonary disease (COPD) is generally for it to slowly worsen over time and for episodic exacerbations to occur. Cessation of smoking can lead to an improvement in symptoms, particularly for chronic bronchitis. Worsening can be demonstrated by an increase in symptoms, a decline in exercise tolerance, or a deterioration in test results (e.g. spirometry). Whether there is deterioration over and above the normal course of the disease will be a matter for medical judgement. Treatment may improve symptoms and can prevent or reduce exacerbations and prolong survival, but will generally not significantly alter the underlying pathology of the disease.
Persistent airflow limitation most commonly arises from chronic inhalation of respiratory irritants, particularly tobacco smoke. But irreversible airflow limitation can also be a feature of other diseases such as severe asthma. In the setting where there is a history of asthma with reversible airflow limitation and there is also irreversible airflow limitation, with a FEV1/FVC of < 70%, then whether the irreversible component is assessed as being a manifestation of the asthma (and so covered by that diagnosis) or warranting a separate diagnosis of COPD, will be a matter for clinical judgement. The same approach would apply for bronchiectasis and alpha-1 antitrypsin deficiency with persistent airflow limitation.
If there is a history of cigar smoking it will be necessary to obtain information about:
The evidence gathered should be as complete and accurate as possible. Information already held in departmental files, eg in previous statements and clinical notes, should not be overlooked. Conflicting evidence should be resolved.
Before a causal link between a smoking habit and service may be established, consideration must be given to Repatriation Commission Guideline CM5030 - Guideline for claims assessors on smoking and alcohol related conditions and military service [6].
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [7] | CRD905.docx [8] |
Claimant Report | Smoking | CRV905.pdf [9] | CRV905.docx [10] |
26916 there is some evidence that cigar smoking may be a factor in the development or worsening of the condition under consideration.
4915 the veteran has ever smoked cigars.
24522 the veteran has established the causal connection between the cigar smoking and VEA service for chronic bronchitis and / or emphysema.
24523 the veteran has established the causal connection between the cigar smoking and VEA service for the clinical onset of chronic bronchitis and / or emphysema.
24525 the veteran has established the causal connection between the cigar smoking and operational service for the clinical onset of chronic bronchitis and / or emphysema.
or
24526 the veteran has established the causal connection between the cigar smoking and eligible service for the clinical onset of chronic bronchitis and / or emphysema.
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.
24524 the veteran has established the causal connection between the cigar smoking and VEA service for the clinical worsening of chronic bronchitis and / or emphysema.
24527 the veteran has established the causal connection between the cigar smoking and operational service for the clinical worsening of chronic bronchitis and / or emphysema.
or
24528 the veteran has established the causal connection between the cigar smoking and eligible service for the clinical worsening of chronic bronchitis and / or emphysema.
24529 the veteran has smoked at least five pack years of cigars before the clinical onset of chronic bronchitis and / or emphysema.
4921 the veteran has some period or periods of cigar smoking that are causally related to operational service.
24530 the veteran has smoked at least ten pack years of cigars before the clinical onset of chronic bronchitis and / or emphysema.
4922 the veteran has some period or periods of cigar smoking that are causally related to eligible service.
Clinical worsening and operational service [24527]
24531 the veteran has smoked at least five pack years of cigars before the clinical worsening of chronic bronchitis and / or emphysema.
4921 the veteran has some period or periods of cigar smoking that are causally related to operational service.
24532 the clinical onset of chronic bronchitis and / or emphysema occurred prior to that part of operational service to which the period or periods of cigar smoking are causally related.
24533 the veteran has smoked at least ten pack years of cigars before the clinical worsening of chronic bronchitis and / or emphysema.
4922 the veteran has some period or periods of cigar smoking that are causally related to eligible service.
24534 the clinical onset of chronic bronchitis and / or emphysema occurred prior to that part of eligible service to which the period or periods of cigar smoking are causally related.
This factor deals with the personal use of cigarettes, i.e. it does not include passive smoking.
If there is a history of cigarette smoking it will be necessary to obtain information about:
The evidence gathered should be as complete and accurate as possible. Information already held in departmental files, eg in previous statements and clinical notes, should not be overlooked. Conflicting evidence should be resolved.
Before a causal link between a smoking habit and service may be established, consideration must be given to Repatriation Commission Guideline CM5030 - Guideline for claims assessors on smoking and alcohol related conditions and military service [6].
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [7] | CRD905.docx [8] |
Claimant Report | Smoking | CRV905.pdf [9] | CRV905.docx [10] |
5803 the veteran has ever smoked cigarettes.
24507 the veteran has established the causal connection between the cigarette smoking and VEA service for chronic bronchitis and / or emphysema.
24508 the veteran has established the causal connection between the cigarette smoking and VEA service for the clinical onset of chronic bronchitis and / or emphysema.
24510 the veteran has established the causal connection between the cigarette smoking and operational service for the clinical onset of chronic bronchitis and / or emphysema.
or
24511 the veteran has established the causal connection between the cigarette smoking and eligible service for the clinical onset of chronic bronchitis and / or emphysema.
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.
24509 the veteran has established the causal connection between the cigarette smoking and VEA service for the clinical worsening of chronic bronchitis and / or emphysema.
24512 the veteran has established the causal connection between the cigarette smoking and operational service for the clinical worsening of chronic bronchitis and / or emphysema.
or
24513 the veteran has established the causal connection between the cigarette smoking and eligible service for the clinical worsening of chronic bronchitis and / or emphysema.
24514 the veteran has smoked at least five pack years of cigarettes before the clinical onset of chronic bronchitis and / or emphysema.
3116 the veteran has some period or periods of cigarette smoking that are causally related to operational service.
24515 the veteran has smoked at least ten pack years of cigarettes before the clinical onset of chronic bronchitis and / or emphysema.
3521 the veteran has some period or periods of cigarette smoking that are causally related to eligible service.
24516 the veteran has smoked at least five pack years of cigarettes before the clinical worsening of chronic bronchitis and / or emphysema.
3116 the veteran has some period or periods of cigarette smoking that are causally related to operational service.
24517 the clinical onset of chronic bronchitis and / or emphysema occurred prior to that part of operational service to which the period or periods of cigarette smoking are causally related.
24518 the veteran has smoked at least ten pack years of cigarettes before the clinical worsening of chronic bronchitis and / or emphysema.
3521 the veteran has some period or periods of cigarette smoking that are causally related to eligible service.
24519 the clinical onset of chronic bronchitis and / or emphysema occurred prior to that part of eligible service to which the period or periods of cigarette smoking are causally related.
The RMA has defined "a respiratory tract irritant" to mean:
Medical advice may be needed to identify if any other respirable agent caused comparable tissue damage.
Physical requirements, duties, and workplace hazards of specific military occupations contains an embedded hotword, military occupations with fumes and irritants component, which provides information about various service occupations which may involve such exposure.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Exposure to a Specified Respiratory Tract Irritant - Chronic Bronchitis and Emphysema | CR9103.pdf [11] | CR9103.docx [12] |
30009 there is some evidence that exposure to a respiratory tract irritant may be a factor in the development or worsening of the condition under consideration.
24449 the veteran was exposed to a respiratory tract irritant, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, at some time.
24450 the veteran has established the causal connection between the exposure to a respiratory tract irritant and VEA service for chronic bronchitis and / or emphysema.
24461 the veteran was exposed to a respiratory tract irritant, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical onset of the condition under consideration.
24451 the veteran has established the causal connection between the exposure to a respiratory tract irritant and VEA service for the clinical onset of chronic bronchitis and / or emphysema.
24457 the veteran has established the causal connection between the exposure to a respiratory tract irritant and operational service for the clinical onset of chronic bronchitis and / or emphysema.
or
24458 the veteran has established the causal connection between the exposure to a respiratory tract irritant and eligible service for the clinical onset of chronic bronchitis and / or emphysema.
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.
24462 the veteran was exposed to a respiratory tract irritant, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical worsening of the condition under consideration.
24452 the veteran has established the causal connection between the exposure to a respiratory tract irritant and VEA service for the clinical worsening of chronic bronchitis and / or emphysema.
24459 the veteran has established the causal connection between the exposure to a respiratory tract irritant and operational service for the clinical worsening of chronic bronchitis and / or emphysema.
or
24460 the veteran has established the causal connection between the exposure to a respiratory tract irritant and eligible service for the clinical worsening of chronic bronchitis and / or emphysema.
24463 on operational service, the veteran was exposed to a respiratory tract irritant, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical onset of the condition under consideration.
24464 the exposure to a respiratory tract irritant on operational service, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical onset of the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
24467 on eligible service, the veteran was exposed to a respiratory tract irritant, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical onset of the condition under consideration.
24468 on eligible service, as a causal result of eligible service, the veteran was exposed to a respiratory tract irritant, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical onset of the condition under consideration.
24469 the exposure to a respiratory tract irritant on eligible service, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical onset of the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
24470 on operational service, the veteran was exposed to a respiratory tract irritant, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical worsening of the condition under consideration.
24474 the exposure to a respiratory tract irritant on operational service, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical worsening of the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
24475 on eligible service, the veteran was exposed to a respiratory tract irritant, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical worsening of the condition under consideration.
24476 on eligible service, as a causal result of eligible service, the veteran was exposed to a respiratory tract irritant, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical worsening of the condition under consideration.
24479 the exposure to a respiratory tract irritant on eligible service, which resulted in signs and symptoms of acute and serious insult to the lower respiratory tract, within the ten years immediately before the clinical worsening of the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.
"Immersed in an atmosphere with a visible tobacco smoke haze" means being in an environment within which tobacco smoke is present to the point where such smoke is obviously hanging in the air about and around the veteran or member.
Information about the scope and nature of various service occupations is also contained in Physical requirements, duties, and workplace hazards of specific military occupations.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Passive Smoking | CRD902.pdf [13] | CRD902.docx [14] |
Claimant Report | Passive Smoking | CRV902.pdf [15] | CRV902.docx [16] |
25962 there is some evidence that being in an atmosphere with a visible smoke haze may be a factor in the development or worsening of the condition under consideration.
24500 the veteran has smoked less than 100 cigarettes or the equivalent thereof in other tobacco products.
4926 the veteran has been in an atmosphere with a visible tobacco smoke haze in an enclosed space. [Default true]
34341 the veteran has established the causal connection between immersion in an atmosphere with a visible tobacco smoke haze and operational service for chronic bronchitis and / or emphysema.
34342 the veteran has established the causal connection between immersion in an atmosphere with a visible tobacco smoke haze and operational service for the clinical onset of chronic bronchitis and / or emphysema.
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.
34343 the veteran has established the causal connection between immersion in an atmosphere with a visible tobacco smoke haze and operational service for the clinical worsening of chronic bronchitis and / or emphysema.
34344 the veteran has been immersed in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours at some time.
34345 the veteran has been immersed in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours before the clinical onset of chronic bronchitis and / or emphysema.
34347 operational service made a material contribution to the veteran's immersion in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours before the clinical onset of chronic bronchitis and / or emphysema.
34344 the veteran has been immersed in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours at some time.
34346 the veteran has been immersed in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours after the clinical onset and before the clinical worsening of chronic bronchitis and / or emphysema.
34348 operational service made a material contribution to the veteran's immersion in an atmosphere with a visible tobacco smoke haze in an enclosed space for at least 10000 hours after the clinical onset and before the clinical worsening of chronic bronchitis and / or emphysema.
There is no Repatriation Medical Authority (RMA) definition of this Statement of Principle (SOP) factor.
The most common forms of crystalline silica are quartz, cristobalite and tridymite. Crystalline silica is the principle component of sandstone and other rocks.
Examples of occupations with respirable crystalline silica dust exposure
Additional information about the scope and nature of particular service occupations may be located in Physical requirements, duties, and workplace hazards of specific military occupations which also contains an embedded hotword: Military occupations with fumes and irritants component.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Inhaling Respirable Crystalline Silica Dust | CR9105.pdf [17] | CR9105.docx [18] |
24551 there is some evidence that inhaling respirable crystalline silica dust may be a factor in the development or worsening of the condition under consideration.
24552 the veteran has inhaled respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema at some time.
24554 the veteran has established the causal connection between inhaling respirable crystalline silica dust and VEA service for chronic bronchitis and / or emphysema.
24555 the veteran has established the causal connection between inhaling respirable crystalline silica dust and VEA service for the clinical onset of chronic bronchitis and / or emphysema.
24557 the veteran has established the causal connection between inhaling respirable crystalline silica dust and operational service for the clinical onset of chronic bronchitis and / or emphysema.
or
24558 the veteran has established the causal connection between inhaling respirable crystalline silica dust and eligible service for the clinical onset of chronic bronchitis and / or emphysema.
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.
24556 the veteran has established the causal connection between inhaling respirable crystalline silica dust and VEA service for the clinical worsening of chronic bronchitis and / or emphysema.
24559 the veteran has established the causal connection between inhaling respirable crystalline silica dust and operational service for the clinical worsening of chronic bronchitis and / or emphysema.
or
24560 the veteran has established the causal connection between inhaling respirable crystalline silica dust and eligible service for the clinical worsening of chronic bronchitis and / or emphysema.
24561 the veteran has inhaled respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 370 days.
24562 the veteran has inhaled respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 370 days before the clinical onset of chronic bronchitis and / or emphysema.
24567 operational service made a material contribution to the veteran's inhalation of respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 370 days before the clinical onset of chronic bronchitis and / or emphysema.
24564 the veteran has inhaled respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 925 days.
24565 the veteran has inhaled respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 925 days before the clinical onset of chronic bronchitis and / or emphysema.
24568 eligible service made a material contribution to the veteran's inhalation of respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 925 days before the clinical onset of chronic bronchitis and / or emphysema.
24561 the veteran has inhaled respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 370 days.
24563 the veteran has inhaled respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 370 days after the clinical onset and before the clinical worsening of chronic bronchitis and / or emphysema.
24569 operational service made a material contribution to the veteran's inhalation of respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 370 days after the clinical onset and before the clinical worsening of chronic bronchitis and / or emphysema.
24564 the veteran has inhaled respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 925 days.
24566 the veteran has inhaled respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 925 days after the clinical onset and before the clinical worsening of chronic bronchitis and / or emphysema.
24570 eligible service made a material contribution to the veteran's inhalation of respirable crystalline silica dust as defined in the Statements of Principles for chronic bronchitis and / or emphysema for a period or periods of time totalling at least 925 days after the clinical onset and before the clinical worsening of chronic bronchitis and / or emphysema.
Biomass is organic non-fossil material, collectively. For example, recently living plants (including trees) and animals are biomass, as are the materials they produce, such as animal droppings and wood.
Fossil fuels are hydrocarbon-containing natural resources such as coal, petroleum and natural gas.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Inhaling Smoke from Biomass or Fossil Fuel Combustion | CR9104.pdf [19] | CR9104.docx [20] |
24481 there is some evidence that inhaling smoke from the combustion of biomass or fossil fuels may be a factor in the development or worsening of the condition under consideration.
24484 the veteran has established the causal connection between inhaling smoke from the combustion of biomass or fossil fuels and VEA service for chronic bronchitis and / or emphysema.
24485 the veteran has established the causal connection between inhaling smoke from the combustion of biomass or fossil fuels and VEA service for the clinical onset of chronic bronchitis and / or emphysema.
24487 the veteran has established the causal connection between inhaling smoke from the combustion of biomass or fossil fuels and operational service for the clinical onset of chronic bronchitis and / or emphysema.
or
24488 the veteran has established the causal connection between inhaling smoke from the combustion of biomass or fossil fuels and eligible service for the clinical onset of chronic bronchitis and / or emphysema.
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.
24486 the veteran has established the causal connection between inhaling smoke from the combustion of biomass or fossil fuels and VEA service for the clinical worsening of chronic bronchitis and / or emphysema.
24489 the veteran has established the causal connection between inhaling smoke from the combustion of biomass or fossil fuels and operational service for the clinical worsening of chronic bronchitis and / or emphysema.
or
24490 the veteran has established the causal connection between inhaling smoke from the combustion of biomass or fossil fuels and eligible service for the clinical worsening of chronic bronchitis and / or emphysema.
24482 the veteran has inhaled smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 2000 hours at some time.
24491 the veteran inhaled smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 2000 hours before the clinical onset of chronic bronchitis and / or emphysema.
24492 operational service made a material contribution to the veteran's inhalation of smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 2000 hours before the clinical onset of chronic bronchitis and / or emphysema.
24483 the veteran has inhaled smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 5000 hours at some time.
24494 the veteran inhaled smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 5000 hours before the clinical onset of chronic bronchitis and / or emphysema.
24495 eligible service made a material contribution to the veteran's inhalation of smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 5000 hours before the clinical onset of chronic bronchitis and / or emphysema.
24482 the veteran has inhaled smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 2000 hours at some time.
24498 the veteran inhaled smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 2000 hours after the clinical onset and before the clinical worsening of chronic bronchitis and / or emphysema.
24499 operational service made a material contribution to the veteran's inhalation of smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 2000 hours after the clinical onset and before the clinical worsening of chronic bronchitis and / or emphysema.
24483 the veteran has inhaled smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 5000 hours at some time.
24502 the veteran inhaled smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 5000 hours after the clinical onset and before the clinical worsening of chronic bronchitis and / or emphysema.
24503 eligible service made a material contribution to the veteran's inhalation of smoke from the combustion of biomass or fossil fuels whilst in an enclosed space for a total of at least 5000 hours after the clinical onset and before the clinical worsening of chronic bronchitis and / or emphysema.
Inability to obtain appropriate clinical management for chronic bronchitis and emphysema
Appropriate clinical management for chronic bronchitis and/or emphysema includes identification of the disease process, institution of measures to prevent further deterioration (e.g. cessation of smoking, avoidance of respiratory infection) active treatment of infection, maximising of residual lung function and management of complications.
Inability to obtain appropriate clinical management
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Inability to Obtain Appropriate Clinical Management | GQACM.pdf [21] | GQACM.docx [22] |
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.Ê
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.
If there is a history of pipe smoking it will be necessary to obtain information about:
The evidence gathered should be as complete and accurate as possible. Information already held in departmental files, eg in previous statements and clinical notes, should not be overlooked. Conflicting evidence should be resolved.
Before a causal link between a smoking habit and service may be established, consideration must be given to Repatriation Commission Guideline CM5030 - Guideline for claims assessors on smoking and alcohol related conditions and military service [6].
Note: The Statement of Principles (SOP) factor dealing with pipe smoking covers only the smoking of tobacco. It does not include non-tobacco products such as marijuana or hashish. This is because the Repagtriation Medical Authority SOP factors refer to "cigarettes or the equivalent thereof in other tobacco products".
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [7] | CRD905.docx [8] |
Claimant Report | Smoking | CRV905.pdf [9] | CRV905.docx [23] |
26927 there is some evidence that pipe smoking may be a factor in the development or worsening of the condition under consideration.
4880 the veteran has ever smoked pipe tobacco.
24537 the veteran has established the causal connection between the pipe smoking and VEA service for chronic bronchitis and / or emphysema.
24538 the veteran has established the causal connection between the pipe smoking and VEA service for the clinical onset of chronic bronchitis and / or emphysema.
24540 the veteran has established the causal connection between the pipe smoking and operational service for the clinical onset of chronic bronchitis and / or emphysema.
or
2454 the veteran has established the causal connection between the pipe smoking and eligible service for the clinical onset of chronic bronchitis and / or emphysema.
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.
24539 the veteran has established the causal connection between the pipe smoking and VEA service for the clinical worsening of chronic bronchitis and / or emphysema.
24542 the veteran has established the causal connection between the pipe smoking and operational service for the clinical worsening of chronic bronchitis and / or emphysema.
or
24543 the veteran has established the causal connection between the pipe smoking and eligible service for the clinical worsening of chronic bronchitis and / or emphysema.
24544 the veteran has smoked at least five pack years of pipe tobacco before the clinical onset of chronic bronchitis and / or emphysema.
4911 the veteran has some period or periods of pipe smoking that are causally related to operational service.
24545 the veteran has smoked at least ten pack years of pipe tobacco before the clinical onset of chronic bronchitis and / or emphysema.
4913 the veteran has some period or periods of pipe smoking that are causally related to eligible service.
24546 the veteran has smoked at least five pack years of pipe tobacco before the clinical worsening of chronic bronchitis and / or emphysema.
4911 the veteran has some period or periods of pipe smoking that are causally related to operational service.
24547 the clinical onset of chronic bronchitis and / or emphysema occurred prior to that part of operational service to which the period or periods of pipe smoking are causally related.
24548 the veteran has smoked at least ten pack years of pipe tobacco before the clinical worsening of chronic bronchitis and / or emphysema.
4913 the veteran has some period or periods of pipe smoking that are causally related to eligible service.
24549 the clinical onset of chronic bronchitis and / or emphysema occurred prior to that part of eligible service to which the period or periods of pipe smoking are causally related.
Smoking cigarettes, cigars or pipe tobacco due to VEA service need only have made a material contribution to the minimum smoking requirements specified in the SOP (refer Kattenberg v Repatriation Commission [2002] FCA 412). It has not been possible to make changes to the smoking module in CCPS to take account of this, but for many cases this is of no consequence because service-related smoking alone is sufficient to meet the Statement of Principle (SOP) requirements. However, for smoking cases that do not succeed under the CCPS smoking module, there is a contention:
Smoking tobacco products - material contribution
This contention covers all types of smoking – cigarettes, pipe and cigars - with rulebase questions to ascertain whether or not VEA service made a material contribution to the SOP requirements. This may entail addressing issues that have already been covered in the smoking module because it has not been possible to isolate specific facts established within that module
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Smoking | CRD905.pdf [7] | CRD905.docx [8] |
Claimant Report | Smoking | CRV905.pdf [9] | CRV905.docx [23] |
30303 the veteran has smoked cigarettes, cigars or pipe tobacco at some time.
34325 the veteran has established the causal connection between smoking tobacco products and VEA service for chronic bronchitis and / or emphysema.
34326 the veteran has established the causal connection between smoking tobacco products and VEA service for the clinical onset of chronic bronchitis and / or emphysema.
34328 the veteran has established the causal connection between smoking tobacco products and operational service for the clinical onset of chronic bronchitis and / or emphysema.
or
34329 the veteran has established the causal connection between smoking tobacco products and eligible service for the clinical onset of chronic bronchitis and / or emphysema.
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.
34327 the veteran has established the causal connection between smoking tobacco products and VEA service for the clinical worsening of chronic bronchitis and / or emphysema.
34330 the veteran has established the causal connection between smoking tobacco products and operational service for the clinical worsening of chronic bronchitis and / or emphysema.
or
34331 the veteran has established the causal connection between smoking tobacco products and eligible service for the clinical worsening of chronic bronchitis and / or emphysema.
34332 the veteran has smoked at least five pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of chronic bronchitis and / or emphysema.
34336 smoking as a causal result of operational service made a material contribution to the Statement of Principles requirements for the clinical onset of chronic bronchitis and / or emphysema.
34333 the veteran has smoked at least ten pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of chronic bronchitis and / or emphysema.
34337 smoking as a causal result of eligible service made a material contribution to the Statement of Principles requirements for the clinical onset of chronic bronchitis and / or emphysema.
34334 the veteran has smoked at least five pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of chronic bronchitis and / or emphysema.
34701 the veteran's smoking of at least five pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical worsening of chronic bronchitis and / or emphysema took place after the clinical onset of chronic bronchitis and / or emphysema.
34338 smoking as a causal result of operational service made a material contribution to the Statement of Principles requirements for the clinical worsening of chronic bronchitis and / or emphysema.
Links
[1] http://www.rma.gov.au/assets/SOP/2023/437e5d9c3a/017.pdf
[2] http://www.rma.gov.au/assets/SOP/2023/fae7b0ec8a/018.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/63396%23comment-form
[5] http://www.rma.gov.au/SOP/alpha_ind/c.htm
[6] https://clik.dva.gov.au/compensation-and-support-reference-library/commission-guidelines/cm5030-guideline-claims-assessors-smoking-and-alcohol-related-conditions-and-military-service
[7] https://clik.dva.gov.au/system/files/media/CRD905_4.pdf
[8] https://clik.dva.gov.au/system/files/media/CRD905_3.docx
[9] https://clik.dva.gov.au/system/files/media/CRV905_4.pdf
[10] https://clik.dva.gov.au/system/files/media/CRV905_6.docx
[11] https://clik.dva.gov.au/system/files/media/CR9103.pdf
[12] https://clik.dva.gov.au/system/files/media/CR9103.docx
[13] https://clik.dva.gov.au/system/files/media/CRD902.pdf
[14] https://clik.dva.gov.au/system/files/media/CRD902.docx
[15] https://clik.dva.gov.au/system/files/media/CRV902.pdf
[16] https://clik.dva.gov.au/system/files/media/CRV902.docx
[17] https://clik.dva.gov.au/system/files/media/CR9105.pdf
[18] https://clik.dva.gov.au/system/files/media/CR9105.docx
[19] https://clik.dva.gov.au/system/files/media/CR9104.pdf
[20] https://clik.dva.gov.au/system/files/media/CR9104.docx
[21] https://clik.dva.gov.au/system/files/media/GQACM_7.pdf
[22] https://clik.dva.gov.au/system/files/media/GQACM_7.docx
[23] https://clik.dva.gov.au/system/files/media/CRV905_4.docx