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SOP Bulletin No. 104

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8 May 2006

THE FOLLOWING RMA DECLARATION AND SOPS ARE TO TAKE EFFECT ON 10 MAY, 2006
Declaration / Osteopaenia
New SOPs / Vascular Dementia
Revocations & Replacements / Soft Tissue Sarcoma
Non-Melanotic Malignant Neoplasm of the Skin
Malignant Neoplasm of the Lung
Paget's Disease of Bone
Amendments / Open-Angle Glaucoma
Angle-Closure Glaucoma

IMPORTANT OPERATIONAL FEATURES

Osteopaenia

  • The RMA has determined that “Osteopaenia” is not a disease under the VEA. Claims for “Osteopaenia” should be investigated to see whether any other diagnoses can be made to answer the claim, but “Osteopaenia” should be treated as “no incapacity found”.
  • Osteopaenia is where there is reduced bone mass, but the bone mass is not reduced sufficiently for osteoporosis to be diagnosed. The current Osteoporosis SOPs have different definitions of disease for RH and BOP. The Osteoporosis SOPs are currently under investigation and new SOPs are anticipated in July this year.
  • The declaration finalises the formal investigation into this non-SOP condition. During the investigation, claims could not be determined for this condition. Outstanding cases may now be finalised.

Vascular Dementia
/ New – 21 & 22 of ‘06
  • These are new SOPs which cover dementia due to impaired blood supply in the brain. This is the second most common form of dementia after Alzheimer’s Disease.
  • There are causal and worsening factors in both RH and BOP for having a cerebrovascular accident before the clinical onset. This factor will directly propagate to the Cerebrovascular Accident SOP and is expected to be the most commonly used factor.
  • There are causal and worsening factors in both RH and BOP for having cerebrovascular disease before the clinical onset. Cerebrovascular disease is defined in the SOPs as any abnormality of the brain resulting from a pathologic process of the blood vessels. This is a very broad definition and includes, for example, inflammatory vascular disease and non-inflammatory arteriopathy. Cerebrovascular disease includes those conditions where there is vascular disease causing brain abnormalities, but which has not presented as a CVA.
  • These SOPs finalise the formal investigation into this previously non-SOP condition. During the investigation, claims could not be determined for this condition. Outstanding cases may now be finalised.

Soft Tissue Sarcoma / Revocation – 13 & 14 of ‘06
Replaces 23 and 24 of '01
  • There have been minor wording changes to the definition without change in meaning.
  • The Vietnam factor has the new wording, and thus includesconsumingpotable water. The latency period is now five years.
  • The herbicide factors are now dioxin factors in both RH and BOP, and includecontact with chlorophenols, which previously had separate factors.
  • There are new causal factors in both RH and BOP for ionising radiation from internal deposition of a substance which emits alpha particles, with dose and time requirements. This includes depleted uranium, which emits alpha particles. Exposure could occur from depleted uranium shrapnel.
  • This alpha emitter factor also covers exposure to thorium dioxide (Thorotrast) which previously had separate factors.
  • There is a new causal factor in RH only for having cutaneous scarring for at least three years before the clinical onset at that site.
  • The gaseous vinyl chloride factors now have a specified dose requirement, and for BOP, apply to hepatic angiosarcoma only.
  • In RH, the treatment with immunosuppressive drugs factor now applies regardless of the reason for treatment. In BOP, the factor now applies to all soft tissue sarcomas, and includes being treated with cyclophosphamide or drugs used for the purpose of suppressing the immune response after organ transplantation. Both factors require treatment for a continuous period of five months.
  • The hepatic angiosarcoma arsenic factors have been combined into one factor in the RH. This factor now includes exposure to arsenic by drinking water with a specified arsenic content or having clinical evidence of excessive arsenic exposure. There are time requirements and the latency period is now five years.
  • The arsenic factors have been removed from the BOP SOP.
  • The chronic solar skin damage factor for cutaneous atypical fibroxanthoma has been removed from the BOP SOP.
  • The uterine sarcoma tamoxifen factor is now also in the BOP SOP, with treatment time requirements of 2 months RH/ 4 months BOP

Non-Melanotic Malignant Neoplasm of the Skin / Revocation – 15 & 16 of ‘06
Replaces 48 and 49 of '04
  • The SOP definition has been changed to include carcinoma in situ (aka Bowen’s disease). Claims for carcinoma in situ of the skin should now be considered under these SOPs.

Malignant Neoplasm of the Lung / Revocation – 17 & 18 of ‘06
Replaces 35 and 36 of '01
  • The definition has been reworded and now excludes carcinoid tumour.
  • There is a new causal factor in RH only for drinking at least 350 kilograms of alcohol within a continuous 25 year period.
  • The Vietnam factor has new wording and includes consuming potable water.
  • The passive smoking factor has been reworded to remove the carcinoid tumour exclusion which is no longer required. The total hours of exposure have been reduced to 5000 for both RH and BOP (previously 5200 hrs).
  • The latency periods for the RH asbestos factors has been reduced from ten to five years.
  • The required length of exposure for the industrial coke oven factors has been changed to 4500 hrs for both RH and BOP (previously 180 days). The latency for the BOP factor has been increased to ten years.
  • The dioxin factors have been reworded and have a new definition.
  • The factors for inhaling inorganic arsenic, cadmium, nickel hexavalent chromate, beryllium, bis (chloromethyl) ether or chloromethyl methyl ether fumes have been combined into one factor. The latency is five years RH/10 years BOP (previously 10/20). The arsenic substance is now inorganic arsenic (previously organic arsenic).
  • There is a new causal factor in both RH and BOP for having berylliosis at the time of the clinical onset.

Paget’s' Disease of Bone / Revocation – 19 & 20 of ‘06
Replaces 15 and 16 of '96
  • These SOPs have been re-organised into the new format. No changes to SOP definition. SOPs still have only the “appropriate clinical management” factor.

Open-Angle Glaucoma / Amendment – 23 & 24 of ’06
Amends 69 and 70 of '01
  • The definition of “significant trauma to the affected eye” has been amended to include radiation injury. The definition now reads:

“‘significant trauma to the affected eye’ means penetrating, blunt, chemical or radiation injury involving the affected eye that results in intraocular inflammation, intraocular bleeding or other intraocular tissue disruption;”

Angle-Closure Glaucoma / Amendment – 25 & 26 of ’06
Amends 15 and 16 of '99
  • The definition of “significant trauma to the affected eye” has been amended to be the same as is now in Open-Angle Glaucoma. The phrase “to the affected eye” was changed to “involving the affected eye”.

Contact Officers for this bulletin:
Maureen Anderson50365
Dr Bev Grehan48376
Dr Jon Kelley48412

Remember! If you are having any problems with SOPs, or SOPs in CCPS, talk to us!

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