Cushing syndrome
Meaning of cushing syndrome: For the purposes of this Statement of Principles, Cushing syndrome means an endocrine disorder resulting from an excess of endogenous or exogenous glucocorticoids.
Reasonable Hypothesis (RH) — Statement of Principles No. 43 of 2018
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting Cushing syndrome or death from Cushing syndrome with the circumstances of a person's relevant service:
- (1)having a specified condition at the time of the clinical onset of Cushing syndrome;
Note: specified condition is defined in the Schedule 1 - Dictionary.
- (2)having glucocorticoid therapy as specified before the clinical onset of Cushing syndrome, and where the glucocorticoid therapy as specified has ceased or decreased, the last dose of the therapy was received within the 30 days before the clinical onset of Cushing syndrome;
Note: glucocorticoid therapy as specified is defined in the Schedule 1 - Dictionary.
- (3)being treated with medroxyprogesterone acetate or megestrol acetate for a malignant disease or human immunodeficiency virus infection: (a) for at least four weeks before the clinical onset of Cushing syndrome; and (b) where treatment has ceased, the clinical onset of Cushing syndrome has occurred within 30 days of cessation;
- (4)inability to obtain appropriate clinical management for Cushing syndrome;
Aggravation-only factors: the factors in subsection 9(4) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 44 of 2018
4 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, Cushing syndrome or death from Cushing syndrome is connected with the circumstances of a person's relevant service:
- (1)having a specified condition at the time of the clinical onset of Cushing syndrome;
Note: specified condition is defined in the Schedule 1 - Dictionary.
- (2)having glucocorticoid therapy as specified before the clinical onset of Cushing syndrome, and where the glucocorticoid therapy as specified has ceased or decreased, the last dose of the therapy was received within the 30 days before the clinical onset of Cushing syndrome;
Note: glucocorticoid therapy as specified is defined in the Schedule 1 - Dictionary.
- (3)being treated with medroxyprogesterone acetate or megestrol acetate for a malignant disease or human immunodeficiency virus infection: (a) for at least four weeks before the clinical onset of Cushing syndrome; and (b) where treatment has ceased, the clinical onset of Cushing syndrome has occurred within 30 days of cessation;
- (4)inability to obtain appropriate clinical management for Cushing syndrome;
Aggravation-only factors: the factors in subsection 9(4) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
