Deep vein thrombosis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 35 of 2021

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 deep vein thrombosis or death from deep vein thrombosis with the circumstances of a person's relevant service:

1. (1)
   having superficial vein thrombosis within the twelve months before the clinical onset of deep vein thrombosis;
2. (2)
   having external compression of the affected vein or a vein draining the affected vein at the time of the clinical onset of deep vein thrombosis;

   Note: external compression of the affected vein or a vein draining the affected vein is defined in the Schedule 1 - Dictionary.

3. (3)
   having an infection involving the affected vein at the time of the clinical onset of deep vein thrombosis;
4. (4)
   for deep vein thrombosis in an upper limb only, engagement in exercise of the affected upper limb within the seven days before the clinical onset of deep vein thrombosis;

   Note: exercise of the affected upper limb is defined in the Schedule 1 - Dictionary.

5. (5)
   undergoing a course of therapeutic radiation for cancer, where the affected vein was in the field of radiation, within the three months before the clinical onset of deep vein thrombosis;
6. (6)
   having acute myocardial infarction within the six months before the clinical onset of deep vein thrombosis;
7. (7)
   having heart failure at the time of the clinical onset of deep vein thrombosis;
8. (8)
   having a malignant neoplasm at the time of the clinical onset of deep vein thrombosis;
9. (9)
   having an aneurysm of the affected vein at the time of the clinical onset of deep vein thrombosis;
10. (10)
    being overweight or obese at the time of the clinical onset of deep vein thrombosis;

    Note: being overweight or obese is defined in the Schedule 1 - Dictionary.

11. (11)
    having chronic obstructive pulmonary disease at the time of the clinical onset of deep vein thrombosis;
12. (12)
    having sleep apnoea at the time of the clinical onset of deep vein thrombosis;
13. (13)
    being pregnant within the three months before the clinical onset of deep vein thrombosis;
14. (14)
    having cytomegalovirus infection of new onset within the 30 days before the clinical onset of deep vein thrombosis;
15. (15)
    having infection with human immunodeficiency virus or hepatitis C virus at the time of the clinical onset of deep vein thrombosis;
16. (16)
    having active tuberculosis disease within the 30 days before the clinical onset of deep vein thrombosis;

    Note: active tuberculosis disease is defined in the Schedule 1 - Dictionary.

17. (17)
    having infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within the three months before the clinical onset of deep vein thrombosis;

    Note: SARS-CoV-2 is the virus which causes coronavirus disease 2019 (COVID-19).

18. (18)
    having an autoimmune disease at the time of the clinical onset of deep vein thrombosis;

    Note: Examples of autoimmune diseases that may cause deep vein thrombosis include rheumatoid arthritis, polymyositis and Sjögren syndrome.

19. (19)
    having diabetes mellitus at the time of the clinical onset of deep vein thrombosis;
20. (20)
    having a hypercoagulable state as specified at the time of the clinical onset of deep vein thrombosis;

    Note: hypercoagulable state as specified is defined in the Schedule 1 - Dictionary.

21. (21)
    having a kidney disease from the specified list of kidney diseases at the time of the clinical onset of deep vein thrombosis;

    Note: specified list of kidney diseases is defined in the Schedule 1 - Dictionary.

22. (22)
    having a device implanted within the affected vein for a continuous period of at least 24 hours within the six months before the clinical onset of deep vein thrombosis;

    Note: Examples of implanted devices include a central venous catheter, an indwelling cardiac pacemaker and defibrillator leads.

23. (23)
    having surgery requiring a general, spinal or epidural anaesthetic within the six months before the clinical onset of deep vein thrombosis;
24. (24)
    having an injury or illness as specified within the six months before the clinical onset of deep vein thrombosis;

    Note: injury or illness as specified is defined in the Schedule 1 - Dictionary.

25. (25)
    having restricted mobility for a continuous period of at least four hours within the eight weeks before the clinical onset of deep vein thrombosis;

    Note: Examples of situations in which restricted mobility can occur include travel by road, rail or air and physical restraint.

26. (26)
    having a neurological disease that causes loss or impairment of motor function of a limb within the three months before the clinical onset of deep vein thrombosis;

    Note: Examples of neurological diseases that cause loss or impairment of motor function of a limb include cerebrovascular accident, multiple sclerosis and motor neurone disease.

27. (27)
    having a clinically significant disorder of mental health as specified at the time of the clinical onset of deep vein thrombosis;

    Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.

28. (28)
    taking a drug from the specified list of drugs within the three months before the clinical onset of deep vein thrombosis;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

29. (29)
    taking combined estrogen-progestogen contraception or taking menopausal hormone therapy as an oral estrogen, or a non-oral estrogen combined with a progestogen, for a continuous period of at least four weeks, within the three months before the clinical onset of deep vein thrombosis;

    Note: menopausal hormone therapy is defined in the Schedule 1 - Dictionary.

30. (30)
    having smoked tobacco products: (a) in an amount of at least one pack-year before the clinical onset of deep vein thrombosis; or (b) in an amount of at least 10 cigarettes per day, or the equivalent thereof in other tobacco products, for a period of at least three months before the clinical onset of deep vein thrombosis; and if smoking has ceased before the clinical onset of deep vein thrombosis, then that onset occurred within six months of cessation;

    Note: cigarettes per day, or the equivalent thereof in other tobacco products and pack-year are defined in the Schedule 1 - Dictionary.

31. (31)
    being at an altitude of at least 3,000 metres for a continuous period of at least five days within the three months before the clinical onset of deep vein thrombosis;
32. (32)
    inability to obtain appropriate clinical management for deep vein thrombosis;

Aggravation-only factors: the factors in subsection 9(32) 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.