Peripheral neuropathy — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 72 of 2023

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 peripheral neuropathy or death from peripheral neuropathy with the circumstances of a person's relevant service:

1. (1)
   having amyloidosis at the time of the clinical onset of peripheral neuropathy;

   Note: amyloidosis is defined in the Schedule 1 - Dictionary.

2. (2)
   having chronic liver disease at the time of the clinical onset of peripheral neuropathy;
3. (3)
   having chronic renal failure at the time of the clinical onset of peripheral neuropathy;

   Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

4. (4)
   having sarcoidosis at the time of the clinical onset of peripheral neuropathy;
5. (5)
   having an endocrine disease from the specified list of endocrine diseases at the time of the clinical onset of peripheral neuropathy;

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

6. (6)
   having an autoimmune disease from the specified list of autoimmune diseases at the time of the clinical onset of peripheral neuropathy;

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

7. (7)
   having a systemic vasculitis from the specified list of forms of systemic vasculitis at the time of the clinical onset of peripheral neuropathy;

   Note: specified list of forms of systemic vasculitis is defined in the Schedule 1 - Dictionary.

8. (8)
   having an infection from the specified list of infections at the time of the clinical onset of peripheral neuropathy;

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

9. (9)
   having a haematological or lymphoproliferative disorder from the specified list of haematological or lymphoproliferative disorders at the time of the clinical onset of peripheral neuropathy;

   Note: specified list of haematological or lymphoproliferative disorders is defined in the Schedule 1 - Dictionary.

10. (10)
    having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, at the time of the clinical onset of peripheral neuropathy;
11. (11)
    having a neurological paraneoplastic syndrome at the time of the clinical onset of peripheral neuropathy;
12. (12)
    having a critical illness within the 30 days before the clinical onset of peripheral neuropathy;

    Note: critical illness is defined in the Schedule 1 - Dictionary.

13. (13)
    having severe alcohol use disorder at the time of the clinical onset of peripheral neuropathy;

    Note: severe alcohol use disorder is defined in the Schedule 1 - Dictionary.

14. (14)
    consuming at least 200 kilograms of alcohol within the 10 years before the clinical onset of peripheral neuropathy;

    Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

15. (15)
    inhaling, ingesting or having cutaneous contact with a chemical from the specified list of chemicals (short term exposure); (a) on at least 30 occasions within a continuous period of 6 months before the clinical onset of peripheral neuropathy; and (b) where exposure has ceased before the clinical onset of peripheral neuropathy, then that onset occurred within 3 months of cessation;

    Note: specified list of chemicals ( short term exposure) is defined in the Schedule 1 - Dictionary.

16. (16)
    inhaling, ingesting or having cutaneous contact with a chemical from the specified list of chemicals (long term exposure): (a) on more days than not for at least 1 year before the clinical onset of peripheral neuropathy; and (b) where exposure has ceased before the clinical onset of peripheral neuropathy, then that onset occurred within 3 months of cessation;

    Note: specified list of chemicals (long term exposure) is defined in the Schedule 1 - Dictionary.

17. (17)
    having a severe substance use disorder involving inhalation of a substance from the specified list of substances at the time of the clinical onset of peripheral neuropathy;

    Note: severe substance use disorder and specified list of substances are defined in the Schedule 1 - Dictionary.

18. (18)
    inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) within the 30 days before the clinical onset of peripheral neuropathy;

    Note: inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) is defined in the Schedule 1 - Dictionary.

19. (19)
    having an episode of acute cholinergic poisoning from exposure to an organophosphorus compound or a carbamate insecticide within the 2 months before the clinical onset of peripheral neuropathy;

    Note: acute cholinergic poisoning and organophosphorus compound are defined in the Schedule 1 - Dictionary.

20. (20)
    being poisoned with an agent from the specified list of agents, as demonstrated by clinical, haematological or biochemical evidence, within the 30 days before the clinical onset of peripheral neuropathy;

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

21. (21)
    having a nutritional deficiency as specified at the time of the clinical onset of peripheral neuropathy;

    Note: nutritional deficiency as specified is defined in the Schedule 1 - Dictionary.

22. (22)
    having hypophosphataemia while undergoing total parenteral nutrition at the time of the clinical onset of peripheral neuropathy;
23. (23)
    taking a drug from the specified list of drugs that cannot be ceased or substituted, at the time of the clinical onset of peripheral neuropathy;

    Note: specified list of drugs that cannot be ceased or substituted is defined in the Schedule 1 - Dictionary.

24. (24)
    taking a drug that cannot be ceased or substituted and which is associated in the individual with the clinical onset of peripheral neuropathy during drug therapy and either: (a) the improvement of peripheral neuropathy within 3 months of discontinuing or tapering drug therapy; or (b) the redevelopment of peripheral neuropathy on rechallenge with the same drug or another drug from the same class of drugs; and where the drug was being taken at the time of the clinical onset of peripheral neuropathy;
25. (25)
    taking a drug from the specified list of drugs at the time of the clinical onset of peripheral neuropathy;

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

26. (26)
    taking a drug which is associated in the individual with the clinical onset of peripheral neuropathy during drug therapy and either: (a) the improvement of peripheral neuropathy within 3 months of discontinuing or tapering drug therapy; or (b) the redevelopment of peripheral neuropathy on rechallenge with the same drug or another drug from the same class of drugs; and where the drug was being taken at the time of the clinical onset of peripheral neuropathy;
27. (27)
    being treated with cisplatin within the 6 months before the clinical onset of peripheral neuropathy;
28. (28)
    having bariatric surgery within the 5 years before the clinical onset of peripheral neuropathy;

    Note: bariatric surgery is defined in the Schedule 1 - Dictionary.

29. (29)
    having vitamin B6 (pyridoxine) hypervitaminosis at the time of the clinical onset of peripheral neuropathy;

    Note: vitamin B6 (pyridoxine) hypervitaminosis is defined in the Schedule 1 - Dictionary.

30. (30)
    undergoing stem cell or bone marrow transplantation before the clinical onset of peripheral neuropathy;
31. (31)
    having acute carbon monoxide poisoning, with a carboxyhaemoglobin level of over 20 percent, within the 30 days before the clinical onset of peripheral neuropathy;
32. (32)
    having amyloidosis at the time of the clinical worsening of peripheral neuropathy;

    Note: amyloidosis is defined in the Schedule 1 - Dictionary.

33. (33)
    having chronic liver disease at the time of the clinical worsening of peripheral neuropathy;
34. (34)
    having chronic renal failure at the time of the clinical worsening of peripheral neuropathy;

    Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

35. (35)
    having sarcoidosis at the time of the clinical worsening of peripheral neuropathy;
36. (36)
    having an endocrine disease from the specified list of endocrine diseases at the time of the clinical worsening of peripheral neuropathy;

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

37. (37)
    having an autoimmune disease from the specified list of autoimmune diseases at the time of the clinical worsening of peripheral neuropathy;

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

38. (38)
    having a systemic vasculitis from the specified list of forms of systemic vasculitis at the time of the clinical worsening of peripheral neuropathy;

    Note: specified list of forms of systemic vasculitis is defined in the Schedule 1 - Dictionary.

39. (39)
    having a haematological or lymphoproliferative disorder from the specified list of haematological or lymphoproliferative disorders at the time of the clinical worsening of peripheral neuropathy;

    Note: specified list of haematological or lymphoproliferative disorders is defined in the Schedule 1 - Dictionary.

40. (40)
    having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, at the time of the clinical worsening of peripheral neuropathy;
41. (41)
    having a neurological paraneoplastic syndrome at the time of the clinical worsening of peripheral neuropathy;
42. (42)
    having a critical illness within the 30 days before the clinical worsening of peripheral neuropathy;

    Note: critical illness is defined in the Schedule 1 - Dictionary.

43. (43)
    having severe alcohol use disorder at the time of the clinical worsening of peripheral neuropathy;

    Note: severe alcohol use disorder is defined in the Schedule 1 - Dictionary.

44. (44)
    consuming at least 200 kilograms of alcohol within the 10 years before the clinical worsening of peripheral neuropathy;

    Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

45. (45)
    inhaling, ingesting or having cutaneous contact with a chemical from the specified list of chemicals (short term exposure); (a) on at least 30 occasions within a continuous period of 6 months before the clinical worsening of peripheral neuropathy; and (b) where exposure has ceased before the clinical worsening of peripheral neuropathy, then that worsening occurred within 3 months of cessation;

    Note: specified list of chemicals (short term exposure) is defined in the Schedule 1 - Dictionary.

46. (46)
    inhaling, ingesting or having cutaneous contact with a chemical from the specified list of chemicals (long term exposure): (a) on more days than not for at least 1 year before the clinical worsening of peripheral neuropathy, and (b) where exposure has ceased before the clinical worsening of peripheral neuropathy, then that worsening occurred within 3 months of cessation;

    Note: specified list of chemicals (long term exposure) is defined in the Schedule 1 - Dictionary.

47. (47)
    having a severe substance use disorder involving inhalation of a substance from the specified list of substances at the time of the clinical worsening of peripheral neuropathy;

    Note: severe substance use disorder and specified list of substances are defined in the Schedule 1 - Dictionary.

48. (48)
    inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) within the 30 days before the clinical worsening of peripheral neuropathy;

    Note: inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) is defined in the Schedule 1 - Dictionary.

49. (49)
    having an episode of acute cholinergic poisoning from exposure to an organophosphorus compound or a carbamate insecticide within the 2 months before the clinical worsening of peripheral neuropathy;

    Note: acute cholinergic poisoning and organophosphorus compound are defined in the Schedule 1 - Dictionary.

50. (50)
    being poisoned with an agent from the specified list of agents, as demonstrated by clinical, haematological or biochemical evidence, within the 30 days before the clinical worsening of peripheral neuropathy;

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

51. (51)
    having a nutritional deficiency as specified at the time of the clinical worsening of peripheral neuropathy;

    Note: nutritional deficiency as specified is defined in the Schedule 1 - Dictionary.

52. (52)
    having hypophosphataemia while undergoing total parenteral nutrition at the time of the clinical worsening of peripheral neuropathy;
53. (53)
    taking a drug from the specified list of drugs that cannot be ceased or substituted, at the time of the clinical worsening of peripheral neuropathy;

    Note: specified list of drugs that cannot be ceased or substituted is defined in the schedule 1 - Dictionary.

54. (54)
    taking a drug that cannot be ceased or substituted and which is associated in the individual with the clinical worsening of peripheral neuropathy during drug therapy and either: (a) the improvement of peripheral neuropathy within 3 months of discontinuing or tapering drug therapy; or (b) the clinical worsening of peripheral neuropathy on rechallenge with the same drug or another drug from the same class of drugs; and where the drug was being taken at the time of the clinical worsening of peripheral neuropathy;
55. (55)
    taking a drug from the specified list of drugs at the time of the clinical worsening of peripheral neuropathy;

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

56. (56)
    taking a drug which is associated in the individual with the clinical worsening of peripheral neuropathy during drug therapy and either: (a) the improvement of peripheral neuropathy within 3 months of discontinuing or tapering drug therapy; or (b) the clinical worsening of peripheral neuropathy on rechallenge with the same drug or another drug from the same class of drugs; and where the drug was being taken at the time of the clinical worsening of peripheral neuropathy;
57. (57)
    being treated with cisplatin within the 6 months before the clinical worsening of peripheral neuropathy;
58. (58)
    having bariatric surgery within the 5 years before the clinical worsening of peripheral neuropathy;

    Note: bariatric surgery is defined in the Schedule 1 - Dictionary.

59. (59)
    having vitamin B6 (pyridoxine) hypervitaminosis at the time of the clinical worsening of peripheral neuropathy;

    Note: vitamin B6 (pyridoxine) hypervitaminosis is defined in the Schedule 1 - Dictionary.

60. (60)
    undergoing stem cell or bone marrow transplantation before the clinical worsening of peripheral neuropathy;
61. (61)
    having acute carbon monoxide poisoning, with a carboxyhaemoglobin level of over 20 percent, within the 30 days before the clinical worsening of peripheral neuropathy;
62. (62)
    inability to obtain appropriate clinical management for peripheral neuropathy before the clinical worsening of peripheral neuropathy;

Aggravation-only factors: the factors in subsections 9(32) to 9(62) 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.