Pulmonary thromboembolism — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 37 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 pulmonary thromboembolism or death from pulmonary thromboembolism with the circumstances of a person's relevant service:

1. (1)
   having a deep vein thrombosis within the six months before the clinical onset of pulmonary thromboembolism;
2. (2)
   having superficial vein thrombosis within the twelve months before the clinical onset of pulmonary thromboembolism;
3. (3)
   having acute myocardial infarction within the six months before the clinical onset of pulmonary thromboembolism;
4. (4)
   having heart failure or a thrombus within the right atrium or right ventricle at the time of the clinical onset of pulmonary thromboembolism;
5. (5)
   having a malignant neoplasm at the time of the clinical onset of pulmonary thromboembolism;
6. (6)
   having an aneurysm of a vein in the deep venous system at the time of the clinical onset of pulmonary thromboembolism;
7. (7)
   being overweight or obese at the time of the clinical onset of pulmonary thromboembolism;

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

8. (8)
   having chronic obstructive pulmonary disease at the time of the clinical onset of pulmonary thromboembolism;
9. (9)
   having sleep apnoea at the time of the clinical onset of pulmonary thromboembolism;
10. (10)
    being pregnant within the three months before the clinical onset of pulmonary thromboembolism;
11. (11)
    having cytomegalovirus infection of new onset within the 30 days before the clinical onset of pulmonary thromboembolism;
12. (12)
    having infection with human immunodeficiency virus or hepatitis C virus at the time of the clinical onset of pulmonary thromboembolism;
13. (13)
    having active tuberculosis disease within the 30 days before the clinical onset of pulmonary thromboembolism;

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

14. (14)
    having infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within the three months before the clinical onset of pulmonary thromboembolism;

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

15. (15)
    having an autoimmune disease at the time of the clinical onset of pulmonary thromboembolism;

    Note: Examples of autoimmune diseases that may cause pulmonary thromboembolism include rheumatoid arthritis, polymyositis and Sjögren syndrome.

16. (16)
    having diabetes mellitus at the time of the clinical onset of pulmonary thromboembolism;
17. (17)
    having a hypercoagulable state as specified at the time of the clinical onset of pulmonary thromboembolism;

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

18. (18)
    having a kidney disease from the specified list of kidney diseases at the time of the clinical onset of pulmonary thromboembolism;

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

19. (19)
    having implantation of an intravenous device for a continuous period of at least 24 hours within the six months before the clinical onset of pulmonary thromboembolism;

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

20. (20)
    having surgery requiring a general, spinal or epidural anaesthetic within the six months before the clinical onset of pulmonary thromboembolism;
21. (21)
    having an injury or illness as specified within the six months before the clinical onset of pulmonary thromboembolism;

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

22. (22)
    having restricted mobility for a continuous period of at least four hours within the eight weeks before the clinical onset of pulmonary thromboembolism;

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

23. (23)
    having a neurological disease that causes loss or impairment of motor function of a limb within the three months before the clinical onset of pulmonary thromboembolism;

    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.

24. (24)
    having a clinically significant disorder of mental health as specified at the time of the clinical onset of pulmonary thromboembolism;

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

25. (25)
    taking a drug from the specified list of drugs within the three months before the clinical onset of pulmonary thromboembolism;

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

26. (26)
    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 pulmonary thromboembolism;

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

27. (27)
    having smoked tobacco products: (a) in an amount of at least one pack-year before the clinical onset of pulmonary thromboembolism; 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 pulmonary thromboembolism; and if smoking has ceased before the clinical onset of pulmonary thromboembolism, 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.

28. (28)
    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 pulmonary thromboembolism;
29. (29)
    inability to obtain appropriate clinical management for pulmonary thromboembolism;

Aggravation-only factors: the factors in subsection 9(29) 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.