Rheumatoid arthritis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 50 of 2017

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 rheumatoid arthritis or death from rheumatoid arthritis with the circumstances of a person's relevant service:

1. (1)
   smoking at least five pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of rheumatoid arthritis, and where smoking has ceased, the clinical onset of rheumatoid arthritis has occurred within 20 years of cessation;

   Note: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

2. (2)
   inhaling respirable crystalline silica dust, at the time material containing crystalline silica was being: (a) produced; (b) excavated; (c) drilled, cut or ground; or (d) used in construction, manufacturing, cleaning or blasting; for a cumulative period of at least 2 500 hours within a continuous period of ten years, before the clinical onset of rheumatoid arthritis;
3. (3)
   being treated with a drug from Specified List 1 of drugs within the eight weeks before the clinical onset of rheumatoid arthritis;

   Note: Specified List 1 of drugs is defined in the Schedule 1 - Dictionary.

4. (4)
   having periodontitis for at least the three months before the clinical onset of rheumatoid arthritis;
5. (5)
   being obese for at least five years within the ten years before the clinical onset of rheumatoid arthritis;

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

6. (6)
   consuming an average of at least 400 millilitres per day of beverages sweetened with high fructose corn syrup, for a period of at least one year within the five years before the clinical onset of rheumatoid arthritis;
7. (7)
   having vitamin D deficiency, with a serum 25(OH)D level of less than 50 nanomoles per litre, for a continuous period of at least one year within the ten years before the clinical onset of rheumatoid arthritis;
8. (8)
   smoking at least five pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical worsening of rheumatoid arthritis, and where smoking has ceased, the clinical worsening of rheumatoid arthritis has occurred within five years of cessation;

   Note: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

9. (9)
   inhaling respirable crystalline silica dust, at the time material containing crystalline silica was being: (a) produced; (b) excavated; (c) drilled, cut or ground; or (d) used in construction, manufacturing, cleaning or blasting; for a cumulative period of at least 2 500 hours within a continuous period of ten years, before the clinical worsening of rheumatoid arthritis;
10. (10)
    being treated with a drug from Specified List 2 of drugs within the eight weeks before the clinical worsening of rheumatoid arthritis;

    Note: Specified List 2 of drugs is defined in the Schedule 1 - Dictionary.

11. (11)
    suddenly discontinuing treatment with a disease modifying antirheumatic drug after undergoing continuous disease modifying antirheumatic drug treatment for at least six months, within the six months before the clinical worsening of rheumatoid arthritis;

    Note: disease modifying antirheumatic drug is defined in the Schedule 1 - Dictionary.

12. (12)
    having periodontitis for at least the three months before the clinical worsening of rheumatoid arthritis;
13. (13)
    being obese for at least five years within the ten years before the clinical worsening of rheumatoid arthritis;

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

14. (14)
    consuming an average of at least 400 millilitres per day of beverages sweetened with high fructose corn syrup, for a period of at least one year within the five years before the clinical worsening of rheumatoid arthritis;
15. (15)
    having vitamin D deficiency, with a serum 25(OH)D level of less than 50 nanomoles per litre, for a continuous period of at least one year within the ten years before the clinical worsening of rheumatoid arthritis;
16. (16)
    inability to obtain appropriate clinical management for rheumatoid arthritis;

Aggravation-only factors: the factors in subsections 9(8) to 9(16) 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.