Statement of Principles concerning coeliac disease No. 18 of 1997 (Cth)

Instrument No.18 of 1997

Determination

of

Statement of Principles

concerning

COELIAC DISEASE

ICD CODE: 579.0

Veterans’ Entitlements Act 1986

1. This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the Act).

Kind of injury, disease or death

1. (a) This Statement of Principles is about coeliac disease and death from coeliac disease.

(b) For the purposes of this Statement of Principles, “coeliac disease” means a chronic malabsorption syndrome due to inflammation in the small intestine precipitated in susceptible individuals by the ingestion of gluten, and which is characterised clinically by a range of gastrointestinal and extraintestinal manifestations which improve upon withdrawal of gluten from the diet, and by specific biopsy-demonstrated histological changes in the small intestine which improve upon withdrawal of gluten from the diet.  Coeliac disease is also known as coeliac crisis, gluten sensitive enteropathy or nontropical sprue, attracting ICD code 579.0.

Basis for determining the factors

1. On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that coeliac disease and death from coeliac disease can be related to relevant service rendered by veterans or members of the Forces.

Factors that must be related to service

1. Subject to clause 6, the factor set out in the paragraph in clause 5 must be related to any relevant service rendered by the person.

Factors

1. The factor that must exist before it can be said that, on the balance of probabilities, coeliac disease or death from coeliac disease is connected with the circumstances of a person’s relevant service is:

(a)        inability to obtain appropriate clinical management for coeliac disease, for example, consumption of a gluten containing diet where gluten containing products could not be ceased or substituted at the time of the clinical worsening of coeliac disease.

Factors that apply only to material contribution or aggravation

1. Paragraph 5(a) applies only to material contribution to, or aggravation of, coeliac disease where the person’s coeliac disease was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e) or 70(5)(d) of the Act refers.

Other definitions

1. For the purposes of this Statement of Principles:

“gluten” means a protein containing an alcohol soluble gliadin fraction which is toxic to the small intestine mucosa of patients with coeliac disease and which is found in wheat, rye and barley cereal grains and in processed food products containing these cereal grains;

“ICD code” means a number assigned to a particular kind of injury or disease in the Australian Version of The International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM), effective date of 1 July 1996, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 24447 2;

“relevant service” means:

(a)       eligible war service (other than operational service); or

(b)       defence service (other than hazardous service).

Dated this       Twentieth          day of              February           1997

The Common Seal of the    )

Repatriation Medical Authority                   )

was affixed to this instrument   )

in the presence of   )

KEN DONALD

CHAIRMAN