Statement of Principles concerning dementia pugilistica No. 8 of 2000 (Cth)

Instrument No.8 of 2000

Revocation and Determination

of

Statement of Principles

concerning

DEMENTIA PUGILISTICA

ICD-10-AM CODE: F02.8

Veterans’ Entitlements Act 1986

1. The Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the Act):

(a)revokes Instrument No.22 of 1997; and

(b)determines in its place the following Statement of Principles.

Kind of injury, disease or death

2.         (a)       This Statement of Principles is about dementia pugilistica and death from dementia pugilistica.

(b)      For the purposes of this Statement of Principles, “dementia pugilistica” means a chronic and progressive neurological syndrome characterised by evidence of damage to pyramidal, extrapyramidal, and cerebellar systems with associated psychosis, dementia, personality change, impaired social functioning and Parkinsonism.  It is also known as “slap-happy syndrome”, “punch drunk syndrome”, “chronic traumatic encephalopathy” or “chronic progressive traumatic encephalopathy of boxers”, attracting ICD-10-AM code F02.8.

Basis for determining the factors

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

Factors that must be related to service

4.         Subject to clause 6, at least one of the factors set out in clause 5 must be related to any relevant service rendered by the person.

Factors

5.         The factors that must exist before it can be said that, on the balance of probabilities, dementia pugilistica or death from dementia pugilistica is connected with the circumstances of a person’s relevant service are:

(a)        having experienced at least 100 discrete episodes of head trauma during each of which numerous blows to the head were sustained, where the first episode was at least ten years before the clinical onset of dementia pugilistica; or

(b)inability to obtain appropriate clinical management for dementia pugilistica.

Factors that apply only to material contribution or aggravation

6.         Paragraph 5(b) applies only to material contribution to, or aggravation of, dementia pugilistica where the person’s dementia pugilistica 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.

Inclusion of Statements of Principles

7.         In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles.

Other definitions

8.         For the purposes of this Statement of Principles:

“blows to the head” means external trauma to the head at least of the intensity that would be received from a forceful punch to the head from a gloved fist;

“death from dementia pugilistica” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s dementia pugilistica;

“ICD-10-AM code” means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), effective date of 1 July 1998, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86451 340 3;

“relevant service” means:

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

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

“terminal event” means the proximate or ultimate cause of death and includes:

a)         pneumonia;

b)         respiratory failure;

c)         cardiac arrest;

d)         circulatory failure; or

e)         cessation of brain function.

Application

9. This Instrument applies to all matters to which section 120B of the Act applies.

Dated this       Twenty-third      day of              March         2000

The Common Seal of the    )

Repatriation Medical Authority                   )

was affixed to this instrument   )

in the presence of:   )

KEN DONALD

CHAIRMAN