Statement of Principles concerning endometriosis No. 8 of 2004 (Cth)

Instrument No. 8 of 2004

Determination

of

Statement of Principles

concerning

ENDOMETRIOSIS

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

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

(b)For the purposes of this Statement of Principles, “endometriosis” means a condition in which tissue containing typical endometrial glandular and stromal elements occurs ectopically, resulting in clinical symptoms and signs or requiring treatment.

(c)Endometriosis attracts ICD-10-AM code N80.

(d)In the application of this Statement of Principles, the definition of “endometriosis” is that given at paragraph 2(b) above.

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

(a)       for postmenopausal women only, having hormone replacement therapy for a period of at least three months immediately before the clinical onset of endometriosis; or

(b)       for postmenopausal women only, having continuous tamoxifen therapy for a period of at least three months immediately before the clinical onset of endometriosis; or

(c)       for endometriosis of the abdominal wall, cervix, vagina, vulva or perineum only, having surgery or trauma involving the site of endometriosis at least 6 months before the clinical onset of endometriosis; or

(d)for postmenopausal women only, having hormone replacement therapy for a period of at least three months immediately before the clinical worsening of endometriosis; or

(e)for postmenopausal women only, having continuous tamoxifen therapy for a period of at least three months immediately before the clinical worsening of endometriosis; or

(f)       inability to obtain appropriate clinical management for endometriosis;

Factors that apply only to material contribution or aggravation

6.         Paragraphs 5(d) to 5(f) apply only to material contribution to, or aggravation of, endometriosis where the person’s endometriosis 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:

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

“hormone replacement therapy” means administration of oestrogen preparations often in combination with progesterone to offset a hormone deficiency following surgically induced or naturally occurring menopause;

“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), Third Edition, effective date of 1 July 2002, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 413 9;

“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.

Dated this       26th              day of              March   2004

The Common Seal of the    )

Repatriation Medical Authority                   )

was affixed to this instrument   )

in the presence of:   )

KEN DONALD

CHAIRMAN