Statement of Principles concerning mitral valve prolapse (Balance of Probabilities) (No. 16 of 2023) (Cth)

Statement of Principles

concerning

MITRAL VALVE PROLAPSE
 (Balance of Probabilities)

(No. 16 of 2023)

The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.

Dated    27 February 2023

The Common Seal of the
Repatriation Medical Authority
was affixed to this instrument
at the direction of:

Professor Terence Campbell AM
Chairperson

Contents

1Name........................................................................................................................................... 3

2Commencement........................................................................................................................ 3

3Authority..................................................................................................................................... 3

4Repeal......................................................................................................................................... 3

5Application................................................................................................................................. 3

6Definitions.................................................................................................................................. 3

7Kind of injury, disease or death to which this Statement of Principles relates............... 3

8Basis for determining the factors........................................................................................... 4

9Factors that must exist............................................................................................................. 4

10Relationship to service............................................................................................................. 4

11Factors referring to an injury or disease covered by another Statement of Principles. 5

Schedule 1 - Dictionary............................................................................................. 6

1Definitions.................................................................................................................................. 6

1. Name

This is the Statement of Principles concerning mitral valve prolapse (Balance of Probabilities) (No. 16 of 2023).

1. Commencement

This instrument commences on 27 March 2023.

1. Authority

This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.

1. Repeal

The Statement of Principles concerning mitral valve prolapse No. 44 of 2014 (Federal Register of Legislation No. F2014L00473) made under subsection/s 196B(3) of the VEA is repealed.

1. Application

This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.

1. Definitions

The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.

1. Kind of injury, disease or death to which this Statement of Principles relates

(1)This Statement of Principles is about mitral valve prolapse and death from mitral valve prolapse.

Meaning of mitral valve prolapse

(2)For the purposes of this Statement of Principles, mitral valve prolapse:

(a)means a degenerative, structural disorder of the mitral valve apparatus in which there is systolic displacement of an abnormally thickened or redundant mitral leaflet into the left atrium, and where this disorder has been confirmed by echocardiographic studies; and

(b)excludes:

(i)flail mitral valve leaflet;

(ii)inherited connective tissue disorders including Marfan syndrome;

(iii)isolated mitral regurgitation in the absence of echocardiographic evidence of mitral valve prolapse; and

(iv)mitral valve disorder due to rheumatic heart disease.

Note 1: Mitral valve prolapse is also known as Barlow syndrome, Barlow disease or floppy mitral valve syndrome.

Note 2: The diagnosis of mitral valve prolapse does not include displacement or billowing of the anterior mitral valve leaflet identified only in the 4-chamber apical view.

(3)While mitral valve prolapse attracts ICD‑10‑AM code I34.1, in applying this Statement of Principles the meaning of mitral valve prolapse is that given in subsection (2).

(4)For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.

Death from mitral valve prolapse

(5)For the purposes of this Statement of Principles, mitral valve prolapse, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's mitral valve prolapse.

Note: terminal event is defined in the Schedule 1 – Dictionary.

1. Basis for determining the factors

On the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that mitral valve prolapse and death from mitral valve prolapse can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.

Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.

1. Factors that must exist

At least one of the following factors must exist before it can be said that, on the balance of probabilities, mitral valve prolapse or death from mitral valve prolapse is connected with the circumstances of a person's relevant service:

(1)inability to obtain appropriate clinical management for mitral valve prolapse.

1. Relationship to service

(1)The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.

(2)The factor set out in subsection 9(1) applies only to material contribution to, or aggravation of, mitral valve prolapse where the person's mitral valve prolapse was suffered or contracted before or during (but did not arise out of) the person's relevant service.

1. Factors referring to an injury or disease covered by another Statement of Principles

In this Statement of Principles:

(1)if a factor referred to in section 9 applies in relation to a person; and

(2)that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;

then the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.

Schedule 1 - Dictionary

Note: See Section 6

1. Definitions

In this instrument:

mitral valve prolapse—see subsection 7(2).

MRCAmeans the Military Rehabilitation and Compensation Act 2004.

relevant service means:

(a)eligible war service (other than operational service) under the VEA;

(b)defence service (other than hazardous service and British nuclear test defence service) under the VEA; or

(c)peacetime service under the MRCA.

Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.

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

(a) pneumonia;

(b) respiratory failure;

(c) cardiac arrest;

(d) circulatory failure; or

(e) cessation of brain function.

VEA means the Veterans' Entitlements Act 1986.