Statement of Principles concerning myelodysplastic disorder No. 16 of 2000 (Cth)

Instrument No.16 of 2000

Determination

of

Statement of Principles

concerning

MYELODYSPLASTIC DISORDER

ICD-10-AM CODE: D46

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 myelodysplastic disorder and death from myelodysplastic disorder.

(b)       For the purposes of this Statement of Principles, “myelodysplastic disorder” is any one of a group of acquired disorders of haematopoiesis, characterised by peripheral cytopenia, and dysplastic changes of the cell lineages of erythropoiesis, granulopoiesis and megakaryopoiesis in the bone marrow, attracting ICD-10-AM code D46.  This definition includes refractory anaemia, refractory anaemia with ring sideroblasts, refractory anaemia with excess blasts and refractory anaemia with excess blasts in transformation and excludes chronic myelomonocytic leukaemia.

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 myelodysplastic disorder and death from myelodysplastic disorder 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, at least one of the factors set out in clause 5 must be related to any relevant service rendered by the person.

Factors

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

(a)       systemic administration of a chemotherapeutic agent from the specified list at least one year before the clinical onset of a myelodysplastic disorder; or

(b)       being exposed to benzene on more days than not over a period or periods totalling five years before the clinical onset of a myelodysplastic disorder; or

(c)       inability to obtain appropriate clinical management for a myelodysplastic disorder.

Factors that apply only to material contribution or aggravation

1. Paragraph 5(c) applies only to material contribution to, or aggravation of, a myelodysplastic disorder where the person’s myelodysplastic disorder 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

1. 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

1. For the purposes of this Statement of Principles:

“a chemotherapeutic agent from the specified list” means:

(i)        an alkylating agent; or

(ii)a topoisomerase II inhibitor; or

(iii)a platinum compound;

“being exposed to benzene” means:

(i)inhaling benzene vapour where such exposure occurs at measured or estimated ambient benzene concentrations exceeding one part per million; or

(ii)having skin contact with liquids containing benzene;

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

“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), Second Edition, effective date of 1 July 2000, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 271 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.

Dated this       Twelfth              day of              July  2000

The Common Seal of the    )

Repatriation Medical Authority                   )

was affixed to this instrument   )

in the presence of   )

KEN DONALD

CHAIRMAN