Statement of Principles concerning obstructive nephropathy No. 87 of 1996 (Cth)
Instrument No.87 of 1996
Determination
of
Statement of Principles
concerning
OBSTRUCTIVE NEPHROPATHY
ICD CODES: 591, 593.5, 593.89, 599.6
Veterans’ Entitlements Act 1986
This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act).
Kind of injury, disease or death
(a) This Statement of Principles is about obstructive nephropathy and death from obstructive nephropathy.
(b) For the purposes of this Statement of Principles, “obstructive nephropathy” means a disorder characterised by functional and pathological changes in the kidney resulting from complete or partial obstruction of the urinary tract, and which includes the conditions of hydronephrosis or hydroureter, attracting ICD code 591, 593.5, 593.89 or 599.6.
Basis for determining the factors
The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that obstructive nephropathy can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces.
Factors that must be related to service
Subject to clause 6, the factors set out in at least one of the paragraphs in clause 5 must be related to any relevant service rendered by the person.
Factors
The factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting obstructive nephropathy or death from obstructive nephropathy with the circumstances of a person’s relevant service are:
(a) suffering complete obstruction of the renal pelvicalyceal system or ureter on the affected side, for a continuous period of at least 7 days before the clinical onset of obstructive nephropathy; or
(b) suffering partial obstruction of the renal pelvicalyceal system or ureter on the affected side, for a continuous period of at least 30 days before the clinical onset of obstructive nephropathy; or
(c) suffering obstruction of the bladder outlet for a continuous period of at least 30 days before the clinical onset of obstructive nephropathy; or
(d) suffering obstruction of the urethra for a continuous period of at least 30 days before the clinical onset of obstructive nephropathy; or
(e) suffering complete obstruction of the renal pelvicalyceal system or ureter on the affected side, for a continuous period of at least 7 days before the clinical worsening of obstructive nephropathy; or
(f) suffering partial obstruction of the renal pelvicalyceal system or ureter on the affected side, for a continuous period of at least 30 days before the clinical worsening of obstructive nephropathy; or
(g) suffering obstruction of the bladder outlet for a continuous period of at least 30 days before the clinical worsening of obstructive nephropathy; or
(h) suffering obstruction of the urethra for a continuous period of at least 30 days before the clinical worsening of obstructive nephropathy; or
(j) inability to obtain appropriate clinical management for obstructive nephropathy.
Factors that apply only to material contribution or aggravation
Paragraphs 5(e) to 5(j) apply only to material contribution to, or aggravation of, obstructive nephropathy where the person’s obstructive nephropathy was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70(5A)(d) of the Act refers.
Other definitions
For the purposes of this Statement of Principles:
“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 1995, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 22235 5;
“obstruction of the bladder outlet” means a blockage to the flow of urine resulting from pathology such as:
(i) bladder calculi, ICD code 594.1; or
(ii) bladder tumours, ICD code 188, 198.1, 223.3, 236.7 or 239.4; or
(iii) neurogenic bladder, ICD code 344.61 or 596.5; or
(iv) pelvic masses; or
(v) bladder pathology resulting from cyclophosphamide therapy, ICD code 595.89; or
(vi) bladder neck obstruction, ICD code 596.0; or
(vii) pelvic or abdominal trauma (including surgery); or
(viii) vesicoureteral reflux, ICD code 593.7;
“obstruction of the urethra” means a blockage to the flow of urine resulting from pathology such as:
(i) urethral calculi, ICD code 594.2, 594.8 or 594.9; or
(ii) tumours, ICD code 189.3, 198.1, 223.81 or 236.99; or
(iii) benign prostatomegaly, ICD code 222.2 or 600; or
(iv) prostatic carcinoma, ICD code 185, 198.82 or 236.5; or
(v) urethral stricture, ICD code 593.4 or 598; or
(vi) pelvic or abdominal trauma (including surgery);
“obstruction of the renal pelvicalyceal system or ureter” means a blockage to the flow of urine at the level of the upper urinary tract, resulting from pathology such as:
(i) calculi, ICD code 592.0, 592.1; or
(ii) blood clots, ICD code 593.4; or
(iii) sloughed renal papillae, ICD code 593.4; or
(iv) tumours of the renal pelvis, ureter or bladder, ICD code 188, 189.1, 189.2, 198.1, 223.1, 223.2 or 223.3; or
(v) stricture of the ureter, ICD code 593.3; or
(vi) genitourinary tuberculosis, ICD code 016.1 or 016.2; or
(vii) interstitial cystitis, ICD code 595.1; or
(viii) chronic inflammatory bowel disease, ICD code 555 or 556; or
(ix) retroperitoneal fibrosis, ICD code 593.4; or
(x) abdominal and pelvic masses (eg. uterine leiomyoma, benign neoplasm of ovary, malignant neoplasm of ovary, malignant neoplasm of uterus, malignant neoplasm of colon); or
(xi) surgical ligation of the ureter; or
(xii) aortoiliac surgery; or
(xiii) pelvic or abdominal trauma; or
(xiv) pelvic endometriosis, ICD code 617.3; or
(xv) urinary schistosomiasis, ICD code 120.0; or
(xvi) retroperitoneal haematoma, ICD code 568.81;
“relevant service” means:
(a) operational service; or
(b) peacekeeping service; or
(c) hazardous service.
Dated this Eighteenth day of June 1996
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of )
KEN DONALD
CHAIRMAN
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