Statement of Principles concerning polymyalgia rheumatica (Balance of Probabilities) (No. 20 of 2016) (Cth)

Statement of Principles

concerning

POLYMYALGIA RHEUMATICA
(Balance of Probabilities)

(No. 20 of 2016)

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

Dated    4 March   2016

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

Professor Nicholas Saunders AO

Chairperson

Contents

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

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

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

4Revocation................................................................................................................................. 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

9Factor that must exist............................................................................................................... 4

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

Schedule 1 - Dictionary............................................................................................. 5

1Definitions.................................................................................................................................. 5

1. Name

This is the Statement of Principles concerning polymyalgia rheumatica (Balance of Probabilities) (No. 20 of 2016).

1. Commencement

This instrument commences on 4 April 2016.

1. Authority

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

1. Revocation

The Statement of Principles concerning polymyalgia rheumatica No. 24 of 2008 made under subsection 196B(3) of the VEA is revoked.

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 polymyalgia rheumatica and death from polymyalgia rheumatica.

Meaning of polymyalgia rheumatica

(2)For the purposes of this Statement of Principles, polymyalgia rheumatica means:

(a)a clinical syndrome consisting of bilateral aching and stiffness persisting for at least one month involving the neck or torso, shoulder or proximal regions of the arms, or the pelvic girdle; a rapid relief of symptoms in response to corticosteroids; and with an erythrocyte sedimentation rate greater than 40 mm/hour or systemic symptoms such as malaise, fatigue and a low-grade fever, occurring in the absence of other diseases capable of causing the musculoskeletal system symptoms; and

(b)excludes polymyalgia rheumatica coexistent with giant cell arteritis.

(3)While polymyalgia rheumatica attracts ICD‑10‑AM code M35.3, in applying this Statement of Principles the meaning of polymyalgia rheumatica 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), Ninth Edition, effective date of 1 July 2015, copyrighted by the Independent Hospital Pricing Authority, ISBN 978‑1‑76007‑020‑5.

Death from polymyalgia rheumatica

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

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 polymyalgia rheumatica and death from polymyalgia rheumatica can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.

Note: relevant service is defined in the Schedule 1 – Dictionary.

1. Factor that must exist

The factor that must exist before it can be said that, on the balance of probabilities, polymyalgia rheumatica or death from polymyalgia rheumatica is connected with the circumstances of a person’s relevant service is inability to obtain appropriate clinical management for polymyalgia rheumatica.

1. Relationship to service

The existence in a person of the factor referred to in section 9, applies only to material contribution to, or aggravation of, polymyalgia rheumatica where the person’s polymyalgia rheumatica was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Schedule 1 - Dictionary

Note: See Section 6

1. Definitions

In this instrument:

MRCAmeans the Military Rehabilitation and Compensation Act 2004.

polymyalgia rheumatica—see subsection 7(2).

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.

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.