Statement of Principles concerning varicocele No. 124 of 1996 (Cth)

Instrument No.124 of 1996

Determination

of

Statement of Principles

concerning

VARICOCELE

ICD CODE: 456.4

Veterans’ Entitlements Act 1986

1. 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

1. (a) This Statement of Principles is about varicocele and death from varicocele.

(b) For the purposes of this Statement of Principles, “varicocele” means an abnormal tortuosity and dilatation of the veins of the pampiniform plexus within the spermatic cord usually presenting as a scrotal swelling, attracting ICD code 456.4.

Basis for determining the factors

1. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that varicocele and death from varicocele 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

1. 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

1. The factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting varicocele or death from varicocele with the circumstances of a person’s relevant service are:

(a)        suffering occlusion or narrowing of the ipsilateral testicular vein before the clinical onset of varicocele; or

(b)       for right-sided varicocele, suffering occlusion or narrowing of the inferior vena cava before the clinical onset of varicocele; or

(c)       for right-sided varicocele, where the right testicular vein drains into the right renal vein, suffering occlusion or narrowing of the right renal vein before the clinical onset of varicocele; or

(d)       for left-sided varicocele, suffering occlusion or narrowing of the left renal vein before the clinical onset of varicocele; or

(e)       suffering occlusion or narrowing of the ipsilateral testicular vein before the clinical worsening of varicocele; or

(f)        for right-sided varicocele, suffering occlusion or narrowing of the inferior vena cava before the clinical worsening of varicocele; or

(g)       for right-sided varicocele, where the right testicular vein drains into the right renal vein, suffering occlusion or narrowing of the right renal vein before the clinical worsening of varicocele; or

(h)       for left-sided varicocele, suffering occlusion or narrowing of the left renal vein before the clinical worsening of varicocele; or

(j)        inability to obtain appropriate clinical management for varicocele.

Factors that apply only to material contribution or aggravation

1. Paragraphs 5(e) to 5(j) apply only to material contribution to, or aggravation of, varicocele where the person’s varicocele 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

1. 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 1996, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 24447 2;

“relevant service” means:

(a)       operational service; or

(b)       peacekeeping service; or

(c)       hazardous service;

“suffering occlusion or narrowing” means suffering from thrombosis, tumour invasion or external compression of a vein, from conditions such as abdominal or pelvic tumour, retroperitoneal masses, or retroperitoneal fibrosis;

“testicular vein” means the vein that drains the pampiniform plexus and opens into the left renal vein on the left side, usually opening into the inferior vena cava on the right side, and which  occasionally enters the right renal vein.

Dated this       Twenty-sixth     day of          September         1996

The Common Seal of the    )

Repatriation Medical Authority                   )

was affixed to this instrument   )

in the presence of   )

KEN DONALD

CHAIRMAN