Instrument No.4 of 2003
Revocation and Determination
of
Statement of Principles
concerning
ALLERGIC RHINITIS
ICD-10-AM CODES: J30.1, J30.2, J30.3, J30.4
Veterans’ Entitlements Act 1986
1. The Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the Act):
(a) revokes Instrument No.66 of 1995 and Instrument No.161 of 1995; and
(b) determines in their place the following Statement of Principles.
Kind of injury, disease or death
2. (a) This Statement of Principles is about allergic rhinitis and death from allergic rhinitis.
(b) For the purposes of this Statement of Principles, “allergic rhinitis” means inflammation of the mucous membranes of the nasal passages occurring after allergen exposure and mediated by an IgE allergic response. Allergic rhinitis attracts ICD-10-AM code J30.1, J30.2, J30.3 or J30.4.
Basis for determining the factors
3. On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that allergic rhinitis and death from allergic rhinitis can be related to relevant service rendered by veterans or members of the Forces.
Factors that must be related to service
4. 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
5. The factors that must exist before it can be said that, on the balance of probabilities, allergic rhinitis or death from allergic rhinitis is connected with the circumstances of a person’s relevant service are:
(a) being exposed to an allergen causing allergic rhinitis within the 24 hours before the clinical onset of allergic rhinitis; or
(b) being exposed to an allergen causing allergic rhinitis within the 24 hours before the clinical worsening of allergic rhinitis; or
(c) inability to obtain appropriate clinical management for allergic rhinitis.
Factors that apply only to material contribution or aggravation
6. Paragraphs 5(b) to 5(c) apply only to material contribution to, or aggravation of, allergic rhinitis where the person’s allergic rhinitis 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
7. 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
8. For the purposes of this Statement of Principles:
“allergen causing allergic rhinitis” means a substance which has been reported in a peer reviewed medical or scientific publication to precipitate the onset of allergic rhinitis after exposure, and where reported cases have been defined by the close temporal relationship between exposure to an allergen, and
(a) onset of allergic rhinitis symptoms; or
(b) a positive skin prick test with a wheal diameter of at least 3 mm within 20 minutes of exposure to a known allergen; or
(c) a positive radioallergosorbent test (RAST) of ≥0.35 kU/l to a known allergen; or
(d) a controlled allergen provocation/challenge test identifying a known allergen;
“death from allergic rhinitis” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s allergic rhinitis;
“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), Third Edition, effective date of 1 July 2002, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 413 9. Where in this Statement of Principles an ICD code is referenced, such reference is not to constrain or limit the proper meaning of the definition or words preceding the alphanumeric code reference;
“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
(c) cessation of brain function.
Application
9. This Instrument applies to all matters to which section 120B of the Act applied.
Dated this Ninth day of January 2003
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN