Instrument No.17 of 2001
Revocation and Determination
of
Statement of Principles
concerning
ALZHEIMER’S DISEASE
ICD-10-AM CODE: G30
Veterans’ Entitlements Act 1986
1. The Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act):
(a) revokes Instrument No.378 of 1995; and
(b) determines in its place the following Statement of Principles.
Kind of injury, disease or death
2. (a) This Statement of Principles is about Alzheimer’s disease and death from Alzheimer’s disease.
(b) For the purposes of this Statement of Principles, “Alzheimer’s disease” means a dementia that is characterised histopathologically by an abundance of senile (neuritic) plaques and/or neurofibrillary tangles in neocortical regions excluding the hippocampus and subiculum; and characterised clinically by an insidious onset of dementia symptoms including intellectual, cognitive, and social decline in function and memory impairment which progresses gradually and is irreversible, attracting ICD-10-AM code G30.
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that Alzheimer’s disease and death from Alzheimer’s disease 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
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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting Alzheimer’s disease or death from Alzheimer’s disease with the circumstances of a person’s relevant service are:
(a) suffering from a head injury at least 10 years or more before the clinical onset of Alzheimer’s disease; or
(b) inability to obtain appropriate clinical management for Alzheimer’s disease.
Factors that apply only to material contribution or aggravation
6. Paragraph 5(b) applies only to material contribution to, or aggravation of Alzheimer’s disease where the person’s Alzheimer’s disease 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.
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:
“death from Alzheimer’s disease” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s Alzheimer’s disease;
“head injury” means trauma to the head which results in:
(i) a fracture of the skull; or
(ii) loss of consciousness for more than 15 minutes, or
(iii) post-traumatic amnesia for more than 30 minutes; or
(iv) a cerebral laceration or contusion;
“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) operational service; or
(b) peacekeeping service; or
(c) 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.
Application
9. This Instrument applies to all matters to which section 120A of the Act applies.
Dated this Nineteenth day of March 2001
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN