Statement of Principles concerning anal fissure No. 248 of 1995

Statement of Principles

concerning

ANAL FISSURE

Instrument No. 248 of 1995 as amended

made under section 196B(3) of the

Veterans’ Entitlements Act 1986

This compilation was prepared on 7 August 2008 taking into account Amendment of Statement of Principles concerning anal fissure (Instrument No. 12 of 1997)

Prepared by the Repatriation Medical Authority Secretariat, Brisbane.

Statement of Principles

concerning

ANAL FISSURE

ICD CODES: 565.0

Veterans’ Entitlements Act 1986
subsection 196B(3)

1. Being of the view that on the sound medical-scientific evidence available to the Repatriation Medical Authority, it is more probable than not that anal fissure and death from anal fissure can be related to eligible war service (other than operational service) rendered by veterans and defence service (other than hazardous service) rendered by members of the Forces, the Repatriation Medical Authority determines, under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the Act), that the factors that must exist before it can be said that, on the balance of probabilities, anal fissure or death from anal fissure is connected with the circumstances of that service, are:

(a) undergoing anal surgery immediately before the clinical onset of anal fissure; or

(b) suffering trauma to the perineum immediately before the clinical onset of anal fissure; or

(c) being infected with HIV before the clinical onset of anal fissure; or

(d) suffering Crohn's disease before the clinical onset of anal fissure; or

(e) suffering constipation immediately before the clinical onset of anal fissure; or

(f) suffering from ulcerative colitis before the clinical onset of anal fissure; or

(g) inability to obtain appropriate clinical management for the anal fissure.

2. Subject to clause 3 (below) at least one of the factors set out in paragraph 1(a) to 1(g) must be related to any service rendered by a person.

3. The factor set out in paragraph 1(g) applies only where:

(a) the person's anal fissure developed before a period, or part of a period, of service to which the factor is related; and

(b) the relationship suggested between the anal fissure and the particular service of a person is a relationship set out in paragraph 8(1)(e), 9(1)(e) or 70(5)(d) of the Act.

4. For the purposes of this Statement of Principles:

“anal fissure” means a longitudinal, elliptical or rounded defect in the anoderm, extending part or all of the way from the anal verge to the pectinate line, attracting ICD code 565.0;

“being infected with HIV” means serological evidence of infection with Human Immunodeficiency Virus, attracting an ICD code in the range 042 - 044;

“constipation” means infrequent or difficult evacuation of the faeces that leads to straining at stool, attracting ICD code 564.0;

“Crohn's disease” means an inflammatory disease of the digestive system, involving the bowel wall, characterised by the presence of epithelioid cell granuloma, often with giant cells, attracting ICD code 555;

“'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;

“trauma to the perineum” means injury to the region between the thighs caused, for example, by childbirth, laceration by a foreign body, sexual assault or surgical procedures, attracting ICD code 664, 863.89, 863.99;

“ulcerative colitis” means a chronic recurrent inflammatory disease of the colon, usually limited to the mucosa and submucosa, characterised by diffuse inflammatory cell infiltrate and crypt abscesses, attracting ICD code 556.

Notes to Statement of Principles concerning anal fissure (Instrument No. 248 of  1995)

The Statement of Principles concerning anal fissure (Instrument No. 248 of1995) in force under section 196B(3) of the Veterans’ Entitlements Act 1986, as shown in this compilation is amended as indicated in the Tables below.

Table of Instruments

Table of Amendments