Instrument No.73 of 1995
Statement of Principles
concerning
BUERGER'S DISEASE
(THROMBOANGIITIS OBLITERANS)
ICD CODE: 443.1
Veterans’ Entitlements Act 1986
subsection 196B(2)
1. Being of the view that there is sound medical-scientific evidence that indicates that Buerger's disease and death from Buerger's disease can be related to operational service rendered by veterans, peacekeeping service rendered by members of Peacekeeping forces and hazardous service rendered by members of the Forces, the Repatriation Medical Authority determines, under subsection 196B(2) of the Veterans’ Entitlements Act 1986, that the factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting Buerger's disease or death from Buerger's disease with the circumstances of that service, are:
(a) smoking 20 cigarettes per day or its equivalent in tobacco products, for at least three years before the clinical onset of Buerger's disease; or
(b) smoking for three pack years before the clinical worsening of Buerger's disease; or
(c) inability to obtain appropriate clinical management for Buerger's disease.
2. Subject to clause 3 (below) at least one of the factors set out in paragraphs 1(a) to 1(c) must be related to any service rendered by a person.
3. The factors set out in paragraphs 1(b) to 1(c) apply only where:
(a) the person’s Buerger's disease was contracted prior to a period, or part of a period, of service to which the factor is related; and
(b) the relationship suggested between the Buerger's disease and the particular service of a person is a relationship set out in paragraph 8(1)(e), 9(1)(e), 70(5)(d), or 70(5A)(d) of the Act.
4. For the purposes of this Statement of Principles:
“Buerger's disease (thromboangiitis obliterans)” means a nonatherosclerotic, segmental, inflammatory, occlusive vascular disease affecting the small and medium-sized arteries and veins, attracting ICD code 443.1;
“ICD code” means a number assigned to a particular kind of injury or disease in the tenth edition of the International Classification of Diseases 9th Revision, effective date of 1 October 1993, copyrighted by the US Commission on Professional and Hospital Activities, and having the Library of Congress number 77-94472;
“pack years” means 7,300 cigarettes, or 7,300gms of pipe tobacco, or 1,460 cigars.
Dated this twentieth day of February 1995
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN
Overview
The Statement of Principles concerning Buerger's Disease (Thromboangiitis Obliterans) issued under the Veterans' Entitlements Act 1986 was enacted in 1995 to address the need for a clear framework that links the occurrence of Buerger's disease or death from Buerger's disease to specific types of military service, including operational service, peacekeeping service, and hazardous service. The Repatriation Medical Authority, acting under the authority granted by the Act, identified the medical-scientific evidence supporting this connection and established criteria for determining when a reasonable hypothesis could be said to exist. The policy objective behind this legislative instrument is to ensure that veterans, peacekeeping force members, and military personnel who have served in hazardous conditions can receive appropriate recognition and benefits when their Buerger's disease is related to their service. The instrument outlines specific conditions related to smoking habits and the timing of disease onset and service, ensuring that claims are substantiated by solid evidence.
Scope and Application
The Statement of Principles concerning Buerger's Disease (Thromboangiitis Obliterans) applies to veterans, members of peacekeeping forces, and members of the Forces who have contracted Buerger's disease, or died from it, under circumstances related to their service. This legislative instrument, issued under the Veterans’ Entitlements Act 1986, sets out the minimum criteria that must be met to establish a connection between the disease and the service rendered. Specifically, the statement requires that at least one of the outlined factors, including smoking a significant amount of tobacco or an inability to obtain appropriate clinical management, must be linked to the service in question. The statement further clarifies that certain factors apply only if the disease was contracted before a period of service, and the relationship between the disease and service must align with specific provisions of the Act. This statement of principles is a crucial component in determining the eligibility of veterans for compensation related to their service and health conditions.
Key Provisions
The Statement of Principles concerning Buerger's Disease (Thromboangiitis Obliterans), issued under subsection 196B(2) of the Veterans’ Entitlements Act 1986, sets out the minimum factors that must be present to establish a connection between the disease and service rendered by veterans, peacekeeping forces, or hazardous service members. According to section 1 of the document, these factors include smoking at least 20 cigarettes per day or its equivalent in tobacco products for at least three years prior to the clinical onset of Buerger's disease (subsection 1(a)), smoking for three pack years prior to the clinical worsening of Buerger's disease (subsection 1(b)), or the inability to obtain appropriate clinical management for Buerger's disease (subsection 1(c)). These factors must be related to the service rendered by the person for a reasonable hypothesis to be raised connecting the disease with the circumstances of the service (section 2). Furthermore, factors in subsections 1(b) and 1(c) apply only if the person's Buerger's disease was contracted prior to the period or part of the period of service, and the relationship suggested between the disease and the service is set out in paragraphs 8(1)(e), 9(1)(e), 70(5)(d), or 70(5A)(d) of the Act (section 3).
The obligations and requirements imposed by this Statement of Principles on the parties or entities it governs include demonstrating the existence of at least one of the minimum factors outlined in section 1, as related to the service rendered by the person. This would require the provision of relevant medical and service records, including evidence of smoking habits and any inability to obtain appropriate clinical management for Buerger's disease. Furthermore, it is essential for the relationship between the disease and the service to comply with the criteria specified in paragraphs 8(1)(e), 9(1)(e), 70(5)(d), or 70(5A)(d) of the Act.
The Statement of Principles does not explicitly outline any offences, penalties, or civil/criminal consequences for breach of its provisions. However, failure to meet the requirements set out in the Statement of Principles could result in the denial of veterans' entitlements related to Buerger's disease. This may include the refusal to acknowledge the connection between the disease and service rendered, which in turn could lead to the denial of compensation, medical care, or other benefits provided under the Veterans’ Entitlements Act 1986. It is important to note that the Repatriation Medical Authority has the authority to review and make determinations regarding the eligibility for such entitlements based on the factors outlined in the Statement of Principles.