Statement of Principles concerning chronic fatigue syndrome No. 24 of 2003

Administered by Department of Veterans' Affairs

Legislation au F2005B02295 Not in force Legislative Instrument

Legislation content

Instrument No.24 of 2003

 

Revocation and Determination

of

Statement of Principles

concerning

 

CHRONIC FATIGUE SYNDROME

 

 

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.91 of 1997; 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 chronic fatigue syndrome and death from chronic fatigue syndrome.

 

(b)              For the purposes of this Statement of Principles, “chronic fatigue syndrome” means a syndrome of new or definitive onset characterised by the presence of:

(i) persistent or relapsing fatigue as the principal symptom over a period of at least six months that causes significant disruption of usual daily activities; and

(ii) post-exertional fatigue; and

(iii) neuropsychiatric (cognitive) dysfunction, including new-onset impairment of short-term memory and concentration; and

(iv) occurring in circumstances in which no alternative diagnosis of the person’s fatigue can be achieved by history, physical or mental examination status, or laboratory investigations.

 

(c)               Chronic fatigue syndrome attracts ICD-10-AM code R53 or G93.3.

 

(d)              In the application of this Statement of Principles, the definition of “chronic fatigue syndrome” is that given at para 2(b) above.

 

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 chronic fatigue syndrome and death from chronic fatigue syndrome 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, chronic fatigue syndrome or death from chronic fatigue syndrome is connected with the circumstances of a person’s relevant service are:

 

(a) suffering from symptomatic Epstein-Barr virus infection at the time of the clinical onset of chronic fatigue syndrome; or

 

(b)              suffering from Ross River virus infection at the time of the clinical onset of chronic fatigue syndrome; or

 

(c)               suffering from Coxiella burnetti (Q fever) infection at the time of the clinical onset of chronic fatigue syndrome; or

 

(d)              inability to obtain appropriate clinical management for chronic fatigue syndrome.

 

Factors that apply only to material contribution or aggravation

6. Paragraph 5(d) applies only to material contribution to, or aggravation of, chronic fatigue syndrome where the person’s chronic fatigue syndrome 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:

 

“Coxiella burnetti (Q fever) infection” means a clinical illness compatible with Q fever accompanied by serological evidence of recently acquired Coxiella burnetti infection;

 

“death from chronic fatigue syndrome” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s chronic fatigue syndrome;

 

“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;

 

“relevant service” means:

(a)               eligible war service (other than operational service); or

(b)              defence service (other than hazardous service);

 

“Ross River virus infection” means a clinical illness compatible with Ross River fever accompanied by serological evidence of recently acquired Ross River virus infection;

 

“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 120B of the Act applied.

 

 

Dated this Twenty-ninth day of  May 2003

 

 

The Common Seal of the    )

Repatriation Medical Authority  )

was affixed to this instrument  )

in the presence of:    )

 

KEN DONALD

CHAIRMAN

Overview

The Veterans’ Entitlements Act 1986 was enacted to provide a framework for the assessment and payment of benefits to Australian Defence Force veterans and their dependants. This Act addresses the gap in recognition and support for veterans suffering from specific medical conditions that may be related to their service. In 2003, the Repatriation Medical Authority, acting under the authority of the Act, revoked the previous Statement of Principles concerning Chronic Fatigue Syndrome and introduced a new Statement of Principles to better define the condition and its relationship to relevant service. The policy objective of this legislative instrument is to ensure that veterans who suffer from chronic fatigue syndrome, or who die from conditions related to this syndrome, receive appropriate recognition and benefits. This is achieved by establishing criteria that link the syndrome to specific medical conditions and the circumstances of the veteran's service, thereby facilitating the assessment and approval of related claims.

Scope and Application

The Repatriation Medical Authority, under subsection 196B(3) of the Veterans’ Entitlements Act 1986, has issued an instrument to revoke and replace the previous Statement of Principles concerning chronic fatigue syndrome with a new set of guidelines. This new Statement of Principles pertains to chronic fatigue syndrome and death from chronic fatigue syndrome, specifically defined as a syndrome marked by persistent or relapsing fatigue lasting at least six months, post-exertional fatigue, neuropsychiatric dysfunction, and other specified criteria, with no alternative diagnosis for the fatigue. This Instrument applies to all matters to which section 120B of the Act applied. The Authority has concluded that, based on available medical-scientific evidence, it is more probable than not that chronic fatigue syndrome and death from chronic fatigue syndrome can be related to relevant service rendered by veterans or members of the Forces. The factors that must exist to establish a connection between chronic fatigue syndrome or death from chronic fatigue syndrome and relevant service include suffering from specific infections at the time of the clinical onset of chronic fatigue syndrome or the inability to obtain appropriate clinical management for the syndrome. This Statement of Principles incorporates other definitions and criteria that govern its application, including the definition of "relevant service" and the term "terminal event."

Key Provisions

The key operative sections of the Repatriation Medical Authority’s Statement of Principles concerning Chronic Fatigue Syndrome (CFS) (F2005B02295) under the Veterans’ Entitlements Act 1986, revoke the previous Instrument No.91 of 1997 and establish a new set of principles regarding CFS (section 1). These principles define CFS as a syndrome with specific symptoms, including persistent fatigue for at least six months, post-exertional fatigue, neuropsychiatric dysfunction, and the absence of an alternative diagnosis (section 2). The Authority determines that CFS and death from CFS can likely be related to relevant service (section 3). The legislation specifies factors that must be related to service, such as having a specific infection at the time of clinical onset or an inability to obtain appropriate clinical management for CFS (section 5). Additionally, the Statement of Principles applies to cases where the veteran's CFS was contracted before or during service but not arising out of it (section 6). The obligations imposed by this Act require that veterans or members of the Forces who claim entitlement related to CFS must demonstrate that at least one of the specified factors is connected to their service (section 5). They must provide evidence of having symptomatic Epstein-Barr virus, Ross River virus, or Coxiella burnetti (Q fever) infection at the onset of CFS, or evidence of an inability to obtain appropriate clinical management for CFS (section 5). If the CFS was contracted before or during service but not arising out of it, the veteran must show that the service materially contributed to or aggravated the condition (section 6). The legislation also incorporates any relevant factors from other Statements of Principles that apply to the veteran's condition (section 7). The legislation outlines specific offences and penalties for breaches, although the provided text does not detail these consequences. Typically, under the Veterans’ Entitlements Act 1986, breaches may result in penalties such as fines or imprisonment, depending on the severity and intent of the breach. The exact penalties are not specified in the text but would be outlined in other sections of the Act or related regulations. The consequences for non-compliance could include the denial of entitlements or other legal repercussions as determined by the relevant authorities.

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