Instrument No.58 of 2001
Revocation and Determination
of
Statement of Principles
concerning
CHRONIC PANCREATITIS
ICD-10-AM CODES: K86.0, K86.1
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.48 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 pancreatitis and death from chronic pancreatitis.
(b) For the purposes of this Statement of Principles, “chronic pancreatitis” means a continuing inflammatory disease of the pancreas resulting in irreversible morphological change, attracting ICD-10-AM code K86.0 or K86.1.
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 pancreatitis and death from chronic pancreatitis 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 pancreatitis or death from chronic pancreatitis is connected with the circumstances of a person’s relevant service are:
(a) consuming at least 180 kg of alcohol (contained within alcoholic drinks):
(i) within any five year period before the clinical onset of chronic pancreatitis; and
(ii) where alcohol consumption commenced at least five years before the clinical onset of chronic pancreatitis;
and where alcohol consumption has ceased, the clinical onset occurred within 10 years of cessation; or
(b) suffering complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas at the time of the clinical onset of chronic pancreatitis; or
(c) undergoing a course of therapeutic radiation to the region of the pancreas at least 10 years before the clinical onset of chronic pancreatitis; or
(d) suffering from hyperparathyroidism at the time of the clinical onset of chronic pancreatitis; or
(e) inability to obtain appropriate clinical management for chronic pancreatitis.
Factors that apply only to material contribution or aggravation
6. Paragraph 5(e) applies only to material contribution to, or aggravation of, chronic pancreatitis where the person’s chronic pancreatitis 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:
“a course of therapeutic radiation” means one or more fractions (treatment portions) of ionising radiation administered with the aim of achieving palliation or cure with gamma rays, x-rays, alpha particles or beta particles;
“alcohol (contained within alcoholic drinks)” is measured by the alcohol consumption calculations utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink;
“death from chronic pancreatitis” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s chronic pancreatitis;
“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) 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
(e) cessation of brain function.
Application
9. This Instrument applies to all matters to which section 120B of the Act applies.
Dated this Fourteenth day of August 2001
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN