Instrument No.17 of 1997
Determination
of
Statement of Principles
concerning
COELIAC DISEASE
ICD CODE: 579.0
Veterans’ Entitlements Act 1986
1. This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act).
Kind of injury, disease or death
2. (a) This Statement of Principles is about coeliac disease and death from coeliac disease.
(b) For the purposes of this Statement of Principles, “coeliac disease” means a chronic malabsorption syndrome due to inflammation in the small intestine precipitated in susceptible individuals by the ingestion of gluten, and which is characterised clinically by a range of gastrointestinal and extraintestinal manifestations which improve upon withdrawal of gluten from the diet, and by specific biopsy-demonstrated histological changes in the small intestine which improve upon withdrawal of gluten from the diet. Coeliac disease is also known as coeliac crisis, gluten sensitive enteropathy or nontropical sprue, attracting ICD code 579.0.
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that coeliac disease and death from coeliac 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, the factor set out in the paragraph in clause 5 must be related to any relevant service rendered by the person.
Factors
5. The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting coeliac disease or death from coeliac disease with the circumstances of a person’s relevant service is:
(a) inability to obtain appropriate clinical management for coeliac disease, for example, consumption of a gluten containing diet where gluten containing products could not be ceased or substituted at the time of the clinical worsening of coeliac disease.
Factors that apply only to material contribution or aggravation
6. Paragraph 5(a) applies only to material contribution to, or aggravation of, coeliac disease where the person’s coeliac 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.
Other definitions
7. For the purposes of this Statement of Principles:
“gluten” means a protein containing an alcohol soluble gliadin fraction which is toxic to the small intestine mucosa of patients with coeliac disease and which is found in wheat, rye and barley cereal grains and in processed food products containing these cereal grains;
“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;
“relevant service” means:
(a) operational service; or
(b) peacekeeping service; or
(c) hazardous service.
Dated this Twentieth day of February 1997
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of )
KEN DONALD
CHAIRMAN
Overview
The Determination of Statement of Principles concerning Coeliac Disease ICD Code: 579.0, made under the Veterans’ Entitlements Act 1986, aims to address the issue of coeliac disease and death from coeliac disease among veterans and members of peacekeeping forces. This legislative instrument was enacted in 1997 by the Repatriation Medical Authority, which was established under the Act to make such determinations. The primary policy objective is to establish a connection between the service rendered by veterans and the onset or aggravation of coeliac disease, ensuring that those affected receive appropriate entitlements. This statement of principles recognises coeliac disease as a chronic malabsorption syndrome that can be related to the service of veterans, members of peacekeeping forces, or members of the Australian Defence Force, particularly when appropriate clinical management was unavailable during their service.
Scope and Application
This Statement of Principles, determined by the Repatriation Medical Authority under the Veterans' Entitlements Act 1986, pertains specifically to coeliac disease and death resulting from coeliac disease among veterans, members of Peacekeeping Forces, and members of the Forces. The Act recognises coeliac disease as a chronic malabsorption syndrome triggered by gluten ingestion, evidenced by gastrointestinal and extraintestinal symptoms and biopsy-confirmed histological changes in the small intestine. The Authority has established that there is sound medical-scientific evidence linking coeliac disease and death from coeliac disease to relevant service rendered by these individuals. For a reasonable hypothesis to be raised connecting coeliac disease or death from coeliac disease to the circumstances of a person’s service, there must be an inability to obtain appropriate clinical management for coeliac disease, such as consuming a gluten-containing diet where gluten products could not be ceased or substituted at the time of clinical worsening. This factor is particularly relevant if the coeliac disease was suffered or contracted before or during service, contributing to or aggravating the condition.
The scope of this legislation applies to individuals who have served in operational, peacekeeping, or hazardous capacities, ensuring that their coeliac disease is appropriately considered in the context of their service. This determination is crucial for veterans seeking entitlements related to their service-connected health conditions, including coeliac disease and its associated complications. The jurisdictional reach of the Veterans’ Entitlements Act 1986 is national, as it is a Commonwealth Act, thereby applying across Australia. The Statement of Principles does not specify any exclusions, exemptions, or thresholds beyond the criteria set out in the determination itself. The application of the Act may be further refined or detailed through subordinate instruments, although this particular Statement of Principles focuses on the specific medical and service-related factors outlined.
Key Provisions
This legislative instrument, F2008B00007, details a Statement of Principles concerning coeliac disease and death from coeliac disease. The primary sections of this document (sections 1-7) outline the nature of the disease, the basis for determining its relationship to relevant service, and the specific factors that must be considered in connecting the disease with service rendered by veterans or members of peacekeeping or hazardous forces. The determination is made under the authority of the Veterans’ Entitlements Act 1986, specifically subsection 196B(2). This condition, coeliac disease, is defined as a chronic malabsorption syndrome caused by gluten ingestion, identifiable through certain clinical and histological changes (section 2).
The obligations imposed by this Act (sections 5 and 6) require that any claim of coeliac disease or death from it be linked to relevant service, and that the inability to obtain appropriate clinical management for coeliac disease, such as the inability to cease or substitute gluten-containing products during clinical worsening, be considered as a factor (section 5). These provisions apply specifically to cases where coeliac disease was suffered or contracted before or during relevant service (section 6). The definitions provided in section 7 clarify terms such as "gluten," "ICD code," and "relevant service," ensuring the scope of the Statement of Principles is understood within the context of the Act.
Breach of the provisions outlined in this Statement of Principles could result in various legal consequences. Although specific penalties are not mentioned in the document, violations of the Veterans’ Entitlements Act 1986 generally carry significant penalties. These can include fines and imprisonment for criminal offences, or civil penalties such as compensation for incorrect claims, reflecting the importance of accurate and truthful submissions under this Act. The penalties are intended to uphold the integrity of the entitlements system and ensure that only those genuinely affected by coeliac disease in relation to their service receive benefits.