Instrument No.74 of 2002
Revocation
of
Statement of Principles
concerning
DENTAL PULP DISEASE
(including PULPAL ABSCESS)
and
Determination
of
Statement of Principles
concerning
DENTAL PULP DISEASE
ICD-10-AM CODES: K04.0, K04.1, K04.2, K04.6, K04.7, K04.9
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.371 of 1995 concerning dental pulp disease (including pulpal abscess); 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 dental pulp disease and death from dental pulp disease.
(b) For the purposes of this Statement of Principles, “dental pulp disease” means inflammation, infection, necrosis or degeneration of the pulp of the tooth. This definition of dental pulp disease includes endodontic, dentoalveolar or periapical abscess, but excludes acute and chronic apical periodontitis. Dental pulp disease attracts ICD-10-AM code K04.0, K04.1 K04.2, K04.6, K04.7 or K04.9.
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 dental pulp disease and death from dental pulp disease 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, dental pulp disease or death from dental pulp disease is connected with the circumstances of a person’s relevant service are:
(a) suffering from dental caries in the affected tooth immediately before the clinical onset of dental pulp disease; or
(b) suffering from periodontitis in the periodontium supporting the affected tooth immediately before the clinical onset of dental pulp disease; or
(c) suffering trauma to the region of the affected tooth within the six months immediately before the clinical onset of dental pulp disease; or
(d) undergoing invasive dental or orthodontic surgery to the region of the affected tooth within the six months immediately before the clinical onset of dental pulp disease; or
(e) undergoing a noninvasive dental or orthodontic procedure involving the affected tooth or the periodontium supporting the affected tooth within the seven days immediately before the clinical onset of dental pulp disease; or
(f) inability to obtain appropriate clinical management for dental pulp disease.
Factors that apply only to material contribution or aggravation
6. Paragraph 5(f) applies only to material contribution to, or aggravation of, dental pulp disease where the person’s dental pulp 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) 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:
“death from dental pulp disease” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s dental pulp disease;
“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. Where in this Statement of Principles an ICD code is referenced, such reference is not to constrain or limit the proper meaning of the definition or words preceding the alphanumeric code reference;
“noninvasive dental or orthodontic procedure” means the therapeutic application of a chemical substance, heat or cold, or a physical force to the surface of the teeth, occurring during the course of dental or orthodontic treatment;
“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
(c) cessation of brain function;
“trauma to the region of the affected tooth” means a blunt or penetrating injury:
(a) resulting in fracture, luxation, loss or extraction of the tooth; or
(b) to the periodontium resulting in disruption or fracture of the periodontium.
Application
9. This Instrument applies to all matters to which section 120B of the Act applied.
Dated this Twenty-First day of November 2002
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN