Instrument No.51 of 1997
Determination
of
Statement of Principles
concerning
FIBROMUSCULAR DYSPLASIA
ICD CODES: 447.3, 447.8
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 fibromuscular dysplasia and death from fibromuscular dysplasia.
(b) For the purposes of this Statement of Principles, “fibromuscular dysplasia” means a nonatherosclerotic, noninflammatory segmental stenosing disease with or without focal aneurysmal outpouchings of the affected artery in which any layer of the vessel wall may be affected, attracting ICD code 447.3 or 447.8. The disease commonly involves medium-sized arteries and is most often found in the renal artery and in the internal carotid artery.
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that fibromuscular dysplasia and death from fibromuscular dysplasia 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 fibromuscular dysplasia or death from fibromuscular dysplasia with the circumstances of a person’s relevant service is:
(a) inability to obtain appropriate clinical management for fibromuscular dysplasia.
Factors that apply only to material contribution or aggravation
6. Paragraph 5(a) applies only to material contribution to, or aggravation of, fibromuscular dysplasia where the person’s fibromuscular dysplasia 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:
“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 Fourth day of July 1997
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 address the need for a comprehensive legislative framework that governs the entitlements of Australian veterans, members of Peacekeeping Forces, and members of the Australian Defence Force. The Act was introduced by the Australian Parliament to ensure that veterans and their families receive appropriate recognition, compensation, and support for injuries or diseases incurred or aggravated by their service. The Instrument No.51 of 1997 Determination of Statement of Principles concerning Fibromuscular Dysplasia, issued by the Repatriation Medical Authority under the authority vested in it by the Act, aims to provide a clear understanding of the medical conditions that are considered related to service, specifically focusing on fibromuscular dysplasia and its implications. The policy objective is to facilitate the provision of entitlements and benefits to affected individuals by establishing a medical-scientific basis for the connection between fibromuscular dysplasia and relevant military service.
Scope and Application
The Statement of Principles concerning Fibromuscular Dysplasia, established under the Veterans' Entitlements Act 1986, applies to veterans, members of Peacekeeping Forces, and members of the Forces who have contracted fibromuscular dysplasia, a segmental stenosing disease affecting medium-sized arteries, or who have died from this condition. The legislation covers conditions attracting ICD codes 447.3 or 447.8, most commonly found in the renal and internal carotid arteries. The determination is made by the Repatriation Medical Authority, which asserts a link between the disease and relevant service, including operational, peacekeeping, or hazardous service. The legislation stipulates that a reasonable hypothesis connecting fibromuscular dysplasia with the service must involve the inability to obtain appropriate clinical management for the condition, particularly if the disease was present before or during service. Notably, the principles apply only to the material contribution to or aggravation of fibromuscular dysplasia, excluding instances arising directly from service. This Statement of Principles aims to provide clarity and eligibility criteria for affected individuals seeking recognition and compensation under the Act.
Key Provisions
The main operative sections of the Statement of Principles, as determined under subsection 196B(2) of the Veterans’ Entitlements Act 1986, pertain to fibromuscular dysplasia and death resulting from this condition (section 2(a)). Specifically, fibromuscular dysplasia is defined as a nonatherosclerotic, noninflammatory segmental stenosing disease with or without focal aneurysmal outpouchings of the affected artery, attracting ICD codes 447.3 or 447.8. The disease is typically found in medium-sized arteries, such as the renal artery and internal carotid artery (section 2(b)).
The Repatriation Medical Authority asserts that there is sound medical-scientific evidence linking fibromuscular dysplasia and death from this condition to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces (section 3). The Statement of Principles stipulates that any factor related to fibromuscular dysplasia or death from it must be connected to the relevant service rendered by the person (section 4). The critical factor that must exist to raise a reasonable hypothesis linking the condition or death to the service is the inability to obtain appropriate clinical management for fibromuscular dysplasia (section 5(a)).
The obligations imposed by the Act on the parties governed by the Statement of Principles primarily revolve around ensuring that any claim related to fibromuscular dysplasia or death from it is substantiated by evidence that the condition or death can be linked to relevant service. This includes proving that the person's fibromuscular dysplasia was suffered or contracted before or during (but not arising out of) their relevant service, where paragraph 5(a) applies to material contribution to, or aggravation of, the condition (section 6). Additionally, the definition of "relevant service" encompasses operational service, peacekeeping service, or hazardous service (section 7).
In terms of penalties or consequences for breach, the Statement of Principles does not explicitly state specific offences or penalties. However, under the Veterans’ Entitlements Act 1986, there are provisions for civil and criminal penalties for false claims or misrepresentations regarding entitlements, which could apply to the context of these provisions. The maximum penalties could include fines and imprisonment, reflecting the seriousness of fraudulent claims under the Act.