Instrument No.19 of 1997
Determination
of
Statement of Principles
concerning
IDIOPATHIC THROMBOCYTOPAENIC PURPURA
ICD CODE: 287.3
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 idiopathic thrombocytopaenic purpura and death from idiopathic thrombocytopaenic purpura.
(b) For the purposes of this Statement of Principles, “idiopathic thrombocytopaenic purpura” means an acquired low platelet count on repeated testing, which results from excessive platelet destruction mediated by immune mechanisms in the absence of a known cause of thrombocytopaenia and which requires treatment such as steroids, platelet infusion or splenectomy, attracting ICD code 287.3. Known causes of thrombocytopaenia include systemic infections, systemic diseases, drugs and chemical exposures. The bone marrow in idiopathic thrombocytopaenic purpura is essentially normal, and platelet-associated antibodies are demonstrable in the majority of patients. The disease is seen in acute and chronic forms, the acute form usually affecting children and the chronic form affecting adults. When the count is sufficiently low abnormal bleeding manifestations such as purpura occur.
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that idiopathic thrombocytopaenic purpura and death from idiopathic thrombocytopaenic purpura 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 idiopathic thrombocytopaenic purpura or death from idiopathic thrombocytopaenic purpura with the circumstances of a person’s relevant service is:
(a) inability to obtain appropriate clinical management for idiopathic thrombocytopaenic purpura.
Factors that apply only to material contribution or aggravation
6. Paragraph 5(a) applies only to material contribution to, or aggravation of, idiopathic thrombocytopaenic purpura where the person’s idiopathic thrombocytopaenic purpura 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 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 Idiopathic Thrombocytopaenic Purpura (ITP) and death from ITP was enacted in 1997 by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986. This legislative instrument addresses the problem of determining the eligibility of veterans, members of Peacekeeping Forces, or members of the Forces for compensation related to ITP and death from ITP, where there is a lack of known causes for the condition. The policy objective of this Statement of Principles is to establish a clear link between the veterans’ service and the onset or aggravation of ITP, ensuring that those affected receive appropriate recognition and support. The Authority recognises that ITP, characterised by an acquired low platelet count resulting from immune-mediated platelet destruction, can be related to relevant military service, thus warranting compensation under the Act.
Scope and Application
The Statement of Principles concerning Idiopathic Thrombocytopaenic Purpura, determined under the Veterans’ Entitlements Act 1986, applies to veterans, members of Peacekeeping Forces, and members of the Forces who have contracted or died from idiopathic thrombocytopaenic purpura. This legislation establishes a connection between the disease, which involves an acquired low platelet count resulting from immune mechanisms without a known cause, and the service rendered by these individuals. The Act recognises the disease, identifiable by ICD code 287.3, which manifests in acute and chronic forms and requires treatment such as steroids or splenectomy. The scope of the legislation includes the inability to obtain appropriate clinical management for the condition as a factor that must be related to the service rendered by the person. Notably, this Statement of Principles does not apply to cases where the idiopathic thrombocytopaenic purpura was contracted outside of or after the relevant service. The jurisdictional reach of this legislation is national, as it is enacted under the Commonwealth’s authority to provide entitlements to veterans.
Key Provisions
This Statement of Principles, issued by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986, concerns idiopathic thrombocytopaenic purpura (ITP) and death from ITP (sections 1 and 2). The determination focuses on ITP, which is defined as an acquired low platelet count due to excessive platelet destruction mediated by immune mechanisms, without a known cause. This condition requires treatment and is associated with ICD code 287.3. The bone marrow is essentially normal in ITP, and platelet-associated antibodies are present in most patients. ITP is seen in both acute and chronic forms, with the acute form typically affecting children and the chronic form affecting adults. Abnormal bleeding manifestations occur when the platelet count is sufficiently low.
The Repatriation Medical Authority has determined that there is sufficient medical-scientific evidence to relate ITP and death from ITP to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces (section 3). The legislation stipulates that the condition must be related to any relevant service provided by the individual (section 4). A critical factor that must exist to establish a reasonable hypothesis connecting ITP or death from ITP with the person's relevant service is the inability to obtain appropriate clinical management for ITP (section 5). This factor applies only to cases where ITP was suffered or contracted before or during service, but not arising out of service (section 6).
The Statement of Principles imposes obligations on the parties it governs by requiring that any claim for ITP or death from ITP be substantiated by evidence linking the condition to relevant service, specifically focusing on the inability to obtain appropriate clinical management. This determination aids in the assessment of claims by providing clear criteria and medical-scientific evidence for linking ITP to service. In terms of penalties or consequences, the legislative instrument itself does not outline specific penalties for non-compliance. However, any breaches of related legislation or failure to adhere to the statutory requirements could result in civil or criminal consequences as stipulated in other provisions of the Veterans’ Entitlements Act 1986 or other relevant laws.