Instrument No.20 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(3) 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. On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that idiopathic thrombocytopaenic purpura and death from idiopathic thrombocytopaenic purpura 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, 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 exist before it can be said that, on the balance of probabilities, idiopathic thrombocytopaenic purpura or death from idiopathic thrombocytopaenic purpura is connected 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) or 70(5)(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) eligible war service (other than operational service); or
(b) defence service (other than 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 Veterans’ Entitlements Act 1986 was enacted to provide benefits to veterans and members of the Australian Defence Force who suffer from illnesses or disabilities related to their service. In response to the need to establish connections between certain medical conditions and military service, the Repatriation Medical Authority determined a Statement of Principles concerning idiopathic thrombocytopaenic purpura (ITP) and death from ITP under subsection 196B(3) of the Act. This legislative instrument aims to ensure that veterans and members of the Defence Force who develop ITP, a condition characterised by an acquired low platelet count resulting from immune-mediated platelet destruction, can receive appropriate benefits if their condition is related to their service. The Authority found it more probable than not that ITP and death from ITP can be related to relevant military service, given the available medical-scientific evidence.
Scope and Application
This Statement of Principles, determined under the Veterans’ Entitlements Act 1986, specifically pertains to veterans and members of the Australian Defence Force who have developed idiopathic thrombocytopaenic purpura (ITP) or have died from ITP. The Act addresses the eligibility of veterans for certain benefits related to ITP, a condition characterised by an acquired low platelet count resulting from immune-mediated platelet destruction, with no known underlying cause. The Statement of Principles establishes a connection between the development or aggravation of ITP and relevant service, which is defined as eligible war service or defence service, excluding hazardous service. Notably, the condition must have manifested or worsened due to the service, with a particular focus on the inability to obtain appropriate clinical management during the service period. This determination allows for the consideration of ITP as a service-related condition, thereby potentially qualifying affected individuals for veterans' benefits. The jurisdictional reach of the Act is federal, as it pertains to the Commonwealth's responsibilities under the legislation concerning veterans' entitlements.
There are no exclusions or exemptions explicitly stated in this determination, but the condition must meet the criteria outlined, including the specific ICD code. The application of the Statement of Principles is further governed by the terms of the Veterans’ Entitlements Act 1986, which may be extended or restricted through subordinate instruments. This legislative framework ensures that the medical and scientific evidence underpinning the connection between ITP and service is robust, thereby facilitating fair and informed decisions regarding veterans' claims.
Key Provisions
This Statement of Principles, determined under the Veterans’ Entitlements Act 1986, pertains to idiopathic thrombocytopaenic purpura (ITP) and death resulting from ITP (section 1). ITP, identified by ICD code 287.3, is defined as an acquired low platelet count due to immune-mediated platelet destruction without a known cause (section 2). The Repatriation Medical Authority has determined that it is more probable than not that ITP and death from ITP can be related to service rendered by veterans or members of the Forces (section 3).
The critical factor that must exist to connect ITP or death from ITP with 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 term "relevant service" includes eligible war service (excluding operational service) and defence service (excluding hazardous service) (section 7).
The obligations imposed by this Statement of Principles require that any claim regarding ITP or death from ITP must demonstrate a connection to relevant service, specifically highlighting the inability to obtain appropriate clinical management as a key factor. The onus lies on the claimant to provide evidence that ties their condition to their service history in accordance with the criteria set out in the Act. Any failure to meet these criteria may result in the denial of entitlements.
Offences and penalties under this legislation are not explicitly stated in the provided text, but any breaches of the Act or its regulations could potentially lead to civil or criminal consequences. For instance, knowingly providing false information or documents to the Repatriation Medical Authority could result in penalties as prescribed by the relevant laws. The maximum penalties for such offences would depend on the specific provisions of the Veterans’ Entitlements Act 1986 and any associated regulations or subsidiary legislation.