Statement of Principles concerning irritable bowel syndrome No. 103 of 1996

Administered by Department of Veterans' Affairs

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Instrument No.103 of 1996

 

Determination

of

Statement of Principles

concerning

IRRITABLE BOWEL SYNDROME

ICD CODE: 564.1

 

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 irritable bowel syndrome and death from irritable bowel syndrome.

 

 (b) For the purposes of this Statement of Principles, “irritable bowel syndrome” means a heterogeneous group of disorders of diverse symptomatology in which abdominal pain is associated with defaecation or changes in bowel habit, and with features of disordered defeacation and with distention, and which is characterised by the following symptom criteria:

 

At least three months, continuous or recurrent symptoms of:

 

(A) Abdominal pain or discomfort which is

 relieved by defaecation;

 and/or associated with a change in frequency of stool;

 and/or associated with a change in consistency of stool;

 

plus

 

(B) An irregular pattern of defaecation at least 25% of the time, consisting of two or more of the following:

 

  • altered stool frequency;
  • altered stool form (lumpy/hard or loose/watery);
  • altered stool passage (straining, urgency, or feeling of incomplete evacuation);
  • passage of mucus;
  • bloating or feeling of abdominal distension,

 

attracting ICD code 564.1.

 

Basis for determining the factors

3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that irritable bowel syndrome 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 factors set out in the paragraphs in clause 5 must be related to any relevant service rendered by the person.

 

Factors

5. The factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting irritable bowel syndrome or death from irritable bowel syndrome with the circumstances of a person’s relevant service are:

 

(a) being a prisoner of war before the clinical onset of irritable bowel syndrome; or

 

(b) suffering a specified psychiatric condition within the six months immediately before the clinical onset of irritable bowel syndrome; or

 

(c) suffering an episode of severe diarrhoea within the six months immediately before the clinical onset of irritable bowel syndrome; or

 

(d) suffering a specified psychiatric condition within the six months immediately before the clinical worsening of irritable bowel syndrome; or

 

(e) suffering an episode of severe diarrhoea within the six months immediately before the clinical worsening of irritable bowel syndrome; or

 

(f) inability to obtain appropriate clinical management for irritable bowel syndrome.

 

Factors that apply only to material contribution or aggravation

6. Paragraphs 5(d) to 5(f) apply only to material contribution to, or aggravation of, irritable bowel syndrome where the person’s irritable bowel syndrome 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:

 

“a specified psychiatric condition ” means:

 

(a) a psychiatric condition with features of anxiety, including:  

 

(i) generalised anxiety disorder, ICD code 300.02; or

(ii) panic disorder, ICD code 300.01; or

(iii) adjustment disorder with features of anxiety, ICD code 309.24, 309.28, 309.3, 309.4, or 309.9; or

(iv) post traumatic stress disorder, ICD code 309.81; or

 

(b) a psychiatric condition with depressive features, including:

 

(i) major depressive disorder, ICD code 296.2 or 296.3; or

(ii) neurotic depression, ICD code 300.4; or

(iii) other depressive disorders, ICD code 311; or

(iv) adjustment disorder with depressed mood, ICD code 309.0, 309.1, 309.4 or 309.28;

 

“episode of severe diarrhoea” means the acute onset of an illness characterised by the passage of frequent loose watery motions accompanied by a marked urgency to defaecate, caused by an infective organism, and of sufficient severity to warrant medical attention, or in the absence of medical intervention, lasting at least four days;

 

“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 Sixteenth  day of   August              1996

 

 

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 Irritable Bowel Syndrome ICD Code: 564.1 under the Veterans’ Entitlements Act 1986 was enacted to address the issue of veterans suffering from irritable bowel syndrome (IBS) and to provide a framework for assessing claims related to this condition. This legislative instrument was issued by the Repatriation Medical Authority, a body established under the Act, with the policy objective of ensuring that veterans who have developed IBS as a result of their service are provided with appropriate recognition and entitlements. The Repatriation Medical Authority determined that there is sufficient medical-scientific evidence to support a connection between IBS and relevant service, particularly in cases where veterans have experienced specific factors such as being a prisoner of war, suffering a psychiatric condition, or encountering episodes of severe diarrhoea within a certain timeframe relative to the onset or worsening of IBS. This determination aims to facilitate the assessment and compensation processes for affected veterans, ensuring they receive the support they need. The Statement of Principles outlines the criteria for IBS, including symptomatology and the conditions that must be met to establish a reasonable hypothesis linking IBS to service. It specifies factors such as being a prisoner of war, suffering from a psychiatric condition, experiencing severe diarrhoea, or being unable to obtain appropriate clinical management. These factors are crucial in determining the eligibility for benefits and the extent of any material contribution or aggravation of IBS due to service. The document also includes definitions for key terms such as "specified psychiatric condition" and "episode of severe diarrhoea," which are essential for the accurate assessment of claims. By setting these criteria and definitions, the legislation provides a clear and structured approach to addressing the needs of veterans affected by IBS.

Scope and Application

The Statement of Principles concerning Irritable Bowel Syndrome ICD Code: 564.1 under the Veterans’ Entitlements Act 1986 applies to veterans, members of Peacekeeping Forces, and members of the Australian Defence Force who have been diagnosed with irritable bowel syndrome and wish to seek compensation for conditions related to their service. This Statement of Principles is intended to establish a connection between the service rendered by these individuals and the onset or aggravation of irritable bowel syndrome. The geographical reach of this legislation is national, as it applies to all veterans across Australia. The Act provides a framework for determining whether a reasonable hypothesis exists that the irritable bowel syndrome was related to the individual's service, with specific factors outlined to assist in this determination. These factors include being a prisoner of war, suffering a specified psychiatric condition or episode of severe diarrhoea within six months before the clinical onset or worsening of irritable bowel syndrome, or experiencing inability to obtain appropriate clinical management. The determination of these factors is made by the Repatriation Medical Authority, which bases its decisions on sound medical-scientific evidence. The Statement of Principles also clarifies that certain factors apply only to the material contribution to, or aggravation of, irritable bowel syndrome where the condition existed before or during service. This legislation does not specify any exclusions or exemptions, and its application is not extended or restricted by subordinate instruments.

Key Provisions

This legislative instrument, numbered 103 of 1996, concerns the Statement of Principles about irritable bowel syndrome (IBS) under the Veterans' Entitlements Act 1986 (the Act). The Statement of Principles, determined by the Repatriation Medical Authority, establishes the criteria for linking IBS to relevant military service (sections 1 and 2). Specifically, it defines IBS as a condition characterised by abdominal pain, altered bowel habits, and distension, with specific symptom criteria outlined (section 2(b)). The determination is based on sound medical-scientific evidence suggesting a link between IBS and relevant service (section 3). For IBS to be considered related to service, certain factors must be present, such as being a prisoner of war, suffering a specified psychiatric condition, experiencing severe diarrhoea, or being unable to obtain appropriate clinical management before or during service (sections 4 and 5). The Act imposes obligations on the Repatriation Medical Authority to determine if the specified factors are present and related to the service in question. It also places a duty on veterans or other eligible persons to provide relevant medical and service records to substantiate their claims. The Authority must consider the evidence provided and determine whether the IBS was contracted during service or materially contributed to or aggravated by service (section 5). Additionally, the Authority must apply the specified psychiatric conditions and episodes of severe diarrhoea to the context of service, particularly in cases of material contribution or aggravation of IBS (section 6). Failure to comply with the requirements of the Act or providing false information could result in various consequences. For instance, providing false information could be considered an offence under the Act, leading to potential criminal charges. Additionally, the Act does not explicitly state penalties, but breaches could result in civil consequences such as fines or other sanctions. The maximum penalties, if applicable, would depend on the specific nature and severity of the breach, as outlined in other sections of the Act.

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