Statement of Principles concerning malignant neoplasm of the bladder No. 24 of 2000

Administered by Department of Veterans' Affairs

Legislation au F2005B01664 Not in force Legislative Instrument

Legislation content

Instrument No.24 of 2000

 

Revocation and Determination

of

Statement of Principles

concerning

 

MALIGNANT NEOPLASM OF THE BLADDER

 

ICD-10-AM CODE: C67

 

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.232 of 1995, Instrument No.363 of 1995 and Instrument No.95 of 1997; and

 

(b) determines in their place the following Statement of Principles.

 

Kind of injury, disease or death

2. (a) This Statement of Principles is about malignant neoplasm of the bladder and death from malignant neoplasm of the bladder.

 

(b) For the purposes of this Statement of Principles, “malignant neoplasm of the bladder” means a primary malignant neoplasm arising from the cells lining the bladder, attracting ICD-10-AM code C67, but excluding soft tissue sarcoma, non-Hodgkin's lymphoma and Hodgkin's disease. 

 

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 malignant neoplasm of the bladder and death from malignant neoplasm of the bladder 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, malignant neoplasm of the bladder or death from malignant neoplasm of the bladder is connected with the circumstances of a person’s relevant service are:

 

(a) for squamous cell carcinoma of the bladder only, suffering from Schistosoma haematobium infestation of the bladder before the clinical onset of malignant neoplasm of the bladder; or

 

(b) undergoing a course of therapeutic radiation to the region of the pelvis, where the first exposure to therapeutic radiation occurred at least five years before the clinical onset of malignant neoplasm of the bladder; or

 

(c) being exposed to one of the chemicals from the specified list for a cumulative equivalent of at least three days per week for five years before the clinical onset of malignant neoplasm of the bladder; or

 

(d) receiving systemic cyclophosphamide before the clinical onset of malignant neoplasm of the bladder; or

 

(e)               smoking at least five pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of malignant neoplasm of the bladder; or

 

(f)                being exposed to polycyclic aromatic hydrocarbons (PAH) on more days than not at a concentration of at least 0.2mg/m3 benzene soluble matter (BSM) for at least 15 years before the clinical onset of malignant neoplasm of the bladder; or

 

(g) having received a cumulative equivalent dose of at least 0.5 Sievert of atomic radiation to the bladder where this dose was accumulated at least five years before the clinical onset of malignant neoplasm of the bladder; or

 

(h)              inability to obtain appropriate clinical management for the malignant neoplasm of the bladder.

 

Factors that apply only to material contribution or aggravation

6. Paragraph 5(h) applies only to material contribution to, or aggravation of, malignant neoplasm of the bladder where the person’s malignant neoplasm of the bladder 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:

 

“a course of therapeutic radiation” means one or more fractions (treatment portions) of ionising radiation administered with the aim of achieving palliation or cure with gamma rays, x-rays, alpha particles or beta particles;

 

“atomic radiation” means ionising radiation excluding;

(i)                natural background radiation;

(ii)              therapeutic radiation; and

(iii)           radiation from diagnostic procedures;

 

“being exposed to one of the chemicals from the specified list” means having cutaneous contact or inhaling one of the following substances: benzidine, benzidine-derived azo dyes, 2-naphthylamine, 4-aminobiphenyl, 4-nitrobiphenyl, 4,4’-methylene dianiline, 3,3’-dichlorobenzene, 2-chloroaniline, 4-chloro-o-toluidine, o-toluidine, chlornaphazine;

 

“being exposed to polycyclic aromatic hydrocarbons (PAH)” means:

 

(i)                inhaling PAH vapour; or

(ii)              having skin contact with air containing PAH vapour;

 

“benzene soluble matter (BSM)” means a measure of the presence of PAH;

 

“cumulative equivalent dose” means the total equivalent dose of atomic radiation from all types of radiation (eg alpha, gamma).  It accounts for the differences in biological effectiveness of various types of radiation and allows doses from different radiations to be combined.  Each component is calculated by multiplying the absorbed dose in a particular tissue or organ for a given type of radiation by the radiation weighting factor for that radiation.  The unit of equivalent dose is the Sievert (Sv);

 

“death from malignant neoplasm of the bladder” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s malignant neoplasm of the bladder;

 

“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), Second Edition, effective date of 1 July 2000, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 271 3;

 

“pack years of cigarettes or the equivalent thereof in other tobacco products” means a calculation of consumption where one pack year of cigarettes equals twenty tailor made cigarettes (being the “standard” cigarette pack contents) per day for a period of one calendar year, or

7 300 cigarettes.  One tailor made cigarette approximates one gram of tobacco or one gram of cigar or pipe tobacco by weight.  One pack year of tailor made cigarettes equates to 7 300 cigarettes, or 7.3kg of smoking tobacco by weight.  Tobacco products means either cigarettes, pipe tobacco or cigars smoked, alone or in any combination;

 

“polycyclic aromatic hydrocarbons (PAH)” means those chemical substances formed during the combustion of organic material or during high temperature processing of crude oil, coal, coke, or other industrial carbon compounds;

 

“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

e) cessation of brain function.

 

Application

9. This Instrument applies to all matters to which section 120B of the Act applies.

 

Dated thisTwenty-seventh  day of    September    2000

 

 

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 (VEA) was enacted to address the issue of providing appropriate compensation and medical benefits to Australian veterans and their families, particularly those who have suffered injuries or illnesses related to their service. The Act was introduced by the Australian Parliament to ensure that veterans who have been injured or fallen ill due to their service are provided with the necessary support and care. One of the key components of the VEA is the Repatriation Medical Authority's ability to issue Statements of Principles that determine the circumstances under which specific injuries, diseases, or deaths are considered to be related to relevant service. The Repatriation Medical Authority under the VEA has revoked previous instruments and determined a new Statement of Principles concerning malignant neoplasm of the bladder, which is a primary malignant neoplasm arising from the cells lining the bladder. This determination is based on the sound medical-scientific evidence available, which indicates that it is more probable than not that malignant neoplasm of the bladder can be related to relevant service rendered by veterans or members of the Forces. The policy objective of this legislative instrument is to provide clarity and consistency in the assessment of claims related to malignant neoplasm of the bladder, ensuring that veterans who have been exposed to specific risk factors during their service are eligible for appropriate benefits and support. The instrument outlines various factors that must be related to the veteran's service for a claim to be considered valid, including exposure to certain chemicals, therapeutic radiation, and other risk factors. This Statement of Principles aims to streamline the claims process and provide a clear framework for determining the eligibility of veterans for compensation and medical benefits related to malignant neoplasm of the bladder.

Scope and Application

The Legislative Instrument No.24 of 2000, concerning the revocation and determination of the Statement of Principles regarding malignant neoplasm of the bladder (ICD-10-AM code: C67) under the Veterans’ Entitlements Act 1986, applies to matters governed by section 120B of the Act. This Act is concerned with the health conditions of veterans and members of the Australian Defence Force, specifically targeting malignant neoplasm of the bladder, excluding certain conditions like soft tissue sarcoma, non-Hodgkin's lymphoma, and Hodgkin's disease. The Repatriation Medical Authority has determined that malignant neoplasm of the bladder and resultant deaths are likely related to the service rendered by veterans, provided at least one of the specified factors, such as exposure to particular chemicals or therapeutic radiation, is linked to their service. The instrument revokes previous instruments and establishes these new conditions under which veterans may claim entitlements. The scope and application of this legislation are thus focused on veterans and members of the Defence Force who have been diagnosed with malignant neoplasm of the bladder, ensuring they have access to the necessary benefits based on the outlined criteria.

Key Provisions

This legislation revokes three previous instruments (Instrument No.232 of 1995, Instrument No.363 of 1995, and Instrument No.95 of 1997) and establishes a new Statement of Principles concerning malignant neoplasm of the bladder, as well as death from malignant neoplasm of the bladder. The ICD-10-AM code for this condition is C67, excluding soft tissue sarcoma, non-Hodgkin's lymphoma, and Hodgkin's disease (section 2). The Repatriation Medical Authority has determined that, based on available medical-scientific evidence, it is more probable than not that malignant neoplasm of the bladder and death from malignant neoplasm of the bladder can be related to relevant service rendered by veterans or members of the Forces (section 3). The legislation imposes certain obligations and requirements on the parties or entities it governs. For example, at least one of the factors outlined in section 5 must be related to any relevant service rendered by the person. The factors include: having suffered from Schistosoma haematobium infestation of the bladder before the clinical onset of malignant neoplasm of the bladder, undergoing a course of therapeutic radiation to the region of the pelvis at least five years before the clinical onset of malignant neoplasm of the bladder, being exposed to specified chemicals for a cumulative equivalent of at least three days per week for five years before the clinical onset of malignant neoplasm of the bladder, receiving systemic cyclophosphamide before the clinical onset of malignant neoplasm of the bladder, smoking at least five pack years of cigarettes or the equivalent thereof in other tobacco products before the clinical onset of malignant neoplasm of the bladder, being exposed to polycyclic aromatic hydrocarbons (PAH) on more days than not at a concentration of at least 0.2 mg/m3 benzene soluble matter (BSM) for at least 15 years before the clinical onset of malignant neoplasm of the bladder, receiving a cumulative equivalent dose of at least 0.5 Sievert of atomic radiation to the bladder at least five years before the clinical onset of malignant neoplasm of the bladder, and being unable to obtain appropriate clinical management for the malignant neoplasm of the bladder (section 5). The legislation does not explicitly state any offences, penalties, or civil/criminal consequences for breach. However, the revocation and determination of the Statement of Principles may have implications for the assessment and entitlement of benefits for veterans or members of the Forces who suffer from malignant neoplasm of the bladder or death from malignant neoplasm of the bladder. The new Statement of Principles may provide a more accurate and comprehensive basis for determining the connection between the condition and the relevant service rendered, which could potentially affect the eligibility and level of benefits for affected individuals.

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