Statement of Principles concerning malignant neoplasm of the bone or articular cartilage No. 40 of 2002

Administered by Department of Veterans' Affairs

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Instrument No.40 of 2002

 

Revocation and Determination

of

Statement of Principles

concerning

 

MALIGNANT NEOPLASM OF THE BONE OR ARTICULAR CARTILAGE

 

ICD-10-AM CODES: C40, C41

 

Veterans’ Entitlements Act 1986

 

 

1. The Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act):

 

(a) revokes Instrument No.235 of 1995; and

 

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

 

Kind of injury, disease or death

2. (a) This Statement of Principles is about malignant neoplasm of the bone or articular cartilage and death from malignant neoplasm of the bone or articular cartilage.

 

(b)              For the purposes of this Statement of Principles, “malignant neoplasm of the bone or articular cartilage” means a primary malignant neoplasm of any non-haematopoietic cellular elements indigenous to skeletal bone or articular cartilage, but excludes soft tissue sarcoma.  Malignant neoplasm of the bone or articular cartilage attracts ICD-10-AM code C40 or C41.

 

Basis for determining the factors

3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that malignant neoplasm of the bone or articular cartilage and death from malignant neoplasm of the bone or articular cartilage 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, 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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting malignant neoplasm of the bone or articular cartilage or death from malignant neoplasm of the bone or articular cartilage with the circumstances of a person’s relevant service are:

 

(a)              suffering from Paget’s disease of bone at the site before the clinical onset of malignant neoplasm of the bone or articular cartilage; or

 

(b)              suffering from a bone infarct at the site before the clinical onset of malignant neoplasm of the bone or articular cartilage; or

 

(c)              suffering from chronic osteomyelitis at the site before the clinical onset of malignant neoplasm of the bone or articular cartilage; or

 

(d)              undergoing a course of therapeutic radiation to the affected site at least three years before the clinical onset of malignant neoplasm of the bone or articular cartilage; or

 

(e)              undergoing treatment with radium-224, radium-226 or radium-228 before the clinical onset of malignant neoplasm of the bone or articular cartilage; or

 

(f)               undergoing diagnostic scanning with a colloidal solution of thorium dioxide (Thorotrast) before the clinical onset of malignant neoplasm of the bone or articular cartilage; or

 

(g)              inhaling plutonium-239 resulting in a body burden of at least 1.5 kiloBecquerel before the clinical onset of malignant neoplasm of the bone or articular cartilage; or

 

(h)              inability to obtain appropriate clinical management for malignant neoplasm of the bone or articular cartilage.

 

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 bone or articular cartilage where the person’s malignant neoplasm of the bone or articular cartilage 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.

 

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:

 

“Becquerel” means the unit for expressing the amount of radioactivity in a sample of matter; 1 Becquerel (Bq) is the quantity of radioactivity in which there is one atomic disintegration per second;

 

“body burden” means the total amount of radioactive material that is present in the body of a human or an animal;

 

“death from malignant neoplasm of the bone or articular cartilage” 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 bone or articular cartilage;

 

“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.  Where in this Statement of Principles an ICD code is referenced, such reference is not to constrain or limit the proper meaning of the definition or words preceding the alphanumeric code reference;

 

“relevant service” means:

 

(a) operational service; or

(b) peacekeeping service; or

(c)               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 120A of the Act applied.

 

 

Dated this Sixteenth day of  April 2002

 

 

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 various benefits and entitlements to veterans, members of peacekeeping forces, and members of the armed forces. The Act establishes a framework for assessing and determining the eligibility of individuals for compensation and other benefits related to their service. One of the mechanisms through which the Act addresses specific medical conditions and diseases is through the issuance of Statements of Principles by the Repatriation Medical Authority. These Statements of Principles clarify the circumstances under which certain diseases or injuries can be considered related to service, thereby facilitating the assessment and approval of benefits. The Repatriation Medical Authority, under subsection 196B(2) of the Act, has the authority to revoke previous Statements of Principles and issue new ones, as demonstrated in Instrument No.40 of 2002. This particular legislative instrument revokes Instrument No.235 of 1995 and introduces a new Statement of Principles concerning malignant neoplasm of the bone or articular cartilage, aiming to provide clarity and guidance on the conditions under which such medical conditions can be linked to relevant service. This legislative instrument aims to address the problem of ensuring that veterans and members of the armed forces who have developed malignant neoplasm of the bone or articular cartilage, or have died from such conditions, can have their cases assessed fairly and accurately in relation to their service. The policy objective is to provide a clear and evidence-based framework for determining the factors that must be considered when linking these conditions to service, ensuring that those who are legitimately affected can receive the necessary support and benefits. The Repatriation Medical Authority's determination is based on sound medical-scientific evidence, highlighting the importance of a robust and reliable basis for these assessments.

Scope and Application

The Legislative Instrument No.40 of 2002 under the Veterans’ Entitlements Act 1986 (VEA) pertains to the revocation of the previous Statement of Principles concerning malignant neoplasm of the bone or articular cartilage (Instrument No.235 of 1995) and introduces a new Statement of Principles. This legislative instrument applies to veterans, members of Peacekeeping Forces, and members of the Armed Forces who suffer from a malignant neoplasm of the bone or articular cartilage or who die from such a neoplasm. The instrument determines the conditions under which such malignant neoplasms and deaths are considered related to relevant service rendered by these individuals, thereby affecting their eligibility for certain benefits under the VEA. The geographic scope of this legislation is national, as it applies throughout Australia. The exclusions include soft tissue sarcoma, which is not considered within the scope of this Statement of Principles. The application of this instrument is extended or restricted through subordinate instruments as necessary, ensuring that the legislative framework remains adaptable to new medical evidence and changing circumstances.

Key Provisions

The main operative sections of this legislative instrument include the revocation of Instrument No.235 of 1995 and the determination of a new Statement of Principles concerning malignant neoplasm of the bone or articular cartilage (sections 1 and 2). This Statement of Principles outlines the specific conditions and circumstances under which such injuries or diseases may be linked to relevant military service, as well as the criteria that must be met to establish a connection (sections 3-8). Under the Veterans' Entitlements Act 1986, the Repatriation Medical Authority is responsible for determining whether a veteran, member of Peacekeeping Forces, or member of the Forces has a malignant neoplasm of the bone or articular cartilage that can be related to their service. This requires that at least one of the factors outlined in the Statement of Principles must be related to the person's relevant service (section 4). These factors include conditions such as Paget’s disease, bone infarct, chronic osteomyelitis, therapeutic radiation, treatment with radium isotopes, diagnostic scanning with thorium dioxide, inhalation of plutonium-239, or failure to obtain appropriate clinical management (section 5). There are specific obligations and requirements imposed by this Act on the parties it governs. For example, the Repatriation Medical Authority must consider the sound medical-scientific evidence when determining if there is a connection between the malignant neoplasm and relevant service (section 3). It must also ensure that any relevant factors identified are directly related to the service in question (section 4). Furthermore, if a relevant factor includes an injury or disease for which there is already a Statement of Principles, those factors must be applied accordingly (section 7). The legislation does not explicitly detail offences, penalties, or consequences for breach. However, the implications of failing to meet these obligations could involve disputes over veterans' entitlements, potentially leading to legal challenges and reviews by higher authorities. The severity of the consequences would depend on the specific circumstances of any non-compliance and the impact on affected veterans.

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