Statement of Principles concerning malignant neoplasm of the bone or articular cartilage No. 41 of 2002

Administered by Department of Veterans' Affairs

Legislation au F2005B02086 Not in force Legislative Instrument

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Instrument No.41 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(3) of the Veterans’ Entitlements Act 1986 (the Act):

 

(a) revokes Instrument No.236 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. 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 bone or articular cartilage and death from malignant neoplasm of the bone or articular cartilage 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 bone or articular cartilage or death from malignant neoplasm of the bone or articular cartilage is connected 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)              undergoing a course of therapeutic radiation to the affected site at least 10 years before the clinical onset of malignant neoplasm of the bone or articular cartilage; or

 

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

 

(d) 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

 

(e) inhaling plutonium-239 resulting in a body burden of at least 3 kiloBecquerel before the clinical onset of malignant neoplasm of the bone or articular cartilage; or

 

(f) 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(f) 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) 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:

 

“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) 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 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 Repatriation Medical Authority, exercising its authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986, revoked Instrument No.236 of 1995 and established a new Statement of Principles concerning malignant neoplasm of the bone or articular cartilage. This legislative instrument addresses the problem of determining the service-related nature of malignant neoplasm of the bone or articular cartilage and death from such conditions among veterans and members of the Australian Defence Force. By establishing specific criteria that link these conditions to relevant military service, the Act aims to ensure that affected individuals receive appropriate recognition and support. The policy objective is to provide a clear framework for assessing and acknowledging the service connection of these serious medical conditions. This legislative instrument was enacted to address the need for a formal recognition process for malignant neoplasm of the bone or articular cartilage and related deaths among veterans. The Repatriation Medical Authority, acting under the authority vested in it by the Parliament, aims to ensure that veterans who have developed these conditions due to their service are appropriately recognised and supported. The criteria established in this Statement of Principles facilitate the assessment of the service connection of these conditions, thereby ensuring that affected veterans receive the benefits and recognition they deserve.

Scope and Application

The Revocation and Determination of Statement of Principles concerning Malignant Neoplasm of the Bone or Articular Cartilage, ICD-10-AM Codes: C40, C41, issued under the Veterans’ Entitlements Act 1986, applies to the Repatriation Medical Authority's consideration of malignant neoplasm of the bone or articular cartilage and death resulting from such neoplasm in veterans or members of the Forces. This legislative instrument revokes Instrument No.236 of 1995 and determines new principles to be applied in assessing these conditions. The Act applies to veterans and members of the Australian Defence Force who have served in eligible war service or defence service, excluding hazardous service. The determination establishes that it is more probable than not that malignant neoplasm of the bone or articular cartilage and death from such neoplasm can be related to relevant service rendered by veterans or members of the Forces. To substantiate a connection, at least one of the specified factors, such as suffering from Paget’s disease at the site or undergoing therapeutic radiation, must be related to the relevant service. This instrument applies to all matters governed by section 120B of the Act, ensuring a consistent approach in the adjudication of such claims.

Key Provisions

Under the Veterans’ Entitlements Act 1986, the Repatriation Medical Authority has revoked Instrument No.236 of 1995 and in its place has determined a new Statement of Principles (1). This Statement of Principles pertains specifically to malignant neoplasm of the bone or articular cartilage and death from such neoplasm (2). The authority's determination is based on the view that it is more probable than not that these conditions can be related to relevant service rendered by veterans or members of the Forces, given the sound medical-scientific evidence available (3). The Statement of Principles outlines several factors that must exist to establish a connection between the malignant neoplasm or death from such neoplasm and the service circumstances (5). These include suffering from Paget’s disease of bone at the site before the clinical onset of the neoplasm, undergoing therapeutic radiation or specific treatments before the onset, or inhaling certain radioactive materials resulting in a significant body burden (5(a)-(e)). Additionally, inability to obtain appropriate clinical management for the neoplasm can also be a relevant factor (5(f)). Notably, the inability to obtain appropriate clinical management applies only to material contribution or aggravation of the condition where the neoplasm was suffered or contracted before or during service but not arising out of it (6). In terms of obligations, the Repatriation Medical Authority must ensure that at least one of the specified factors is related to the service rendered by the veteran (4). The Authority must also apply existing Statements of Principles if a relevant factor includes an injury or disease covered by such a statement (7). There are no direct penalties or consequences for breaching this legislative instrument, as it primarily serves to guide the assessment and determination of entitlements for veterans suffering from malignant neoplasm of the bone or articular cartilage. However, any failure to adhere to the outlined factors or processes could potentially lead to disputes or challenges in the adjudication of veterans’ claims.

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