Instrument No.284 of 1995
Statement of Principles
concerning
METHAEMOGLOBINAEMIA
ICD CODE: 289.7
Veterans’ Entitlements Act 1986
subsection 196B(2)
1. Being of the view that there is sound medical-scientific evidence that indicates that methaemoglobinaemia and death from methaemoglobinaemia can be related to operational service rendered by veterans, peacekeeping service rendered by members of Peacekeeping Forces and hazardous service rendered by members of the Forces, the Repatriation Medical Authority determines, under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act), that the factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting methaemoglobinaemia or death from methaemoglobinaemia with the circumstances of that service, are:
(a) undergoing treatment with a drug that causes oxidation of haemoglobin immediately before the clinical onset of methaemoglobinaemia; or
(b) being occupationally exposed to a substance that causes oxidation of haemoglobin immediately before the clinical onset of methaemoglobinaemia; or
(c) inability to obtain appropriate clinical management for methaemoglobinaemia.
2. Subject to clause 3 (below) at least one of the factors set out in paragraphs 1(a) to 1(c) must be related to any service rendered by a person.
3. The factor set out in paragraph 1(c) applies only where:
(a) the person's methaemoglobinaemia was contracted before a period, or part of a period, of service to which the factor is related; and
(b) the relationship suggested between the methaemoglobinaemia and the particular service of a person is a relationship set out in paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70(5A)(d) of the Act.
4. 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 1995, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 22235 5;
“methaemoglobinaemia” means a greater than normal amount of methaemoglobin in the blood as a result of the oxidation of haem iron to the ferric state, making it less able to bind with oxygen, causing cyanosis, if the methaemoglobin exceeds 10% of the total haemoglobin, attracting ICD code 289.7;
“substance that causes oxidation of haemoglobin” means any of the following chemical substances:
(a) trinitrotoluene;
(b) nitrobenzene;
(c) dinitrobenzene;
(d) aniline derivatives;
(e) hydroquinone;
(f) beta-naphthylamine;
(g) nitroparaffin;
(h) nitrogen oxides;
“undergoing treatment with a drug that causes oxidation of haemoglobin” means being treated for an injury or a disease with any of the following drugs:
(a) amines;
(b) phenols;
(c) nitrates;
(d) nitrites;
(e) aniline;
(f) sulphonamides;
(g) acetanilide;
(h) phenacetin;
(j) topical anaesthetics such as benzocaine, cetacaine, lidocaine, novocaine, prilocaine, or aniline cocaine;
(k) primaquine;
(m) dapsone;
(n) resorcinol.
Dated this Eighteenth day of July 1995
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, enacted to provide various benefits and services to veterans, addresses the gap in acknowledging and compensating conditions that arise from service-related exposure and treatment. The Repatriation Medical Authority, under the Act, has issued a Statement of Principles concerning methaemoglobinaemia to clarify the conditions under which this condition or death from it may be connected to service. This Statement of Principles, issued in 1995, establishes that a reasonable hypothesis connecting methaemoglobinaemia or death from the condition with service can be made if the service involved treatment with a drug or occupational exposure to a substance that causes oxidation of haemoglobin, or if there was an inability to obtain appropriate clinical management for the condition. The policy objective is to ensure that veterans are appropriately compensated for service-related health conditions, based on sound medical-scientific evidence.
Scope and Application
The Statement of Principles concerning Methaemoglobinaemia issued under the Veterans’ Entitlements Act 1986 outlines the specific conditions under which methaemoglobinaemia or death from methaemoglobinaemia can be considered related to operational service rendered by veterans, peacekeeping service rendered by members of Peacekeeping Forces, and hazardous service rendered by members of the Armed Forces. This legislation applies to veterans and members of Peacekeeping Forces and the Armed Forces who have undergone specific medical treatments or occupational exposures that may lead to methaemoglobinaemia. The conditions involve treatment with drugs that cause the oxidation of haemoglobin or occupational exposure to substances causing such oxidation, and must be related to the service rendered. The legislation provides a clear definition of methaemoglobinaemia and lists specific substances and drugs that cause the oxidation of haemoglobin, which are relevant to establishing a connection between the condition and the service. The jurisdictional reach of this legislation is governed by the Commonwealth, as it is an instrument under the Veterans’ Entitlements Act 1986, which is a Commonwealth Act. No explicit exclusions or exemptions are stated within the text, but the application is restricted to cases where the factors outlined in the Statement of Principles are present and related to the service rendered.
Key Provisions
The Statement of Principles concerning Methaemoglobinaemia outlines the specific factors that must exist to establish a reasonable hypothesis linking methaemoglobinaemia or death from methaemoglobinaemia with service rendered by veterans, peacekeeping forces, or hazardous military operations (section 1). According to the document, at least one of the factors must relate to the service in question, which could include treatment with a drug causing haemoglobin oxidation, occupational exposure to substances causing haemoglobin oxidation, or the inability to obtain appropriate clinical management for methaemoglobinaemia (section 2). The inability to obtain appropriate clinical management applies only if the methaemoglobinaemia was contracted before the service period, and the relationship between the condition and the service is outlined in specific sections of the Veterans’ Entitlements Act 1986 (section 3).
Entities and individuals governed by this legislation must ensure that claims for benefits related to methaemoglobinaemia or death from methaemoglobinaemia are substantiated by evidence that at least one of the specified factors was present and related to the service. This includes providing documentation or testimony that demonstrates exposure to oxidising drugs or substances, or the inability to access appropriate medical care, prior to the onset of the condition (section 4). Claims must be supported by relevant medical records, employment records, or other documentation that verifies the exposure or treatment circumstances.
Failure to comply with the requirements of this Statement of Principles may result in the denial of benefits under the Veterans’ Entitlements Act 1986. The Act does not explicitly state penalties for non-compliance, but it is likely that any fraudulent claims would be subject to civil or criminal penalties as outlined in other relevant legislation, such as the Commonwealth Criminal Code Act 1995. Such penalties could include fines and imprisonment, with the exact penalties depending on the severity of the offence and applicable laws.