Instrument No.12 of 2003
Determination
of
Statement of Principles
concerning
MITRAL VALVE PROLAPSE
Veterans’ Entitlements Act 1986
1. This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the Act).
Kind of injury, disease or death
2. (a) This Statement of Principles is about mitral valve prolapse and death from mitral valve prolapse.
(b) For the purposes of this Statement of Principles, “mitral valve prolapse” means a structural disorder of the mitral valve apparatus in which there is systolic displacement of an abnormally thickened or redundant mitral leaflet into the left atrium, and which has been confirmed by echocardiographic studies. Mitral valve prolapse is also known as floppy mitral valve.
This definition of mitral valve prolapse excludes:
(i) mitral valve displacement or billowing of the anterior mitral valve leaflet identified only in the 4-chamber apical view;
(ii) isolated mitral regurgitation in the absence of echocardiographic evidence of mitral valve prolapse;
(iii) mitral valve disorder due to rheumatic heart disease; or
(iv) flail mitral valve leaflets.
(c) Mitral valve prolapse attracts ICD-10-AM code I34.1.
(d) In the application of this Statement of Principles, the definition of “mitral valve prolapse” is that given at para 2(b) above.
Basis for determining the factors
3. After examining the available sound medical-scientific evidence the Repatriation Medical Authority is of the view that it is more probable than not on the sound medical-scientific evidence available, that the only factor that can be related to the cause of or material contribution to or aggravation of mitral valve prolapse or death from mitral valve prolapse and which can be related to relevant service is that set out in clause 4.
Factors that must be related to service
4. The factor that must exist before it can be said that, on the balance of probabilities, in relation to the circumstances of a person’s relevant service causing or materially contributing to or aggravating mitral valve prolapse or death from mitral valve prolapse is inability to obtain appropriate clinical management for mitral valve prolapse.
Other definitions
5. For the purposes of this Statement of Principles:
“death from mitral valve prolapse” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s mitral valve prolapse;
“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), Third Edition, effective date of 1 July 2002, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 413 9;
“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.
Dated this Seventh day of April 2003
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 by the Parliament of Australia, provides a framework for the entitlements of veterans, including medical care and compensation for injuries and diseases related to their service. The Act was introduced to address the needs of veterans by ensuring they receive appropriate recognition and support for health issues arising from their service. The Statement of Principles concerning Mitral Valve Prolapse was determined by the Repatriation Medical Authority under the Act to provide clarity on the eligibility criteria for veterans suffering from this condition. The policy objective of this Statement of Principles is to establish a definitive understanding of the circumstances under which mitral valve prolapse, or death from mitral valve prolapse, can be linked to relevant military service, thereby ensuring that affected veterans can access the necessary benefits and support.
Scope and Application
The Statement of Principles concerning Mitral Valve Prolapse under the Veterans’ Entitlements Act 1986 applies specifically to veterans who have experienced mitral valve prolapse or death from mitral valve prolapse. This encompasses both the structural disorder of the mitral valve apparatus and any terminal events or conditions that are contributed to by this disorder. The definition of mitral valve prolapse within this context excludes certain conditions such as mitral valve displacement or billowing identified only in the 4-chamber apical view, isolated mitral regurgitation without echocardiographic evidence, mitral valve disorder due to rheumatic heart disease, and flail mitral valve leaflets. The statement applies to both the Commonwealth and state levels, as it is determined by the Repatriation Medical Authority under the Act. This legislation does not extend its application through subordinate instruments but is a standalone determination that sets out the specific circumstances under which veterans can claim entitlements related to mitral valve prolapse.
The Statement of Principles specifies that the only factor that can be related to the cause or material contribution to mitral valve prolapse or death from mitral valve prolapse in the context of relevant service is the inability to obtain appropriate clinical management for the condition. The term "relevant service" includes eligible war service (other than operational service) and defence service (other than hazardous service). The jurisdictional reach is thus broad, covering both federal and state levels, and it applies to those veterans who fall within the specified definitions and criteria. This determination is crucial for veterans seeking to claim entitlements related to mitral valve prolapse, providing a clear framework for eligibility based on the defined medical conditions and service-related factors.
Key Provisions
The Statement of Principles (F2005B02146) under the Veterans’ Entitlements Act 1986 concerns mitral valve prolapse and death from mitral valve prolapse (s2). Specifically, it defines mitral valve prolapse as a structural disorder where there is systolic displacement of an abnormally thickened or redundant mitral leaflet into the left atrium, confirmed by echocardiographic studies. This definition excludes certain conditions such as mitral valve displacement identified only in the 4-chamber apical view, isolated mitral regurgitation without echocardiographic evidence of mitral valve prolapse, mitral valve disorder due to rheumatic heart disease, and flail mitral valve leaflets (s2(b)). The Statement further classifies mitral valve prolapse under ICD-10-AM code I34.1 (s2(a)).
The Repatriation Medical Authority, after examining available medical-scientific evidence, determines that it is more probable than not that the inability to obtain appropriate clinical management for mitral valve prolapse during relevant service is the factor that can be related to the cause or material contribution to or aggravation of mitral valve prolapse or death from mitral valve prolapse (s3, s4). Relevant service, as defined in the Statement, includes eligible war service (other than operational service) and defence service (other than hazardous service) (s5).
In relation to obligations, the Statement of Principles imposes a requirement that the inability to obtain appropriate clinical management for mitral valve prolapse must exist as a factor before it can be said that, on the balance of probabilities, the relevant service caused or materially contributed to or aggravated mitral valve prolapse or death from mitral valve prolapse. This principle is essential for determining entitlement under the Veterans’ Entitlements Act 1986 for veterans suffering from or who have died due to mitral valve prolapse.
There are no explicit offences, penalties, or civil/criminal consequences stated in the Statement of Principles. The primary function of this legislative instrument is to establish criteria and definitions for the assessment and recognition of mitral valve prolapse and death from mitral valve prolapse in the context of veterans’ entitlements, rather than to prescribe punitive measures for breaches.