Statement of Principles concerning obstructive nephropathy No. 87 of 1996

Administered by Department of Veterans' Affairs

Legislation au F2008B00564 Not in force Legislative Instrument

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Instrument No.87 of 1996

 

Determination

of

Statement of Principles

concerning

OBSTRUCTIVE NEPHROPATHY

ICD CODES: 591, 593.5, 593.89, 599.6

 

Veterans’ Entitlements Act 1986

 

 

1. This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act).

 

Kind of injury, disease or death

2. (a) This Statement of Principles is about obstructive nephropathy and death from obstructive nephropathy.

 

 (b) For the purposes of this Statement of Principles, “obstructive nephropathy” means a disorder characterised by functional and pathological changes in the kidney resulting from complete or partial obstruction of the urinary tract, and which includes the conditions of hydronephrosis or hydroureter, attracting ICD code 591, 593.5, 593.89 or 599.6.

 

Basis for determining the factors

3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that obstructive nephropathy 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, the factors set out in at least one of the paragraphs 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 obstructive nephropathy or death from obstructive nephropathy with the circumstances of a person’s relevant service are:

 

(a) suffering complete obstruction of the renal pelvicalyceal system or ureter on the affected side, for a continuous period of at least 7 days before the clinical onset of obstructive nephropathy; or

 

(b) suffering partial obstruction of the renal pelvicalyceal system or ureter on the affected side, for a continuous period of at least 30 days before the clinical onset of obstructive nephropathy; or

 

(c) suffering obstruction of the bladder outlet for a continuous period of at least 30 days before the clinical onset of obstructive nephropathy; or

 

(d) suffering obstruction of the urethra for a continuous period of at least 30 days before the clinical onset of obstructive nephropathy; or

 

(e) suffering complete obstruction of the renal pelvicalyceal system or ureter on the affected side, for a continuous period of at least 7 days before the clinical worsening of obstructive nephropathy; or

 

(f) suffering partial obstruction of the renal pelvicalyceal system or ureter on the affected side, for a continuous period of at least 30 days before the clinical worsening of obstructive nephropathy; or

 

(g) suffering obstruction of the bladder outlet for a continuous period of at least 30 days before the clinical worsening of obstructive nephropathy; or

 

(h) suffering obstruction of the urethra for a continuous period of at least 30 days before the clinical worsening of obstructive nephropathy; or

 

(j) inability to obtain appropriate clinical management for obstructive nephropathy.

 

Factors that apply only to material contribution or aggravation

6. Paragraphs 5(e) to 5(j) apply only to material contribution to, or aggravation of, obstructive nephropathy where the person’s obstructive nephropathy 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.

 

Other definitions

7. 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;

 

“obstruction of the bladder outlet” means a blockage to the flow of urine resulting from pathology such as:

 

(i) bladder calculi, ICD code 594.1; or

(ii) bladder tumours, ICD code 188, 198.1, 223.3, 236.7 or 239.4; or

(iii) neurogenic bladder, ICD code 344.61 or 596.5; or

(iv) pelvic masses; or

(v) bladder pathology resulting from cyclophosphamide therapy, ICD code 595.89; or

(vi) bladder neck obstruction, ICD code 596.0; or

(vii) pelvic or abdominal trauma (including surgery); or

(viii) vesicoureteral reflux, ICD code 593.7;

 

“obstruction of the urethra” means a blockage to the flow of urine resulting from pathology such as:

 

(i) urethral calculi, ICD code 594.2, 594.8 or 594.9; or

(ii) tumours, ICD code 189.3, 198.1, 223.81 or 236.99; or

(iii) benign prostatomegaly, ICD code 222.2 or 600; or

(iv) prostatic carcinoma, ICD code 185, 198.82 or 236.5; or

(v) urethral stricture, ICD code 593.4 or 598; or

(vi) pelvic or abdominal trauma (including surgery);

 

“obstruction of the renal pelvicalyceal system or ureter” means a blockage to the flow of urine at the level of the upper urinary tract, resulting from pathology such as:

 

(i) calculi, ICD code 592.0, 592.1; or

(ii) blood clots, ICD code 593.4; or

(iii) sloughed renal papillae, ICD code 593.4; or

(iv) tumours of the renal pelvis, ureter or bladder, ICD code 188, 189.1, 189.2, 198.1, 223.1, 223.2 or 223.3; or

(v) stricture of the ureter, ICD code 593.3; or

(vi) genitourinary tuberculosis, ICD code 016.1 or 016.2; or

(vii) interstitial cystitis, ICD code 595.1; or

(viii) chronic inflammatory bowel disease, ICD code 555 or 556; or

(ix) retroperitoneal fibrosis, ICD code 593.4; or

(x) abdominal and pelvic masses (eg. uterine leiomyoma, benign neoplasm of ovary, malignant neoplasm of ovary, malignant neoplasm of uterus, malignant neoplasm of colon); or

(xi) surgical ligation of the ureter; or

(xii) aortoiliac surgery; or

(xiii) pelvic or abdominal trauma; or

(xiv) pelvic endometriosis, ICD code 617.3; or

(xv) urinary schistosomiasis, ICD code 120.0; or

(xvi) retroperitoneal haematoma, ICD code 568.81;

 

“relevant service” means:

 

(a) operational service; or

(b) peacekeeping service; or

(c) hazardous service.

 

 

 

Dated this Eighteenth day of  June               1996

 

 

 

The Common Seal of the    )

Repatriation Medical Authority   )

was affixed to this instrument  )

in the presence of    )

 

KEN DONALD

CHAIRMAN

Overview

The Statement of Principles concerning Obstructive Nephropathy ICD Codes: 591, 593.5, 593.89, 599.6, enacted under the Veterans’ Entitlements Act 1986, was determined by the Repatriation Medical Authority in 1996. This Statement of Principles aims to address the issue of obstructive nephropathy among veterans, members of Peacekeeping Forces, or members of the Forces, by establishing the conditions under which such conditions can be related to their service. The determination was made based on sound medical-scientific evidence indicating a possible link between these kidney disorders and the service rendered by these individuals. The policy objective is to ensure that veterans and their families receive appropriate recognition and support for service-related health conditions. The Statement of Principles outlines specific factors that must exist for obstructive nephropathy or death from obstructive nephropathy to be reasonably connected to service, including periods of complete or partial obstruction of the urinary tract. These factors are crucial for establishing a causal relationship between the service and the condition, thus facilitating the provision of relevant entitlements and support to affected individuals. The determination provides a clear framework for assessing claims related to obstructive nephropathy, ensuring that eligible veterans and their families can access the benefits they are entitled to under the Act.

Scope and Application

This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986, and it concerns obstructive nephropathy and death from obstructive nephropathy. The Act applies to veterans, members of Peacekeeping Forces, or members of the Forces, and it aims to provide sound medical-scientific evidence that obstructive nephropathy can be related to their service. The Statement of Principles specifies the factors that must be related to relevant service to establish a connection between obstructive nephropathy or death from obstructive nephropathy and the circumstances of the person’s service. These factors include various types and durations of urinary tract obstructions and the inability to obtain appropriate clinical management. The geographic and jurisdictional reach of the Act is nationwide, as it is a Commonwealth Act. The Act does not specify any exclusions or exemptions, but certain paragraphs apply only to material contribution or aggravation of the condition where the person’s obstructive nephropathy was suffered or contracted before or during their relevant service. The legislative instrument extends the application of the Act through subordinate instruments such as this Statement of Principles.

Key Provisions

This legislative instrument determines a Statement of Principles concerning obstructive nephropathy and death from obstructive nephropathy under the Veterans’ Entitlements Act 1986. The Repatriation Medical Authority, under subsection 196B(2) of the Act, has established this Statement of Principles (section 1). The conditions covered include obstructive nephropathy and death related to this condition, defined as a disorder resulting from the obstruction of the urinary tract, with specific ICD codes identified (section 2). The Authority has determined that there is sufficient medical-scientific evidence linking obstructive nephropathy to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces (section 3). To establish a connection between obstructive nephropathy or death from obstructive nephropathy and the circumstances of a person’s relevant service, certain factors must be present (section 4). These factors include specific types and durations of urinary tract obstruction before the onset or worsening of obstructive nephropathy, or an inability to obtain appropriate clinical management for the condition (section 5). Some of these factors apply only to the material contribution to, or aggravation of, obstructive nephropathy if the condition was suffered or contracted before or during, but not arising out of, the person’s relevant service (section 6). The definitions provided clarify terms such as "ICD code," "obstruction of the bladder outlet," "obstruction of the urethra," "obstruction of the renal pelvicalyceal system or ureter," and "relevant service" (section 7). The Act imposes obligations on the parties involved, including the requirement that the identified factors be related to the person's relevant service to establish a connection to obstructive nephropathy or death from obstructive nephropathy. This includes verifying the duration and type of urinary obstruction as outlined in the Statement of Principles. The Act also requires the Repatriation Medical Authority to provide evidence that supports the link between the condition and the person’s service, ensuring that the claim is substantiated by sound medical-scientific evidence. Failure to comply with these obligations could result in the denial of entitlements related to the condition. The legislation does not explicitly detail offences, penalties, or consequences for breach within the provided text. However, breaches of the Veterans’ Entitlements Act 1986 or related legislative instruments could potentially result in civil or criminal penalties, depending on the nature and severity of the breach. Typically, such breaches might lead to fines, imprisonment, or other legal consequences as prescribed by the relevant laws. The exact penalties would be determined based on the specific provisions of the Act and any subsidiary legislation.

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