Statement of Principles concerning osteomyelitis No. 5 of 2004

Administered by Department of Veterans' Affairs

Legislation au F2005B02390 Not in force Legislative Instrument

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Instrument No. 5 of 2004

 

Determination

of

Statement of Principles

concerning

OSTEOMYELITIS

 

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 osteomyelitis and death from osteomyelitis.

 

(b)              For the purposes of this Statement of Principles, “osteomyelitis” means inflammation of bone caused by infection. This definition includes Brodie’s abscess.

 

(c)               Osteomyelitis attracts ICD-10-AM code M86, K10.2, M46.2 or M90.2.

 

(d)              In the application of this Statement of Principles, the definition of “osteomyelitis” is that given at paragraph 2(b) above.

 

Basis for determining the factors

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

 

(a)              having a wound, laceration, or other injury or disease disrupting the skin or mucosa at the site or adjacent to the site of osteomyelitis, within the two years before the clinical onset of osteomyelitis; or

 

(b)              having an invasive surgical procedure performed within the two years before the clinical onset of osteomyelitis; or

 

(c)               having septicaemia, bacteraemia or systemic fungal infection within the two years before the clinical onset of osteomyelitis; or

 

(d)              having a foreign body at the site or adjacent to the site of osteomyelitis at the time of the clinical onset of osteomyelitis; or

 

(e)               having diabetes mellitus at the time of the clinical onset of osteomyelitis; or

 

(f)                having sickle cell disease at the time of the clinical onset of osteomyelitis; or

 

(g)              having Crohn’s disease at the time of the clinical onset of osteomyelitis; or

(h)              having osteopetrosis at the time of the clinical onset of osteomyelitis; or

(i)                having chronic ischaemia of the affected limb from:

(i)                 peripheral vascular disease; or

(ii)               chronic venous insufficiency

at the time of the clinical onset of osteomyelitis; or

 

(j)                being in an immunocompromised state at the time of the clinical onset of osteomyelitis; or

 

(k)              undergoing a course of therapeutic radiation to the affected site within the six months immediately before the clinical onset of osteomyelitis; or

(l)                having internal deposition of radium-224, radium-226, or radium-228 before the clinical onset of osteomyelitis; or

(m)            having osteonecrosis at the site of osteomyelitis before the clinical onset of osteomyelitis; or

(n)              having diabetes mellitus at the time of the clinical worsening of osteomyelitis; or

(o)              having sickle cell disease at the time of the clinical worsening of osteomyelitis; or

 

(p)              having chronic ischaemia of the affected limb from:

(i)                peripheral vascular disease; or

(ii)              chronic venous insufficiency

at the time of the clinical worsening of osteomyelitis; or

 

(q)              being in an immunocompromised state at the time of the clinical worsening of osteomyelitis; or

 

(r)                inability to obtain appropriate clinical management for osteomyelitis.

Factors that apply only to material contribution or aggravation

6. Paragraphs 5(n) to 5(r) apply only to material contribution to, or aggravation of, osteomyelitis where the person’s osteomyelitis 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:

 

“a course of therapeutic radiation” means one or more fractions (treatment portions) of ionising radiation administered with the aim of achieving palliation or cure with gamma rays, x-rays, alpha particles or beta particles;

 

“death from osteomyelitis” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s osteomyelitis;

 

“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;

 

“immunocompromised state” means a state where the immune response has been attenuated by administration of immunosuppressive drugs, irradiation, certain types of infection, malnutrition, or a malignant disease process;

 

“osteonecrosis” means death of bone due to obstruction of its blood supply;

 

“osteopetrosis” means a genetic disease characterised by abnormally dense bone due to defective reabsorption of immature bone known as marble bones disease;

 

“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.

 


Dated this 26th  day of  March  2004

 

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 entitlements and benefits to Australian veterans, members of Peacekeeping Forces, and members of the Australian Defence Force. This legislation aims to address the unique health and welfare needs of these individuals, particularly those arising from their service. The Repatriation Medical Authority, acting under the authority conferred by the Act, has issued a Statement of Principles concerning Osteomyelitis. This determination clarifies the medical conditions and factors that must be related to relevant service to establish a connection between osteomyelitis and service, facilitating the provision of appropriate benefits and support to affected individuals. The objective of this Statement of Principles is to provide a clear framework for assessing claims related to osteomyelitis, ensuring that veterans and service members receive the recognition and assistance they deserve.

Scope and Application

This legislative instrument, numbered 5 of 2004, pertains to a Statement of Principles concerning osteomyelitis under the Veterans’ Entitlements Act 1986. It is determined by the Repatriation Medical Authority and applies to veterans, members of Peacekeeping Forces, and members of the Forces who have suffered from osteomyelitis or death from osteomyelitis. Osteomyelitis, defined as inflammation of bone caused by infection, must be linked to relevant service to qualify under the Act. The Statement of Principles outlines specific factors that must be related to service, such as having a wound, laceration, or invasive surgical procedure, or conditions like diabetes mellitus or septicaemia within a specific timeframe before the onset of osteomyelitis. The geographic reach of this legislation is national, as it applies to all veterans and service members across Australia. There are no stated exclusions or thresholds in this determination, but it is noted that the factors apply only to material contribution or aggravation of osteomyelitis if the condition was suffered or contracted before or during service. This legislative instrument extends the application of the Veterans’ Entitlements Act 1986 to include specific medical conditions under particular circumstances.

Key Provisions

The Statement of Principles concerning osteomyelitis, as determined by the Repatriation Medical Authority under the Veterans’ Entitlements Act 1986 (section 1), addresses the connection between osteomyelitis, a type of bone infection, and service rendered by veterans, Peacekeeping Forces, or other forces. Osteomyelitis is defined as inflammation of bone caused by infection, including conditions like Brodie’s abscess, and is classified under specific ICD-10-AM codes (section 2). The Repatriation Medical Authority acknowledges that there is credible medical-scientific evidence linking osteomyelitis and death from osteomyelitis to relevant military service (section 3). The legislation imposes obligations on veterans or other affected parties to provide evidence that their osteomyelitis was related to their service, either by demonstrating one or more specified factors listed in the Statement of Principles, or by showing that their condition was materially contributed to or aggravated by their service (sections 4 and 6). The factors that must be related to service include various preconditions such as wounds, surgical procedures, infections, or underlying health conditions occurring within a specific timeframe relative to the onset of osteomyelitis (section 5). If a factor includes an injury or disease already covered by another Statement of Principles, the provisions of that Statement must also be applied (section 7). Failure to comply with the requirements of the Statement of Principles or providing false information may result in civil or criminal consequences. While the specific penalties for breaches are not detailed in this Statement of Principles, the Act provides for general penalties for false claims or statements under the legislation, which could include fines or imprisonment, depending on the severity and intent of the breach (section 9). The precise consequences would be determined in the context of the broader legal framework established by the Veterans’ Entitlements Act 1986.

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