Statement of Principles concerning otitis externa No. 73 of 2001

Statement of Principles

concerning

OTITIS EXTERNA

Instrument No. 73 of 2001 as amended

made under section 196B(2) of the

Veterans’ Entitlements Act 1986

This compilation was prepared on 10 October 2005
taking into account Amendment of Statement of Principles concerning OTITIS EXTERNA (Instrument No. 42 of 2002)

Prepared by the Repatriation Medical Authority Secretariat, Brisbane

Revocation and Determination

of

Statement of Principles

concerning

OTITIS EXTERNA

ICD-10-AM CODES: H60, H62.0, H62.1, H62.2, H62.3, H62.4.

Veterans’ Entitlements Act 1986

1. The Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act):

(a) revokes Instrument No.292 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 otitis externa and death

from otitis externa.

(b)         For the purposes of this Statement of Principles, “otitis externa”

means inflammation of the external auditory canal, attracting

ICD-10-AM code H60, H62.0, H62.1, H62.2, H62.3 or H62.4.

Basis for determining the factors

3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that otitis externa and death from otitis externa 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 factors that must as a minimum exist before it can be said that a

reasonable hypothesis has been raised connecting otitis externa or

death from otitis externa with the circumstances of a person’s relevant

service are:

(a)             swimming or diving in water within the 14 days before the clinical onset of otitis externa; or

(b)             undergoing a course of therapeutic radiation to the head or neck region within the two years before the clinical onset of otitis externa; or

(c)             having a foreign object or implement inserted into, or removed from, the affected ear canal within the 14 days before the clinical onset of otitis externa; or

(d)             suffering inflammation of the ear canal of the affected ear as a complication of a specified systemic inflammatory skin condition at the time of the clinical onset of otitis externa; or

(e)             suffering from chronic suppurative otitis media of the affected ear within the 30 days before the clinical onset of otitis externa; or

(f)              suffering from diabetes mellitus at the time of the clinical onset of otitis externa; or

(g)             being in an immuno-compromised state at the time of the clinical onset of otitis externa; or

(h)             having an obstruction or partial obstruction of the external auditory canal of the affected ear at the time of the clinical onset of otitis externa; or

(j) swimming or diving in water within the 14 days before the clinical worsening of otitis externa; or

(k) having a foreign object or implement inserted into, or removed from, the affected ear canal within the 14 days before the clinical worsening of otitis externa; or

(m) suffering inflammation of the ear canal of the affected ear as a complication of a specified systemic inflammatory skin condition at the time of the clinical worsening of otitis externa; or

(n) suffering from chronic suppurative otitis media of the affected ear within the 30 days before the clinical worsening of otitis externa; or

(o) suffering from diabetes mellitus at the time of the clinical worsening of otitis externa; or

(p) being in an immuno-compromised state at the time of the clinical worsening of otitis externa; or

(q) having an obstruction or partial obstruction of the external

 auditory canal of the affected ear at the time of the clinical

 worsening of otitis externa; or

(r) inability to obtain appropriate clinical management for otitis externa.

Factors that apply only to material contribution or aggravation

6. Paragraphs 5(j) to 5(r) apply only to material contribution to, or

aggravation of, otitis externa where the person’s otitis externa 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;

“an obstruction or partial obstruction of the external auditory canal” means a narrowing or obstruction due to exostosis, osteoma, inflammation, or build up of cerumen impinging on the external auditory canal;

“chronic suppurative otitis media” means a group of recurrent or continuous infective disorders of the middle ear characterised by perforation of the tympanic membrane, long standing painless aural discharge and varying deafness;

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

“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;

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

“relevant service” means:

(a) operational service; or

(b) peacekeeping service; or

(c) hazardous service;

“specified systemic inflammatory skin condition” means contact dermatitis, seborrhoeic dermatitis, neurodermatitis, psoriasis, acne, or systemic lupus erythematosus;

“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 120A of the Act applied.

Notes to Statement of Principles concerning otitis externa (Instrument No. 73 of 2001)

The Statement of Principles concerning otitis externa (Instrument No. 73 of 2001) in force under section 196B(2) of the Veterans’ Entitlements Act 1986, as shown in this compilation is amended as indicated in the Tables below.

Table of Instruments

Table of Amendments