Instrument No.1 of 2003
Determination
of
Statement of Principles
concerning
OTITIS MEDIA
ICD-10-AM CODES: H65, H66, H67
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 otitis media and death from otitis media.
(b) For the purposes of this Statement of Principles “otitis media” means an inflammatory process within the middle ear. This definition of otitis media excludes cholesteatoma of middle ear or isolated perforation of tympanic membrane. Otitis media attracts ICD-10-AM code H65, H66 or H67.
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 media and death from otitis media 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 media or death from otitis media with the circumstances of a person’s relevant service are:
(a) suffering from a viral upper respiratory tract infection within the 21 days immediately before the clinical onset of otitis media; or
(b) suffering from partial or complete obstruction of the eustachian tube of the affected side within the seven days immediately before the clinical onset of otitis media; or
(c) suffering from allergic rhinitis within the seven days immediately before the clinical onset of otitis media; or
(d) suffering from malignant neoplasm of the nasopharynx at the time of the clinical onset of otitis media; or
(e) undergoing a course of therapeutic radiation involving the temporal bone of the affected side within the three years immediately before the clinical onset of otitis media; or
(f) suffering from rupture of the tympanic membrane of the affected side within the seven days immediately before the clinical onset of otitis media; or
(g) suffering from otitic barotrauma within the seven days immediately before the clinical onset of otitis media; or
(h) suffering from tuberculosis at the time of the clinical onset of otitis media; or
(i) suffering from a viral upper respiratory tract infection within the 21 days immediately before the clinical worsening of otitis media; or
(j) suffering from partial or complete obstruction of the eustachian tube of the affected side within the seven days immediately before the clinical worsening of otitis media; or
(k) suffering from allergic rhinitis within the seven days immediately before the clinical worsening of otitis media; or
(l) suffering from rupture of the tympanic membrane of the affected side within the seven days immediately before the clinical worsening of otitis media; or
(m) suffering from otitic barotrauma within the seven days immediately before the clinical worsening of otitis media; or
(n) inability to obtain appropriate clinical management for otitis media.
Factors that apply only to material contribution or aggravation
6. Paragraphs 5(i) to 5(n) apply only to material contribution to, or aggravation of, otitis media where the person’s otitis media 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 otitis media” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s otitis media;
“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. Where in this Statement of Principles an ICD code is referenced, such reference is not to constrain or limit the proper meaning of the definition or words preceding the alphanumeric code reference;
“relevant service” means:
(a) operational service; or
(b) peacekeeping service; or
(c) hazardous service;
“rupture of the tympanic membrane” means a full-thickness injury to the tympanic membrane caused by:
(i) surgical procedures,
(ii) intrusion of a foreign body such as a weapon, implement, stick, bullet or shrapnel fragment into the tympanic cavity, or
(iii) blast injury;
“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 Ninth day of January 2003
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN