Statement of Principles concerning periodontitis No. 1 of 2002

Administered by Department of Veterans' Affairs

Legislation au F2005B03254 Not in force Legislative Instrument

Legislation content

Instrument No.1 of 2002

 

Revocation

of

Statement of Principles

concerning

 

INFLAMMATORY PERIODONTAL DISEASE

and

Determination

of

Statement of Principles

concerning

 

PERIODONTITIS

 

ICD-10-AM CODES: K04.4, K04.5, K05.2, K05.3, K05.4

 

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.368 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 periodontitis and death from periodontitis.

 

(b) For the purposes of this Statement of Principles, “periodontitis” means an inflammatory disease of the bony and ligamentous supporting tissues of the teeth, accompanied by destruction of the periodontal ligament or alveolar bone, attracting ICD-10-AM code K04.4, K04.5, K05.2, K05.3 or K05.4.  This definition includes acute periodontitis, chronic periodontitis, necrotising periodontitis, aggressive periodontitis and early-onset periodontitis but excludes gingivitis.

 

Basis for determining the factors

3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that periodontitis and death from periodontitis 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 periodontitis or death from periodontitis with the circumstances of a person’s relevant service are:

 

(a)              suffering from gingivitis within the two years before the clinical onset of periodontitis, where the periodontitis has occurred adjacent to the gingivitis; or

 

(b)              smoking at least 10 cigarettes per day or the equivalent thereof in other tobacco products for a period of at least five years before the clinical onset of periodontitis, and where smoking has ceased the clinical onset has occurred within 10 years of cessation; or

 

(c)              suffering from diabetes mellitus at the time of the clinical onset of periodontitis; or

 

(d)              suffering from a severe nutritional deficiency at the time of the clinical onset of periodontitis; or

 

(e)              being infected with human immunodeficiency virus (HIV) at the time of the clinical onset of periodontitis; or

 

(f)               suffering from dental pulp disease of a tooth in the affected region of the periodontium at the time of the clinical onset of periodontitis; or

 

(g)              for periodontal abscess only,

 

(i)                having a microscopic or macroscopic foreign body embedded in the affected region of the periodontium at the time of the clinical onset of periodontitis; or

 

(ii)               suffering penetrating trauma (including surgery or open fracture) to the affected region of the periodontium within the seven days before the clinical onset of periodontitis; or

 

(h)              suffering from gingivitis at the time of the clinical worsening of periodontitis, where the periodontitis has occurred adjacent to the gingivitis; or

 

(i)                suffering from diabetes mellitus at the time of the clinical worsening of periodontitis; or

 

(j)                being infected with human immunodeficiency virus (HIV) at the time of the clinical worsening of periodontitis; or

 

(k)              suffering from dental pulp disease of a tooth in the affected region of the periodontium at the time of the clinical worsening of periodontitis; or

 

(l)                for periodontal abscess only,

 

(i)                having a microscopic or macroscopic foreign body embedded in the affected region of the periodontium at the time of the clinical worsening of periodontitis; or

 

(ii)               suffering penetrating trauma (including surgery or open fracture) to the affected region of the periodontium within the seven days before the clinical worsening of periodontitis; or

 

(m)           inability to obtain appropriate clinical management for periodontitis.

 

Factors that apply only to material contribution or aggravation

6. Paragraphs 5(h) to 5(m) apply only to material contribution to, or aggravation of, periodontitis where the person’s periodontitis was 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:

 

“cigarettes per day or the equivalent thereof, in other tobacco products” means either cigarettes, pipe tobacco or cigars, alone or in any combination where one tailor made cigarette approximates one gram of tobacco; or one gram of cigar, pipe or other smoking tobacco by weight;

 

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

 

“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;

 

“periodontal abscess” means a rapidly developing, destructive inflammatory disease with local accumulation of pus within the bony and ligamentous supporting structures of the teeth;

 

“relevant service” means:

 

(a) operational service; or

(b) peacekeeping service; or

(c) hazardous service;

 

“suffering from a severe nutritional deficiency” means suffering from scurvy or having clinical or biochemical evidence of a severe protein-energy malnutrition due to starvation, being a prisoner of war, systemic disease or chronic gastrointestinal malabsorption;

 

“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.

 

 

Dated this  Ninth day of  January 2002

 

 

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 is a piece of Australian legislation enacted to address the entitlement of veterans to medical, pension, and other benefits related to their service. The Act was introduced to ensure that Australian Defence Force members who have served and those who have been injured or fallen ill due to their service are provided with appropriate care and support. The Act is overseen by the Repatriation Medical Authority, which is tasked with determining Statements of Principles concerning various diseases and injuries that may be related to service, including periodontitis. The primary policy objective of the Act is to provide comprehensive support to veterans and their families by recognising and compensating for service-related injuries and illnesses. The Repatriation Medical Authority has issued a legislative instrument to revoke the previous Statement of Principles concerning inflammatory periodontal disease and to introduce a new Statement of Principles concerning periodontitis. Periodontitis, an inflammatory disease affecting the supporting structures of the teeth, is now defined under this Statement to include various forms such as acute, chronic, necrotising, aggressive, and early-onset periodontitis. The new Statement outlines specific factors that must be related to relevant service, such as suffering from gingivitis, smoking, diabetes, severe nutritional deficiencies, infection with HIV, dental pulp disease, or inability to obtain appropriate clinical management. These factors are crucial in establishing a connection between periodontitis and the circumstances of a person’s service, facilitating the provision of appropriate benefits and support.

Scope and Application

The legislative instrument, F2005B03254, concerns the revocation and replacement of a Statement of Principles related to inflammatory periodontal disease and periodontitis under the Veterans’ Entitlements Act 1986. Specifically, it revokes Instrument No.368 of 1995 and establishes a new Statement of Principles concerning periodontitis and death from periodontitis. This Statement of Principles applies to periodontitis, defined as an inflammatory disease of the supporting structures of the teeth with destruction of the periodontal ligament or alveolar bone, attracting specific ICD-10-AM codes. The instrument delineates the factors that must be related to the relevant service rendered by veterans, members of peacekeeping forces, or members of the forces for periodontitis and death from periodontitis to be considered related to service. These factors include suffering from gingivitis, smoking, diabetes mellitus, severe nutritional deficiency, HIV infection, dental pulp disease, foreign body presence, or penetrating trauma. The application of this instrument extends to all matters to which section 120A of the Act applies.

Key Provisions

The legislative instrument under discussion primarily involves the revocation of a previous statement of principles concerning inflammatory periodontal disease and the establishment of a new statement of principles concerning periodontitis, as outlined in section 1(a) and (b) of the instrument. The new Statement of Principles specifies that it pertains to periodontitis and death from periodontitis, defining periodontitis as an inflammatory disease affecting the supporting structures of the teeth, with specific ICD-10-AM codes provided (section 2(b)). The Repatriation Medical Authority has determined that periodontitis and death from periodontitis can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces, based on sound medical-scientific evidence (section 3). The new Statement of Principles imposes several obligations and requirements on the parties it governs. For a reasonable hypothesis to connect periodontitis or death from periodontitis with a person's relevant service, at least one of the specified factors must be related to the service (section 4). These factors include suffering from gingivitis within two years before the clinical onset of periodontitis, smoking a certain number of cigarettes per day for a specified period, suffering from diabetes mellitus or a severe nutritional deficiency at the time of onset, being infected with HIV, suffering from dental pulp disease, or experiencing certain traumatic events (section 5). For material contribution or aggravation of periodontitis, additional factors are considered, such as suffering from gingivitis or diabetes mellitus at the time of clinical worsening (section 6). The legislative instrument also delineates the consequences for non-compliance or breach of the obligations outlined. Although specific offences, penalties, or civil/criminal consequences are not detailed within the text of the instrument itself, under the Veterans' Entitlements Act 1986, breaches of statutory requirements or provisions can result in civil penalties, including fines and, in some cases, criminal penalties. The maximum penalties would depend on the nature and severity of the breach, as well as any additional provisions outlined in the primary Act or related legislation.

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