Statement of Principles concerning pleural plaque No. 52 of 2003

Overview

The Veterans’ Entitlements Act 1986 was enacted to provide for the entitlements of veterans and their families, addressing various health and welfare needs arising from military service. The 2003 Determination of Statement of Principles concerning Pleural Plaque is a legislative instrument made under the Act, which was developed to clarify the circumstances in which pleural plaque and deaths attributable to pleural plaque can be considered related to relevant military service. This Statement of Principles was determined by the Repatriation Medical Authority, reflecting the need for sound medical-scientific evidence to support the connection between pleural plaque and military service. The policy objective behind this instrument is to ensure that veterans who develop pleural plaque or die from conditions related to pleural plaque receive appropriate recognition and benefits, provided that specific factors related to their service can be identified. This Statement of Principles identifies pleural plaque as a sharply circumscribed patch of thickening of the pleura, which may or may not be associated with calcification, and sets out the criteria that must be met to establish a link between pleural plaque and military service. It stipulates that at least one factor, such as exposure to respirable asbestos fibres in certain conditions or the inability to obtain appropriate clinical management, must be related to the veteran’s service. The instrument aims to ensure that the connection between pleural plaque and military service is based on a balance of probabilities, thereby facilitating the provision of appropriate entitlements and support to affected veterans.

Scope and Application

The Statement of Principles concerning Pleural Plaque, as determined by the Repatriation Medical Authority under subsection 196B(3) of the Veterans' Entitlements Act 1986, applies specifically to veterans and members of the Australian Defence Forces who have developed pleural plaque or have died from pleural plaque, provided that their condition is linked to their service. The Act establishes the criteria for determining whether such conditions are connected to the service, requiring that at least one of the specified factors, such as inhaling respirable asbestos fibres in an enclosed or open environment for a certain period, must be related to the service. Pleural plaque is defined as a sharply circumscribed patch of thickening of the pleura, which may or may not be associated with calcification, and is identified by ICD-10-AM code J92.0. The determination applies to eligible war service and defence service, excluding operational and hazardous service respectively, and considers the circumstances of the service to ascertain the connection to the development or aggravation of pleural plaque. This legislation does not extend to conditions arising from service but rather those materially contributed to or aggravated by the service.

Key Provisions

The key provisions of this Statement of Principles, determined by the Repatriation Medical Authority under section 196B(3) of the Veterans’ Entitlements Act 1986, pertain to pleural plaque and death from pleural plaque. Specifically, it defines "pleural plaque" as a sharply circumscribed patch of thickening of the pleura which may or may not be associated with calcification, and it provides the ICD-10-AM code J92.0 for pleural plaque. The Authority's determination is based on the sound medical-scientific evidence available, asserting that it is more probable than not that pleural plaque and death from pleural plaque can be related to relevant service rendered by veterans or members of the Forces. For a connection to be established between pleural plaque or death from pleural plaque and relevant service, at least one of the factors outlined in the Statement must be related to that service. These factors include inhaling respirable asbestos fibres in an enclosed space at the time material containing asbestos fibres was being applied, removed, dislodged, cut or drilled, with the first such inhalation occurring at least 10 years before the clinical onset of pleural plaque. Alternatively, inhaling respirable asbestos fibres for a cumulative period of at least 1000 hours in an open environment under similar conditions and timeframe applies. Another condition is the inability to obtain appropriate clinical management for pleural plaque. Additionally, if a relevant factor includes an injury or disease for which there is a Statement of Principles, then the factors in that statement apply in accordance with its terms. The Statement imposes obligations on parties by requiring that at least one of the specified factors be linked to relevant service to establish a connection between pleural plaque or death from pleural plaque and that service. The factors necessitate detailed evidence regarding exposure to asbestos fibres and the timeline of such exposure in relation to the onset of pleural plaque. It also stipulates that the inability to obtain appropriate clinical management for pleural plaque must be linked to the relevant service to be considered in establishing the connection. The inclusion of other Statements of Principles for related injuries or diseases further defines the scope and requirements of the evidence needed. The legislation does not explicitly outline offences, penalties, or consequences for breach within the provided text. However, any breach of the terms outlined in the Statement of Principles could potentially lead to disputes or challenges regarding entitlements under the Veterans’ Entitlements Act 1986. Such disputes could be resolved through administrative review or judicial review, with potential implications for the eligibility of veterans or members of the Forces for benefits related to pleural plaque and death from pleural plaque. The maximum penalties for breaches are not specified in the provided text.