Statement of Principles
concerning
POLYCYTHAEMIA VERA
Instrument No. 79 of 1999 as amended
made under section 196B(3) of the
Veterans’ Entitlements Act 1986
This compilation was prepared on 5 October 2005
taking into account Amendment of Statement of Principles concerning POLYCYTHAEMIA VERA (Instrument No. 12 of 2001).
Prepared by the Repatriation Medical Authority Secretariat, Brisbane
Revocation and Determination
of
Statement of Principles
concerning
POLYCYTHAEMIA VERA
ICD-10-AM CODE: D45
Veterans’ Entitlements Act 1986
1. The Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the Act):
(a) revokes Instrument No.68 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 polycythaemia vera and death from polycythaemia vera.
(b) For the purposes of this Statement of Principles, “polycythaemia vera”, also known as polycythaemia rubra vera, means a chronic myeloproliferative disorder, characterised by abnormal proliferation of haematopoietic bone marrow elements, resulting in an absolute increase in red cell mass, an excess of platelets and white blood cells, and splenomegaly, attracting ICD-10-AM code D45. This definition excludes relative polycythaemia and polycythaemia resulting from hypoxaemia.
Basis for determining the factors
3. After examining the available sound medical-scientific evidence the Repatriation Medical Authority is of the view that it is more probable than not on the sound medical-scientific evidence available, that the only factor that can be related to the cause of or material contribution to or aggravation of polycythaemia vera or death from polycythaemia vera and which can be related to relevant service is that set out in clause 4.
Factors that must be related to service
4. The factor that must exist before it can be said that, on the balance of probabilities, in relation to the circumstances of a person’s relevant service causing or materially contributing to or aggravating polycythaemia vera or death from polycythaemia vera is inability to obtain appropriate clinical management for polycythaemia vera.
Inclusion of Statements of Principles
5. 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
6. For the purposes of this Statement of Principles:
“death from polycythaemia vera” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s polycythaemia vera;
“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), effective date of 1 July 1998, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86451 340 3;
“relevant service” means:
(a) eligible war service (other than operational service); or
(b) defence service (other than 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.
Application
7. This Instrument applies to all matters to which section 120B of the Act applies.
Notes to Statement of Principles concerning polycythaemia vera (Instrument No. 79 of 1999)
The Statement of Principles concerning polycythaemia vera (Instrument No. 79 of 1999) in force under section 196B(3) of the Veterans’ Entitlements Act 1986, as shown in this compilation is amended as indicated in the Tables below.
Table of Instruments
Title | Date of notification
in Gazette or FRLI registration | Date of
commencement | Application, saving or
transitional provisions |
Statement of Principles concerning polycythaemia vera (Instrument No. 79 of 1999) | 10 November 1999 (see Gazette 1999, No. GN 45 ) | 10 November 1999 | |
Amendment of Statement of Principles concerning polycythaemia vera (Instrument No. 12 of 2001) | 10 January 2001 (see Gazette 2001, No. GN 1 ) | 10 January 2001 | — |
Table of Amendments
ad. = added or inserted am. = amended rep. = repealed rs. = repealed and substituted |
Provision affected | How affected |
Clause 3 – ‘Basis for determining the factors’ | rs. Instrument No.12 of 2001 |
Clause 4 – ‘Factors that must be related to service’ | rs. Instrument No.12 of 2001 |
Clause 5 – ‘Factors’...... | rep. Instrument No.12 of 2001 |
Clause 6 – ‘Factors that apply only to material contribution or aggravation’ | rep. Instrument No.12 of 2001 |
Clause 5 – ‘Inclusion of Statements of Principles’ | am. Instrument No.12 of 2001 |
Clause 6 – ‘Other definitions’ | am. Instrument No.12 of 2001 |
Clause 7 – ‘Application’... | am. Instrument No.12 of 2001 |
Overview
The Statement of Principles concerning Polycythaemia Vera was enacted under section 196B(3) of the Veterans’ Entitlements Act 1986 by the Repatriation Medical Authority in 1999, with subsequent amendments in 2001. This legislative instrument was introduced to address the need for clear criteria to determine the service-related factors that could cause or materially contribute to polycythaemia vera or death from this condition among veterans. Polycythaemia vera, also known as polycythaemia rubra vera, is a chronic myeloproliferative disorder characterised by the abnormal proliferation of haematopoietic bone marrow elements, leading to increased red cell mass, excess platelets and white blood cells, and splenomegaly. The policy objective of this instrument is to provide a definitive framework for assessing the eligibility of veterans for compensation related to this specific medical condition, by establishing the connection between relevant service and the inability to obtain appropriate clinical management for polycythaemia vera.
Scope and Application
The Statement of Principles concerning polycythaemia vera, which was established under section 196B(3) of the Veterans’ Entitlements Act 1986, governs the assessment and application of this chronic myeloproliferative disorder in the context of veterans' entitlements. This legislative instrument applies to all matters covered by section 120B of the Act, specifically addressing the eligibility criteria for compensation or pension benefits for veterans diagnosed with polycythaemia vera, or who have died from causes related to the disease. The principles outlined in this document aim to provide a framework for determining whether service-related factors contributed to the onset, aggravation, or material contribution of polycythaemia vera. The scope includes defining the condition, the factors that must be related to the veteran’s service, and the conditions under which other statements of principles may apply. Notably, this legislative instrument excludes relative polycythaemia and polycythaemia resulting from hypoxaemia, thereby narrowing its focus to specific service-related causations of polycythaemia vera. The application of this statement is further refined through amendments, such as those made by Instrument No. 12 of 2001, which introduced changes to the basis for determining factors, the factors related to service, and other definitions.
Key Provisions
This legislative instrument, made under section 196B(3) of the Veterans’ Entitlements Act 1986, revokes Instrument No.68 of 1995 and replaces it with a new Statement of Principles concerning polycythaemia vera (referred to as "the Statement of Principles"). The Statement of Principles outlines the medical conditions and service-related factors that must be considered in determining the eligibility of veterans for certain benefits. Polycythaemia vera is defined as a chronic myeloproliferative disorder with abnormal proliferation of haematopoietic bone marrow elements, resulting in an absolute increase in red cell mass, an excess of platelets and white blood cells, and splenomegaly. The Statement of Principles specifies that the inability to obtain appropriate clinical management for polycythaemia vera is the service-related factor that must exist for a veteran’s condition to be related to their service (section 4).
The obligations imposed by the Statement of Principles require the Repatriation Medical Authority to consider the specific service-related factor of inadequate clinical management when assessing a veteran’s claim for benefits related to polycythaemia vera or death from polycythaemia vera. If the veteran’s service conditions prevented them from obtaining appropriate clinical management, this must be factored into the assessment of their claim. The Statement of Principles also includes provisions for how other related medical conditions should be considered under existing Statements of Principles (section 5). Veterans and their representatives must provide evidence supporting the claim that the inability to obtain clinical management was due to their service, including documentation of their medical history and service records.
Failure to comply with the requirements set out in the Statement of Principles may result in the denial of benefits for polycythaemia vera or death from polycythaemia vera. There are no explicit criminal or civil penalties mentioned in the Statement of Principles for non-compliance. However, any breaches of the Veterans’ Entitlements Act 1986 related to the administration of benefits could potentially lead to legal consequences. The maximum penalties for offences under the Act can include fines and imprisonment, but these are not detailed specifically within the Statement of Principles. Instead, the focus is on ensuring that the medical and service-related criteria are correctly applied to each case to determine the eligibility for benefits.