Instrument No.89 of 1996
Determination
of
Statement of Principles
concerning
POLYMYALGIA RHEUMATICA
ICD CODE: 725
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 polymyalgia rheumatica and death from polymyalgia rheumatica.
(b) For the purposes of this Statement of Principles, “polymyalgia rheumatica” means a clinical syndrome characterised by acute onset of symmetrical limb girdle aching and stiffness, along with evidence of an underlying systemic inflammatory reaction, attracting ICD code 725.
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that polymyalgia rheumatica 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, the factor set out in the paragraph in clause 5 must be related to any relevant service rendered by the person.
Factors
5. The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting polymyalgia rheumatica or death from polymyalgia rheumatica with the circumstances of a person’s relevant service is:
(a) inability to obtain appropriate clinical management for polymyalgia rheumatica.
Factors that apply only to material contribution or aggravation
6. Paragraph 5(a) applies only to material contribution to, or aggravation of, polymyalgia rheumatica where the person’s polymyalgia rheumatica 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.
Other definitions
7. For the purposes of this Statement of Principles:
“ICD code” means a number assigned to a particular kind of injury or disease in the Australian Version of The International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM), effective date of 1 July 1995, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 22235 5;
“relevant service” means:
(a) operational service; or
(b) peacekeeping service; or
(c) hazardous service.
Dated this Eighteenth day of June 1996
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of )
KEN DONALD
CHAIRMAN
Overview
The Statement of Principles concerning Polymyalgia Rheumatica ICD Code: 725, determined in 1996 under the Veterans' Entitlements Act 1986, addresses the issue of establishing a connection between polymyalgia rheumatica and service rendered by veterans, members of Peacekeeping Forces, or members of the Armed Forces. This legislative instrument was enacted by the Repatriation Medical Authority to provide clarity on the circumstances under which polymyalgia rheumatica, a clinical syndrome characterised by acute onset of symmetrical limb girdle aching and stiffness, can be considered related to the service of these individuals. The primary objective of this Statement of Principles is to ensure that the medical-scientific evidence supports a reasonable hypothesis that polymyalgia rheumatica or death from the condition is connected to the service circumstances of a person, thereby facilitating appropriate recognition and compensation under the Act.
Scope and Application
The Veterans’ Entitlements Act 1986 applies to veterans, members of Peacekeeping Forces, and members of the Forces, providing them with various benefits and entitlements related to their service. This particular legislative instrument focuses on the recognition and assessment of polymyalgia rheumatica, a clinical syndrome, under the act. The Statement of Principles determined by the Repatriation Medical Authority clarifies that polymyalgia rheumatica and death from this condition can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces. The geographic and jurisdictional reach of the Act is national, as it is a Commonwealth legislation. The application of the Act may extend or be restricted through subordinate instruments, which are not detailed in this particular determination. The exclusions or exemptions in this context relate to cases where polymyalgia rheumatica was suffered or contracted before or during service but did not arise out of service, in which case the aggravation or material contribution factors do not apply.
This Statement of Principles applies to individuals who have served in the Australian Defence Force and are experiencing polymyalgia rheumatica or have died from this condition, as long as there is a connection to their relevant service. Relevant service includes operational, peacekeeping, or hazardous service, as defined by the Act. The legislation aims to provide appropriate clinical management for polymyalgia rheumatica and ensures that veterans, members of Peacekeeping Forces, or members of the Forces can access the benefits and support they need. The jurisdictional reach of the Act is Commonwealth-wide, applying to all eligible individuals across Australia. Any additional exclusions, exemptions, or thresholds are not specified in this legislative instrument but may be found in other related instruments or the Act itself.
Key Provisions
The main operative sections of this Statement of Principles, as determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act) (Section 1), pertain to polymyalgia rheumatica and death from polymyalgia rheumatica (Section 2). It outlines that polymyalgia rheumatica is a clinical syndrome characterised by acute onset of symmetrical limb girdle aching and stiffness, along with evidence of an underlying systemic inflammatory reaction, which is identified by the ICD code 725 (Section 2(a), (b)). The determination is based on sound medical-scientific evidence indicating a possible connection between polymyalgia rheumatica and relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces (Section 3). The essential factor that must exist to connect polymyalgia rheumatica or death from polymyalgia rheumatica with a person's relevant service is the inability to obtain appropriate clinical management for polymyalgia rheumatica (Section 5(a)).
The Statement of Principles imposes specific obligations on the parties involved. It requires that the identified factor of inability to obtain appropriate clinical management for polymyalgia rheumatica must be related to any relevant service rendered by the person (Section 4). It also stipulates that this factor applies only to material contribution to, or aggravation of, polymyalgia rheumatica if the condition was suffered or contracted before or during, but not arising out of, the person's relevant service (Section 6). Furthermore, the definitions of "ICD code" and "relevant service" are provided to ensure clarity and precision in the application of the principles (Section 7).
There are no explicit offences, penalties, or civil/criminal consequences mentioned in the Statement of Principles for breaches of the provisions. However, the determination of these principles and the criteria for linking polymyalgia rheumatica to relevant service may impact eligibility for veterans’ entitlements under the Act. Failure to adhere to the specified factors or to provide adequate evidence of the condition and its relation to service could potentially result in the denial of entitlements or benefits under the Act. The precise legal and administrative consequences would be governed by the broader provisions of the Veterans’ Entitlements Act 1986 and related regulations.