Instrument No.90 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(3) 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. On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that polymyalgia rheumatica can be related to relevant service rendered by veterans 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 exist before it can be said that, on the balance of probabilities, polymyalgia rheumatica or death from polymyalgia rheumatica is connected 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) or 70(5)(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) eligible war service (other than operational service); or
(b) defence service (other than 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, enacted in 1996, was determined by the Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986. This legislative instrument was introduced to address the issue of providing recognition and support for veterans suffering from polymyalgia rheumatica, a condition marked by acute onset of symmetrical limb girdle aching and stiffness. The Authority established that it is more probable than not that polymyalgia rheumatica can be related to relevant service rendered by veterans or members of the Forces, ensuring that appropriate clinical management issues are considered in relation to the condition. The objective of this determination is to ensure that veterans who have been unable to obtain appropriate clinical management for polymyalgia rheumatica are acknowledged and supported, thereby addressing a gap in the recognition of service-related conditions.
Scope and Application
The Statement of Principles concerning polymyalgia rheumatica, established under the Veterans' Entitlements Act 1986, applies to veterans and members of the Australian Defence Force who have developed polymyalgia rheumatica or died from the condition. This legislation specifically identifies polymyalgia rheumatica, a condition marked by acute onset of symmetrical limb girdle aching and stiffness, along with systemic inflammation, attracting the ICD code 725. The Act determines that it is more probable than not that this condition can be related to relevant service rendered by veterans or Defence Force members, provided that certain factors are met. For instance, the inability to obtain appropriate clinical management for polymyalgia rheumatica is a critical factor that must be related to the service for the condition to be connected with the circumstances of the person's service. The determination applies to relevant service, which includes eligible war service (other than operational service) and defence service (other than hazardous service), and it does not extend to aggravation or material contribution to polymyalgia rheumatica if the condition was suffered or contracted before or during the relevant service. This Statement of Principles is a legislative instrument that extends the application of the Act through the Repatriation Medical Authority's determination.
Key Provisions
The Statement of Principles, determined under subsection 196B(3) of the Veterans’ Entitlements Act 1986, addresses polymyalgia rheumatica and death resulting from this condition (Section 1). Polymyalgia rheumatica, for the purposes of this Statement, is defined as 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 assigned ICD code 725 (Section 2(a)). The Repatriation Medical Authority, based on available medical-scientific evidence, asserts that it is more probable than not that polymyalgia rheumatica can be linked to relevant service rendered by veterans or members of the Forces (Section 3). The critical factor that must exist to establish a connection between polymyalgia rheumatica or death from this condition and the circumstances of a person’s relevant service is the inability to obtain appropriate clinical management for polymyalgia rheumatica (Section 5(a)).
This Statement of Principles imposes specific obligations on the Repatriation Medical Authority, which must determine whether polymyalgia rheumatica or death from this condition is connected to relevant service based on the factors outlined. The relevant service encompasses eligible war service (other than operational service) or defence service (other than hazardous service) (Section 7). The inability to obtain appropriate clinical management for polymyalgia rheumatica must be related to any relevant service rendered by the person to be considered (Section 5). Additionally, the Repatriation Medical Authority must ensure that the medical-scientific evidence is sound and up-to-date to make informed determinations.
The Statement of Principles does not explicitly outline offences, penalties, or civil/criminal consequences for breach. However, it does establish a framework for determining the eligibility of veterans or members of the Forces for benefits related to polymyalgia rheumatica. Failure to comply with the provisions of the Veterans’ Entitlements Act 1986, or to accurately apply the factors set out in the Statement of Principles, could lead to disputes or challenges regarding the validity of claims for benefits. While specific penalties are not mentioned in the text, breaches of the Act or its associated legislative instruments could potentially result in legal action or administrative penalties.