Statement of Principles concerning porphyria cutanea tarda No. 19 of 2001

Administered by Department of Veterans' Affairs

Legislation au F2005B01700 Not in force Legislative Instrument

Legislation content

Instrument No.19 of 2001

 

Revocation and Determination

of

Statement of Principles

concerning

 

PORPHYRIA CUTANEA TARDA

 

ICD-10-AM CODE: E80.1

 

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.71 of 1994; 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 porphyria cutanea tarda and death from porphyria cutanea tarda.

 

(b)               For the purposes of this Statement of Principles, “porphyria cutanea tarda” means a disorder of porphyrin metabolism characterised by cutaneous photosensitivity, hyperpigmentation, hypertrichosis, deficiency of uroporphyrinogen decarboxylase and uroporphyria, attracting ICD-10-AM code E80.1.

 

Basis for determining the factors

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

 

(a)             inhaling, ingesting or cutaneously absorbing a halogenated aromatic hydrocarbon within the 10 years immediately before the clinical onset of porphyria cutanea tarda; or

 

(b)             suffering from alcoholic liver disease at the time of the clinical onset of porphyria cutanea tarda; or

 

(c)             suffering from alcohol dependence or alcohol abuse and consuming alcohol at the time of the clinical onset of porphyria cutanea tarda; or

 

(d)             suffering from hepatitis at the time of the clinical onset of porphyria cutanea tarda; or

 

(e)             suffering from cirrhosis of the liver before the clinical onset of porphyria cutanea tarda; or

 

(f)              being infected with Human Immunodeficiency Virus (HIV) at the time of the clinical onset of porphyria cutanea tarda; or

 

(g)             undergoing a course of oral oestrogen therapy for the 30 days immediately before the clinical onset of porphyria cutanea tarda; or

 

(h)             suffering from hepatic haemosiderosis at the time of the clinical onset of porphyria cutanea tarda; or

 

(j) suffering from haemochromatosis at the time of the clinical onset of porphyria cutanea tarda; or

 

(k)              undergoing haemodialysis for the one year immediately before the clinical onset of porphyria cutanea tarda; or

 

(m)            suffering from a porphyrin-generating hepatocellular tumour at the time of the clinical onset of porphyria cutanea tarda; or

 

(n)              inhaling, ingesting or cutaneously absorbing a halogenated aromatic hydrocarbon within the 10 years immediately before the clinical worsening of porphyria cutanea tarda; or

 

(o)              suffering from alcoholic liver disease at the time of the clinical worsening of porphyria cutanea tarda; or

 

(p)              suffering from alcohol dependence or alcohol abuse and consuming alcohol at the time of the clinical worsening of porphyria cutanea tarda; or

 

(q)              suffering from hepatitis at the time of the clinical worsening of porphyria cutanea tarda; or

 

(r)               suffering from cirrhosis of the liver before the clinical worsening of porphyria cutanea tarda; or

 

(s)               being infected with Human Immunodeficiency Virus (HIV) at the time of the clinical worsening of porphyria cutanea tarda; or

 

(t)                undergoing a course of oral oestrogen therapy for the 30 days immediately before the clinical worsening of porphyria cutanea tarda; or

 

(u)            suffering from hepatic haemosiderosis at the time of the clinical worsening of porphyria cutanea tarda; or

 

(v)            suffering from haemochromatosis at the time of the clinical worsening of porphyria cutanea tarda; or

 

(w)          exposing the affected area of skin to sunlight within the five days immediately before the clinical worsening of porphyria cutanea tarda; or

 

(x)            being treated with a drug or a class of drugs from the specified list, which cannot be ceased or substituted, at the time of the clinical worsening of porphyria cutanea tarda; or

 

(y)            inability to obtain appropriate clinical management for porphyria cutanea tarda.

 

Factors that apply only to material contribution or aggravation

6. Paragraph 5(n) to 5(y) apply only to material contribution to, or aggravation of porphyria cutanea tarda where the person’s porphyria cutanea tarda 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.

 

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:

 

“alcohol abuse” means the presence of cognitive, behavioural or physiological symptoms indicating the use of alcohol despite significant alcohol-related problems, however these symptoms have never met the criteria for alcohol dependence.  Additionally, signs of tolerance or withdrawal are absent;

 

“alcohol dependence” means the presence of a constellation of cognitive, behavioural and physiological symptoms indicating the continuing or past consumption of alcohol despite significant alcohol-related problems.  The pattern of repeated self administration may result in tolerance, withdrawal and compulsive alcohol use behaviour;

 

“being infected with Human Immunodeficiency Virus (HIV)” means serological evidence of infection with Human Immunodeficiency Virus;

 

“being treated with a drug or class of drugs from the specified list” means therapeutic administration of one of the following drugs or class of drugs:

 

(a)               Alpha-methyldopa;

(b)               Amphetamines;

(c)               Barbiturates;

(d)               Busulfan;

(e)               Carbamazepine;

(f)                Chloroquine;

(g)               Colchicine;

(h)               Cyclophosphamide;

(i)                 Dapsone;

(j)                 Diclofenac;

(k)               Ergot derivatives;

(l)                Erythromycin;

(m)           Fluconazole;

(n)              Frusemide;

(o)              Griseofulvin;

(p)              Hydantoins;

(q)              Hydralazine;

(r)               Hydroxychloroquine;

(s)               Iron supplements;

(t)                Lignocaine;

(u)              Metronidazole;

(v)              Nalidixic acid;

(w)            Phenylbutazone;

(x)              Rifampicin;

(y)              Sulfadoxine-pyrimethamine;


(z)              Sulphonamides;

(za) Tetracyclines;

(zb) Theophylline;

(zc) Valproic acid;

 

“cirrhosis of the liver” means a pathologically defined entity involving irreversible chronic injury of the hepatic parenchyma and includes extensive fibrosis in association with regenerative nodules;

 

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

 

“haemochromatosis” means a genetic disorder of iron storage in which an inappropriate increase in intestinal iron absorption results in the deposition of excessive quantities of iron in parenchymal cells, with eventual tissue damage and functional impairment of the organs involved, especially the liver, pancreas, heart and pituitary;

 

“halogenated aromatic hydrocarbon” means a chemical compound containing a benzene ring and multiple chlorine atoms.  Halogenated aromatic hydrocarbon compounds include: dioxins, furans, polychlorinated biphenyls, hexachlorobenzene, DDT, chlordane, mirex, toxaphene or heptachlor;

 

“hepatic haemosiderosis” means the deposit of an abnormal quantity of haemosiderin in the liver, usually in Kupffer cells;

 

“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;

 

“porphyrin-generating hepatocellular tumour” means a tumour arising within the cells of the liver, with evidence of increased porphyrin production at the tumour site;

 

“relevant service” means:

 

(a) operational service; or

(b) peacekeeping service; or

(c) 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

9. This Instrument applies to all matters to which section 120A of the Act applies.

 

Dated this Nineteenth day of  March  2001

 

 

The Common Seal of the    )

Repatriation Medical Authority   )

was affixed to this instrument  )

in the presence of:    )

KEN DONALD

CHAIRMAN

Overview

The Repatriation Medical Authority, under subsection 196B(2) of the Veterans’ Entitlements Act 1986, has issued an instrument to address the medical condition of porphyria cutanea tarda (PCT) and death from PCT, particularly in the context of service-related factors for veterans, members of Peacekeeping Forces, or members of the Australian Defence Force. This legislative instrument revokes the previous Instrument No. 71 of 1994 and establishes a new Statement of Principles to provide clarity on the medical-scientific evidence linking PCT and death from PCT to relevant service. The policy objective is to ensure that there is a clear and medically-supported connection between service and the onset or aggravation of PCT, allowing for appropriate entitlements and benefits to be considered for affected individuals. This instrument outlines specific factors that must be related to service to establish a reasonable hypothesis connecting PCT or death from PCT with the circumstances of a person’s relevant service. These factors include exposure to certain chemicals, pre-existing liver conditions, alcohol dependence, infection with HIV, and other medical treatments. The document also provides definitions for terms used within the Statement of Principles, ensuring that the criteria are applied consistently and accurately in determining eligibility for benefits under the Act. The Authority’s determination aims to address the gap in recognising service-related conditions that may contribute to the development or worsening of PCT, thereby supporting affected individuals through appropriate legislative measures.

Scope and Application

This legislative instrument pertains to the revocation and determination of a Statement of Principles concerning porphyria cutanea tarda and death from porphyria cutanea tarda, issued under the Veterans’ Entitlements Act 1986. The instrument specifically revokes Instrument No.71 of 1994 and replaces it with a new Statement of Principles that outlines the medical-scientific evidence linking porphyria cutanea tarda and death from porphyria cutanea tarda to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces. The new Statement of Principles lists various factors that must be related to the service to establish a connection with the condition, such as exposure to certain chemicals, alcohol-related diseases, and specific medical treatments. It also defines key terms for the purposes of the Statement of Principles, including "relevant service," "alcohol abuse," "cirrhosis of the liver," and others. This instrument applies to all matters to which section 120A of the Veterans’ Entitlements Act 1986 applies, affecting the eligibility and assessment of veterans and other eligible individuals for benefits related to porphyria cutanea tarda and death from this condition. This legislative instrument does not specify any exclusions, exemptions, or thresholds. The application of the Act is extended or restricted through subordinate instruments, such as regulations or guidelines, which may provide further details on the eligibility criteria, assessment procedures, and benefits available to affected individuals. The geographic and jurisdictional reach of the Act is Commonwealth, as it is an Australian federal legislation.

Key Provisions

The legislative instrument in question primarily revolves around the revocation and determination of a Statement of Principles concerning porphyria cutanea tarda (PCT) under the Veterans' Entitlements Act 1986 (the Act). The Repatriation Medical Authority revokes Instrument No.71 of 1994 and establishes a new Statement of Principles regarding PCT and death from PCT (Section 1). This Statement of Principles outlines the nature of the disorder, its ICD-10-AM code, and the basis for determining its relation to relevant service rendered by veterans or members of peacekeeping forces (Sections 2 and 3). It specifies the factors that must be related to service, which include exposure to certain chemicals, diseases, or treatments within defined time frames (Sections 4-6). The obligations imposed by this Act include the necessity for veterans or members of peacekeeping forces to provide evidence of the factors listed in the Statement of Principles to substantiate their claims regarding PCT and death from PCT (Section 5). This involves providing medical evidence of exposure to halogenated aromatic hydrocarbons, alcohol dependence, liver diseases, HIV infection, or treatment with specific drugs, among other factors, around the onset or worsening of PCT. The legislative instrument does not explicitly detail offences, penalties, or consequences for breaches within its text. However, under the broader framework of the Veterans' Entitlements Act 1986, breaches related to fraudulent claims or misrepresentation of facts can lead to civil or criminal penalties. These may include fines, imprisonment, or other sanctions as determined by the courts, reflecting the seriousness with which the Act treats fraudulent claims. The specific penalties would be guided by the relevant provisions of the Act and the nature of the breach. In summary, the instrument sets out a detailed framework for establishing a connection between PCT or death from PCT and relevant service, stipulating the necessary factors and evidence required. It also implicitly reinforces the integrity of the claims process by aligning with the broader legal consequences for misrepresentation or fraud under the Act.

Legal classification tags

Area of Law
Veterans’ Law
Instrument
Legislative Instrument
Concepts
Definitions & Interpretation
Prohibited Conduct
Reporting & Disclosure Obligations
Catchwords
Statement of Principles

Interactions

Authorises

All Versions

Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.