Statement of Principles concerning pruritus ani No. 42 of 1996

Administered by Department of Veterans' Affairs

Legislation au F2008B00540 Not in force Legislative Instrument

Legislation content

Instrument No.42 of 1996

 

Determination

of

Statement of Principles

concerning

PRURITUS ANI

ICD CODE: 698.0

 

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 pruritus ani and death from pruritus ani.

 

(b) For the purposes of this Statement of Principles, “pruritus ani” means a chronic unpleasant cutaneous sensation that provokes the desire to rub or scratch the perianal skin to obtain relief, attracting ICD code 698.0.

 

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 pruritus ani 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 factors set out in at least one of the paragraphs in clause 5 must be related to any relevant service rendered by the person.

 

Factors

5. The factors that must exist before it can be said that, on the balance of probabilities, pruritus ani or death from pruritus ani is connected with the circumstances of a person’s relevant service are:

 

(a) inability to maintain adequate anal hygiene, daily, over the 30 days immediately before the clinical onset of pruritus ani; or

 

(b) suffering from episodes of diarrhoea, daily, over the seven days immediately before the time of the clinical onset of pruritus ani; or

 

(c) suffering from a colorectal or anal condition from the specified list of colorectal and anal conditions at the time of the clinical onset of pruritus ani; or

 

(d) suffering from a local perianal or anal infection or infestation from the specified list of infections and infestations at the time of the clinical onset of pruritus ani; or

 

(e) suffering from pathological vaginal discharge at the time of the clinical onset of pruritus ani; or

 

(f) suffering from a dermatological disease from the specified list at the time of the clinical onset of pruritus ani; or

 

(g) undergoing a course of therapeutic radiation to the perianal area within the 30 days immediately before the clinical onset of pruritus ani; or

 

(h) applying high potency topical corticosteroid-containing preparations and experiencing steroid related atrophy of the perianal skin, in the 30 days immediately before the clinical onset of pruritus ani; or

 

(j) being systemically treated with water-soluble corticosteroid phosphates within the 24 hours immediately before the clinical onset of pruritus ani; or

 

(k) being systemically treated with nicosamide, clioquinol or mineral oil within the 72 hours immediately before the clinical onset of pruritus ani; or

 

(m) inability to maintain adequate anal hygiene, daily, over the 30 days immediately before the clinical worsening of pruritus ani; or

 

(n) suffering from a colorectal or anal condition from the specified list of colorectal and anal conditions at the time of the clinical worsening of pruritus ani; or

 

(o) suffering from a local perianal or anal infection or infestation from the specified list of infections and infestations at the time of the clinical worsening of pruritus ani; or

 

(p) suffering from pathological vaginal discharge at the time of the clinical worsening of pruritus ani; or

 

(q) suffering from a dermatological disease from the specified list at the time of the clinical worsening of pruritus ani; or

 

(r) undergoing a course of therapeutic radiation to the perianal area within the 30 days immediately before the clinical worsening of pruritus ani; or

 

(s) applying high potency topical corticosteroid-containing preparations, and experiencing steroid related atrophy of the perianal skin, over the 30 days immediately before the clinical worsening of pruritus ani; or

 

(t) being systemically treated with water-soluble corticosteroid phosphates within the 24 hours immediately before the clinical worsening of pruritus ani; or

 

(u) being systemically treated with nicosamide, clioquinol or mineral oil within the 72 hours immediately before the clinical worsening of pruritus ani; or

 

(v) inability to obtain appropriate clinical management for pruritus ani.

 

Factors that apply only to material contribution or aggravation

6. Paragraphs 5(m) to 5(v) apply only to material contribution to, or aggravation of, pruritus ani where the person’s pruritus ani 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:

 

“anal hygiene” means the personal maintenance of cleanliness of the perianal area by wiping with paper or washing with water;

 

“course of therapeutic radiation” means one or more fractions (treatment portions) of therapeutic radiation given with the aim of achieving palliation or cure with ionising radiation;

 

“dermatological disease from the specified list” means the following:

 

(i) contact dermatitis, attracting an ICD code in the range 692.0 to 692.6, or ICD code 692.8, or ICD code 692.9; or

(ii) seborrhoeic dermatitis, attracting ICD code 690; or

(iii) psoriasis, attracting ICD code 696.1; or

(iv) lichen planus, attracting ICD code 697.0; or

(v) lichen sclerosus et atrophicus, attracting ICD code 701.0;

 

“diarrhoea” means predominantly liquid faecal discharge, attracting ICD code 001, 004, 006.0, 006.1, 007, 009.2, 009.3, 306.4, 558.9, 564.4 or 564.5;

 

“high potency topical corticosteroid-containing preparations” means all corticosteroid-containing creams, gels, pastes, powders, ointments and lotions except those preparations containing 1% or less of hydrocortisone and those containing methylprednisolone acetate 0.25% or less;

 

“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;

 

“malignant lesion of the anal or perianal region” means:

 

(i) Paget's disease of skin, attracting ICD code 173.5; or

(ii) Bowen's disease, attracting ICD code 232.5; or

(iii) basal cell carcinoma, attracting ICD code 173.5; or

(iv) squamous cell carcinoma, attracting ICD code 173.5; or

(v) malignant melanoma of the skin, attracting ICD code 172.5; or

(vi) Kaposi's sarcoma, attracting ICD code 176.0 or 176.1; or

(vii) the presence of secondary tumour deposits from any primary malignant neoplasm;

 

“pathological vaginal discharge” means a discharge of fluid from the vagina which is related to, or caused by, one of the following diseases: vulvovaginal candidiasis, trichomonal vaginitis, bacterial vaginosis, chlamydia trachomatis cervicitis and gonorrhoea of the lower genitourinary tract, attracting ICD code 098.0, 098.15, 098.16, 098.2, 098.35, 098.36, 099.53, 112.1, 131.01 or 616.1;

 

“perianal area” means the area of skin immediately surrounding the anus and within the anal cleft, extending anteriorly as far as the genitals and posteriorly to the tip of the coccyx;

 

“relevant service” means:

 

(a) eligible war service (other than operational service); or

(b) defence service (other than hazardous service).

 

“specified list of colorectal or anal conditions ” means the following:

 

(i) anal fistula, attracting ICD code 565.1; or

(ii) anal fissure, attracting ICD code 565.0 or 877; or

(iii) anal skin tags, attracting ICD code 455.9; or

(iv) anal sphincter incompetence, attracting ICD code 787.6; or

(v) malignant lesion of the anal or perianal region (see separate  definition); or

(vi) colorectal adenomatous polyp, attracting ICD code 211.3 or 211.4; or

(vii) haemorrhoids, attracting ICD code 455; or

(viii) ulcerative colitis , attracting ICD code 556; or

(ix) Crohn’s disease, attracting ICD code 555; or

(x) malignant neoplasm of the rectum, attracting ICD code 154.0 or 154.1; or

(xi) malignant neoplasm of the colon, attracting ICD code 153;

 

“specified list of infections and infestations” means the following:

 

(i) erythrasma, attracting ICD code 039.0; or

(ii) streptococcal or staphylococcal impetigo, attracting ICD code 684; or

(iii) condylomata lata, attracting ICD code 091.3; or

(iv) human papilloma virus, attracting ICD code 078.1; or

(v) herpes simplex virus, attracting ICD code 054; or

(vi) candidiasis, attracting ICD code 112.1 or 112.2; or

(vii) tinea, attracting ICD code 110.3; or

(viii) gonorrhoea, attracting ICD code 098.7; or

(ix) pin worm, attracting ICD code 127.4; or

(x) strongyloides, attracting ICD code 127.2; or

(xi) scabies, attracting ICD code 133.0; or

(xii) lice, attracting ICD code 132.2;

 

“therapeutic radiation” means medical treatment by irradiation to the person with gamma rays, x-rays, alpha particles or beta particles;

 

 

 

Dated this  Fourteenth day of  March 1996

 

 

 

The Common Seal of the    )

Repatriation Medical Authority   )

was affixed to this instrument  )

in the presence of    )

 

KEN DONALD

CHAIRMAN

Overview

The Veterans' Entitlements Act 1986 was enacted to provide for the care, rehabilitation, and financial support of Australian Defence Force (ADF) veterans, members of the Australian Forces, and their dependants. This legislation was introduced to address the need for a comprehensive system to support those who have served in the defence forces, ensuring that they receive appropriate benefits and medical care for injuries or diseases sustained or contracted during their service. The Act was enacted by the Parliament of Australia, reflecting the nation's commitment to honouring the sacrifices made by its service personnel. The policy objective of the Act is to provide a robust framework for the assessment and provision of veterans' entitlements, ensuring that those who have served their country are cared for in a manner befitting their contributions.

Scope and Application

This legislative instrument, determined under subsection 196B(3) of the Veterans’ Entitlements Act 1986, establishes a Statement of Principles concerning pruritus ani, a chronic perianal condition, and death resulting from pruritus ani. It applies to veterans and members of the Australian Defence Force who may have developed pruritus ani due to their service. The factors establishing a connection between the condition and service include inability to maintain anal hygiene, episodes of diarrhoea, specific colorectal or anal conditions, infections, dermatological diseases, therapeutic radiation, and treatment with certain medications. The Statement of Principles also outlines criteria for aggravation or material contribution to the condition when it was present before or during service but not directly arising from it. The geographic and jurisdictional reach of this instrument is primarily Commonwealth, as it pertains to veterans and Defence Force members under the Act. The Act itself applies to veterans and members of the Australian Defence Force, focusing on injuries, diseases, or death related to their service. This Statement of Principles is an extension of that Act, providing specific criteria for recognising pruritus ani as a service-related condition. The legislative instrument does not introduce new exclusions or thresholds beyond those specified within the factors outlined. The application of these principles can be extended or further defined through subordinate instruments, ensuring clarity and consistency in the assessment and recognition of service-related pruritus ani.

Key Provisions

This legislative instrument, Determination of Statement of Principles concerning Pruritus Ani ICD Code: 698.0, under the Veterans’ Entitlements Act 1986 (the Act), outlines the criteria for considering pruritus ani and death from pruritus ani as connected to relevant service rendered by veterans or members of the Armed Forces (sections 1 and 2). The Repatriation Medical Authority has determined, based on available medical-scientific evidence, that it is more probable than not that pruritus ani can be related to relevant service (section 3). To establish a connection, certain factors must be present, such as inability to maintain adequate anal hygiene, episodes of diarrhoea, specific colorectal or anal conditions, infections or infestations, pathological vaginal discharge, dermatological diseases, therapeutic radiation, use of high potency topical corticosteroids, and systemic treatment with certain medications (sections 4 and 5). Additionally, for aggravation or material contribution to pruritus ani, factors such as inability to obtain appropriate clinical management and certain medical conditions or treatments must be present (section 6). The definitions provided clarify terms such as "anal hygiene," "course of therapeutic radiation," "dermatological disease," "diarrhoea," "high potency topical corticosteroid-containing preparations," "ICD code," "malignant lesion of the anal or perianal region," "pathological vaginal discharge," "perianal area," "relevant service," "specified list of colorectal or anal conditions," "specified list of infections and infestations," and "therapeutic radiation" (section 7). The obligations imposed by this legislative instrument require veterans or members of the Armed Forces to provide evidence of the factors outlined in sections 4 and 5 to establish a connection between pruritus ani or death from pruritus ani and their relevant service. This includes medical records, witness statements, and other relevant documentation to support their claims. The Repatriation Medical Authority is responsible for reviewing and assessing the provided evidence to determine if the factors are met and if a connection can be established. There are no specific offences, penalties, or civil/criminal consequences outlined in this legislative instrument. However, if a claim is found to be fraudulent or if there is intentional misrepresentation of facts, it could lead to potential legal consequences under the general provisions of the Veterans’ Entitlements Act 1986 or other relevant legislation. The penalties for such offences may vary depending on the severity and nature of the offence.

Legal classification tags

Area of Law
Veterans' Law
Instrument
Legislative Instrument
Concepts
Definitions & Interpretation
Offence Provisions
Reporting & Disclosure Obligations

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.