Statement of Principles concerning pulmonary thromboembolism No. 4 of 2001

Overview

The Determination of Statement of Principles concerning Pulmonary Thromboembolism (No. 4 of 2001) under the Veterans’ Entitlements Act 1986 was enacted to provide a framework for recognising pulmonary thromboembolism and related deaths in veterans. This legislation was introduced to address the need for a clear and structured approach to determining the connection between the service rendered by veterans and the incidence of pulmonary thromboembolism. The Repatriation Medical Authority, acting under subsection 196B(3) of the Act, established this Statement of Principles to ensure that the medical evidence is sound and that the conditions are appropriately linked to the service. The policy objective is to provide a more probable than not basis for relating pulmonary thromboembolism to relevant service, thereby facilitating appropriate compensation and support for affected veterans.

Scope and Application

This Statement of Principles, determined by the Repatriation Medical Authority under the Veterans’ Entitlements Act 1986, addresses pulmonary thromboembolism and death from pulmonary thromboembolism, specifically where these conditions are related to the relevant service rendered by veterans or members of the Australian Defence Force. The Statement of Principles applies to individuals who have experienced pulmonary thromboembolism or death from pulmonary thromboembolism and are seeking to connect these conditions to their service. The legislation outlines specific factors that must be considered, including the presence of deep vein thrombosis, venous thrombosis, or thrombus in the right atrium or right ventricle within certain timeframes before the clinical onset of the condition, as well as smoking habits and the inability to obtain appropriate clinical management. The determination is intended to facilitate the assessment of claims by veterans for related injuries, diseases, or deaths under the Act, with the application of relevant factors being contingent on the specifics of the service and the onset of the condition.

Key Provisions

This Determination (F2005B01693) is a Statement of Principles concerning pulmonary thromboembolism (ICD-10-AM code I26) under the Veterans’ Entitlements Act 1986. It is established by the Repatriation Medical Authority, which has determined that pulmonary thromboembolism and death from pulmonary thromboembolism are likely related to relevant service rendered by veterans or members of the Forces (section 1). Pulmonary thromboembolism, as defined in this Statement, is the obstruction of the pulmonary artery by a mass of clotted blood originating in the deep venous system (section 2(b)). The Repatriation Medical Authority's determination is based on sound medical-scientific evidence, which suggests that pulmonary thromboembolism and death from pulmonary thromboembolism can be related to relevant service (section 3). For a connection to be made, at least one of the specified factors must be related to the service (section 4). These factors include suffering from deep vein thrombosis or venous thrombosis within 90 days before the clinical onset of pulmonary thromboembolism, having a thrombus in the right atrium or right ventricle at the time of onset, smoking at least 35 cigarettes per day for 90 days before onset, or being unable to obtain appropriate clinical management for pulmonary thromboembolism (section 5). Notably, the inability to obtain appropriate clinical management applies only to material contribution to, or aggravation of, pulmonary thromboembolism where the condition was suffered or contracted before or during, but not arising out of, the relevant service (section 6). The Statement of Principles also includes provisions that if a relevant factor applies and it pertains to an injury or disease for which there is another Statement of Principles, then the factors in that other Statement of Principles apply (section 7). It provides definitions for terms such as "death from pulmonary thromboembolism," "deep vein thrombosis," "ICD-10-AM code," "relevant service," "terminal event," and "venous thrombosis" to ensure clarity and consistency in the application of this Statement (section 8). The Act itself imposes obligations on veterans or members of the Forces to provide evidence that they suffer from pulmonary thromboembolism or death from pulmonary thromboembolism and to demonstrate a link between their condition and their relevant service. This includes providing medical records and other documentation that supports the existence of the specified factors. Failure to comply with these requirements may result in the denial of benefits or entitlements under the Act. There are no specific offences, penalties, or consequences outlined in this Statement of Principles itself. However, under the Veterans’ Entitlements Act 1986, any breach of the Act, including misrepresentation or fraud in the application for benefits, can result in civil or criminal penalties. Civil penalties may include fines and the recovery of benefits paid, while criminal penalties may include imprisonment and fines, depending on the severity of the offence.