Instrument No.33 of 2003
Determination
of
Statement of Principles
concerning
RESTLESS LEGS SYNDROME
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 restless legs syndrome and death from restless legs syndrome.
(b) For the purposes of this Statement of Principles, “restless legs syndrome” means a disorder characterised by paraesthesias or other abnormal sensations, principally of the lower limbs, associated with the urge to move the affected limb(s) with at least temporary relief upon such movement.
(c) In the application of this Statement of Principles, the definition of “restless legs syndrome” is that given at para 2(b) above.
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that restless legs syndrome and death from restless legs syndrome 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 restless legs syndrome or death from restless legs syndrome with the circumstances of a person’s relevant service are:
(a) suffering from diabetes mellitus at the time of the clinical onset of restless legs syndrome; or
(b) suffering from iron deficiency at the time of the clinical onset of restless legs syndrome; or
(c) suffering from chronic renal failure at the time of the clinical onset of restless legs syndrome; or
(d) suffering from peripheral neuropathy or radiculopathy at the time of the clinical onset of restless legs syndrome; or
(e) undergoing treatment with a drug from the specified list, which cannot be ceased or substituted, at the time of the clinical onset of restless legs syndrome, or
(f) suffering from diabetes mellitus at the time of the clinical worsening of restless legs syndrome; or
(g) suffering from iron deficiency at the time of the clinical worsening of restless legs syndrome; or
(h) suffering from chronic renal failure at the time of the clinical worsening of restless legs syndrome; or
(i) suffering from peripheral neuropathy or radiculopathy at the time of the clinical worsening of restless legs syndrome; or
(j) undergoing treatment with a drug from the specified list, which cannot be ceased or substituted, at the time of the clinical worsening of restless legs syndrome,
(k) inability to obtain appropriate clinical management for restless legs syndrome.
Factors that apply only to material contribution or aggravation
6. Paragraphs 5(f) to 5(k) apply only to material contribution to, or aggravation of, restless legs syndrome where the person’s restless legs syndrome 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:
“chronic renal failure” means irreversible kidney damage which leads to impaired renal function;
“death from restless legs syndrome” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s restless legs syndrome;
“iron deficiency” means having a serum ferritin level of < 20 micrograms per litre;
“radiculopathy” means a disease of the nerve roots resulting in symptoms of weakness, pain, or loss of sensation;
“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;
“undergoing treatment with a drug from the specified list” means therapeutic administration of one of the following drugs:
(i) Lithium;
(ii) Mianserin;
(iii) Mirtazapine;
(iv) Olanzapine;
(v) Paroxetine;
(vi) Risperidone; or
(vii) Sertraline.
Dated this Twelfth day of August 2003
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN