Instrument No.93 of 1995
Statement of Principles
concerning
RHEUMATIC HEART DISEASE
ICD CODES: 393 - 398
Veterans’ Entitlements Act 1986
subsection 196B(2)
1. Being of the view that there is sound medical-scientific evidence that indicates that rheumatic heart disease and death from rheumatic heart disease can be related to operational service rendered by veterans, peacekeeping service rendered by members of Peacekeeping forces and hazardous service rendered by members of the Forces, the Repatriation Medical Authority determines, under subsection 196B(2) of the Veterans’ Entitlements Act 1986, that the factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting rheumatic heart disease or death from rheumatic heart disease with the circumstances of that service, are:
(a) suffering from rheumatic fever before the clinical onset of rheumatic heart disease; or
(b) suffering a streptococcal A infection before the clinical onset of rheumatic heart disease; or
(c) inability to obtain appropriate clinical management for rheumatic heart disease.
2. Subject to clause 3 (below) at least one of the factors set out in paragraphs 1(a) to 1(c) must be related to any service rendered by a person.
3. The factor set out in paragraph 1(c) applies only where:
(a) the person’s rheumatic heart disease was contracted prior to a period, or part of a period, of service to which the factor is related; and
(b) the relationship suggested between the rheumatic heart disease and the particular service of a person is a relationship set out in paragraph 8(1)(e), 9(1)(e), 70(5)(d), or 70(5A)(d) of the Act.
4. For the purposes of this Statement of Principles:
“ICD code” means a number assigned to a particular kind of injury or disease in the tenth edition of the International Classification of Diseases 9th Revision, effective date of 1 October 1993, copyrighted by the US Commission on Professional and Hospital Activities, and having the Library of Congress number 77-94472;
“rheumatic fever” means a febrile disease occurring as a delayed sequela of infections with group A beta-hemolytic streptococci and characterised by multiple focal inflammatory lesions of connective tissue especially involving the heart, blood vessels and joints with resultant arthritis, chorea, or carditis appearing alone or in combination, and attracting ICD codes 390, 391, or 392;
“rheumatic heart disease” means a chronic condition characterised by scarring and deformity of the heart valves and/or pericardium, and attracting ICD codes 393 to 398;
“streptococcal A infection” means invasion of the tissues, commonly of the throat or skin, by micro-organisms known as group A beta-hemolytic streptococci and which may result in a pyogenic, or suppurative, infection.
Dated this Eighth day of March 1995
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 Rheumatic Heart Disease issued in 1995 under the Veterans’ Entitlements Act 1986 addresses the medical-scientific evidence indicating a connection between rheumatic heart disease or death from rheumatic heart disease and operational service by veterans, peacekeeping service by members of Peacekeeping forces, and hazardous service by members of the Forces. The Repatriation Medical Authority, recognising the necessity to establish a minimum threshold for linking such diseases to service circumstances, stipulates that a reasonable hypothesis can be raised if the individual suffered from rheumatic fever or a streptococcal A infection prior to the onset of rheumatic heart disease, or if they were unable to obtain appropriate clinical management for the disease. This legislative instrument aims to ensure that veterans, peacekeeping force members, and service personnel are fairly assessed and compensated for service-related health conditions. The instrument was enacted to fill the gap in recognising the link between these specific medical conditions and the service rendered, ensuring that eligible individuals receive appropriate entitlements and support.
Scope and Application
The Statement of Principles concerning Rheumatic Heart Disease issued by the Repatriation Medical Authority under the Veterans’ Entitlements Act 1986, specifically subsection 196B(2), applies to veterans, members of peacekeeping forces, and members of the Forces who have contracted rheumatic heart disease or died from it, provided that certain conditions are met. This legislation seeks to establish a reasonable hypothesis linking rheumatic heart disease or death from it to the service rendered by these individuals. The factors considered include suffering from rheumatic fever or a streptococcal A infection before the clinical onset of rheumatic heart disease, or the inability to obtain appropriate clinical management for the condition. The application of these principles is limited to instances where the rheumatic heart disease was contracted prior to the relevant period of service, and where the relationship between the disease and the service falls within specified categories of the Act. This legislation applies nationally across Australia, with its scope potentially extended or restricted through subordinate instruments under the Act.
Key Provisions
The Statement of Principles, under the Veterans’ Entitlements Act 1986, establishes criteria that must be met for a reasonable hypothesis to be raised regarding the connection between rheumatic heart disease or death from rheumatic heart disease and service rendered by veterans, peacekeeping forces, or hazardous service. Section 1(a) to 1(c) stipulates that the disease must be linked to either prior rheumatic fever, a streptococcal A infection, or the inability to obtain appropriate clinical management before the onset of the disease. At least one of these factors must relate to the individual's service (Section 2). The inability to obtain appropriate clinical management (Section 1(c)) is applicable only if the disease was contracted before the relevant service period and the relationship between the disease and the service falls within specified categories (Section 3).
The obligations imposed by the Act on the parties involved, primarily veterans or their representatives, include providing evidence of the factors outlined in the Statement of Principles. This entails demonstrating a history of rheumatic fever, a streptococcal A infection, or a documented inability to access appropriate clinical management before the onset of rheumatic heart disease. Veterans or their representatives must substantiate these claims with medical records, testimonies, and other relevant documentation. The Repatriation Medical Authority, on the other hand, is obligated to review and assess the provided evidence to determine if the criteria set out in the Statement of Principles have been met.
The legislation does not explicitly outline specific offences, penalties, or consequences for breach. However, the implications of non-compliance can be significant. If a veteran or their representative fails to provide adequate evidence to support their claim, it could result in the denial of benefits related to rheumatic heart disease. This could lead to substantial financial and emotional repercussions for the veteran and their family. Conversely, if the Repatriation Medical Authority fails to properly assess claims, it could result in the unjust denial of benefits to eligible individuals, potentially leading to legal challenges and the need for corrective action.