Instrument No.94 of 1995
Statement of Principles
concerning
RHEUMATIC HEART DISEASE
ICD CODES: 393 - 398
Veterans’ Entitlements Act 1986
subsection 196B(3)
1. Being of the view that, on the sound medical-scientific evidence available to the Repatriation Medical Authority, it is more probable than not that rheumatic heart disease and death from rheumatic heart disease can be related to eligible war service (other than operational service) rendered by veterans and defence service (other than hazardous service) rendered by members of the Forces, the Repatriation Medical Authority determines, under subsection 196B(3) of the Veterans’ Entitlements Act 1986, that the factors that must exist before it can be said that, on the balance of probabilities, rheumatic heart disease or death from rheumatic heart disease is connected with the circumstances of that service, are:
(a) suffering from rheumatic fever before the clinical onset of rheumatic heart disease; or
(b) 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(b) must be related to any service rendered by a person.
3. The factor set out in paragraph 1(b) 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), or 70(5)(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.
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 was introduced by the Repatriation Medical Authority under the Veterans’ Entitlements Act 1986 to clarify the conditions under which rheumatic heart disease and deaths from rheumatic heart disease can be connected to war service or defence service rendered by veterans and members of the Australian Defence Force, excluding operational and hazardous service respectively. This legislative instrument was enacted to address the medical and evidentiary complexities involved in establishing a link between service and the onset or progression of rheumatic heart disease. The Act aims to ensure that veterans and defence personnel receive appropriate recognition and entitlements when their service circumstances have contributed to their medical condition, thereby fulfilling a policy objective of providing fair and just compensation for service-related health conditions.
Scope and Application
This Statement of Principles under the Veterans' Entitlements Act 1986 pertains to rheumatic heart disease, specifying the conditions under which such disease, or death from it, may be considered connected to war service or defence service rendered by veterans and members of the Forces. The Act applies to veterans and members of the Forces who have contracted rheumatic heart disease, provided that their service predates the onset of the disease or that they were unable to obtain appropriate clinical management during their service. The instrument stipulates that for a connection to be made, the individual must have either suffered from rheumatic fever before the onset of rheumatic heart disease or been unable to receive appropriate clinical management for the disease during their service. This legislation is applicable nationally within Australia and is subject to the provisions of the Veterans' Entitlements Act 1986. The determination made by the Repatriation Medical Authority is based on sound medical-scientific evidence and is subject to the specific factors outlined in the instrument, which also clarifies the definitions of relevant terms such as 'rheumatic fever' and 'rheumatic heart disease' as per the International Classification of Diseases.
Key Provisions
The Statement of Principles concerning Rheumatic Heart Disease (F2008B00613) outlines the criteria for determining whether rheumatic heart disease or death from rheumatic heart disease can be related to eligible war service or defence service. According to the document, it must be more probable than not that the disease is connected to the service, based on available medical-scientific evidence (Section 1). Specifically, the person must have suffered from rheumatic fever before the onset of rheumatic heart disease or must have been unable to obtain appropriate clinical management for the condition (Section 1(a) and (b)). At least one of these factors must be related to the person's service (Section 2). However, if the person's rheumatic heart disease was contracted before the service, the inability to obtain clinical management must relate to a specific period of service and the relationship must be set out in the Act (Section 3). The definitions provided in the document clarify the terms "ICD code," "rheumatic fever," and "rheumatic heart disease" (Section 4).
The Statement imposes specific obligations on the parties involved. It requires that at least one of the outlined factors be related to the person's service for the disease to be considered connected to that service. For the factor of inability to obtain appropriate clinical management, the relationship must be to a specific period of service, and the type of relationship must be as set out in the Act. This ensures a structured approach to assessing the connection between the service and the disease, based on clear medical and service criteria.
The document does not explicitly outline offences, penalties, or civil/criminal consequences for breach. However, as a legislative instrument, failure to comply with the criteria set out in the Statement of Principles could potentially impact the eligibility for benefits under the Veterans’ Entitlements Act 1986. The implications of such non-compliance would depend on the specific provisions of the Act and any relevant administrative or judicial processes.