Instrument No.255 of 1995
Statement of Principles
concerning
SCHISTOSOMIASIS
ICD CODE: 120
Veterans’ Entitlements Act 1986
subsection 196B(2)
1. Being of the view that there is sound medical-scientific evidence that indicates that schistosomiasis and death from schistosomiasis 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 (the Act), that the factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting schistosomiasis or death from schistosomiasis with the circumstances of that service, are:
(a) being in contact with water in an area described in the Schedule before the clinical onset of schistosomiasis; or
(b) inability to obtain appropriate clinical management for schistosomiasis.
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 schistosomiasis was contracted before a period, or part of a period, of service to which the factor is related; and
(b) the relationship suggested between the schistosomiasis 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:
“an area described in the Schedule” means an area described in the Schedule attached to this instrument, such area being an area in which the Schistosoma blood fluke is known to be distributed;
“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;
“schistosomiasis” (otherwise known as bilharziasis) means infection by a parasite of the genus Schistosoma, (trematode flatworms, commonly known as blood flukes) being S. mansoni, S. haematobium, S. japonicum, S. intercalatum, S. mekongi or S. malayensis, attracting ICD code 120.
Schedule
Global Distribution of the Schistosoma Blood Fluke
COUNTRY or AREA | mansoni mansoni | haematobium | intercalatum | japonicum | Mekong | malayensis |
African Region Algeria Angola Benin Botswana Burkino Faso Burundi Cameroon Central African Republic Chad Congo Equatorial Guinea Ethiopia Gabon Gambia Ghana Guinea-Bissau Guinea Ivory Coast Kenya Liberia Madagascar Malawi Mali Mauritania Mauritius Mozambique Namibia Niger Nigeria Rwanda Sào Tome and Principe Senegal Sierra Leone South Africa Swaziland Tanzania Togo Uganda Zaire Zambia Zimbabwe | + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + | + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + | + + + + + + + + + + | | | |
(continued...)
COUNTRY or AREA | mansoni mansoni | haematobium | intercalatum | japonicum | Mekong | malayensis |
Region of the Americas Antigua Brazil Dominican Republic Guadeloupe Martinique Montserrat Puerto Rico Saint Lucia | + + + + + + + + | | | | | |
Surinam Venezuela | + + | | | | | |
Eastern Mediterranean Region Egypt Iran Iraq Jordan Lebanon Libya Morocco Oman Saudi Arabia Somalia Sudan Syria Tunisia Yemen | + + + + + + + + + + | + + + + + + + + + + + + + + | | | | |
European Region Turkey Portugal | | + + | | | | |
South East Asia Region Indonesia Thailand India | | + | | + + | | |
Western Pacific Region China Cambodia Japan Lao People's Republic Malaysia Philippines | | | | + + + | + + | + |
|
Note: + denotes that a particular species of Schistosoma is distributed in that area.
Dated this Twenty-first day of June 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 SCHISTOSOMIASIS ICD CODE: 120, issued under the Veterans’ Entitlements Act 1986, was enacted in 1995 to address the issue of establishing a connection between schistosomiasis and certain military service activities. This legislative instrument, issued by the Repatriation Medical Authority, aims to clarify the circumstances under which schistosomiasis can be reasonably linked to specific service rendered by veterans. It specifies that for a hypothesis connecting schistosomiasis or death from schistosomiasis with military service to be valid, there must be evidence of contact with water in an area where the Schistosoma blood fluke is known to be distributed before the onset of the disease, or an inability to obtain appropriate clinical management for schistosomiasis. This determination helps ensure that veterans who contracted schistosomiasis under specific conditions receive appropriate benefits and recognition.
Scope and Application
This Statement of Principles applies to veterans who contracted schistosomiasis, a disease caused by a parasite of the genus Schistosoma, during their service in areas where the Schistosoma blood fluke is known to be distributed. This includes veterans who were in contact with water in such areas before the clinical onset of schistosomiasis or those who were unable to obtain appropriate clinical management for the disease prior to their service. The Statement of Principles is made under subsection 196B(2) of the Veterans’ Entitlements Act 1986, and it specifies the factors that must be present to establish a reasonable hypothesis connecting schistosomiasis or death from schistosomiasis with the circumstances of the service rendered. The areas described in the Schedule include regions in Africa, the Americas, the Eastern Mediterranean, the European, Southeast Asia, and the Western Pacific, where specific species of Schistosoma are distributed. This Statement of Principles extends the application of the Act to these specific circumstances of service and disease, providing a framework for assessing the connection between schistosomiasis and the veteran's service.
Key Provisions
The Statement of Principles, under the Veterans' Entitlements Act 1986, outlines the conditions necessary to establish a connection between schistosomiasis and certain types of military service, such as operational, peacekeeping, or hazardous service (section 1). For a reasonable hypothesis to be raised linking schistosomiasis or death from schistosomiasis to such service, the individual must have either been in contact with water in an area where the Schistosoma blood fluke is known to be distributed before the clinical onset of the disease, or they must have been unable to obtain appropriate clinical management for schistosomiasis (section 1(a) and (b)). The inability to obtain clinical management applies only if the individual contracted schistosomiasis before or during the relevant service period and if the relationship between the disease and service falls within specific categories outlined in the Act (section 3). These categories refer to instances where the service rendered is directly related to the onset or exacerbation of the condition.
The Statement of Principles imposes specific obligations on parties, particularly on veterans and their representatives, to provide evidence that satisfies the criteria outlined in the Statement. This includes providing documentation or testimony that demonstrates the individual's exposure to schistosomiasis-endemic areas or their inability to access appropriate medical treatment. The onus is on the claimant to establish the required connection between their military service and the disease, ensuring that the evidence presented is relevant and sufficient to meet the criteria set out by the Repatriation Medical Authority.
Breaches of the requirements set out in the Statement of Principles could lead to various civil or criminal consequences, depending on the context and severity of the breach. While the Statement of Principles itself does not explicitly outline penalties for non-compliance, the broader legislative framework under which it operates may impose sanctions. For example, providing false information in a claim could be considered fraudulent and might result in legal action, including fines or imprisonment. The exact penalties would be determined by the relevant legislation governing veterans' entitlements and would depend on factors such as the intent behind the breach and the extent of the misrepresentation.