Instrument No.26 of 1995
Statement of Principles
concerning
SCRUB TYPHUS
ICD CODE: 081.2
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 scrub typhus and death from scrub typhus 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, scrub typhus or death from scrub typhus is connected with the circumstances of that service, are:
(a) being in an area indicated by the shaded area on the map contained in the Schedule not more than 21 days before the clinical onset of scrub typhus; or
(b) inability to obtain appropriate clinical management for scrub typhus.
2. Subject to clause 3 (below) at least one of the factors set out in paragraphs 1(a) and (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 scrub typhus 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 scrub typhus 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;
“scrub typhus” means a rickettsial disease attracting ICD code 081.2 that is:
(a) caused by R tsutsugamushi;
(b) limited to eastern and south-eastern Asia, India, northern Australia and to all islands immediately proximate to these areas;
(c) transmitted by the larvae of several species of mites, particularly Leptotrombidium (Trombicula) akamushi and L.deliense); and
(d) characterised by:
(i) a primary lesion at the site of the bite of an infected mite;
(ii) a fever of about two weeks duration;
(iii) a cutaneous rash which develops about the fifth day; and
(iv) the appearance late in the second week of agglutinins of the OX-K strain of Proteus bacillus.
SCHEDULE
Dated this twelfth day of January 1995
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN
Overview
The Veterans’ Entitlements Act 1986, enacted by the Parliament of Australia, was introduced to provide various benefits to veterans and members of the Australian Defence Force and their dependants. One of the significant gaps it addressed was the need for clear guidelines on the medical conditions related to service that would qualify for these benefits. The Statement of Principles concerning SCRUB TYPHUS, issued under subsection 196B(3) of the Act, specifically aims to provide a framework for determining whether scrub typhus, a disease caused by R tsutsugamushi and transmitted by certain mites, is connected to eligible war service. The policy objective is to ensure that veterans who contracted scrub typhus, a condition with specific geographical limitations and symptoms, can have their claims assessed based on sound medical-scientific evidence. The Repatriation Medical Authority, which is responsible for issuing these principles, seeks to establish the necessary conditions under which scrub typhus can be deemed related to service, thus aiding in the appropriate allocation of entitlements.
Scope and Application
The Statement of Principles concerning Scrub Typhus, issued under the Veterans’ Entitlements Act 1986, specifies the criteria by which veterans and members of the Australian Defence Forces may claim entitlement related to scrub typhus contracted during their service. This legislative instrument applies to veterans and members of the Defence Forces who rendered service other than operational or hazardous service and who contracted scrub typhus, or died from it, under conditions related to their service. The application is not limited to a specific geographic area but rather to regions where scrub typhus is prevalent, including eastern and south-eastern Asia, India, northern Australia, and proximate islands. The determination is based on medical-scientific evidence and requires either that the person was in a specified area not more than 21 days before the onset of scrub typhus or that they could not obtain appropriate clinical management for the disease. The principles set out in this Statement of Principles are subject to the conditions outlined in the Veterans’ Entitlements Act 1986 and may be extended or clarified through subordinate instruments issued by the Repatriation Medical Authority.
Key Provisions
The Statement of Principles issued under subsection 196B(3) of the Veterans’ Entitlements Act 1986, specifically addresses the connection between scrub typhus and service rendered by veterans and members of the Forces. This determination is based on the medical-scientific evidence available to the Repatriation Medical Authority. The key provisions of the Statement of Principles outline that scrub typhus or death from scrub typhus can be related to eligible war service or defence service if at least one of the specified factors is met. The first factor requires that the individual was in an area shaded on the map in the Schedule no more than 21 days before the clinical onset of scrub typhus. The second factor pertains to the inability to obtain appropriate clinical management for scrub typhus.
Under the Statement of Principles, these factors must be related to the service rendered by a person. However, the factor regarding the inability to obtain appropriate clinical management applies only if the scrub typhus was contracted before the period or part of the service in question. Additionally, the relationship between the scrub typhus and the service must align with the relationships specified in the Act. This means that the disease must be contracted in a way that correlates with the service rendered, as defined in the Act.
The Statement of Principles imposes certain obligations on parties involved. For veterans and members of the Forces, it means that they must provide evidence that they were in the specified area before contracting scrub typhus or demonstrate an inability to obtain appropriate clinical management. These provisions ensure that claims for entitlements related to scrub typhus are substantiated by relevant service-related factors. Failure to provide adequate evidence may result in the denial of entitlements.
In terms of legal consequences, there are no specific offences, penalties, or civil/criminal consequences mentioned in the Statement of Principles itself. However, any breach of the requirements for entitlements could potentially lead to administrative actions or denial of benefits. The focus is on ensuring that the evidence provided supports the claims made, rather than imposing punitive measures. The maximum penalties for misrepresentation or fraud in claiming entitlements would be as outlined in the Veterans’ Entitlements Act 1986, which could include fines or imprisonment, but these are not detailed within this specific Statement of Principles.