Statement of Principles concerning soft tissue sarcoma No. 24 of 2001

Administered by Department of Veterans' Affairs

Legislation au F2006B00471 Not in force Legislative Instrument

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Instrument No.24 of 2001

 

Revocation and Determination

of

Statement of Principles

concerning

 

SOFT TISSUE SARCOMA

 

ICD-10-AM CODES: C22.3, C22.4, C30.0, C32.3, C47, C48, C49

 

Veterans’ Entitlements Act 1986

 

 

1. The Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the Act):

 

(a) revokes Instrument No.50 of 1998; and

 

(b) determines in its place the following Statement of Principles.

 

Kind of injury, disease or death

2. (a) This Statement of Principles is about soft tissue sarcoma and death from soft tissue sarcoma.

 

(b)  For the purposes of this Statement of Principles, “soft tissue sarcoma” means any of a histologically and morphologically diverse group of extra‑skeletal, non‑haematopoietic, non‑epithelial primary malignant neoplasms, attracting ICD‑10‑AM codes C22.3, C22.4, C30.0, C32.3, C47, C48 or C49, that originates in the soft tissues derived from the embryonic mesodermal layer, and which can occur at any site in the body, both within and between parenchymal organs, including atypical fibroxanthoma, but excluding mesothelioma, Kaposi's sarcoma, malignant neoplasm of the bone or articular cartilage and malignant neoplasm of the lymphopoietic and haematopoietic tissue.

 

Basis for determining the factors

3. On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that soft tissue sarcoma and death from soft tissue sarcoma can be related to relevant service rendered by veterans 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 exist before it can be said that, on the balance of probabilities, soft tissue sarcoma or death from soft tissue sarcoma is connected with the circumstances of a person’s relevant service are:

 

(a) inhaling or absorbing a herbicide for a cumulative period of at least 60 days, at least five years before the clinical onset of soft tissue sarcoma; or

 

(b)              inhaling or absorbing a chlorophenol for at least 14 consecutive days or for a cumulative period of at least 60 days, at least five years before the clinical onset of soft tissue sarcoma; or

 

(c)              undergoing treatment with radium-224 at least five years before the clinical onset of soft tissue sarcoma; or

 

(d) undergoing a course of therapeutic radiation to the affected region at least five years before the clinical onset of soft tissue sarcoma; or

 

(e) being occupationally exposed to gaseous vinyl chloride during the production of polyvinyl chloride, at least five years before the clinical onset of soft tissue sarcoma; or

 

(f) undergoing diagnostic scanning with a colloidal solution of thorium dioxide (Thorotrast), at least five years before the clinical onset of soft tissue sarcoma and where the soft tissue sarcoma has occurred at the site of the thorotrast injection or in tissue containing thorotrast deposits; or

 

(g) for angiosarcoma only, undergoing a course of therapeutic radiation to the affected region at least two years before the clinical onset of soft tissue sarcoma; or

 

(h) for angiosarcoma only, suffering from lymphoedema of the affected region at the time of the clinical onset of soft tissue sarcoma; or

 

(j) for hepatic angiosarcoma only, undergoing diagnostic scanning with a colloidal solution of thorium dioxide (Thorotrast), at least five years before the clinical onset of soft tissue sarcoma; or

 

(k)              for hepatic angiosarcoma only, ingesting arsenic or arsenic containing compounds where ingestion commenced at least five years before the clinical onset of soft tissue sarcoma; or

 

(m)              for hepatic angiosarcoma only, being involved in the manufacture of arsenic-containing pesticides or spraying pesticides containing arsenic, and in each case, at least five years before the clinical onset of soft tissue sarcoma; or

 

(n)              for cutaneous atypical fibroxanthoma only, suffering from chronic solar skin damage of the skin involving the tumour, at the time of the clinical onset of soft tissue sarcoma; or

 

(o)              for leiomyosarcoma of the bladder only, being treated with cyclophosphamide for

(i)                organ transplantation, or

(ii)              a malignant neoplasm excluding non-metastatic non-melanotic malignant neoplasm of the skin, or

(iii)           autoimmune disease, or

(iv)            renal disorder, or

(v)              psoriasis, or

(vi)            inflammatory bowel disease

 

before the clinical onset of soft tissue sarcoma; or

 

(p) inability to obtain appropriate clinical management for soft tissue sarcoma.

 

Factors that apply only to material contribution or aggravation

6. Paragraph 5(p) applies only to material contribution to, or aggravation of, soft tissue sarcoma where the person’s soft tissue sarcoma was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e) or 70(5)(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:

 

“a chlorophenol” means any one of the following chemical agents:

 

2,4-dichlorophenol (2,4-DCP)

2,4,5-trichlorophenol (2,4,5-TCP)

2,4,6-trichlorophenol (2,4,6-TCP)

tetrachlorophenol

pentachlorophenol (PCP);

 

“a course of therapeutic radiation” means one or more fractions (treatment portions) of ionising radiation administered with the aim of achieving palliation or cure with gamma rays, x-rays, alpha particles or beta particles;

 

“a herbicide” means any one of the following chemical agents:

 

2,4-dichlorophenoxyacetic acid (2,4-D)

2,4-dichlorophenoxypropionic acid (2,4-DP)

2,4-dichlorophenoxybutyric acid (2,4-DB)

2,4,5-trichlorophenoxyacetic acid (2,4,5-T)

2,4,5-trichlorophenoxypropionic acid (2,4,5-TP)

4-chloro-2-methyl-phenoxyacetic acid (MCPA)

4-chloro-2-methyl-phenoxypropionic acid (MCPP)

4-chloro-2-methyl-phenoxybutyric acid (MCPB)

o,o-dimethyl-o-(2,4,5-trichlorophenyl)-phosphorothioate (Ronnel)

2-(2,4,5-trichlorophenoxy)-ethyl 2,2-dichloropropionate (Erbon);

 

“angiosarcoma” means lymphangiosarcoma or haemangiosarcoma;

 

“chronic solar skin damage” means a permanent pathological skin change due to exposure to ultraviolet light;

 

“death from soft tissue sarcoma” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s soft tissue sarcoma;

 

“ICD-10-AM code” means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), Second Edition, effective date of 1 July 2000, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 271 3;

 

“ingesting arsenic or arsenic containing compounds” means consuming arsenic through regular medicinal treatment with inorganic trivalent arsenic compounds such as Fowler’s solution or Donovan’s solution;

 

“inhaling or absorbing a chlorophenol” means:

(a)               undertaking work involving decanting or spraying of a chlorophenol; or

(b)              undertaking work involving cleaning and maintenance of equipment used to apply a chlorophenol; or

(c)               having been sprayed with a chlorophenol; or

(d)              undertaking work involving the handling or sawing of timber treated with a chlorophenol; or

(e)               working in an environment shrouded in dust from timber treated with a chlorophenol; or

(f)                undertaking work involving the use of cutting oils contaminated with a chlorophenol;

 

“inhaling or absorbing a herbicide” means:

(a)               undertaking work involving decanting or spraying of a herbicide; or

(b)               undertaking work involving cleaning and maintenance of equipment used to apply a herbicide; or

(c)               having been sprayed with a herbicide;

 

“lymphoedema” means chronic oedema due to accumulation of interstitial fluid as a result of stasis of lymph, which is secondary to obstruction of lymph vessels or disorders of the lymph nodes;

 

“relevant service” means:

 

(a) eligible war service (other than operational service); or

(b) defence service (other than 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.

 

Application

8. This Instrument applies to all matters to which section 120B of the Act applies.

 

 

Dated this First day of  May  2001

 

 

 

The Common Seal of the    )

Repatriation Medical Authority   )

was affixed to this instrument  )

in the presence of:    )

KEN DONALD

CHAIRMAN

Overview

The Repatriation Medical Authority, under the authority of the Veterans’ Entitlements Act 1986, has enacted Instrument No. 24 of 2001, which revokes the previous Instrument No. 50 of 1998 and establishes a new Statement of Principles concerning soft tissue sarcoma. This legislation aims to address the need for a comprehensive framework governing the recognition of soft tissue sarcoma as a condition related to service for veterans. By recognising the connection between specific service-related factors and the development of soft tissue sarcoma, this Statement of Principles facilitates the provision of appropriate benefits and support to affected veterans, thereby fulfilling a significant policy objective of the Act to ensure the well-being of those who have served. The Repatriation Medical Authority, acting under the authority vested in it by the Parliament, has determined that soft tissue sarcoma and death from such sarcoma can be related to relevant service rendered by veterans or members of the Armed Forces, based on sound medical-scientific evidence. This legislative instrument delineates the specific factors that must exist for a connection between the condition and service to be established, ensuring that veterans who have been exposed to certain chemicals, radiation, or other conditions during their service are eligible for the requisite benefits. The comprehensive definition of terms and conditions provided in the Statement of Principles aims to offer clarity and precision in the application of the legislation, thereby safeguarding the rights and entitlements of affected veterans.

Scope and Application

The legislative instrument F2006B00471, which pertains to the Veterans’ Entitlements Act 1986, specifically addresses the Statement of Principles concerning soft tissue sarcoma, including death from soft tissue sarcoma. The Act applies to veterans and members of the Australian Defence Forces who have contracted soft tissue sarcoma or died from it, as long as the condition falls within the specified ICD-10-AM codes and is linked to their relevant service. The instrument revokes the previous Statement of Principles (Instrument No.50 of 1998) and establishes new criteria for determining the connection between soft tissue sarcoma and the service rendered by veterans. The instrument outlines specific factors that must be related to service, such as exposure to certain chemicals, undergoing specific treatments, or being occupationally exposed to hazardous substances at least five years before the clinical onset of the condition. The instrument also includes detailed definitions for various terms used, such as "herbicide" and "chlorophenol", and specifies the types of exposure that are considered relevant. This legislative instrument has a Commonwealth jurisdictional reach and applies to all matters governed by section 120B of the Veterans' Entitlements Act 1986. There are no stated exclusions, exemptions, or thresholds within the instrument itself, although the application may be further defined or restricted by subordinate instruments or medical evaluations. The instrument also allows for the incorporation of other Statements of Principles if the relevant factors include an injury or disease for which there is an existing Statement of Principles. This ensures that the determination of service-related soft tissue sarcoma considers all applicable medical-scientific evidence and legal criteria. The instrument's scope is comprehensive in defining the types of exposure and conditions that could lead to the development of soft tissue sarcoma, thereby providing a clear framework for veterans seeking compensation or benefits related to their condition.

Key Provisions

This legislative instrument, under subsection 196B(3) of the Veterans’ Entitlements Act 1986, revokes Instrument No. 50 of 1998 and establishes a new Statement of Principles regarding soft tissue sarcoma and death from soft tissue sarcoma (section 1). The Statement of Principles identifies soft tissue sarcoma as a group of malignant neoplasms with specific ICD-10-AM codes, excluding certain types like mesothelioma and Kaposi's sarcoma (section 2). The Repatriation Medical Authority considers it more probable than not that soft tissue sarcoma and death from the condition can be related to relevant service rendered by veterans or members of the Forces based on available medical-scientific evidence (section 3). The Act outlines specific factors that must be related to the service rendered by the person to establish a connection between their soft tissue sarcoma or death from the condition and their relevant service (section 4). These factors include exposure to herbicides or chlorophenols, therapeutic radiation, occupational exposure to chemicals, and other specific circumstances (section 5). Paragraph 5(p) specifically addresses material contribution to, or aggravation of, soft tissue sarcoma where the sarcoma was suffered or contracted before or during relevant service (section 6). If a relevant factor in the Statement of Principles includes an injury or disease for which there is another Statement of Principles, the factors in that other Statement of Principles apply (section 7). The instrument imposes obligations on parties and entities governed by the Act, including the requirement to provide evidence of relevant service and exposure to specified factors. It also mandates that the factors must be related to the service to establish a connection with the soft tissue sarcoma or death from the condition (section 4). Failure to comply with the provisions or providing false information may result in legal consequences, though the specific offences, penalties, or civil/criminal consequences are not detailed in the provided text. However, breaches of the Veterans’ Entitlements Act 1986 can result in penalties under the Act, including fines and imprisonment, depending on the nature and severity of the offence. In summary, the legislative instrument establishes a new Statement of Principles concerning soft tissue sarcoma and death from the condition, revoking the previous instrument. It sets out the factors that must be related to relevant service to establish a connection and imposes obligations on parties and entities governed by the Act. While the specific penalties for non-compliance are not outlined in the text, breaches of the Act can result in fines and imprisonment.

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