Instrument No. 13 of 2004
Revocation
of
Statement of Principles
concerning
TINEA
and
Determination
of
Statement of Principles
concerning
TINEA OF THE SKIN
Veterans’ Entitlements Act 1986
1. The Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act):
(a) revokes Instrument No.27 of 1994, as amended by Instrument No. 184 of 1995 and Instrument No. 7 of 2002; and
(b) determines in their place the following Statement of Principles.
Kind of injury, disease or death
2. (a) This Statement of Principles is about tinea of the skin and death from tinea of the skin.
(b) For the purposes of this Statement of Principles, “tinea of the skin” is a fungal infection of the skin caused by dermatophytes resulting in clinical lesions. This definition excludes tinea unguium.
(c) Tinea of the skin attracts ICD-10-AM code B35.0, B35.2, B35.3, B35.4, B35.5, B35.6, B35.8, or B35.9.
(d) In the application of this Statement of Principles, the definition of “tinea of the skin” is that given at paragraph 2(b) above.
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that tinea of the skin and death from tinea of the skin can be related to relevant service rendered by veterans, members of Peacekeeping Forces, 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 factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting tinea of the skin or death from tinea of the skin with the circumstances of a person’s relevant service is:
(a) having skin maceration at the affected site within the 14 days before the clinical onset of tinea of the skin; or
(b) having diabetes mellitus at the time of the clinical onset of tinea of the skin; or
(c) being in an immunocompromised state at the time of the clinical onset of tinea of the skin; or
(d) for tinea pedis only, having chronic ischaemia of the affected lower limb from:
(i) peripheral vascular disease; or
(ii) chronic venous insufficiency
at the time of the clinical onset of tinea of the skin; or
(e) having skin maceration at the affected site within the 14 days before the clinical worsening of tinea of the skin; or
(f) having diabetes mellitus at the time of the clinical worsening of tinea of the skin; or
(g) being in an immunocompromised state at the time of the clinical worsening of tinea of the skin; or
(h) for tinea pedis only, having chronic ischaemia of the affected lower limb from:
(i) peripheral vascular disease; or
(ii) chronic venous insufficiency
at the time of the clinical worsening of tinea of the skin; or
(i) inability to obtain appropriate clinical management for tinea of the skin.
Factors that apply only to material contribution or aggravation
6. Paragraphs 5(e) to 5(i) apply only to material contribution to, or aggravation of, tinea of the skin where the person’s tinea of the skin was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70(5A)(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:
“death from tinea of the skin” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s tinea of the skin;
“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), Third Edition, effective date of 1 July 2002, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 413 9;
“immunocompromised state” means a state where the immune response has been attenuated by administration of immunosuppressive drugs, irradiation, malnutrition, a malignant disease process or certain types of infection;
“relevant service” means:
(a) operational service; or
(b) peacekeeping service; or
(c) hazardous service;
“skin maceration” means the softening of the skin by moisture;
“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;
“tinea pedis” means tinea of the foot, also called athlete’s foot.
Application
9. This Instrument applies to all matters to which section 120A of the Act applies.
Dated this 24th day of May 2004
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN