Instrument No.70 of 1998
Revocation
of
Statement of Principles
concerning
VARICOSE VEINS
and
Determination
of
Statement of Principles
concerning
VARICOSE VEINS OF THE LOWER LIMB
ICD-9-CM CODE: 454
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.3 of 1995 (Statement of Principles concerning varicose veins); 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 varicose veins of the lower limb and death from varicose veins of the lower limb.
(b) For the purposes of this Statement of Principles, “varicose veins of the lower limb” means dilatation, lengthening and tortuosity of a subcutaneous superficial vein or veins of the lower limb such as the saphenous veins and perforating veins and does not include telangiectasis (intradermal venectasis), attracting ICD-9-CM code 454.
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that varicose veins of the lower limb and death from varicose veins of the lower limb 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 factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting varicose veins of the lower limb or death from varicose veins of the lower limb with the circumstances of a person’s relevant service are:
(a) suffering from thrombosis of a deep vein draining the affected lower limb before the clinical onset of varicose veins of the lower limb; or
(b) suffering complete or partial obstruction of a vein draining the affected lower limb at the time of the clinical onset of varicose veins of the lower limb; or
(c) being pregnant at the time of the clinical onset of varicose veins of the lower limb; or
(d) having an acquired arteriovenous fistula involving the blood vessels supplying the affected lower limb at the time of the clinical onset of varicose veins of the lower limb; or
(e) suffering from thrombosis of a deep vein draining the affected lower limb before the clinical worsening of varicose veins of the lower limb; or
(f) suffering complete or partial obstruction of a vein draining the affected lower limb at the time of the clinical worsening of varicose veins of the lower limb; or
(g) being pregnant at the time of the clinical worsening of varicose veins of the lower limb; or
(h) having an acquired arteriovenous fistula involving the blood vessels supplying the affected lower limb at the time of the clinical worsening of varicose veins of the lower limb;
(j) inability to obtain appropriate clinical management for varicose veins of the lower limb.
Factors that apply only to material contribution or aggravation
6. Paragraphs 5(e) to 5(j) apply only to material contribution to, or aggravation of, varicose veins of the lower limb where the person’s varicose veins of the lower limb 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 varicose veins of the lower limb” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s varicose veins of the lower limb;
“deep vein draining the affected lower limb” means a vein contained within the deep fascia of the limb or pelvis (such as the veins of the calf pump, popliteal veins, femoral veins and iliac veins), which drains the affected limb;
“ICD-9-CM code” means a number assigned to a particular kind of injury or disease in the Australian Version of The International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM), effective date of 1 July 1996, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 24447 2;
“relevant service” means:
(a) operational service; or
(b) peacekeeping service; or
(c) 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
9. This Instrument applies to all matters to which section 120A of the Act applies.
Dated this Thirteenth day of October 1998
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of )
KEN DONALD
CHAIRMAN