Statement of Principles concerning seborrhoeic keratosis No. 55 of 2015

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Statement of Principles
No. 55 of 2015
for the purposes of the
Veterans’ Entitlements Act 1986
Military Rehabilitation and Compensation Act 2004
1.         This Instrument may be cited as Statement of Principles concerning seborrhoeic keratosis No. 55 of 2015.
2.         The Repatriation Medical Authority under subsection 196B(2) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)        revokes Instrument No. 31 of 2006 concerning seborrhoeic keratosis; and
(b)        determines in its place this Statement of Principles.
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about seborrhoeic keratosis and death from seborrhoeic keratosis.
(b)               For the purposes of this Statement of Principles, "seborrhoeic keratosis" means a benign, non-invasive skin tumour with histopathological features including hyperkeratosis, acanthosis and papillomatosis with horny invaginations known as pseudo-horn cysts.  Proliferation of squamous cells and basaloid cells occurs in the acanthotic epidermis.  This lesion commonly presents as a soft, friable plaque that shows slight to marked pigmentation, and displays a "stuck on" appearance macroscopically.
(c)                Seborrhoeic keratosis attracts ICD-10-AM code L82.
(d)               In the application of this Statement of Principles, the definition of "seborrhoeic keratosis" is that given at paragraph 3(b) above.
Basis for determining the factors
4.         The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that seborrhoeic keratosis and death from seborrhoeic keratosis can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).
Factors that must be related to service
5.         Subject to clause 7, at least one of the factors set out in clause 6 must be related to the relevant service rendered by the person.
6.         The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting seborrhoeic keratosis or death from seborrhoeic keratosis with the circumstances of a person’s relevant service is:
(a)                having sunlight exposure to unprotected skin at the affected site for at least 2 250 hours while in a tropical area, or having equivalent sunlight exposure in other latitude zones, before the clinical onset of seborrhoeic keratosis; or
(b)               inability to obtain appropriate clinical management for seborrhoeic keratosis.
Factors that apply only to material contribution or aggravation
7.         Paragraph 6(b) applies only to material contribution to, or aggravation of, seborrhoeic keratosis where the person’s seborrhoeic keratosis was suffered or contracted before or during (but not arising out of) the person’s relevant service.
Inclusion of Statements of Principles
8.         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 as in force from time to time.
Other definitions
9.         For the purposes of this Statement of Principles:
"death from seborrhoeic keratosis" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s seborrhoeic keratosis;
"equivalent sunlight exposure in other latitude zones" means the cumulative hours of sunlight exposure equivalent to that specified for a tropical area, calculated by multiplying the hours of exposure in each latitude zone by the latitude weighting factor for the zone as per the latitude weighting factor schedule and adding together the result for each zone:
Latitude weighting factor schedule
Latitude zone                                                   Latitude weighting factor
a latitude between 23° 27' S and 23° 27' N                1.0
a latitude from > 23° 27' to 35°                                  0.75
a latitude from > 35° to 45°                                        0.5
a latitude from > 45° to 65°                                        0.25;
"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), Eighth Edition, effective date of 1 July 2013, copyrighted by the Independent Hospital Pricing Authority, and having ISBN 978-1-74128-213-9;
"relevant service" means:
(a)                operational service under the VEA;
(b)               peacekeeping service under the VEA;
(c)                hazardous service under the VEA;
(d)               British nuclear test defence service under the VEA;
(e)                warlike service under the MRCA; or
(f)                non-warlike service under the MRCA;
"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.
10.       This Instrument applies to all matters to which section 120A of the VEA or section 338 of the MRCA applies.
Date of effect
11.       This Instrument takes effect from 30 March 2015.
Dated this  twenty-seventh   day of   February   2015
The Common Seal of the                    )
Repatriation Medical Authority          )
was affixed at the direction of:          )

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