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Statement of Principles concerning decompression sickness No. 13 of 2015

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Statement of Principles
No. 13 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 decompression sickness No. 13 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. 43 of 2006 concerning decompression sickness; and
(b)        determines in its place this Statement of Principles.
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about decompression sickness and death from decompression sickness.
(b)               For the purposes of this Statement of Principles, "decompression sickness" means a multi-organ disorder caused by the formation of bubbles of nitrogen and other gases within tissues, as a result of the reduction in the ambient barometric pressure exerted by the envelope of air or water surrounding the person, and which is manifest by musculoskeletal, cutaneous, lymphatic, cardiopulmonary, inner ear or neurological signs or symptoms. Decompression sickness is also known as caisson disease.
(c)                Decompression sickness attracts ICD-10-AM code T70.3.
(d)               In the application of this Statement of Principles, the definition of "decompression sickness" 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 decompression sickness and death from decompression sickness 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 decompression sickness or death from decompression sickness with the circumstances of a person’s relevant service is:
(a)                experiencing an episode of decompression within the seven days before the clinical onset of decompression sickness; or
(b)               inability to obtain appropriate clinical management for decompression sickness.
Factors that apply only to material contribution or aggravation
7.         Paragraph 6(b) applies only to material contribution to, or aggravation of, decompression sickness where the person’s decompression sickness 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:
"an episode of decompression" means a reduction in the ambient barometric pressure exerted by the envelope of air or water surrounding the person, occurring with:
(a)                ascending from a submerged craft or device, or a pressurised tunnel or caisson;
(b)               decompression after being compressed in a hyperbaric chamber;
(c)                decompression in a hypobaric chamber;
(d)               flying; or
(e)                underwater diving;
"death from decompression sickness" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s decompression sickness;
"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 27 January 2015.
Dated this   nineteenth   day of   December   2014
The Common Seal of the                    )
Repatriation Medical Authority          )
was affixed at the direction of:          )