Statement of Principles concerning polycythaemia vera No. 12 of 2013

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Statement of Principles
No. 12 of 2013
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 polycythaemia vera No. 12 of 2013.
2.         The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)        revokes Instrument No. 79 of 1999, as amended by Instrument No. 12 of 2001, concerning polycythaemia vera; and
(b)       determines in their place this Statement of Principles.
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about polycythaemia vera and death from polycythaemia vera.
(b)       For the purposes of this Statement of Principles, "polycythaemia vera" means a chronic myeloproliferative neoplasm, characterised by abnormal proliferation of haematopoietic bone marrow elements, resulting in an absolute increase in red cell mass and total blood volume, and generally associated with an excess of platelets and white blood cells, and splenomegaly. This definition excludes relative polycythaemia, polycythaemia due to congenital disorders and secondary polycythaemia resulting from hypoxaemia or an increased erythropoietin level. Polycythaemia vera is also known as polycythaemia rubra vera.
(c)        Polycythaemia vera attracts ICD-10-AM code D45.
(d)       In the application of this Statement of Principles, the definition of "polycythaemia vera" is that given at paragraph 3(b) above.
Basis for determining the factors
4.         After examining the available sound medical-scientific evidence the Repatriation Medical Authority is of the view that it is more probable than not on the sound medical-scientific evidence available, that the only factor that can be related to the cause of or material contribution to or aggravation of polycythaemia vera or death from polycythaemia vera and which can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA) is that set out in clause 5.
Factors that must be related to service
5.         The factor that must exist before it can be said that, on the balance of probabilities, in relation to the circumstances of a person’s relevant service causing or materially contributing to or aggravating polycythaemia vera or death from polycythaemia vera is inability to obtain appropriate clinical management for polycythaemia vera.
Other definitions
6.         For the purposes of this Statement of Principles:
"death from polycythaemia vera" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s polycythaemia vera;
"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), Seventh Edition, effective date of 1 July 2010, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 978 1 74210 154 5;
"relevant service" means:
(a)                eligible war service (other than operational service) under the VEA;
(b)               defence service (other than hazardous service and British nuclear test defence service) under the VEA; or
(c)                peacetime 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.
7.         This Instrument applies to all matters to which section 120B of the VEA or section 339 of the MRCA applies.
Date of effect
8.         This Instrument takes effect from 13 March 2013.
Dated this   fourth  day of   March   2013
The Common Seal of the                    )
Repatriation Medical Authority          )
was affixed to this instrument                        )
in the presence of:                               )