Statement of Principles
No. 18 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 primary myelofibrosis No. 18 of 2013.
2. This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the VEA).
Kind of injury, disease or death
3. (a) This Statement of Principles is about primary myelofibrosis and death from primary myelofibrosis.
(b) For the purposes of this Statement of Principles, "primary myelofibrosis" means a chronic myeloproliferative neoplasm characterised by the replacement of bone marrow by fibrous tissue, extramedullary haematopoiesis with splenomegaly and leukoerythroblastosis in blood. This definition excludes myelofibrosis secondary to essential thrombocythaemia, polycythaemia vera or another myeloid neoplasm. This definition also excludes secondary myelofibrosis resulting from other causes of bone marrow fibrosis including infections, autoimmune disorders or other chronic inflammatory conditions, hairy cell leukaemia or other lymphoid neoplasms, metastatic malignancies or toxic (chronic) myelopathies.
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 primary myelofibrosis or death from primary myelofibrosis 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 primary myelofibrosis or death from primary myelofibrosis is inability to obtain appropriate clinical management for primary myelofibrosis.
6. For the purposes of this Statement of Principles:
death from primary myelofibrosis" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s primary myelofibrosis;
"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:
(b) respiratory failure;
(c) cardiac arrest;
(d) circulatory failure; or
(e) cessation of brain function.
Date of effect
7. 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: )
PROFESSOR NICHOLAS SAUNDERS AO