Statement of Principles
concerning
 
PRIMARY MYELOFIBROSIS
No. 17 of 2013
 
for the purposes of the
 
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
Title
1.         This Instrument may be cited as Statement of Principles concerning primary myelofibrosis No. 17 of 2013.
Determination
2.         This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(2) 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 there is sound medical-scientific evidence that indicates that the only factor that may 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, members of Peacekeeping Forces, 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 as a minimum exist 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.
Other definitions
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)                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.
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
CHAIRPERSON