Statement of Principles concerning irritable bowel syndrome No. 28 of 2011

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Statement of Principles
concerning
 
IRRITABLE BOWEL SYNDROME
No. 28 of 2011
 
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 irritable bowel syndrome No. 28 of 2011.
 
Determination
2.         The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)        revokes Instrument No. 104 of 1996 concerning irritable bowel syndrome; and
(b)        determines in its place this Statement of Principles.
 
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about irritable bowel syndrome and death from irritable bowel syndrome.
(b)              For the purposes of this Statement of Principles, "irritable bowel syndrome" means a condition characterised by chronic or recurrent abdominal pain associated with altered bowel function (i.e., constipation, diarrhoea, or alternating constipation and diarrhoea). It is defined as the presence of at least two of the following symptoms occurring for at least 12 weeks in the preceding 12 months:
(i)                 abdominal pain or discomfort that is relieved with defaecation;
(ii)               the onset of abdominal pain associated with a change in the frequency of bowel movements; and
(iii)             the onset of abdominal pain associated with a change in the form (appearance) of stool;
in the absence of significant physical findings and abnormalities on standard laboratory tests, and normal gross and histologic findings on flexible sigmoidoscopy or colonoscopy.
(c)              Irritable bowel syndrome attracts ICD-10-AM code K58.
(d)              In the application of this Statement of Principles, the definition of "irritable bowel syndrome" is that given at paragraph 3(b) above.
 
Basis for determining the factors
4.         On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that irritable bowel syndrome and death from irritable bowel syndrome 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).
 
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.
 
Factors
6.         The factor that must exist before it can be said that, on the balance of probabilities, irritable bowel syndrome or death from irritable bowel syndrome is connected with the circumstances of a person’s relevant service is:
 
(a)                having a specified psychiatric condition at the time of the clinical onset of irritable bowel syndrome; or
 
(b)               having an episode of severe diarrhoea within the three months before the clinical onset of irritable bowel syndrome; or
 
(c)                having a specified psychiatric condition at the time of the clinical worsening of irritable bowel syndrome; or
 
(d)               having an episode of severe diarrhoea within the three months before the clinical worsening of irritable bowel syndrome; or
 
(e)                inability to obtain appropriate clinical management for irritable bowel syndrome.
 
Factors that apply only to material contribution or aggravation
7.         Paragraphs 6(c) to 6(e) apply only to material contribution to, or aggravation of, irritable bowel syndrome where the person’s irritable bowel syndrome 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:
 
"a specified psychiatric condition" means:
(a)                anxiety disorder;
(b)               depressive disorder;
(c)                panic disorder; or
(d)               posttraumatic stress disorder;
 
"an episode of severe diarrhoea" means an acute illness characterised by the passage of frequent loose watery motions assessed as being caused by an infective organism, and of sufficient severity to warrant medical attention, or in the absence of medical intervention, lasting at least four days;
 
"death from irritable bowel syndrome" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s irritable bowel syndrome;
 
"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; or
(b)       defence service (other than hazardous 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.
 
Application
10.       This Instrument applies to all matters to which section 120B of the VEA or section 339 of the MRCA applies.
 
Date of effect
11.       This Instrument takes effect from 25 May 2011.
 
Dated this   ninth   day of   May   2011
 
The Common Seal of the                    )
Repatriation Medical Authority          )
was affixed to this instrument                        )
in the presence of:                               )
 
KEN DONALD
CHAIRPERSON

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