Statement of Principles concerning varicose veins of the lower limb No. 120 of 2011

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Statement of Principles
concerning
 
VARICOSE VEINS OF THE LOWER LIMB
No. 120 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 varicose veins of the lower limb No. 120 of 2011.
 
Determination
2.         The Repatriation Medical Authority under subsection 196B(2) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)        revokes Instrument No. 70 of 1998 concerning varicose veins of the lower limb; and
(b)        determines in its place this Statement of Principles.
 
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about varicose veins of the lower limb and death from varicose veins of the lower limb.
(b)               For the purposes of this Statement of Principles, "varicose veins of the lower limb" means dilatation and lengthening of a subcutaneous superficial vein or veins of the lower limb, such as the saphenous veins and perforating veins, and excluding spider veins (telangiectasis).
(c)                Varicose veins of the lower limb attracts ICD-10-AM code I83 or O22.0.
(d)              In the application of this Statement of Principles, the definition of "varicose veins of the lower limb" 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 varicose veins of the lower limb and death from varicose veins of the lower limb 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.
 
Factors
6.         The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting varicose veins of the lower limb or death from varicose veins of the lower limb with the circumstances of a person’s relevant service is:
(a)                having thrombosis of a deep vein draining the affected lower limb before the clinical onset of varicose veins of the lower limb; or
(b)               having complete or partial obstruction of a vein draining the affected lower limb at the time of the clinical onset of varicose veins of the lower limb; or
(c)                being pregnant at the time of the clinical onset of varicose veins of the lower limb; or
(d)               having an acquired arteriovenous fistula involving the blood vessels supplying the affected lower limb at the time of the clinical onset of varicose veins of the lower limb; or
(e)                non-ambulatory standing for at least four hours per day, on more days than not, for a continuous period of at least the five years before the clinical onset of varicose veins of the lower limb; or
(f)                for varicose veins of the thigh only, having a varicosity of an abdominal or pelvic vein, leading to reflux into the affected thigh vein via interconnecting or collateral veins, at the time of the clinical onset of varicose veins of the lower limb; or
(g)               having thrombosis of a deep vein draining the affected lower limb before the clinical worsening of varicose veins of the lower limb; or
(h)               having complete or partial obstruction of a vein draining the affected lower limb at the time of the clinical worsening of varicose veins of the lower limb; or
(i)                 being pregnant at the time of the clinical worsening of varicose veins of the lower limb; or
(j)                 having an acquired arteriovenous fistula involving the blood vessels supplying the affected lower limb at the time of the clinical worsening of varicose veins of the lower limb; or
(k)               non-ambulatory standing for at least four hours per day, on more days than not, for a continuous period of at least the five years before the clinical worsening of varicose veins of the lower limb; or
(l)                 for varicose veins of the thigh only, having a varicosity of an abdominal or pelvic vein, leading to reflux into the affected thigh vein via interconnecting or collateral veins, at the time of the clinical worsening of varicose veins of the lower limb; or
(m)             inability to obtain appropriate clinical management for varicose veins of the lower limb.
Factors that apply only to material contribution or aggravation
7.         Paragraphs 6(g) to 6(m) apply only to material contribution to, or aggravation of, varicose veins of the lower limb where the person’s varicose veins of the lower limb 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 deep vein draining the affected lower limb" means a vein contained within the deep fascia of the limb or pelvis (such as the veins of the calf pump, popliteal veins, femoral veins and iliac veins), which drains the affected limb;
 
"death from varicose veins of the lower limb" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s varicose veins of the lower limb;
 
"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)        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.
 
Application
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 2 November 2011.
 
Dated this   twenty-first   day of   October   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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