Statement of Principles
concerning
MALIGNANT NEOPLASM OF THE CEREBRAL MENINGES
No. 21 of 2009
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 malignant neoplasm of the cerebral meninges No. 21 of 2009.
Determination
2. The Repatriation Medical Authority under subsection 196B(2) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a) revokes Instrument No. 205 of 1995 concerning malignant neoplasm of the cerebral meninges; and
(b) determines in its place this Statement of Principles.
Kind of injury, disease or death
3. (a) This Statement of Principles is about malignant neoplasm of the cerebral meninges and death from malignant neoplasm of the cerebral meninges.
(b) For the purposes of this Statement of Principles, "malignant neoplasm of the cerebral meninges" means a primary malignant neoplasm arising from the cells of the cerebral meninges. This definition excludes soft tissue sarcoma, carcinoid tumour, non-Hodgkin's lymphoma, Hodgkin's lymphoma and melanoma.
(c) Malignant neoplasm of the cerebral meninges attracts ICD-10-AM code C70.0 or C70.9.
(d) In the application of this Statement of Principles, the definition of "malignant neoplasm of the cerebral meninges" 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 malignant neoplasm of the cerebral meninges and death from malignant neoplasm of the cerebral meninges 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 malignant neoplasm of the cerebral meninges or death from malignant neoplasm of the cerebral meninges with the circumstances of a person’s relevant service is:
(a) undergoing a course of therapeutic radiation to the head or neck region before the clinical onset of malignant neoplasm of the cerebral meninges, where the first exposure to therapeutic radiation occurred at least two years before the clinical onset of malignant neoplasm of the cerebral meninges; or
(b) having received a cumulative equivalent dose of 0.05 Sievert of atomic radiation to the brain, where this dose was accumulated at least five years before the clinical onset of malignant neoplasm of the cerebral meninges; or
(c) inability to obtain appropriate clinical management for malignant neoplasm of the cerebral meninges.
Factors that apply only to material contribution or aggravation
7. Paragraph 6(c) applies only to material contribution to, or aggravation of, malignant neoplasm of the cerebral meninges where the person’s malignant neoplasm of the cerebral meninges 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 course of therapeutic radiation" means one or more fractions (treatment portions) of ionising radiation administered with the aim of achieving palliation or cure with gamma rays, x-rays, alpha particles or beta particles;
"atomic radiation" means ionising radiation excluding:
(a) natural background radiation;
(b) therapeutic radiation; and
(c) radiation from diagnostic procedures;
"cumulative equivalent dose" means the total equivalent dose of radiation from all types of ionising radiation. It accounts for the differences in biological effectiveness of various types of radiation and allows doses from different radiations to be combined. Each component is calculated by multiplying the absorbed dose in a particular tissue or organ for a given type of radiation by the radiation weighting factor for that radiation. The unit of equivalent dose is the Sievert;
"death from malignant neoplasm of the cerebral meninges" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s malignant neoplasm of the cerebral meninges;
"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), Sixth Edition, effective date of 1 July 2008, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 978 1 74210 016 6;
"relevant service" means:
(a) operational service under the VEA;
(b) peacekeeping service under the VEA;
(c) hazardous service under the VEA;
(d) warlike service under the MRCA; or
(e) 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 6 May 2009.
Dated this twenty-fourth day of April 2009
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRPERSON
