Statement of Principles concerning immersion foot No. 26 of 2009

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Statement of Principles
No. 26 of 2009
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 immersion foot No. 26 of 2009.
2.         The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)       revokes Instrument No. 169 of 1995 concerning immersion foot; and
(b)       determines in its place this Statement of Principles.
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about immersion foot and death from immersion foot.
(b)              For the purposes of this Statement of Principles, "immersion foot" (also known as trench foot) means a disease of the sympathetic nerves and blood vessels in the foot due to prolonged exposure of the foot to wet and cold conditions.  This definition excludes tropical immersion foot.
(c)              Immersion foot attracts ICD-10-AM code T69.0.
(d)              In the application of this Statement of Principles, the definition of "immersion foot" 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 immersion foot and death from immersion foot 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.
6.         The factor that must exist before it can be said that, on the balance of probabilities, immersion foot or death from immersion foot is connected with the circumstances of a person’s relevant service is:
(a)               exposing the affected foot to moisture and non-freezing temperatures below 15°Celsius, for a period of at least 10 hours within the 12 hours before the clinical onset of immersion foot; or
(b)              inability to obtain appropriate clinical management for immersion foot.
Factors that apply only to material contribution or aggravation
7.         Paragraph 6(b) applies only to material contribution to, or aggravation of, immersion foot where the person’s immersion foot 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:
"death from immersion foot" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s immersion foot;
"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)       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.
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 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:                            )

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