Amendment Statement of Principles
concerning
ISCHAEMIC HEART DISEASE
No. 44 of 2009
for the purposes of the
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
1. This Instrument may be cited as Statement of Principles concerning ischaemic heart disease No. 44 of 2009.
2. The Repatriation Medical Authority amends, under subsection 196B(8) of the Veterans’ Entitlements Act 1986, Statement of Principles concerning ischaemic heart disease No. 90 of 2007 by:
(A) Inserting a new factor "(p)(iv)" in clause 6 as follows:
"(p)(iv) having a clinically significant anxiety spectrum disorder as specified, at the time of the clinical onset of ischaemic heart disease; or";
(B) Inserting a new factor "(ff)(iv)" in clause 6 as follows:
"(ff)(iv) having a clinically significant anxiety spectrum disorder as specified, at the time of the clinical worsening of ischaemic heart disease; or";
(C) Inserting a new definition for "a clinically significant anxiety spectrum disorder as specified" in clause 9 as follows:
'"a clinically significant anxiety spectrum disorder as specified" means one of the following disorders:
(a) anxiety disorder due to a general medical condition;
(b) generalised anxiety disorder;
(c) panic disorder;
(d) phobic anxiety;
(e) posttraumatic stress disorder; or
(f) anxiety disorder not otherwise specified,
that attract a diagnosis under DSM-IV-TR and is sufficient to warrant ongoing management. The ongoing management may involve regular visits (for example, at least monthly), to a psychiatrist, clinical psychologist or general practitioner;';
(D) Inserting a new definition for "DSM-IV-TR" in clause 9 as follows:
'"DSM-IV-TR" means the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000;';
(E) Inserting a new definition for "panic attack" in clause 9 as follows:
'"panic attack" means a discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:
(a) palpitations, pounding heart, or accelerated heart rate;
(b) sweating;
(c) trembling or shaking;
(d) sensations of shortness of breath or smothering;
(e) feeling of choking;
(f) chest pain or discomfort;
(g) nausea or abdominal distress;
(h) feeling dizzy, unsteady, light headed or faint;
(i) derealisation (feelings of unreality) or depersonalisation (being detached from oneself);
(j) fear of losing control or going crazy;
(k) fear of dying;
(l) paraesthesias (numbness or tingling sensations); or
(m) chills or hot flushes.
This definition is derived from DSM-IV-TR;'; and
(F) Inserting a new definition for "phobic anxiety" in clause 9 as follows:
'"phobic anxiety" means a psychiatric condition which significantly limits an individual’s normal routine, occupational and social activities by excessive or unreasonable persistent fears brought on by the presence or anticipation of certain situations or objects. The exposure to the stimulus invariably provokes an immediate anxiety response such as a panic attack and the response is recognised as being excessive or unreasonable by the affected individual. This definition includes the diagnoses agoraphobia, social phobia or a specific phobia as derived from DSM-IV-TR;'.
3. The amendments made by this instrument apply to all matters to which Instrument No. 90 of 2007, section 120B of the Veterans’ Entitlements Act 1986 and section 339 of the Military Rehabilitation and Compensation Act 2004 apply.
4. The amendment made by this instrument takes effect from 1 July 2009.
Dated this nineteenth day of June 2009
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of )
KEN DONALD
CHAIRPERSON
