Statement of Principles
concerning
BENIGN NEOPLASM OF THE EYE AND ADNEXA
No. 34 of 2008
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 benign neoplasm of the eye and adnexa No. 34 of 2008.
Determination
2. The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a) revokes Instrument No. 183 of 1995 concerning benign neoplasm of the eye; and
(b) determines in its place this Statement of Principles.
Kind of injury, disease or death
3. (a) This Statement of Principles is about benign neoplasm of the eye and adnexa and death from benign neoplasm of the eye and adnexa.
(b) For the purposes of this Statement of Principles, "benign neoplasm of the eye and adnexa" means a non-malignant neoplastic proliferation of the cells of the eye classified according to site as conjunctiva, cornea, retina, choroid, ciliary body, lacrimal gland, lacrimal duct and orbit. This definition excludes benign neoplasms of eyelids, optic nerve, meninges, orbital bone, lipoma, haemangioma, lymphangioma, melanocytic naevi and neurofibromatosis.
(c) Benign neoplasm of the eye and adnexa attracts ICD-10-AM code D31.
(d) In the application of this Statement of Principles, the definition of "benign neoplasm of the eye and adnexa" 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 benign neoplasm of the eye and adnexa and death from benign neoplasm of the eye and adnexa 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, benign neoplasm of the eye and adnexa or death from benign neoplasm of the eye and adnexa is connected with the circumstances of a person’s relevant service is:
(a) for schwannoma only,
(i) having received a cumulative equivalent dose of at least 0.50 Sievert of atomic radiation to the eye or orbit where this dose was accumulated at least five years before the clinical onset of benign neoplasm of the eye and adnexa; or
(ii) undergoing a course of therapeutic radiation to the head or neck region, where the first exposure to therapeutic radiation occurred at least five years before the clinical onset of benign neoplasm of the eye and adnexa; or
(b) inability to obtain appropriate clinical management for benign neoplasm of the eye and adnexa.
Factors that apply only to material contribution or aggravation
7. Paragraph 6(b) applies only to material contribution to, or aggravation of, benign neoplasm of the eye and adnexa where the person’s benign neoplasm of the eye and adnexa 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 benign neoplasm of the eye and adnexa" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s benign neoplasm of the eye and adnexa;
"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), Fifth Edition, effective date of 1 July 2006, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 772 3;
"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;
"schwannoma" means a benign neoplasm originating from Schwann cells of the myelin sheath of neurons of peripheral nerves and comprise two types, neurilemomas and neurofibromas;
"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 30 April 2008.
Dated this fourteenth day of April 2008
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRPERSON
