Statement of Principles
concerning
 
SARCOIDOSIS
No. 115 of 2007
 
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 sarcoidosis No. 115 of 2007.
 
Determination
2.                  The Repatriation Medical Authority under subsection 196B(2) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)       revokes Instrument No. 288 of 1995 concerning sarcoidosis; and
(b)       determines in its place this Statement of Principles.
 
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about sarcoidosis and death from sarcoidosis.
(b)              For the purposes of this Statement of Principles, "sarcoidosis" means a chronic, multisystem disorder characterised in affected organs by an accumulation of T lymphocytes and mononuclear phagocytes, noncaseating epithelioid granulomas, and derangement of the normal tissue architecture.
(c)              Sarcoidosis attracts ICD-10-AM code D86.
(d)              In the application of this Statement of Principles, the definition of "sarcoidosis" 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 sarcoidosis and death from sarcoidosis 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 sarcoidosis or death from sarcoidosis with the circumstances of a person’s relevant service is:
 
(a)               being treated with interferon alpha for chronic infection with the hepatitis C virus within the six months before the clinical onset of sarcoidosis; or
 
(b)              being treated for HIV infection with antiretroviral drugs at the time of the clinical onset of sarcoidosis; or
 
(c)              having received an organ or tissue transplant from a donor with sarcoidosis within the six months before the clinical onset of sarcoidosis; or
 
(d)              being treated with interferon alpha for chronic infection with the hepatitis C virus within the six months before the clinical worsening of sarcoidosis; or
 
(e)              being treated for HIV infection with antiretroviral drugs at the time of the clinical worsening of sarcoidosis; or
 
(f)               inability to obtain appropriate clinical management for sarcoidosis.
 
Factors that apply only to material contribution or aggravation
7.         Paragraphs 6(d) to 6(f) apply only to material contribution to, or aggravation of, sarcoidosis where the person’s sarcoidosis 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:
 
"chronic infection with the hepatitis C virus" means:
(a)          positive polymerase chain reaction testing for hepatitis C virus (HCV) ribonucleic acid (RNA),
(b)          the presence of anti-HCV and elevated serum aminotransferase levels, more than six months after evidence of an acute hepatitis C infection; or
(c)          positive serology for hepatitis C plus evidence of chronic hepatitis or other chronic changes on liver biopsy;
 
"death from sarcoidosis" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s sarcoidosis;
 
"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)     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 14 November 2007.
 
Dated this       first         day of              November    2007
 
 
The Common Seal of the                  )
Repatriation Medical Authority       )
was affixed to this instrument          )
in the presence of:                            )
 
KEN DONALD
CHAIRPERSON