Statement of Principles concerning   PAGET’S DISEASE OF BONE No. 20 of 2006   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 Paget’s disease of bone No. 20 of 2006.   Determination 2.                  The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA): (a)       revokes Instrument No. 16 of 1996; and (b)       determines in its place this Statement of Principles.   Kind of injury, disease or death 3.         (a)        This Statement of Principles is about Paget’s disease of bone and death from Paget’s disease of bone. (b)              For the purposes of this Statement of Principles, “Paget’s disease of bone” means a disease of bone marked by repeated episodes of increased bone resorption followed by excessive attempts at repair, resulting in weakened deformed bones of increased mass. (c)              Paget’s disease of bone attracts ICD-10-AM code M88. (d)              In the application of this Statement of Principles, the definition of “Paget’s disease of bone” is that given at paragraph 3(b) above.  
Basis for determining the factors 4.         After examining the available sound medical-scientific evidence the Repatriation Medical Authority is of the view that it is more probable than not on the sound medical-scientific evidence available, that the only factor that can be related to the cause of or material contribution to or aggravation of Paget’s disease of bone or death from Paget’s disease of bone and which 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) is that set out in clause 5.   Factors that must be related to service 5.         The factor that must exist before it can be said that, on the balance of probabilities, in relation to the circumstances of a person’s relevant service causing or materially contributing to or aggravating Paget’s disease of bone or death from Paget’s disease of bone is inability to obtain appropriate clinical management for Paget’s disease of bone.   Other definitions 6.         For the purposes of this Statement of Principles:   “death from Paget’s disease of bone” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s Paget’s disease of bone;   “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), Fourth Edition, effective date of 1 July 2004, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 594 1;   “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.   Application 7.         This Instrument applies to all matters to which section 120B of the VEA or section 339 of the MRCA applies.     Date of effect 8.         This Instrument takes effect from 10 May 2006.   Dated this   twenty-sixth          day of              April         2006     The Common Seal of the                              ) Repatriation Medical Authority                   ) was affixed to this instrument                      ) in the presence of:                                        )   KEN DONALD CHAIRPERSON