1Statement of Principles concerning anosmia (Balance of Probabilities) (No. 20 of 2021)

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Statement of Principles concerning anosmia (Balance of Probabilities) (No. 20 of 2021)

made under subsection 196B(3) of the

Veterans' Entitlements Act 1986

Compilation No. 1

Compilation date: 19 September 2022

Includes amendments up to: Veterans' Entitlements (Statements of Principles—definition of "one pack-year") Amendment Determination 2022 (No. 94 of 2022) (F2022L01128)

The day of commencement of this Amendment Determination is 19 September 2022.

About this compilation

This compilation

This is a compilation of the Statement of Principles concerning anosmia (Balance of Probabilities) (No. 20 of 2021) that shows the text of the law as amended and in force on 19 September 2022.

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self‑repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

Contents

1 Name

3 Authority

5 Application

6 Definitions

7 Kind of injury, disease or death to which this Statement of Principles relates

8 Basis for determining the factors

9 Factors that must exist

10 Relationship to service

11 Factors referring to an injury or disease covered by another Statement of Principles

Schedule 1 - Dictionary

1 Definitions

Endnotes

Endnote 1—About the endnotes..........................................

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

1 Name

This is the Statement of Principles concerning anosmia (Balance of Probabilities) (No. 20 of 2021).

3 Authority

This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.

5 Application

This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.

6 Definitions

The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.

7 Kind of injury, disease or death to which this Statement of Principles relates

(1) This Statement of Principles is about anosmia and death from anosmia.

Meaning of anosmia

(2) For the purposes of this Statement of Principles, anosmia means an acquired, total and permanent loss of the ability to smell, due to a defect in the olfactory neuroepithelium, olfactory nerves or olfactory neural pathways in the brain.

Note: Loss of the ability to smell includes loss of the ability to detect odours, discriminate between odours or to identify odours.

(3) While anosmia attracts ICD‑10‑AM code R43.0, in applying this Statement of Principles the meaning of anosmia is that given in subsection (2).

(4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.

Death from anosmia

(5) For the purposes of this Statement of Principles, anosmia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's anosmia.

Note: terminal event is defined in the Schedule 1 - Dictionary.

8 Basis for determining the factors

On the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that anosmia and death from anosmia can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.

Note: MRCA, relevant service and VEA are defined in the Schedule 1 - Dictionary.

9 Factors that must exist

At least one of the following factors must exist before it can be said that, on the balance of probabilities, anosmia or death from anosmia is connected with the circumstances of a person's relevant service:

(1) having sinusitis for at least the five years before the clinical onset of anosmia;

(2) having perennial allergic rhinitis for at least the five years before the clinical onset of anosmia;

Note: perennial allergic rhinitis is defined in the Schedule 1 - Dictionary.

(3) having an autoimmune disease from the specified list of autoimmune diseases at the time of the clinical onset of anosmia;

Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.

(4) having sarcoidosis at the time of the clinical onset of anosmia;

(5) having Paget's disease of bone affecting the skull at the time of the clinical onset of anosmia;

(6) having a neurological disease from the specified list of neurological diseases at the time of the clinical onset of anosmia;

Note: specified list of neurological diseases is defined in the Schedule 1 - Dictionary.

(7) having hepatic encephalopathy at the time of the clinical onset of anosmia;

(8) having chronic renal failure at the time of the clinical onset of anosmia;

Note: chronic renal failure is defined in the Schedule 1 - Dictionary.

(9) having alcohol-induced major neurocognitive disorder, amnestic-confabulatory type, persistent or alcohol use disorder at the time of the clinical onset of anosmia;

(10) having a condition or procedure from the specified list of conditions and procedures, which damages the olfactory neuroepithelium, the olfactory bulb or the olfactory neural pathways in the brain at the time of the clinical onset of anosmia;

Note: specified list of conditions and procedures is defined in the Schedule 1 - Dictionary.

(11) being treated with a drug which is associated in the individual with:

(a) the development of anosmia within three weeks of commencing drug therapy, in the absence of clinical or laboratory evidence of anosmia prior to commencing drug therapy; and

(b) the persistence of anosmia after discontinuing drug therapy;

(12) undergoing a course of therapeutic radiation for cancer, where the olfactory neuroepithelium, olfactory bulb, or olfactory neural pathways in the brain were in the field of radiation, within the 30 days before the clinical onset of anosmia;

(13) receiving an intranasal application of a preparation containing zinc gluconate or zinc sulphate within the 48 hours before the clinical onset of anosmia;

(14) taking intranasal cocaine such that there is destruction of the nasal septum, palate or paranasal sinuses before the clinical onset of anosmia;

(15) inhaling fumes from cadmium or nickel for a cumulative period of at least 5,000 hours before the clinical onset of anosmia and where that exposure has ceased, the clinical onset of anosmia has occurred within one year of cessation;

Note: fumes is defined in the Schedule 1 - Dictionary.

(16) inhaling fumes from acrylate or methylacrylate for a cumulative period of at least 5,000 hours before the clinical onset of anosmia and where that exposure has ceased, the clinical onset of anosmia has occurred within one year of cessation;

Note: fumes is defined in the Schedule 1 - Dictionary.

(17) experiencing acute, symptomatic poisoning from a neurotoxic substance from the specified list of neurotoxic substances within the 30 days before the clinical onset of anosmia;

Note: specified list of neurotoxic substances is defined in the Schedule 1 - Dictionary.

(18) where smoking has not ceased prior to the clinical onset of anosmia, having smoked at least 20 pack-years of tobacco products before the clinical onset of anosmia;

Note: one pack-year is defined in the Schedule 1 - Dictionary.

(19) having vitamin B12 deficiency at the time of the clinical onset of anosmia;

(20) having envenomation by the Australian mulga snake (Pseudoechis australis) or the South African Berg adder (Bitis atropos) at the time of the clinical onset of anosmia.

10 Relationship to service

The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.

11 Factors referring to an injury or disease covered by another Statement of Principles

In this Statement of Principles:

(1) if a factor referred to in section 9 applies in relation to a person; and

(2) that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;

then the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.

Schedule 1 - Dictionary

Note: See Section 6

1 Definitions

In this instrument:

anosmia—see subsection 7(2).

chronic renal failure means:

(a) having a glomerular filtration rate of less than 15 mL/min/1.73 m2 for a period of at least three months; or

(b) a need for renal replacement therapy (dialysis or transplantation) for treatment of complications of decreased glomerular filtration rate which would otherwise increase the risk of morbidity and mortality; or

(c) undergoing chronic dialysis.

fumes means combustion products, aerosols, vapours or dust arising through industrial processes or from workplace practices that involve the refining, manufacture or use of the stated material.

MRCA means the Military Rehabilitation and Compensation Act 2004.

one pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.

Note 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.

Note 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.

perennial allergic rhinitis means chronic or frequently recurrent rhinitis as distinct from rhinitis that is purely seasonal.

relevant service means:

(a) eligible war service (other than operational service) under the VEA;

(b) defence service (other than hazardous service and British nuclear test defence service) under the VEA; or

(c) peacetime service under the MRCA.

Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.

specified list of autoimmune diseases means:

(a) Behcet disease;

(b) eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome);

(c) granulomatosis with polyangiitis (Wegener granulomatosis);

(d) Sjogren syndrome;

(e) systemic lupus erythematosus; or

(f) systemic sclerosis.

specified list of conditions and procedures means:

(a) a head injury;

(b) an infection;

(c) an injury to the cribriform plate;

(d) a primary or secondary neoplasm; or

(e) a surgical procedure.

specified list of neurological diseases means:

(a) Alzheimer disease;

(b) cerebrovascular accident;

(c) frontotemporal dementia;

(d) multiple sclerosis;

(e) neurocognitive disorder with Lewy bodies;

(f) neuromyelitis optica;

(g) Parkinson's disease or secondary parkinsonism;

(h) subarachnoid haemorrhage; or

(i) temporal lobe epilepsy.

specified list of neurotoxic substances means:

(a) ammonia;

(b) barbituric acid;

(c) chlorine; or

(d) formaldehyde.

terminal event means the proximate or ultimate cause of death and includes the following:

(a) pneumonia;

(b) respiratory failure;

(c) cardiac arrest;

(d) circulatory failure; or

(e) cessation of brain function.

VEA means the Veterans' Entitlements Act 1986.

Note: Endnotes

Note: Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.

Note: Endnote 2—Abbreviation key

Note: Endnote 3—Legislation history

Note: Endnote 4—Amendment history