Statement of Principles concerning essential thrombocythaemia (Balance of Probabilities) (No. 92 of 2021)
1Statement of Principles concerning essential thrombocythaemia (Balance of Probabilities) (No. 92 of 2021)
Start here
Get a plain-English read of 1
Turn the raw legal text into a practical explanation grounded in Statement of Principles concerning essential thrombocythaemia (Balance of Probabilities) (No. 92 of 2021).
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
1 Name
This is the Statement of Principles concerning essential thrombocythaemia (Balance of Probabilities) (No. 92 of 2021).
2 Commencement
This instrument commences on 20 September 2021.
3 Authority
This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.
4 Repeal
The Statement of Principles concerning essential thrombocythaemia No. 16 of 2013 (Federal Register of Legislation No. F2013L00411) made under subsection 196B(3) of the VEA is repealed.
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 essential thrombocythaemia and death from essential thrombocythaemia.
Meaning of essential thrombocythaemia
(2) For the purposes of this Statement of Principles, essential thrombocythaemia:
(a) means a chronic, Philadelphia-chromosome negative myeloproliferative neoplasm characterised by bone marrow megakaryocytic proliferation, resulting in excessive, clonal platelet production and marked thrombocytosis in peripheral blood; and
(b) excludes secondary or reactive thrombocytosis.
Note 1: Typical clinical manifestations of essential thrombocythaemia include formation of blood clots, bleeding, fatigue, night sweats, visual disturbances, headache, nausea and abdominal pain.
Note 2: The clinical course is usually indolent, but transformation to bone marrow failure, myelofibrosis and acute leukaemia may occur.
Note 3: Causes of secondary or reactive thrombocytosis include infection, trauma and haemorrhage.
(3) While essential thrombocythaemia attracts ICD‑10‑AM code D47.3, in applying this Statement of Principles the meaning of essential thrombocythaemia 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 essential thrombocythaemia
(5) For the purposes of this Statement of Principles, essential thrombocythaemia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's essential thrombocythaemia.
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 essential thrombocythaemia and death from essential thrombocythaemia 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, essential thrombocythaemia or death from essential thrombocythaemia is connected with the circumstances of a person's relevant service:
(1) having smoked tobacco products:
(a) in an amount of at least 10 pack-years before the clinical onset of essential thrombocythaemia; and
(b) commencing at least 5 years before the clinical onset of essential thrombocythaemia; and
if smoking has ceased before the clinical onset of essential thrombocythaemia, then that onset occurred within 15 years of cessation;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
(2) inability to obtain appropriate clinical management for essential thrombocythaemia.
10 Relationship to service
(1) The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.
(2) The factor set out in subsection 9(2) applies only to material contribution to, or aggravation of, essential thrombocythaemia where the person's essential thrombocythaemia was suffered or contracted before or during (but did not arise out of) the person's relevant service.
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:
essential thrombocythaemia—see subsection 7(2).
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.
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.
terminal event means the proximate or ultimate cause of death and includes the following: