1Statement of Principles concerning fibromuscular dysplasia (Reasonable Hypothesis) (No. 81 of 2025)

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RMA Australian Government Coat of Arms

 

Statement of Principles

concerning

FIBROMUSCULAR DYSPLASIA (Reasonable Hypothesis)

(No. 81 of 2025)

The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

 

Dated    24 October 2025

 

 

 

 

 

 

 

 

 

 

Professor Terence Campbell AM

Chairperson

by and on behalf of

The Repatriation Medical Authority

 

 

 

Contents

1 Name

2 Commencement

3 Authority

4 Repeal

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

 

 

1.                Name

This is the Statement of Principles concerning fibromuscular dysplasia (Reasonable Hypothesis) (No. 81 of 2025).

1.                Commencement

              This instrument commences on 24 November 2025.

1.                Authority

This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.

1.                Repeal

The Statement of Principles concerning fibromuscular dysplasia (Reasonable Hypothesis) (No. 79 of 2016) (Federal Register of Legislation No. F2016L01674) made under subsection 196B(2) of the VEA is repealed.

1.                Application

This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies.

1.                Definitions

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

1.                Kind of injury, disease or death to which this Statement of Principles relates
2.           This Statement of Principles is about fibromuscular dysplasia and death from fibromuscular dysplasia.

Meaning of fibromuscular dysplasia

1.           For the purposes of this Statement of Principles, fibromuscular dysplasia means a non-atherosclerotic and non-inflammatory segmental disease of the musculature of arterial walls, leading to stenosis of small and medium-sized arteries and either:
2.           warrants medical treatment; or
3.           results in at least one of the following clinical manifestations involving a small or medium sized artery (most commonly renal or carotid): 1.             partial or complete occlusion; 2.          aneurysm; 3.        dissection; or 4.         ischaemia to an organ; and
4.           excludes carotid web.

Note: Clinical features of fibromuscular dysplasia vary widely, depending on what artery is affected, for example moderate to severe or poorly controlled hypertension when a renal artery is affected or headache and pulsatile tinnitus when a carotid artery is affected.

1.           While fibromuscular dysplasia attracts ICD‑10‑AM code I77.3, in applying this Statement of Principles the meaning of fibromuscular dysplasia is that given in subsection (2).
2.           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 fibromuscular dysplasia

1.           For the purposes of this Statement of Principles, fibromuscular dysplasia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's fibromuscular dysplasia.

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

1.                Basis for determining the factors

The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that fibromuscular dysplasia and death from fibromuscular dysplasia 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 MRCA.

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

1.                Factors that must exist

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting fibromuscular dysplasia or death from fibromuscular dysplasia with the circumstances of a person's relevant service:

1.           having smoked at least 5 pack-years before clinical onset or clinical worsening;

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

1.           inability to obtain appropriate clinical management for fibromuscular dysplasia before clinical worsening.

2.            Relationship to service

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

4.           The clinical worsening aspect of factors set out in section 9 apply to material contribution to, or aggravation of, fibromuscular dysplasia where the person's fibromuscular dysplasia was suffered or contracted before or during (but did not arise out of) the person's relevant service.

5.            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(2) 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:

                                fibromuscular dysplasia—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)          operational service under the VEA;

(b)          peacekeeping service under the VEA;

(c)          hazardous service under the VEA;

(d)          British nuclear test defence service under the VEA;

(e)          warlike service under the MRCA; or

(f)           non-warlike service under the MRCA.

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

                               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.