Statement of Principles concerning irritable bowel syndrome (Reasonable Hypothesis) (No. 65 of 2019)
1Statement of Principles concerning irritable bowel syndrome (Reasonable Hypothesis) (No. 65 of 2019)
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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 irritable bowel syndrome (Reasonable Hypothesis) (No. 65 of 2019).
2 Commencement
This instrument commences on 22 July 2019.
3 Authority
This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.
4 Repeal
The Statement of Principles concerning irritable bowel syndrome No. 27 of 2011 (Federal Register of Legislation No. F2011L00783) made under subsection 196B(2) of the VEA is repealed.
5 Application
Section 1 - Statement of Principles concerning irritable bowel syndrome (Reasonable Hypothesis) (No. 65 of 2019) - Statement of Principles concerning irritable bowel syndrome (Reasonable Hypothesis) (No. 65 of 2019) | Zoe
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.
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 irritable bowel syndrome and death from irritable bowel syndrome.
Meaning of irritable bowel syndrome
(2) For the purposes of this Statement of Principles, irritable bowel syndrome means recurrent abdominal pain occurring on average at least one day per week for at least three months, where the pain is associated with two or more of the following:
(a) defaecation;
(b) a change in the frequency of stool; or
(c) a change in the form (appearance) of stool;
with the symptom onset at least six months prior to the diagnosis.
(3) While irritable bowel syndrome attracts ICD‑10‑AM code K58, in applying this Statement of Principles the meaning of irritable bowel syndrome 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 irritable bowel syndrome
(5) For the purposes of this Statement of Principles, irritable bowel syndrome, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's irritable bowel syndrome.
Note: terminal event is defined in the Schedule 1 – Dictionary.
8 Basis for determining the factors
The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that irritable bowel syndrome and death from irritable bowel syndrome 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.
9 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 irritable bowel syndrome or death from irritable bowel syndrome with the circumstances of a person's relevant service:
(1) being a prisoner of war before the clinical onset of irritable bowel syndrome;
(2) having a clinically significant disorder of mental health as specified within the six months before the clinical onset of irritable bowel syndrome;
Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.
(3) having an episode of severe diarrhoea within the six months before the clinical onset of irritable bowel syndrome;
Note: episode of severe diarrhoea is defined in the Schedule 1 - Dictionary.
(4) living or working in a hostile or life-threatening environment for a cumulative period of at least four weeks within the six months before the clinical onset of irritable bowel syndrome;
Note: hostile or life-threatening environment is defined in the Schedule 1 - Dictionary.
(5) experiencing a category 1A stressor within the six months before the clinical onset of irritable bowel syndrome;
Note: category 1A stressor is defined in the Schedule 1 - Dictionary.
(6) experiencing a category 1B stressor within the six months before the clinical onset of irritable bowel syndrome;
Note: category 1B stressor is defined in the Schedule 1 - Dictionary.
(7) experiencing a category 2 stressor within the one year before the clinical onset of irritable bowel syndrome;
Note 1: A category 2 stressor can arise in a variety of circumstances connected with service. Such circumstances can arise during the course of service, as a result of separation from service and the conditions associated with that separation, and in the transition to civilian life in the years following separation.
Note 2: category 2 stressor is defined in the Schedule 1 - Dictionary.
(8) experiencing severe childhood abuse before the clinical onset of irritable bowel syndrome;
Note: severe childhood abuse is defined in the Schedule 1 - Dictionary.
(9) having a clinically significant disorder of mental health as specified within the six months before the clinical worsening of irritable bowel syndrome;
Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.
(10) having an episode of severe diarrhoea within the six months before the clinical worsening of irritable bowel syndrome;
Note: episode of severe diarrhoea is defined in the Schedule 1 - Dictionary.
(11) living or working in a hostile or life-threatening environment for a cumulative period of at least four weeks within the six months before the clinical worsening of irritable bowel syndrome;
Note: hostile or life-threatening environment is defined in the Schedule 1 - Dictionary.
(12) experiencing a category 1A stressor within the six months before the clinical worsening of irritable bowel syndrome;
Note: category 1A stressor is defined in the Schedule 1 - Dictionary.
(13) experiencing a category 1B stressor within the six months before the clinical worsening of irritable bowel syndrome;
Note: category 1B stressor is defined in the Schedule 1 - Dictionary.
(14) experiencing a category 2 stressor within the one year before the clinical worsening of irritable bowel syndrome;
Note: category 2 stressor is defined in the Schedule 1 - Dictionary.
(15) inability to obtain appropriate clinical management for irritable bowel syndrome.
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 factors set out in subsections 9(9) to 9(15) apply only to material contribution to, or aggravation of, irritable bowel syndrome where the person's irritable bowel syndrome 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(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:
category 1A stressor means one of the following severe traumatic events:
(a) experiencing a life-threatening event;
(b) being subject to a serious physical attack or assault including rape and sexual molestation; or
(c) being threatened with a weapon, being held captive, being kidnapped or being tortured.
category 1B stressor means one of the following severe traumatic events:
(a) killing or maiming a person;
(b) being an eyewitness to a person being killed or critically injured;
(c) being an eyewitness to atrocities inflicted on another person;
(d) participating in the clearance of a corpse or a critically injured casualty; or
(e) viewing a corpse or a critically injured casualty as an eyewitness.
Note: corpse and eyewitness are also defined in the Schedule 1 - Dictionary.
category 2 stressor means one of the following negative life events, the effects of which are chronic in nature and cause the person to feel ongoing distress, concern or worry:
(a) being socially isolated and unable to maintain friendships or family relationships, due to physical location, language barriers, disability, or medical or psychiatric illness;
(b) experiencing a problem with a long-term relationship including the break-up of a close personal relationship, the need for marital or relationship counselling, marital separation or divorce;
(c) having concerns in the work or school environment including ongoing disharmony with fellow work or school colleagues, perceived lack of social support within the work or school environment, perceived lack of control over tasks performed and stressful workloads, or experiencing bullying in the workplace or school environment;
(d) experiencing serious legal issues including being detained or held in custody, ongoing involvement with the police concerning violations of the law, or court appearances associated with personal legal problems;
(e) having severe financial hardship including loss of employment, long periods of unemployment, foreclosure on a property or bankruptcy;
(f) having a family member or significant other experience a major deterioration in their health; or
(g) being a full-time caregiver to a family member or significant other with a severe physical, mental or developmental disability.
Note: significant other is also defined in the Schedule 1 - Dictionary.
clinically significant disorder of mental health as specified means one of the following conditions, which is of sufficient severity to warrant ongoing management:
(a) agoraphobia;
(b) alcohol use disorder;
(c) anxiety disorder;
(d) bipolar disorder;
(e) depressive disorder;
(f) eating disorder;
(g) obsessive compulsive disorder;
(h) panic disorder; or
(i) posttraumatic stress disorder.
Note 1: Management of the condition may involve regular visits (for example, at least monthly) to a psychiatrist, counsellor or general practitioner.
Note 2: To warrant ongoing management does not require that any actual management was received or given for the condition.
corpse means the human remains or body parts of one or more persons who have met a violent or horrific death.
Note: Examples of a violent or horrific death may include death due to suicide, gunshot, improvised explosive devices, natural and technological disasters, terrorist attacks or motor vehicle accidents. Seeing a closed body bag or viewing a body in an open-casket coffin are excluded from this definition.
episode of severe diarrhoea means an acute illness characterised by the passage of frequent, loose, watery motions assessed as being caused by an infective organism, and of sufficient severity to warrant medical attention, or in the absence of medical intervention, lasting at least four days.
eyewitness means a person who experiences an incident first hand and can give direct evidence of it. This excludes persons exposed only to public broadcasting or mass media coverage of the incident.
hostile or life-threatening environment means a situation or setting which is characterised by a pervasive threat to life or bodily integrity, such as would be experienced in the following circumstances:
(a) experiencing or being under threat of artillery, missile, rocket, mine or bomb attack; or
(b) experiencing or being under threat of nuclear, biological or chemical agent attack; or
(c) being involved in combat or going on combat patrols.
irritable bowel syndrome—see subsection 7(2).
MRCA means the Military Rehabilitation and Compensation Act 2004.
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 also defined in the Schedule 1 - Dictionary.
severe childhood abuse means:
(a) serious physical, emotional, psychological or sexual harm whilst a child aged under 16 years; or
(b) neglect involving a serious failure to provide the necessities for health, physical and emotional development, or wellbeing whilst a child aged under 16 years;
where such serious harm or neglect has been perpetrated by a parent, a care provider, an adult who works with or around that child, or any other adult in contact with that child.
significant other means a person who has a close family bond or a close personal relationship and is important or influential in one's life.
terminal event means the proximate or ultimate cause of death and includes the following: