Statement of Principles concerning psoriasis (Balance of Probabilities) (No. 14 of 2021)
1Statement of Principles concerning psoriasis (Balance of Probabilities) (No. 14 of 2021)
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Statement of Principles concerning psoriasis (Balance of Probabilities) (No. 14 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 psoriasis (Balance of Probabilities) (No. 14 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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.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
Section 1 - Statement of Principles concerning psoriasis (Balance of Probabilities) (No. 14 of 2021) - Statement of Principles concerning psoriasis (Balance of Probabilities) (No. 14 of 2021) | Zoe
10 Relationship to service
11 Factors referring to an injury or disease covered by another Statement of Principles
This is the Statement of Principles concerning psoriasis (Balance of Probabilities) (No. 14 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 psoriasis and death from psoriasis.
Meaning of psoriasis
(2) For the purposes of this Statement of Principles, psoriasis means a chronic inflammatory skin disorder characterised by keratinocyte hyperproliferation that results in erythematous plaques, patches and papules.
Note: Morphological variants of psoriasis include the common plaque type, as well as flexural, erythrodermic, pustular (including impetigo herpetiformis) and guttate forms.
(3) While psoriasis attracts ICD‑10‑AM code L40.0, L40.1, L40.2, L40.4, L40.8, L40.9 or L40, in applying this Statement of Principles the meaning of psoriasis 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 psoriasis
(5) For the purposes of this Statement of Principles, psoriasis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's psoriasis.
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 psoriasis and death from psoriasis 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, psoriasis or death from psoriasis is connected with the circumstances of a person's relevant service:
(1) having an injury to the skin of the affected site or developing a lesion of the affected site within the 30 days before the clinical onset of psoriasis;
(2) taking a drug from the specified list of drugs for at least the seven days before the clinical onset of psoriasis;
Note: specified list of drugs is defined in the Schedule 1 - Dictionary.
(3) taking a drug which is associated in the individual with:
(a) the development of psoriasis during drug therapy; and
(b) the improvement of psoriasis within two months of discontinuing or tapering drug therapy;
where taking the drug continued for at least the seven days before the clinical onset of psoriasis;
(4) withdrawing from tumour necrosis factor-α inhibitor treatment in the six months before the clinical onset of psoriasis;
(5) withdrawing from systemic glucocorticoids, moderate potency topical glucocorticoids or high potency topical glucocorticoids in the 30 days before the clinical onset of psoriasis;
Note: moderate potency topical glucocorticoids and high potency topical glucocorticoids are defined in the Schedule 1 - Dictionary.
(6) having a Streptococcus pyogenes infection of the pharynx, tonsils or skin within the 30 days before the clinical onset of psoriasis;
(7) having infection with human immunodeficiency virus before the clinical onset of psoriasis;
(8) having smoked at least ten pack-years of tobacco products before the clinical onset of psoriasis;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
(9) being exposed to second-hand smoke for at least 10,000 hours before the clinical onset of psoriasis;
Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.
(10) being overweight or obese for at least five years before the clinical onset of psoriasis;
Note: being overweight or obese is defined in the Schedule 1 - Dictionary.
(11) for impetigo herpetiformis only, being pregnant within the six weeks before the clinical onset of impetigo herpetiformis;
Note: impetigo herpetiformis is defined in the Schedule 1 - Dictionary.
(12) having an injury to the skin of the affected site or developing a lesion of the affected site within the 30 days before the clinical worsening of psoriasis;
(13) taking a drug from the specified list of drugs for at least the seven days before the clinical worsening of psoriasis;
Note: specified list of drugs is defined in the Schedule 1 - Dictionary.
(14) taking a drug which is associated in the individual with:
(a) the worsening of psoriasis during drug therapy; and
(b) the improvement of psoriasis within two months of discontinuing or tapering drug therapy;
where taking the drug continued for at least the seven days before the clinical worsening of psoriasis;
(15) withdrawing from tumour necrosis factor-α inhibitor treatment in the six months before the clinical worsening of psoriasis;
(16) withdrawing from systemic glucocorticoids, moderate potency topical glucocorticoids or high potency topical glucocorticoids in the 30 days before the clinical worsening of psoriasis;
Note: moderate potency topical glucocorticoids and high potency topical glucocorticoids are defined in the Schedule 1 - Dictionary.
(17) having a Streptococcus pyogenes infection of the pharynx, tonsils or skin within the 30 days before the clinical worsening of psoriasis;
(18) having infection with human immunodeficiency virus before the clinical worsening of psoriasis;
(19) having smoked at least ten pack-years of tobacco products before the clinical worsening of psoriasis;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
(20) being exposed to second-hand smoke for at least 10,000 hours before the clinical worsening of psoriasis;
Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.
(21) being overweight or obese for at least five years before the clinical worsening of psoriasis;
Note: being overweight or obese is defined in the Schedule 1 - Dictionary.
(22) inability to obtain appropriate clinical management for psoriasis.
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(12) to 9(22) apply only to material contribution to, or aggravation of, psoriasis where the person's psoriasis 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:
being exposed to second-hand smoke means being in an enclosed space and inhaling smoke from burning tobacco products or smoke that has been exhaled by another person who is smoking.
being overweight or obese means having a Body Mass Index (BMI) of 25 or greater.
Note: BMI is also defined in the Schedule 1 - Dictionary.
biologic agent means a therapeutic product which is derived from living organisms or which contains components of living organisms.
Note: Examples of biologic agents used for the treatment of cancer and autoimmune disease include interferons, monoclonal antibodies, tumour necrosis factor-α inhibitors, tyrosine kinase inhibitors and vascular endothelial growth factor antagonists.
BMI means W/H2 where:
(a) W is the person's weight in kilograms; and
(b) H is the person's height in metres.
high potency topical glucocorticoids means:
(a) betamethasone dipropionate 0.05%;
(b) betamethasone valerate 0.1%;
(c) clobetasol 0.05%;
(d) methylprednisolone 0.1%;
(e) mometasone 0.1%; or
(f) another topical glucocorticoid of equivalent potency.
impetigo herpetiformis means a pustular skin condition of pregnancy, characterised by the presence of widespread tiny superficial pustules in a herpetiform pattern on erythematosquamous plaques, and often associated with constitutional symptoms.
moderate potency topical glucocorticoids means:
(a) betamethasone valerate 0.02% and 0.05%;
(b) clobetasone 0.05%;
(c) desonide 0.05%;
(d) triamcinolone 0.02%; or
(e) another topical glucocorticoid of equivalent potency.
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.
psoriasis—see subsection 7(2).
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 drugs means:
(a) angiotensin-converting enzyme inhibitors;
(b) apixaban;
(c) beta-blockers;
(d) biologic agents for the treatment of cancer and autoimmune disease;
(e) bupropion;
(f) chloroquine;
(g) docetaxel;
(h) hydroxychloroquine;
(i) itraconazole;
(j) lithium;
(k) mefloquine;
(l) primaquine;
(m) quinacrine (mepacrine or Atebrin);
(n) terbinafine; or
(o) tetracyclines.
Note: biologic agent is also 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.
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
o = order(s)
ad = added or inserted
Ord = Ordinance
am = amended
orig = original
amdt = amendment
par = paragraph(s)/subparagraph(s)
c = clause(s)
/sub‑subparagraph(s)
C[x] = Compilation No. x
pres = present
Ch = Chapter(s)
prev = previous
def = definition(s)
(prev…) = previously
Dict = Dictionary
Pt = Part(s)
disallowed = disallowed by Parliament
r = regulation(s)/rule(s)
Div = Division(s)
exp = expires/expired or ceases/ceased to have
reloc = relocated
effect
renum = renumbered
F = Federal Register of Legislation
rep = repealed
gaz = gazette
rs = repealed and substituted
LA = Legislation Act 2003
s = section(s)/subsection(s)
LIA = Legislative Instruments Act 2003
Sch = Schedule(s)
(md) = misdescribed amendment can be given
Sdiv = Subdivision(s)
effect
SLI = Select Legislative Instrument
(md not incorp) = misdescribed amendment
SR = Statutory Rules
cannot be given effect
Sub‑Ch = Sub‑Chapter(s)
mod = modified/modification
SubPt = Subpart(s)
No. = Number(s)
underlining = whole or part not
commenced or to be commenced
Note: Endnote 3—Legislation history
Name
Registration
Commencement
Application, saving and transitional provisions
Statement of Principles concerning psoriasis (Balance of Probabilities) (No. 14 of 2021)
4 January 2021F2021L00015
25 January 2021
Veterans' Entitlements (Statements of Principles—definition of "one pack-year") Amendment Determination 2022 (No. 94 of 2022)