Statement of Principles concerning psoriatic arthritis (Balance of Probabilities) (No. 16 of 2021)
1Statement of Principles concerning psoriatic arthritis (Balance of Probabilities) (No. 16 of 2021)
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The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.
Dated 24 December 2020
The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:<br>
<br> <br>Professor Nicholas Saunders AO<br>Chairperson<br>
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 psoriatic arthritis (Balance of Probabilities) (No. 16 of 2021).
2 Commencement
This instrument commences on 25 January 2021.
3 Authority
This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.
4 Repeal
The Statement of Principles concerning psoriatic arthropathy No. 6 of 2012 (Federal Register of Legislation No. F2012L00010) made under subsection 196B(3) of the VEA is repealed.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 psoriatic arthritis and death from psoriatic arthritis.
Meaning of psoriatic arthritis
(2) For the purposes of this Statement of Principles, psoriatic arthritis means a seronegative chronic inflammatory arthritis, occurring in association with skin or nail psoriasis.
Note: Psoriatic arthritis is characterised by synovitis, enthesitis and dactylitis.
(3) While psoriatic arthritis attracts ICD‑10‑AM code M07.0 to M07.3, in applying this Statement of Principles the meaning of psoriatic arthritis 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 psoriatic arthritis
(5) For the purposes of this Statement of Principles, psoriatic arthritis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's psoriatic arthritis.
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 psoriatic arthritis and death from psoriatic arthritis 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, psoriatic arthritis or death from psoriatic arthritis is connected with the circumstances of a person's relevant service:
(1) having psoriasis at the time of the clinical onset of psoriatic arthritis;
(2) having trauma to the affected joint in the 30 days before the clinical onset of psoriatic arthritis;
Note: trauma to the affected joint is defined in the Schedule 1 - Dictionary.
(3) taking a biologic agent for the treatment of cancer and autoimmune disease for at least the seven days before the clinical onset of psoriatic arthritis;
Note: biologic agent is defined in the Schedule 1 - Dictionary.
(4) taking a biologic agent for the treatment of cancer and autoimmune disease for at least the seven days before the clinical worsening of psoriatic arthritis;
Note: biologic agent is defined in the Schedule 1 - Dictionary.
(5) inability to obtain appropriate clinical management for psoriatic arthritis.
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(4) to 9(5) apply only to material contribution to, or aggravation of, psoriatic arthritis where the person's psoriatic arthritis 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:
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.
MRCA means the Military Rehabilitation and Compensation Act 2004.
psoriatic arthritis—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.
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.
trauma to the affected joint means a discrete event involving the application of significant physical force to or through the affected joint, that causes:
(a) damage to the affected joint; and
(b) the development, within 24 hours of the event occurring, of symptoms and signs of pain, tenderness and altered range of movement of the affected joint. In the case of sustained unconsciousness or the masking of pain by analgesic medication, these symptoms and signs must appear on return to consciousness or the withdrawal of the analgesic medication; and
(c) the persistence of these symptoms and signs for a period of at least seven days following their onset, save for where medical intervention for the trauma to that joint has occurred and that medical intervention involves one of the following:
(i) immobilisation of the affected joint by splinting or similar external agent;
(ii) injection of a corticosteroid or local anaesthetic into that joint; or
(iii) surgery to that joint.
VEA means the Veterans' Entitlements Act 1986.
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