Statement of Principles

concerning

MICROSCOPIC POLYANGIITIS

No. 14 of 2011

for the purposes of the

Veterans’ Entitlements Act 1986

and

Military Rehabilitation and Compensation Act 2004

Title

1. This Instrument may be cited as Statement of Principles concerning microscopic polyangiitis No. 14 of 2011.

Determination

2. This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the VEA).

Kind of injury, disease or death

3. (a) This Statement of Principles is about microscopic polyangiitis and death from microscopic polyangiitis.

(b)               For the purposes of this Statement of Principles, "microscopic polyangiitis" means a necrotising vasculitis of capillaries, venules or arterioles that typically involves the lungs, kidneys and peripheral nervous system.

(c)               Microscopic polyangiitis attracts ICD-10-AM code M31.7.

(d)              In the application of this Statement of Principles, the definition of "microscopic polyangiitis" is that given at paragraph 3(b) above.

Basis for determining the factors

4. On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that microscopic polyangiitis and death from microscopic polyangiitis can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).

Factors that must be related to service

5. Subject to clause 7, at least one of the factors set out in clause 6 must be related to the relevant service rendered by the person.

Factors

6. The factor that must exist before it can be said that, on the balance of probabilities, microscopic polyangiitis or death from microscopic polyangiitis is connected with the circumstances of a person’s relevant service is:

(a)                being treated with propylthiouracil or hydralazine at the time of the clinical onset of microscopic polyangiitis; or

(b)               inhaling respirable crystalline silica dust, at the time material containing crystalline silica was being:

(i) produced;

(ii) excavated;

(iii) drilled, cut or ground; or

(iv)             used in construction, manufacturing, cleaning or blasting,

for a cumulative period of at least 5000 hours before the clinical onset of microscopic polyangiitis; or

(c)                being treated with propylthiouracil or hydralazine at the time of the clinical worsening of microscopic polyangiitis; or

(d)               inhaling respirable crystalline silica dust, at the time material containing crystalline silica was being:

(i) produced;

(ii) excavated;

(iii) drilled, cut or ground; or

(iv)             used in construction, manufacturing, cleaning or blasting,

for a cumulative period of at least 5000 hours before the clinical worsening of microscopic polyangiitis; or

(e)                inability to obtain appropriate clinical management for microscopic polyangiitis.

Factors that apply only to material contribution or aggravation

7. Paragraphs 6(c) to 6(e) apply only to material contribution to, or aggravation of, microscopic polyangiitis where the person’s microscopic polyangiitis was suffered or contracted before or during (but not arising out of) the person’s relevant service.

Inclusion of Statements of Principles

8. In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.

Other definitions

9. For the purposes of this Statement of Principles:

"death from microscopic polyangiitis" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s microscopic polyangiitis;

"ICD-10-AM code" means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM), Seventh Edition, effective date of 1 July 2010, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 978 1 74210 154 5;

"relevant service" means:

(a)              eligible war service (other than operational service) under the VEA; or

(b)               defence service (other than hazardous service) under the VEA; or

(c)               peacetime service under the MRCA;

"terminal event" means the proximate or ultimate cause of death and includes:

(a) pneumonia;

(b) respiratory failure;

(c) cardiac arrest;

(d) circulatory failure; or

(e) cessation of brain function.

Date of effect

10. This Instrument takes effect from 5 January 2011.

Dated this   fourteenth   day of   December   2010

The Common Seal of the  )

Repatriation Medical Authority )

was affixed to this instrument  )

in the presence of:   )

KEN DONALD

CHAIRPERSON