Statement of Principles

concerning

GIANT CELL ARTERITIS
(Balance of Probabilities)

(No. 12 of 2021)

The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.

Dated 24 December 2020

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 giant cell arteritis (Balance of Probabilities) (No. 12 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 giant cell arteritis No. 72 of 2012 (Federal Register of Legislation No. F2012L02083) made under subsection 196B(3) of the VEA is repealed.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 giant cell arteritis and death from giant cell arteritis.

Meaning of giant cell arteritis

(2)          For the purposes of this Statement of Principles, giant cell arteritis means a systemic autoimmune vasculitis that involves large and medium-sized arteries and principally affects the cranial branches of the carotid arteries.

Note 1: Examples of affected arteries include the temporal, occipital, ophthalmic, vertebral, distal subclavian and axillary arteries, and the thoracic aorta. Typical clinical symptoms associated with the involvement of the cranial arteries include headache, visual loss and jaw claudication.

Note 2: This condition is also known as temporal arteritis and cranial arteritis.

(3)          While giant cell arteritis attracts ICD‑10‑AM code M31.5 or M31.6, in applying this Statement of Principles the meaning of giant cell arteritis 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 giant cell arteritis

(5)          For the purposes of this Statement of Principles, giant cell arteritis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's giant cell arteritis.

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 giant cell arteritis and death from giant cell arteritis 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, giant cell arteritis or death from giant cell arteritis is connected with the circumstances of a person's relevant service:

(1)          having smoked at least 10 pack-years of tobacco products before the clinical onset of giant cell arteritis, and where smoking has ceased, the clinical onset of giant cell arteritis has occurred within 20 years of cessation;

Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

(2)          having smoked at least 10 pack-years of tobacco products before the clinical worsening of giant cell arteritis, and where smoking has ceased, the clinical worsening of giant cell arteritis has occurred within 20 years of cessation;

Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary

(3)          inability to obtain appropriate clinical management for giant cell arteritis.

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(2) to 9(3) apply only to material contribution to, or aggravation of, giant cell arteritis where the person's giant cell arteritis 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:

                               giant cell arteritis—see subsection 7(2).

                             MRCA means the Military Rehabilitation and Compensation Act 2004.

                               pack-year of tobacco products means:

(a)          20 cigarettes per day for a period of one calendar year; or

(b)          7,300 cigarettes in a period of one calendar year; or 

(c)          7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same, in a period of one calendar year.

                             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.

                             VEA means the Veterans' Entitlements Act 1986.