Statement of Principles

concerning

MYELOMA
(Balance of Probabilities)

(No. 96 of 2021)

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

Dated 20 August 2021

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 myeloma (Balance of Probabilities) (No. 96 of 2021).

2               Commencement

              This instrument commences on 20 September 2021.

3               Authority

This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.

4               Repeal

The Statement of Principles concerning myeloma No. 70 of 2012 (Federal Register of Legislation No. F2012L02080) made under subsections 196B(3) and (8) of the VEA is repealed.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 myeloma and death from myeloma.

Meaning of myeloma

(2)          For the purposes of this Statement of Principles, myeloma:

(a)          means a malignant disease of plasma cells, in which a single line of plasma cells accumulates and produces a monoclonal immunoglobulin; and

(b)          includes:

(i)            extramedullary plasmacytoma;

(ii)         multiple myeloma;

(iii)       plasma cell leukaemia; and

(iv)        solitary plasmacytoma of bone.

(3)          While myeloma attracts ICD‑10‑AM code C90, in applying this Statement of Principles the meaning of myeloma 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 myeloma

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

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

(1)          undergoing organ or tissue transplantation, excluding corneal transplant and autologous stem cell transplantation, before the clinical onset of myeloma;

Note: organ or tissue transplantation is defined in the Schedule 1 - Dictionary.

(2)          being obese for a continuous period of at least 5 years before the clinical onset of myeloma;

Note: being obese is defined in the Schedule 1 - Dictionary.

(3)          inability to obtain appropriate clinical management for myeloma.

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 factor set out in subsection 9(3) applies only to material contribution to, or aggravation of, myeloma where the person's myeloma 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 obese means having a Body Mass Index (BMI) of 30 or greater.

Note: BMI is also defined in the Schedule 1 - Dictionary.

                             BMI means W/H2 where:

(a)          W is the person's weight in kilograms; and

(b)          H is the person's height in metres.

                             MRCA means the Military Rehabilitation and Compensation Act 2004.

                               myeloma—see subsection 7(2).

                             organ or tissue transplantation means the transplantation of:

(a)          all or part of an organ or tissue; or

(b)          a substance obtained from an organ or tissue.

                             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.