Statement of Principles concerning accidental hypothermia (Reasonable Hypothesis) (No. 21 of 2018) (Cth)

Statement of Principles concerning ACCIDENTAL HYPOTHERMIA (Reasonable Hypothesis) (No. 21 of 2018) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

Dated 2 March 2018

The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:

Professor Nicholas Saunders AO Chairperson

Contents 1 Name 2 Commencement 3 Authority 4 Revocation 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 accidental hypothermia (Reasonable Hypothesis) (No. 21 of 2018). 2 Commencement This instrument commences on 2 April 2018. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Revocation The Statement of Principles concerning accidental hypothermia No. 17 of 2010 made under subsection 196B(2) of the VEA is revoked. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 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 accidental hypothermia and death from accidental hypothermia. Meaning of accidental hypothermia (2) For the purposes of this Statement of Principles, accidental hypothermia: (a) means the unintentional lowering of core body temperature to 35 degrees Celsius or lower due to exposure to cold environmental temperature, in an individual without a primary disturbance of thermoregulation; and (b) excludes intentionally induced hypothermia and hypothermia due to a toxicologic or pharmacologic cause. (3) While accidental hypothermia attracts ICD‑10‑AM code T68, in applying this Statement of Principles the meaning of accidental hypothermia 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 accidental hypothermia (5) For the purposes of this Statement of Principles, accidental hypothermia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's accidental hypothermia. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 Basis for determining the factors The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that accidental hypothermia and death from accidental hypothermia can be related to relevant service rendered by veterans, members of Peacekeeping Forces, 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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting accidental hypothermia or death from accidental hypothermia with the circumstances of a person's relevant service: (1) being exposed to low environmental temperature at the time of the clinical onset of accidental hypothermia; Note: Exposure to low environmental temperatures may occur during military training or exercises in the outdoors, but is also likely to occur in other circumstances, examples of which include: occupational exposure (for example, cold room), poorly controlled psychiatric disease or suicide attempt, substances or diseases that affect the level of consciousness (for example, alcohol intoxication, drug overdose or epileptic seizure), injury or diseases that affect the ability to walk (for example, heart attack or stroke), diseases that impair cognition (for example, dementia), and homelessness. (2) inability to obtain appropriate clinical management for accidental hypothermia. 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(2) applies only to material contribution to, or aggravation of, accidental hypothermia where the person's accidental hypothermia 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(2) 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.