Statement of Principles concerning duodenal ulcer and duodenal erosion (Balance of Probabilities) (No. 50 of 2024) (Cth)

Statement of Principles concerning DUODENAL ULCER AND DUODENAL EROSION (Balance of Probabilities) (No. 50 of 2024) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.

Dated 21 June 2024.

Professor Terence Campbell AM Chairperson by and on behalf of The Repatriation Medical Authority

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 duodenal ulcer and duodenal erosion (Balance of Probabilities) (No. 50 of 2024). 2 Commencement This instrument commences on 23 July 2024. 3 Authority This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning gastric ulcer and duodenal ulcer No. 62 of 2015 (Federal Register of Legislation No. F2015L00658) made under subsections 196B(3) and (8) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004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 duodenal ulcer and duodenal erosion and death from duodenal ulcer and duodenal erosion. Meaning of duodenal ulcer and duodenal erosion (2) For the purposes of this Statement of Principles, duodenal ulcer and duodenal erosion: (a) means a non-malignant disruption in the mucosal surface of the duodenum; and (b) includes ulcers or erosions due to duodenal foreign bodies; and (c) excludes: (i) acute superficial mucosal erosions of the duodenum; and (ii) duodenal perforations from external trauma such as stabbing, explosive blast injury or gunshot injury; Note: A duodenal erosion is a disruption in the mucosal surface of the duodenum above the lamina propria, and a duodenal ulcer is a disruption in the mucosal surface of duodenum that extends past the lamina propria and through the muscularis mucosa into the submucosa. (3) While duodenal ulcer and duodenal erosion attracts ICD‑10‑AM code K26, in applying this Statement of Principles the meaning of duodenal ulcer and duodenal erosion 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 duodenal ulcer and duodenal erosion (5) For the purposes of this Statement of Principles, duodenal ulcer and duodenal erosion, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's duodenal ulcer and duodenal erosion. 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 duodenal ulcer and duodenal erosion and death from duodenal ulcer and duodenal erosion 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, duodenal ulcer and duodenal erosion or death from duodenal ulcer and duodenal erosion is connected with the circumstances of a person's relevant service: (1) having Helicobacter pylori infection of the duodenum at the time of clinical onset or clinical worsening; (2) having an infection of the duodenal mucosa by one of the following organisms: