Statement of Principles concerning tinea (Reasonable Hypothesis) (No. 55 of 2024) (Cth)

Statement of Principles concerning TINEA (Reasonable Hypothesis) (No. 55 of 2024) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) 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 tinea (Reasonable Hypothesis) (No. 55 of 2024). 2 Commencement This instrument commences on 23 July 2024. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning tinea No. 11 of 2015 (Federal Register of Legislation No. F2014L01814) made under subsection 196B(2) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004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 tinea and death from tinea. Meaning of tinea (2) For the purposes of this Statement of Principles, tinea: (a) means a fungal infection of the skin, hair or nails caused by the dermatophytes Epidermophyton, Trichophyton, Microsporum, Arthroderma, Ctenomyces, Lophophyton, Nannizzia, Guarromyces or Paraphyton; and (b) includes: (i) tinea infection of the beard (tinea barbae), scalp (tinea capitis), body (tinea corporis), groin/perineal region (tinea cruris/inguinalis), hand (tinea manus/manuum), foot (tinea pedis), and nail (tinea unguium/onchomycosis); (ii) tinea gladiatorum; and (iii) Majocchi's granuloma (granuloma trichophyticum); and (c) excludes: (i) tinea versicolour; (ii) tinea flava; (iii) tinea nigra; (iv) tinea blanca; (v) tinea amiantacea; and (vi) fungal infection involving mucous membranes or a systemic fungal infection. Note 1: Tinea includes Id reactions which is an allergic rash occurring as a result of allergy to fungal antigens from a tinea at a distant site. Note 2: The SoP should be invoked separately in relation to each instance of tinea, in each separate location of the body, and in each instance separate in time. Note 3: Some examples of clinical worsening are where tinea has disseminated, become deeply invasive in the form of Majocchi's granuloma, or has become refractory to first-line treatment. (3) While tinea attracts ICD‑10‑AM code B35, in applying this Statement of Principles the meaning of tinea 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 tinea (5) For the purposes of this Statement of Principles, tinea, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's tinea. 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 tinea and death from tinea 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 tinea or death from tinea with the circumstances of a person's relevant service: (1) having unprotected physical contact with: (a) a person infected with tinea; (b) an animal infected with tinea; (c) objects or surfaces contaminated with dermatophytes; (d) using communal showering or bathing facilities, swimming pool facilities or locker rooms; (e) soil contaminated with dermatophytes; or (f) a site of tinea on the same body; between 2 days and 3 weeks before the clinical onset or clinical worsening; Note 1: Examples of unprotected physical contact with a person could include contact sports and unarmed physical combat. Note 2: Examples of animals that can be infected with tinea include mammals, reptiles, birds, fish, arthropods, and worms. Note 3: Examples of objects that can be contaminated include brushes, hats, razors, footwear, towels or clothing. Examples of surfaces that can be contaminated include communal showers, baths, pools, locker rooms, and laundry facilities.