Anal fissure
Meaning of anal fissure: For the purposes of this Statement of Principles, anal fissure: (a) means an acquired linear longitudinal split in the skin (anoderm) of the distal anal canal; and (b) excludes anal inflammatory bowel disease, anal neoplasia and anal infections. (3) While anal fissure attracts ICD-10-AM code K60.0, K60.1 or K60.2, in applying this Statement of Principles the meaning of anal fissure 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.
Reasonable Hypothesis (RH) — Statement of Principles No. 87 of 2019
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 anal fissure or death from anal fissure with the circumstances of a person's relevant service:
- (1)having trauma to the anal area at the time of the clinical onset of anal fissure;
Note: trauma to the anal area is defined in the Schedule 1 - Dictionary.
- (2)having infection with human immunodeficiency virus before the clinical onset of anal fissure;
- (3)straining at stool due to constipation within the two weeks before the clinical onset of anal fissure;
- (4)being treated with isotretinoin at the time of the clinical onset of anal fissure;
- (5)inability to obtain appropriate clinical management for anal fissure;
Aggravation-only factors: the factors in subsection 9(5) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 88 of 2019
5 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, anal fissure or death from anal fissure is connected with the circumstances of a person's relevant service:
- (1)having trauma to the anal area at the time of the clinical onset of anal fissure;
Note: trauma to the anal area is defined in the Schedule 1 - Dictionary.
- (2)having infection with human immunodeficiency virus before the clinical onset of anal fissure;
- (3)straining at stool due to constipation within the two weeks before the clinical onset of anal fissure;
- (4)being treated with isotretinoin at the time of the clinical onset of anal fissure;
- (5)inability to obtain appropriate clinical management for anal fissure;
Aggravation-only factors: the factors in subsection 9(5) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
