Amendment Statement of Principles concerning alcohol use disorder No. 29 of 2014

Administered by Department of Veterans' Affairs

Legislation au F2014L00335 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

INSTRUMENT NO. 29 OF 2014

 

VETERANS’ ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

EXPLANATORY NOTES FOR TABLING

 

 

  1. The Repatriation Medical Authority (the Authority) has determined, under subsection 196B(2) & (8) of the Veterans’ Entitlements Act 1986 (the VEA) Amendment Statement of Principles Instrument No. 29 of 2014 concerning alcohol use disorder.
  2. This Instrument amends Statement of Principles Instrument No. 1 of 2009 concerning alcohol dependence and alcohol abuse by:
  • changing the name of this Instrument to 'Statement of Principles concerning alcohol use disorder No. 1 of 2009';
  • replacing the phrases 'alcohol dependence and alcohol abuse' and 'alcohol dependence or alcohol abuse' with the words 'alcohol use disorder' wherever these phrases appear in this instrument, with the exception of clause 2(a);
  • replacing the definition of 'alcohol dependence and alcohol abuse' in clause 3 with the definition of 'alcohol use disorder';
  • revising the existing definition of 'a clinically significant psychiatric condition' in clause 9;
  • inserting definitions of 'a specified disorder of mental health' and 'DSM-5' in clause 9; and
  • deleting the definition of 'DSM-IV-TR' in clause 9.

3.             This Instrument gives effect to changes consequent upon the introduction of American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Arlington, VA, American Psychiatric Association, 2013, which simplify the diagnosis of alcohol related illness.

4.             This Instrument specifies a date of effect for the amendment in accordance with subsection 12(1)(a) of the Legislative Instruments Act 2003.

5.             This Instrument incorporates by reference the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Arlington, VA, American Psychiatric Association, 2013.  A copy of this document is available from the offices of the Repatriation Medical Authority, Level 8, Bank of Queensland Building, 259 Queen St, Brisbane Queensland 4000, by contacting the Registrar on telephone (07) 3815 9404.

6.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to alcohol dependence and alcohol abuse in the Government Notices Gazette of 21 August 2013, and circulated a copy of the notice of intention to investigate to a wide range of organisations representing veterans, service personnel and their dependants.  The Authority invited submissions from the Repatriation Commission, organisations and persons referred to in section 196E of the VEA, and any person having expertise in the field.  One submission was received for consideration by the Authority during the investigation.

7.             This instrument is compatible with the Human Rights and Freedoms recognised or declared in the International Instruments listed in Section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.  A Statement of Compatibility with Human Rights follows.

8.             The determining of this Instrument finalises the investigation in relation to alcohol dependence and alcohol abuse as advertised in the Government Notices Gazette of 21 August 2013.

9.             A list of references relating to the above condition is available to any person or organisation referred to in subsection 196E(1)(a) to (c) of the VEA.  Any such request must be made in writing to the Repatriation Medical Authority at the following address:

The Registrar

Repatriation Medical Authority

GPO Box 1014

BRISBANE    QLD    4001

 


Statement of Compatibility with Human Rights

(Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011)

 

Instrument No.:   Amendment Statement of Principles No. 29 of 2014

Kind of Injury, Disease or Death: Alcohol use disorder

 

This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Overview of the Legislative Instrument

1. This Legislative Instrument is determined pursuant to subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA) for the purposes of the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).

2. This Legislative Instrument:-

  • facilitates claimants in making, and the Repatriation Commission in assessing, claims under the VEA and the MRCA respectively, by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have alcohol use disorder;
  • facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal;
  • includes revised and new definitions relating to factors which the current sound medical-scientific evidence indicates must as a minimum exist, before it can be said that a reasonable hypothesis has been raised, connecting alcohol use disorder with the circumstances of eligible service rendered by a person;
  • amends Instrument No. 1 of 2009; and
  • reflects developments in the available sound medical-scientific evidence concerning alcohol use disorder which have occurred since that earlier instrument was determined. 

3. The Instrument is assessed as being a technical instrument which improves the medico-scientific quality of outcomes under the VEA and the MRCA. 

Human Rights Implications

4. This Legislative Instrument does not derogate from any human rights. It promotes the human rights of veterans, current and former Defence Force members as well as other persons such as their dependents, including:

  • the right to social security (Art 9, International Covenant on Economic, Social and Cultural Rights; Art 26, Convention on the Rights of the Child and Art 28, Convention on the Rights of Persons with Disabilities) by helping to ensure that the qualifying conditions for the benefit are 'reasonable, proportionate and transparent'[1];
  • the right to an adequate standard of living (Art 11, ICSECR; Art 27, CRC and Art 28, CRPD) by facilitating the assessment and determination of social security benefits;
  • the right to the enjoyment of the highest attainable standard of physical and mental health (Art 12, ICSECR and Art 25, CRPD), by facilitating the assessment and determination of compensation and benefits in relation to the treatment and rehabilitation of veterans and Defence Force members; and
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD).

Conclusion

This Legislative Instrument is compatible with human rights as it does not derogate from and promotes a number of human rights.

 

Repatriation Medical Authority

 

 

 

 

 

 

[1] In General Comment No. 19 (The right to social security), the Committee on Economic, Social and Cultural Rights said (at paragraph 24) this to be one of the elements of ensuring accessibility to social security.

Overview

The Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 were amended by the Repatriation Medical Authority Instrument No. 29 of 2014, which was enacted to address the need for an updated approach to the diagnosis and classification of alcohol use disorders in veterans. The Authority, under the provisions of the Veterans’ Entitlements Act 1986, sought to modernise the legislative framework by incorporating the latest diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The policy objective of this Instrument is to streamline the process of assessing and compensating veterans for alcohol use disorders, ensuring that the medical and scientific evidence used is current and aligned with the most recent international standards. This legislative amendment aims to facilitate the claims process for veterans, enhance the accuracy of diagnoses, and ultimately support the provision of appropriate medical treatment and compensation.

Scope and Application

The Repatriation Medical Authority Instrument No. 29 of 2014, made under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, amends the Statement of Principles Instrument No. 1 of 2009 to address alcohol use disorder. This legislative instrument applies to veterans and current or former Defence Force members who are eligible for benefits under the VEA and MRCA, as well as their dependents, by providing clearer criteria for the assessment and determination of claims related to alcohol use disorder. The changes reflect the latest medical-scientific evidence and diagnostic standards, particularly those set out in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The amendments ensure that the qualifying conditions for benefits are reasonable, proportionate, and transparent, thereby promoting human rights such as the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health. The Authority undertook an investigation and invited submissions from relevant organisations and experts before determining this instrument, which is compatible with human rights as it neither derogates from them nor imposes any significant restrictions on their exercise.

Key Provisions

The Repatriation Medical Authority Instrument No. 29 of 2014 amends the Statement of Principles Instrument No. 1 of 2009 to address alcohol use disorder (AUD) under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). It changes the terminology from "alcohol dependence and alcohol abuse" to "alcohol use disorder," updates definitions, and aligns with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). These changes aim to improve the assessment and treatment of veterans suffering from AUD, ensuring that the criteria for qualifying benefits are based on the latest medical-scientific evidence. The Act imposes specific obligations on the parties involved. Claimants must provide accurate and complete information about their AUD, while the Repatriation Commission is responsible for assessing the claims based on the updated criteria. The Veterans' Review Board and the Administrative Appeals Tribunal are tasked with reviewing decisions made by the Repatriation Commission. The Authority must ensure that the definitions and criteria used are clear, consistent, and reflective of current medical standards. The instrument also mandates that any requests for references related to AUD must be made in writing to the Repatriation Medical Authority. Breaches of the requirements set forth in this Instrument may result in legal consequences. For instance, providing false or misleading information in a claim could lead to civil or criminal penalties. While the specific penalties are not detailed in the explanatory notes, they would typically align with the penalties outlined in the VEA and MRCA for fraudulent claims. These penalties could include fines and, in severe cases, imprisonment. Additionally, failure to adhere to the updated criteria and definitions could result in claims being denied or benefits being revoked, impacting the veterans' access to necessary medical treatment and compensation. The instrument emphasizes that it is compatible with human rights as recognized by international instruments. It supports the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health. By facilitating the assessment and determination of social security benefits and treatment for AUD, the instrument promotes the rights of veterans and their dependents. It ensures that the qualifying conditions for benefits are reasonable, proportionate, and transparent, thereby upholding the rights of individuals affected by AUD.

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