Specialist Medical Review Council Declaration: Statements of Principles 53 and 54 of 2013 concerning fibrosing interstitial lung disease and Nos. 55 and 56 of 2013 concerning asbestosis

Overview

The Veterans' Entitlements Act 1986 (VEA) was enacted by the Australian Parliament to provide for the payment of pensions, allowances and other benefits to veterans, their widows, widowers and other dependants. The Specialist Medical Review Council (SMRC) was established under the VEA to provide expert advice to the Repatriation Medical Authority (RMA) on the medical evidence relevant to claims for veterans' benefits. In 2013, the RMA issued Statements of Principles concerning fibrosing interstitial lung disease and asbestosis. In response to a request for review, the SMRC declared that the sound medical-scientific evidence available to the RMA was insufficient to justify an amendment to the Statements of Principles to include new factors for asbestos bodies and pleural plaque or shorter periods of exposure to respirable asbestos fibres. The SMRC recommended that the RMA consider relevant sound medical-scientific evidence concerning direct measurements of asbestos fibre levels during tasks relevant to Australian Naval personnel or derived from the international literature, or alternative measures of exposure to asbestos and the required level of exposure used in the existing factors, for inhaling respirable asbestos fibres in an enclosed space/open environment and for inhaling respirable asbestos fibres in the Statements of Principles.

Scope and Application

The Specialist Medical Review Council Declaration under Section 196W of the Veterans' Entitlements Act 1986 pertains specifically to the review of the Statements of Principles concerning fibrosing interstitial lung disease and asbestosis as established by the Repatriation Medical Authority (RMA). The declaration applies to the medical-scientific evidence considered by the RMA in relation to these conditions and their associated deaths. The Council, composed of medical professionals and experts, assesses whether the existing evidence is sufficient to amend the Statements of Principles to include additional factors such as asbestos bodies and pleural plaque, or to account for shorter periods of exposure to respirable asbestos fibres. The Council's purview extends to ensuring that any future investigations by the RMA into these conditions consider any new or alternative measures of exposure that may be relevant to Australian Naval personnel, thereby influencing the criteria for entitlement to veterans' benefits. This declaration applies nationally across Australia, impacting all veterans who may be affected by these conditions and seeking benefits under the Veterans’ Entitlements Act. The application of this legislation is not limited by state or territory boundaries, reflecting its Commonwealth jurisdiction.

Key Provisions

The Specialist Medical Review Council (the Council), under section 196W of the Veterans’ Entitlements Act 1986 (VEA), has declared that the sound medical-scientific evidence available to the Repatriation Medical Authority (the RMA) is insufficient to justify an amendment to the existing Statements of Principles for fibrosing interstitial lung disease and asbestosis. Specifically, the Council has found that the evidence is insufficient to support the inclusion of asbestos bodies and pleural plaque as factors, or to support the inclusion of shorter periods of exposure to respirable asbestos fibres. This decision pertains to Statements of Principles Nos. 53 and 54 concerning fibrosing interstitial lung disease and death from fibrosing interstitial lung disease, and Nos. 55 and 56 concerning asbestosis and death from asbestosis, all made under section 196B of the VEA. The obligations imposed by the Act on the parties involved are primarily concerned with the review and assessment of medical-scientific evidence. The Council is tasked with reviewing the Statements of Principles made by the RMA and determining whether there is sufficient evidence to support amendments to these statements. The RMA, in turn, is required to consider the Council’s recommendations when carrying out any future investigations. Furthermore, the Council recommends that the RMA consider additional evidence in any future investigations, such as direct measurements of asbestos fibre levels during tasks relevant to Australian Naval personnel, or alternative measures of exposure derived from international literature. Failure to comply with the obligations set out in the Act may lead to civil or criminal consequences. However, the specific offences, penalties, or consequences for breach are not explicitly stated in the text. It is important to note that while the text does not detail the penalties, breaches of statutory obligations under the VEA could potentially result in legal action, including fines or other civil penalties, depending on the nature and severity of the breach. The declaration by the Council under section 196W of the VEA serves to guide the RMA in its future investigations and decisions regarding the Statements of Principles. By finding the current evidence insufficient, the Council has effectively restricted the scope of factors that can be considered in future amendments to these Statements of Principles. This decision ensures that any amendments made in the future are supported by robust and sound medical-scientific evidence, thereby maintaining the integrity and fairness of the entitlements process for veterans affected by fibrosing interstitial lung disease and asbestosis.