Statement of Principles concerning accommodation disorder (Balance of Probabilities) (No. 39 of 2017)

Administered by Department of Veterans' Affairs

Legislation au F2017L00889 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

ACCOMMODATION DISORDER

(BALANCE OF PROBABILITIES) (NO. 39 OF 2017)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning accommodation disorder (Balance of Probabilities) (No. 39 of 2017).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), revokes Instrument No. 6 of 2009, determined under subsection 196B(3) of the VEA concerning accommodation disorder.

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that accommodation disorder and death from accommodation disorder can be related to particular kinds of service.  The Authority has therefore determined pursuant to subsection 196B(3) of the VEA a Statement of Principles concerning accommodation disorder (Balance of Probabilities) (No. 39 of 2017).  This Instrument will in effect replace the revoked Statement of Principles.

Purpose and Operation

4.             The Statement of Principles will be applied in determining claims under the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).

5.             The Statement of Principles sets out the factors that must exist, and which of those factors must be related to the following kinds of service rendered by a person:

 eligible war service (other than operational service) under the VEA;

 defence service (other than hazardous service and British nuclear test defence service) under the VEA;

 peacetime service under the MRCA,

before it can be said that, on the balance of probabilities, accommodation disorder or death from accommodation disorder is connected with the circumstances of that service.  The Statement of Principles has been determined for the purposes of both the VEA and the MRCA.

6.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 3 May 2016  concerning accommodation disorder in accordance with section 196G of the VEA.  The investigation involved an examination of the sound medical-scientific evidence now available to the Authority, including the sound medical-scientific evidence it has previously considered.

7.             The contents of this Instrument are in similar terms as the revoked Instrument.  Comparing this Instrument and the revoked Instrument, the differences include:

  • adopting the latest revised Instrument format, which commenced in 2015;
  • specifying a day of commencement for the Instrument in section 2;
  • revising the definition of 'accommodation disorder' in subsection 7(2);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factor in subsection 9(1) concerning 'an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle', by the inclusion of a note;
  • new factors in subsections 9(2) & 9(7) concerning 'concussion';
  • new factors in subsections 9(3) & 9(8) concerning 'moderate to severe traumatic brain injury';
  • new factors in subsections 9(4) & 9(9) concerning 'being treated with atropine or an atropine-like drug, where the drug cannot be ceased or substituted';
  • new factors in subsections 9(5) & 9(10) concerning 'being treated with a drug, or a drug from a class of drugs';
  • new factor in subsection 9(6) concerning 'an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle', for clinical worsening;
  • new definitions of 'atropine-like drug', 'MRCA', 'specified list of drugs' and 'VEA' in Schedule 1 - Dictionary; and
  • revising the definitions of 'an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle' and 'relevant service' in Schedule 1  Dictionary.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to accommodation disorder in the Government Notices Gazette of 3 May 2016, 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.  No submissions were received for consideration by the Authority during the investigation.

Human Rights

9.             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.

Finalisation of Investigation

10.         The determining of this Instrument finalises the investigation in relation to accommodation disorder as advertised in the Government Notices Gazette of 3 May 2016.

References

11.         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.:   Statement of Principles No. 39 of 2017

Kind of Injury, Disease or Death: Accommodation 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).  Part XIA of the VEA requires the determination of these instruments outlining the factors linking particular kinds of injury, disease or death with service such being determined solely on the available sound medical-scientific evidence.

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 accommodation disorder;
  • facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal;
  • outlines the factors which the current sound medical-scientific evidence indicates must exist before it can be said that, on the balance of probabilities, accommodation disorder is connected with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 6 of 2009; and
  • reflects developments in the available sound medical-scientific evidence concerning accommodation 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;
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD); and
  • ensuring that those rights "will be exercised without discrimination of any kind as to race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status" (Art 2, ICESCR).

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 Statement of Principles concerning Accommodation Disorder (Balance of Probabilities) (No. 39 of 2017) was enacted to address the need for updated medical criteria concerning accommodation disorder for veterans and service members under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This legislative instrument was developed by the Repatriation Medical Authority in response to new medical-scientific evidence that links certain types of service with accommodation disorder or death from accommodation disorder. The purpose of the Statement of Principles is to specify the factors that must exist for accommodation disorder or death from accommodation disorder to be considered connected with particular kinds of service, thereby facilitating the assessment and determination of claims under the aforementioned Acts. This instrument replaces the previous Statement of Principles and incorporates recent developments in medical-scientific evidence. It is compatible with human rights, ensuring that veterans, current and former Defence Force members, and their dependents can exercise their rights without discrimination. The Statement of Principles aims to improve the quality of medico-scientific outcomes under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 by clearly outlining the circumstances in which medical treatment and compensation can be extended to eligible persons with accommodation disorder. By specifying the necessary factors, it facilitates the claims process for veterans and service members, supports the review of decisions by the Veterans' Review Board and the Administrative Appeals Tribunal, and promotes the human rights of those affected, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health.

Scope and Application

The Statement of Principles concerning Accommodation Disorder (Balance of Probabilities) (No. 39 of 2017) applies to individuals who are making or have made claims under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). It sets out the circumstances in which accommodation disorder and death from accommodation disorder may be considered connected to particular types of service, such as eligible war service, defence service, and peacetime service. The Statement of Principles facilitates the assessment and determination of claims for medical treatment and compensation by establishing clear factors that must be met based on sound medical-scientific evidence. The application of these principles ensures that claimants can access appropriate benefits, and the Repatriation Commission, Veterans' Review Board, and Administrative Appeals Tribunal can make informed decisions. The instrument has been updated to reflect the latest available medical evidence, replacing the previous Instrument No. 6 of 2019, and includes revised definitions and factors that align with current scientific understanding of accommodation disorder. The instrument does not specify any exclusions, exemptions, or thresholds, but it does rely on the availability of sound medical-scientific evidence to determine the connection between accommodation disorder and the specified service types.

Key Provisions

The Statement of Principles concerning accommodation disorder (Balance of Probabilities) (No. 39 of 2017) (the Instrument) sets out the circumstances in which accommodation disorder and death from accommodation disorder are considered to be connected with certain kinds of service under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) (sections 5 and 6). The Instrument replaces Instrument No. 6 of 2009 and incorporates the latest sound medical-scientific evidence concerning accommodation disorder (section 6). The Instrument specifies the factors that must exist, and which of those factors must be related to eligible war service (other than operational service), defence service (other than hazardous service and British nuclear test defence service) under the VEA, and peacetime service under the MRCA, before it can be said that, on the balance of probabilities, accommodation disorder or death from accommodation disorder is connected with the circumstances of that service (section 5). The 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 accommodation disorder (section 2). The Instrument is also designed to facilitate the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal (section 2). The Instrument imposes obligations on claimants to provide evidence that meets the criteria set out in the Instrument for a claim to be assessed and approved under the VEA or MRCA (section 5). It also imposes obligations on the Repatriation Commission to assess claims against the criteria set out in the Instrument, and to make determinations based on the evidence presented (section 5). The Instrument does not impose any criminal offences or penalties for breach. However, failure to comply with the requirements of the Instrument may result in a claim being denied or a decision being overturned on review (section 5). The maximum penalty for an offence under the VEA or MRCA is imprisonment for two years or a fine of 120 penalty units, or both (section 283, VEA and section 307, MRCA).

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