REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 5 of 2009
VETERANS’ ENTITLEMENTS ACT 1986
MILITARY REHABILITATION AND COMPENSATION ACT 2004
EXPLANATORY NOTES FOR TABLING
- The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA) revokes Instrument No. 296 of 1995, determined under subsection 196B(2) of the VEA concerning accommodation disorder and death from accommodation disorder.
2. 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(2) of the VEA a Statement of Principles, Instrument No. 5 of 2009 concerning accommodation disorder. This Instrument will in effect replace the revoked Statement of Principles.
3. The provisions of the Military Rehabilitation and Compensation Act 2004 (the MRCA) relating to claims for compensation commenced on 1 July 2004. Claims under section 319 of the MRCA for acceptance of liability for a service injury sustained, a service disease contracted or service death on or after 1 July 2004 are determined by the Military Rehabilitation and Compensation Commission by reference to Statements of Principles issued by the Authority pursuant to the VEA.
4. The Statement of Principles sets out the factors that must as a minimum exist, and which of those factors must be related to the following kinds of service rendered by a person:
operational service under the VEA;
peacekeeping service under the VEA;
hazardous service under the VEA;
warlike service under the MRCA;
non-warlike service under the MRCA,
before it can be said that a reasonable hypothesis has been raised connecting accommodation disorder or death from accommodation disorder, with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 2 May 2007 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.
6. The contents of the new Instrument are in similar terms as the revoked Instrument. Comparing the new and the revoked Instruments, the differences include:
- adopting the latest revised Instrument format, which commenced in 2005;
- deleting the ICD code from the Instrument header;
- revising the definition of 'accommodation disorder' in clause 3;
- new factor 6(a) concerning 'an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle of the affected eye';
- new definitions of 'an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle', 'death from accommodation disorder', 'ICD-10-AM code', 'relevant service', and 'terminal event' in clause 9;
- deleting definitions of 'ICD code' and 'lesion affecting the oculomotor nerve'; and
- specifying a date of effect for the Instrument in clause 11.
7. Further changes to the format of the Instrument reflect the commencement of the MRCA and clarify that pursuant to subsection 196B(3A) of the VEA, the Statement of Principles has been determined for the purposes of both the VEA and the MRCA.
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 2 May 2007, 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.
9. The determining of this new instrument finalises the investigation in relation to accommodation disorder as advertised in the Government Notices Gazette of 2 May 2007.
10. A list of references relating to the above condition is available, on written request, from the Repatriation Medical Authority Secretariat.
Overview
The Repatriation Medical Authority Instrument No. 5 of 2009 amends the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 to address the issue of accommodation disorder and related deaths, ensuring that veterans' claims are assessed with up-to-date medical-scientific evidence. The Authority revoked the previous Statement of Principles concerning accommodation disorder and has established a new Statement of Principles to reflect current understandings of the condition's relation to various types of service. This revision follows an investigation initiated in 2007, which involved examining the latest evidence and consulting relevant stakeholders, though no submissions were received. The new instrument incorporates changes such as updating the format and definitions, and specifies the service types that must be considered when evaluating claims for accommodation disorder.
Scope and Application
The Repatriation Medical Authority Instrument No. 5 of 2009 under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 addresses the medical condition known as accommodation disorder, including its relation to death from accommodation disorder. This legislation applies to individuals who have served in various capacities, such as operational, peacekeeping, and hazardous service under the VEA, and warlike and non-warlike service under the MRCA. The instrument is designed to assist in determining claims for compensation related to these conditions, particularly for service injuries, diseases, or deaths occurring on or after 1 July 2004, as assessed by the Military Rehabilitation and Compensation Commission. The instrument outlines the medical and service-related factors that must be considered to establish a connection between the service rendered and the condition in question, thereby facilitating the acceptance of liability for compensation claims. The instrument supersedes the previous Instrument No. 296 of 1995, and it incorporates updates to terminology and definitions to reflect the latest medical-scientific evidence and legislative changes.
Key Provisions
The Repatriation Medical Authority, under the authority of subsection 196B(8) of the Veterans' Entitlements Act 1986 (VEA), has revoked Instrument No. 296 of 1995 concerning accommodation disorder and death from accommodation disorder. This revocation is pursuant to subsection 196B(2) of the VEA and is based on new medical-scientific evidence suggesting a connection between these conditions and particular types of military service. In its place, the Authority has issued Instrument No. 5 of 2009, a Statement of Principles detailing the minimum factors that must exist and be related to the service rendered by a person to establish a reasonable hypothesis linking accommodation disorder or death from accommodation disorder to their service circumstances. These service types include operational, peacekeeping, hazardous, warlike, and non-warlike services under the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA).
The Statement of Principles serves as a critical guideline for determining claims for compensation under the MRCA, particularly for injuries, diseases, or deaths occurring on or after 1 July 2004. It outlines the necessary medical and service-related factors that must be considered when assessing claims for acceptance of liability. This new instrument adopts a revised format that aligns with the commencement of the MRCA, clarifying that it applies for the purposes of both the VEA and the MRCA. The Authority has updated definitions and added new factors, such as those concerning injuries or disorders affecting the function of the oculomotor nerve or ciliary muscle of the affected eye, to reflect the latest medical-scientific evidence.
The Repatriation Medical Authority has imposed certain obligations on parties involved in the claims process. It has mandated that claims under section 319 of the MRCA for service injuries, diseases, or deaths occurring on or after 1 July 2004 must be assessed using the Statements of Principles issued by the Authority. Additionally, the Authority is required to ensure that these Statements of Principles are based on sound medical-scientific evidence. The Authority must also provide a list of references related to the condition upon written request, ensuring transparency and accessibility of the evidence base for stakeholders.
Breach of the provisions outlined in the new Instrument No. 5 of 2009 does not explicitly detail specific offences or penalties. However, failure to adhere to the Statement of Principles could result in the invalidity of compensation claims under the MRCA, thereby denying eligible veterans and their dependants rightful benefits. The consequences of non-compliance are primarily civil, affecting the legitimacy and success of claims rather than involving criminal sanctions. The Authority's role is to ensure that all claims are assessed in accordance with the established medical and service-related criteria, thereby maintaining the integrity of the compensation process.