REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 97 of 2015
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. 38 of 2007, determined under subsection 196B(3) of the VEA concerning Achilles tendinopathy and bursitis.
- The Authority is of the view that there is sound medical-scientific evidence that indicates that Achilles tendinopathy and bursitis and death from Achilles tendinopathy and bursitis 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 Achilles tendinopathy and bursitis (Balance of Probabilities) (No. 97 of 2015). This Instrument will in effect replace the revoked Statement of Principles.
Purpose and Operation
3. The Statement of Principles will be applied in determining claims under the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).
4. 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, Achilles tendinopathy or bursitis or death from Achilles tendinopathy or bursitis 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.
5. This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 31 October 2012 concerning Achilles tendinopathy and bursitis 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 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 'Achilles tendinopathy' in subsection 7(2);
- new factors in subsections 9(1) & 9(11) concerning 'running or jogging';
- revising factors in subsections 9(2) & 9(12) concerning 'weight bearing exercise';
- new factors in subsections 9(3) & 9(13) concerning 'increasing the frequency, duration or intensity of weight bearing activity';
- revising factors in subsections 9(4) & 9(14) concerning 'systemic arthritic diseases';
- revised factors in subsections 9(5) & 9(15) concerning 'significant biomechanical abnormality';
- new factors in subsections 9(7) & 9(17) concerning 'glucocorticoid drugs';
- new factor in subsection 9(18) concerning 'glucocorticoid injection', for clinical worsening only;
- new factors in subsections 9(8) & 9(19) concerning 'being obese';
- new factors in subsections 9(9) & 9(20) concerning 'diabetes mellitus';
- new factors in subsections 9(10) & 9(21) concerning 'an aromatase inhibitor';
- new definitions of 'being obese', 'glucocorticoid drug as specified', 'MRCA', 'specified list of systemic arthritic diseases' and 'VEA' in Schedule 1 - Dictionary;
- revising the definitions of 'relevant service' and 'significant biomechanical abnormality' in Schedule 1 - Dictionary; and
- deleting the definitions of 'a systemic arthritic disease' and 'reactive arthropathy'.
Consultation
7. Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to Achilles tendinopathy and bursitis in the Government Notices Gazette of 31 October 2012, 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
8. 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
9. The determining of this Instrument finalises the investigation in relation to Achilles tendinopathy and bursitis as advertised in the Government Notices Gazette of 31 October 2012.
References
10. 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. 97 of 2015
Kind of Injury, Disease or Death: Achilles tendinopathy and bursitis
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 Achilles tendinopathy or bursitis;
- 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, Achilles tendinopathy or bursitis is connected with the circumstances of eligible service rendered by a person, as set out in clause 4 of the Explanatory Notes;
- replaces Instrument No. 38 of 2007; and
- reflects developments in the available sound medical-scientific evidence concerning Achilles tendinopathy and bursitis 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.