Statement of Principles concerning acute lymphoblastic leukaemia/lymphoblastic lymphoma (Balance of Probabilities) (No. 34 of 2021)

Administered by Department of Veterans' Affairs

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EXPLANATORY STATEMENT

 

Statement of Principles concerning

ACUTE LYMPHOBLASTIC LEUKAEMIA/LYMPHOBLASTIC LYMPHOMA

(Balance of PROBABILITIES) (NO. 34 OF 2021)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning acute lymphoblastic leukaemia/lymphoblastic lymphoma (Balance of Probabilities) (No. 34 of 2021).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 76 of 2012 (Federal Register of Legislation No. F2012L02086) determined under subsections 196B(3) and (8) of the VEA concerning acute lymphoblastic leukaemia.

3.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that acute lymphoblastic leukaemia/lymphoblastic lymphoma and death from acute lymphoblastic leukaemia/lymphoblastic lymphoma 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 acute lymphoblastic leukaemia/lymphoblastic lymphoma (Balance of Probabilities) (No. 34 of 2021).  This Instrument will in effect replace the repealed Statement of Principles.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, acute lymphoblastic leukaemia/lymphoblastic lymphoma or death from acute lymphoblastic leukaemia/lymphoblastic lymphoma 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 23 April 2020 concerning acute lymphoblastic leukaemia 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 repealed Instrument.  Comparing this Instrument and the repealed 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 name of the condition from 'acute lymphoblastic leukaemia' to 'acute lymphoblastic leukaemia/lymphoblastic lymphoma';
  • new definition of 'acute lymphoblastic leukaemia/lymphoblastic lymphoma' in subsection 7(2);
  • revising the factor in subsection 9(1) concerning having received ionising radiation to the bone marrow, for clinical onset only, by the inclusion of a note;
  • revising the factor in subsection 9(2) concerning taking an alkylating agent or a DNA topoisomerase II inhibitor for the treatment of a malignant neoplasm, for clinical onset only;
  • revising the factor in subsection 9(3) concerning undergoing organ or tissue transplantation, excluding corneal transplant, for clinical onset only;
  • new definitions of 'MRCA', 'organ or tissue transplantation' and 'VEA' in Schedule 1 - Dictionary; and
  • revising the definition of 'relevant service' in Schedule 1 - Dictionary.

Incorporation

8.             The definition of "cumulative equivalent dose" contained in the Schedule 1 – Dictionary incorporates the Guide to calculation of 'cumulative equivalent dose' for the purpose of applying ionising radiation factors contained in Statements of Principles determined under Part XIA of the Veterans' Entitlements Act 1986 (Cth), Australian Radiation Protection and Nuclear Safety Agency, as in force on 2 August 2017.  This writing is incorporated pursuant to subsection 14(b) of the Legislation Act 2003.

9.             A copy of this document is available to any person on the website of the Repatriation Medical Authority at www.rma.gov.au or from the Repatriation Medical Authority, Level 8, 259 Queen St, Brisbane, Queensland 4000, by contacting the Registrar on telephone (07) 3815 9404.

Consultation

10.         Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to acute lymphoblastic leukaemia in the Government Notices Gazette of 23 April 2020, 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, the Military Rehabilitation and Compensation 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 in relation to the investigation.

Human Rights

11.         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

12.         The determining of this Instrument finalises the investigation in relation to acute lymphoblastic leukaemia as advertised in the Government Notices Gazette of 23 April 2020.

References

13.         A list of references relating to the above condition is available on the Authority’s website at: www.rma.gov.au. Any other document referred to in this Statement of Principles is available on request to the Repatriation Medical Authority at the following address:

              

Email:    info@rma.gov.au

Post:      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. 34 of 2021

Kind of Injury, Disease or Death: Acute lymphoblastic leukaemia/lymphoblastic lymphoma

 

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(3) 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 connecting 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 and the Military Rehabilitation and Compensation 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 acute lymphoblastic leukaemia/lymphoblastic lymphoma;
  • 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, acute lymphoblastic leukaemia/lymphoblastic lymphoma 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. 76 of 2012; and
  • reflects developments in the available sound medical-scientific evidence concerning acute lymphoblastic leukaemia/lymphoblastic lymphoma 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 Acute Lymphoblastic Leukaemia/Lymphoblastic Lymphoma (Balance of Probabilities) (No. 34 of 2021) was enacted to address the gap in medical evidence linking acute lymphoblastic leukaemia/lymphoblastic lymphoma to particular kinds of service as stipulated under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). This legislative instrument was determined by the Repatriation Medical Authority (the Authority) under subsection 196B(3) of the VEA. It aims to facilitate the claims process for veterans and service personnel by setting out the factors that must exist to establish a connection between acute lymphoblastic leukaemia/lymphoblastic lymphoma and the service rendered, thereby ensuring that compensation and medical treatment are extended appropriately. This legislative instrument replaces the previous Instrument No. 76 of 2012 and incorporates updated medical-scientific evidence. The Authority's determination, in line with the sound medical-scientific evidence available, indicates that it is more probable than not that acute lymphoblastic leukaemia/lymphoblastic lymphoma and death from this condition can be related to specific kinds of service. This determination was finalised after an investigation that involved an examination of the available evidence and resulted in the creation of a Statement of Principles for both the VEA and the MRCA. The new instrument not only reflects the latest medical evidence but also adopts a revised Instrument format, updates the name of the condition, and revises certain definitions and factors to improve clarity and accuracy in the claims process.

Scope and Application

The Statement of Principles concerning acute lymphoblastic leukaemia/lymphoblastic lymphoma (Balance of Probabilities) (No. 34 of 2021) applies to individuals making claims under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). It sets out the conditions under which a claimant can establish a connection between their service and acute lymphoblastic leukaemia/lymphoblastic lymphoma on the balance of probabilities. The Act applies to eligible war service, defence service, and peacetime service as defined under the respective Acts. The geographical reach of the Act is national, as it pertains to veterans and service members across Australia. The Act does not specify exclusions, exemptions, or thresholds but instead outlines specific factors that must be met for a claim to be considered valid. The application of the Act can be extended or restricted through subordinate instruments, which are not detailed in the provided text. This Legislative Instrument is designed to assist claimants and relevant authorities in assessing claims for benefits related to acute lymphoblastic leukaemia/lymphoblastic lymphoma. It ensures that the assessment process is based on the latest medical-scientific evidence available, thereby improving the quality of medico-scientific outcomes under the VEA and MRCA. The Instrument also promotes various human rights, including the right to social security, an adequate standard of living, and the highest attainable standard of health, without discrimination. This ensures that the rights of veterans, current and former Defence Force members, and their dependents are protected and upheld in the claims process.

Key Provisions

The main operative sections of the Statement of Principles concerning acute lymphoblastic leukaemia/lymphoblastic lymphoma (Balance of Probabilities) (No. 34 of 2021) include the determination of the factors that must exist for acute lymphoblastic leukaemia/lymphoblastic lymphoma or death from acute lymphoblastic leukaemia/lymphoblastic lymphoma to be considered connected with the circumstances of service under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) (sections 5 and 9). This Statement of Principles also incorporates definitions and terms relevant to the legislation, such as "cumulative equivalent dose" and "relevant service" (Schedule 1 - Dictionary). The Statement of Principles imposes obligations on claimants, the Repatriation Commission, and the Military Rehabilitation and Compensation Commission to ensure that claims under the VEA and MRCA are assessed in accordance with the specified factors connecting the disease with service. It also requires the Repatriation Medical Authority to facilitate the review of decisions by the Veterans' Review Board and the Administrative Appeals Tribunal. The obligations extend to ensuring that the determination of the Statement of Principles is based on sound medical-scientific evidence and that it reflects any developments in this evidence since the previous instrument was determined. The Statement of Principles does not explicitly outline specific offences, penalties, or civil/criminal consequences for breach. However, the nature of the instrument implies that failure to comply with the determined factors for assessing claims could lead to the denial of benefits and compensation. The determination of the Statement of Principles is designed to ensure that claims are assessed fairly and in accordance with the sound medical-scientific evidence available. The instrument does not detail specific penalties for non-compliance but implies that adherence to the determined factors is crucial for the proper administration of benefits under the VEA and MRCA. The Authority has ensured that the Statement of Principles is compatible with human rights, promoting the rights of veterans, current and former Defence Force members, and their dependents. It does not derogate from any human rights and facilitates the assessment and determination of social security benefits, compensation, and treatment and rehabilitation benefits. The instrument's aim is to ensure that the qualifying conditions for benefits are reasonable, proportionate, and transparent, facilitating the enjoyment of the highest attainable standard of physical and mental health. In summary, the Statement of Principles concerning acute lymphoblastic leukaemia/lymphoblastic lymphoma (Balance of Probabilities) (No. 34 of 2021) outlines the factors that must be present for the disease to be connected with service under the VEA and MRCA. It imposes obligations on claimants, the Repatriation Commission, the Military Rehabilitation and Compensation Commission, and the Repatriation Medical Authority to ensure that claims are assessed in accordance with the determined factors. While it does not detail specific penalties for non-compliance, adherence to the determined factors is crucial for the proper administration of benefits. The instrument is compatible with human rights, promoting the rights of veterans, current and former Defence Force members, and their dependents.

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