Statement of Principles concerning acute pancreatitis No. 85 of 2011

Administered by Department of Veterans' Affairs

Legislation au F2011L01442 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

INSTRUMENT NO. 85 of 2011

 

VETERANS’ ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

EXPLANATORY NOTES FOR TABLING

 

 

  1. The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), revokes Instrument No. 45 of 1997, as amended by Instrument No. 74 of 1998 and Instrument No. 41 of 2003, determined under subsection 196B(2) of the VEA concerning acute pancreatitis.

 

2.             The Authority is of the view that there is sound medical-scientific evidence that indicates that acute pancreatitis and death from acute pancreatitis 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. 85 of 2011 concerning acute pancreatitis.  This Instrument will in effect replace the revoked Statements 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 acute pancreatitis or death from acute pancreatitis, with the circumstances of that service.

 

5.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 25 June 2008 concerning acute pancreatitis 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 Instruments.  Comparing this Instrument 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 'acute pancreatitis' in clause 3;
  • revising factor 6(a) concerning 'cholelithiasis';
  • new factor 6(b) concerning 'biliary microlithiasis or biliary sludge';
  • revising factor 6(c) concerning 'drinking alcohol';
  • revising factor 6(d) concerning 'acute infection with an organism from the specified list';
  • revising factor 6(e) concerning 'ascariasis or clonorchiasis';
  • revising factor 6(f) concerning 'human immunodeficiency virus';
  • revising factor 6(g) concerning 'pancreatic outflow obstruction';
  • revising factor 6(h) concerning 'a drug from the specified table';
  • new factor 6(i) concerning 'being treated with a drug';
  • new factor 6(j) concerning 'smoking';
  • revising factor 6(k) concerning 'intra-abdominal or intrathoracic surgery';
  • revising factor 6(l) concerning 'solid organ transplantation';
  • revising factor 6(m) concerning 'penetrating or major blunt trauma';
  • revising factor 6(n) concerning 'endoscopic retrograde cholangio-pancreatography, endoscopic sphincterotomy or manometry';
  • revising factor 6(o) concerning 'hypertriglyceridaemia';
  • revising factor 6(p) concerning 'hypercalcaemia';
  • new factor 6(q) concerning 'a disease from the specified list' which subsumes the previous factor concerning 'systemic vasculitis';
  • revising factor 6(r) concerning 'envenomation by a snake or scorpion';
  • revising factor 6(s) concerning 'oral ingestion of mushrooms containing alpha-amanitin';
  • new factor 6(t) concerning 'ingesting an agent from the specified list', which subsumes the previous factors concerning 'oral ingestion of methyl alcohol', 'oral ingestion of organophosphorus or carbamate insecticides' and 'paracetamol overdose';
  • revising factor 6(u) concerning 'a disorder resulting in disseminated intravascular coagulation and/or profound systemic hypotension';
  • new factor 6(v) concerning 'a course of peritoneal dialysis';
  • new definitions of 'a disease from the specified list', 'a snake or scorpion from the specified list', 'an agent from the specified list', 'being treated with a drug from the specified table', 'biliary microlithiasis or biliary sludge', 'ICD-10-AM code' and 'pack-years of cigarettes, or the equivalent thereof in other tobacco products' in clause 9;
  • revising definitions of 'acute infection with an organism from the specified list', 'pancreatic outflow obstruction due to a disorder from the specified list' and 'relevant service' in clause 9;
  • deleting definitions of 'a disorder resulting in disseminated intravascular coagulation and/or profound systemic hypotension', 'ascariasis', 'being infected with human immunodeficiency virus (HIV)', 'cholelithiasis', 'clonorchiasis', 'endoscopic retrograde cholangio-pancreatography (ERCP)', 'endoscopic sphincterotomy (of the sphincter of Oddi)', 'hypercalcaemia', 'ICD code', 'manometry of the sphincter of Oddi', 'methyl alcohol', 'organophosphorus or carbamate insecticides', 'penetrating or major blunt trauma' and 'systemic vasculitis' from Clause 9;
  • deleting the Schedule from Clause 9; 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 acute pancreatitis in the Government Notices Gazette of 25 June 2008, 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 Instrument finalises the investigation in relation to acute pancreatitis as advertised in the Government Notices Gazette of 25 June 2008.

 

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 Secretariat

GPO Box 1014

BRISBANE    QLD    4001

Overview

The Repatriation Medical Authority Instrument No. 85 of 2011, issued under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), addresses the issue of defining the medical criteria for claims related to acute pancreatitis in Australian military personnel. The Authority, exercising its powers under the VEA, revoked the previous Instrument No. 45 of 1997, which was amended by Instruments No. 74 of 1998 and No. 41 of 2003. This new Instrument, based on recent medical-scientific evidence, establishes a Statement of Principles that outlines the factors necessary to link acute pancreatitis or death from acute pancreatitis to specific military services, including operational, peacekeeping, and hazardous services under the VEA, and warlike and non-warlike services under the MRCA. The Instrument incorporates changes to definitions, factors, and the format of the Instrument to reflect the current legislative framework and to ensure clarity in the determination of compensation claims for military personnel.

Scope and Application

The Repatriation Medical Authority Instrument No. 85 of 2011, concerning acute pancreatitis, applies to veterans and service personnel under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). Specifically, it governs claims for compensation related to acute pancreatitis or death from acute pancreatitis that are linked to operational service, peacekeeping service, hazardous service, warlike service, or non-warlike service. The Instrument establishes a Statement of Principles that outlines the necessary factors for such claims, including various medical conditions and circumstances that must be related to the service rendered. The Instrument revokes previous Statements of Principles concerning acute pancreatitis and replaces them with updated criteria, reflecting the latest medical-scientific evidence. It is applicable nationally and is determined by the Military Rehabilitation and Compensation Commission for claims initiated on or after 1 July 2004. The Instrument does not explicitly state any exclusions, exemptions, or thresholds but provides a detailed list of factors and conditions that must be considered in the determination of claims. Any further specifications or clarifications are subject to subordinate instruments issued under the authority of the VEA and MRCA.

Key Provisions

The Repatriation Medical Authority (the Authority) has issued Instrument No. 85 of 2011 under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) to address claims related to acute pancreatitis. This Instrument revokes the previous Instrument No. 45 of 1997 and subsequent amendments, replacing them with a new Statement of Principles concerning acute pancreatitis. This Statement outlines the necessary conditions that must exist, and which must be related to specific types of service, for a reasonable hypothesis to connect acute pancreatitis or death from acute pancreatitis with the circumstances of that service. The Statement of Principles delineates the types of service that can be linked to acute pancreatitis, including operational, peacekeeping, and hazardous service under the VEA, as well as warlike and non-warlike service under the MRCA. To establish a connection between the service and the condition, certain factors must be considered. These factors include medical conditions such as cholelithiasis, biliary microlithiasis, and biliary sludge; lifestyle factors like alcohol consumption, smoking, and drug use; and medical procedures such as surgery or transplantation. The new Instrument revises and updates these factors based on the latest medical evidence. The Authority's determination imposes specific obligations on claimants and service personnel. Claimants must demonstrate that their acute pancreatitis or death from the condition is connected to their service, by providing evidence that meets the criteria outlined in the Statement of Principles. Service personnel and their representatives must ensure that all relevant medical and service records are available for review by the Authority to substantiate their claims. Additionally, the Authority is obligated to consider all submissions and evidence provided during the investigation and to make a determination that is consistent with the medical-scientific evidence available. There are no direct offences, penalties, or consequences specified within this Instrument itself. However, failure to comply with the requirements of the VEA and MRCA, or providing false or misleading information, could result in legal consequences under those Acts. For instance, making false statements in a claim could lead to civil penalties or criminal charges. The Authority also has the power to recover overpayments made under the Acts, and failure to repay such amounts could result in additional financial penalties. The maximum penalties for these offences are stipulated in the respective Acts and can include fines and imprisonment.

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