Statement of Principles concerning acute pancreatitis (Reasonable Hypothesis) (No. 5 of 2020)

Administered by Department of Veterans' Affairs

Legislation au F2020L00211 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

ACUTE PANCREATITIS

(REASONABLE HYPOTHESIS) (NO. 5 OF 2020)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning acute pancreatitis (Reasonable Hypothesis) (No. 5 of 2020).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 85 of 2011 (Federal Register of Legislation No. F2011L01442) determined under subsection 196B(2) of the VEA concerning acute pancreatitis.

3.             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 concerning acute pancreatitis (Reasonable Hypothesis) (No. 5 of 2020).  This Instrument will in effect replace the repealed Statement of Principles.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 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;

 British nuclear test defence 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.  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 6 November 2018 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.

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 definition of 'acute pancreatitis' in subsection 7(2);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factor in subsection 9(1) concerning smoking;
  • revising the factor in subsection 9(2) concerning alcohol;
  • revising the factor in subsection 9(4) concerning biliary microlithiasis or biliary sludge, with the inclusion of a note;
  • revising the factor in subsection 9(5) concerning pancreatic outflow obstruction, with the inclusion of a note;
  • revising the factor in subsection 9(6) concerning penetrating or major blunt trauma;
  • new factor in subsection 9(7) concerning spinal cord injury;
  • new factor in subsection 9(8) concerning undergoing a procedure;
  • revising the factor in subsection 9(10) concerning a course of peritoneal dialysis or haemodialysis;
  • revising the factor in subsection 9(11) concerning solid organ transplant;
  • revising the factor in subsection 9(12) concerning being treated with a drug or a drug from a class of drugs;
  • revising the factor in subsection 9(13) concerning being treated with a drug which is associated in the individual with specified requirements;
  • new factor in subsection 9(14) concerning diabetes mellitus;
  • revising the factor in subsection 9(15) concerning having hypertriglyceridaemia;
  • revising the factor in subsection 9(17) concerning having a disease;
  • revising the factor in subsection 9(19) concerning acute infection with an organism;
  • revising the factor in subsection 9(20) concerning infection with human immunodeficiency virus;
  • revising the factor in subsection 9(21) concerning an infestation;
  • revising the factor in subsection 9(22) concerning being envenomated by a snake or scorpion;
  • revising the factor in subsection 9(23) concerning acute toxicity after oral ingestion of mushrooms, with the inclusion of a note;
  • revising the factor in subsection 9(24) concerning ingesting an agent;
  • new factor in subsection 9(25) concerning being obese, for severe acute pancreatitis only;
  • deleting the factor concerning undergoing intra-abdominal or intrathoracic surgery, as it is subsumed by the factor in subsection 9(8) concerning undergoing a procedure;
  • deleting the factor concerning ascariasis or clonorchiasis, as it is subsumed by the factor in subsection 9(21) concerning an infestation;
  • new definitions of 'acute infection with an organism', 'being obese', 'BMI', 'MRCA', 'pancreatic outflow obstruction', 'severe acute pancreatitis', 'specified list of agents', 'specified list of diseases', 'specified list of drugs', 'specified list of infestations', 'specified list of procedures' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definitions of 'pack-years of cigarettes, or the equivalent thereof in other tobacco products' and 'relevant service' in Schedule 1 - Dictionary; and
  • deleting the definitions of 'a disease from the specified list', 'acute infection with an organism from the specified list', 'an agent from the specified list', 'being treated with a drug from the specified table' and 'pancreatic outflow obstruction due to a disorder from the specified list'.

Consultation

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 6 November 2018, 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

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 acute pancreatitis as advertised in the Government Notices Gazette of 6 November 2018.

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. 5 of 2020

Kind of Injury, Disease or Death: Acute pancreatitis

 

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(2) 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 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 pancreatitis;
  • 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 as a minimum exist, before it can be said that a reasonable hypothesis has been raised, connecting acute pancreatitis with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 85 of 2011; and
  • reflects developments in the available sound medical-scientific evidence concerning acute pancreatitis 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 pancreatitis (Reasonable Hypothesis) (No. 5 of 2020) was enacted to address the gap in the existing medical-scientific evidence concerning the connection between acute pancreatitis and certain types of service, particularly those rendered under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). This instrument was developed by the Repatriation Medical Authority, acting under the authority of the VEA, to provide a framework for assessing claims related to acute pancreatitis. The primary objective of this instrument is to ensure that the qualifying conditions for benefits are reasonable, proportionate, and transparent, thereby facilitating the assessment and determination of social security benefits and compensation for veterans and Defence Force members who have suffered from acute pancreatitis. This instrument is designed to assist both claimants and the Repatriation Commission in evaluating claims under the VEA and MRCA by specifying the circumstances in which medical treatment and compensation can be provided to eligible persons with acute pancreatitis. It also facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal. The Statement of Principles replaces the earlier Instrument No. 85 of 2011 and incorporates the latest sound medical-scientific evidence concerning acute pancreatitis. This instrument promotes several human rights, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health, while ensuring these rights are exercised without discrimination.

Scope and Application

The Statement of Principles concerning acute pancreatitis (Reasonable Hypothesis) (No. 5 of 2020) applies to veterans, current and former Defence Force members, and other persons such as their dependents, who are eligible under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). This Statement of Principles outlines the medical and scientific criteria that must be satisfied to establish a reasonable hypothesis connecting acute pancreatitis or death from acute pancreatitis with particular kinds of service. It applies to operational, peacekeeping, hazardous, and British nuclear test defence service under the VEA, and to warlike and non-warlike service under the MRCA. The principles are designed to facilitate claims for medical treatment and compensation for those affected by acute pancreatitis, and to assist the Repatriation Commission in assessing these claims. The scope of the Act is national, applying across Australia under the Commonwealth jurisdiction. There are no specific exclusions mentioned, but the criteria must be met to establish the required connection between the service and the condition. The Act may be extended or restricted through subordinate instruments, but no such instruments are mentioned in the provided text.

Key Provisions

The main operative sections of the Statement of Principles concerning acute pancreatitis (Reasonable Hypothesis) (No. 5 of 2020) outline the factors that must exist to connect acute pancreatitis or death from acute pancreatitis to certain kinds of service rendered by a person. This includes operational, peacekeeping, hazardous, and British nuclear test defence service under the Veterans' Entitlements Act 1986 (VEA), and warlike and non-warlike service under the Military Rehabilitation and Compensation Act 2004 (MRCA) (sections 5 and 7). The Instrument also includes definitions of terms used throughout (Schedule 1 – Dictionary). These provisions are designed to facilitate claimants in making, and the Repatriation Commission in assessing, claims under the VEA and MRCA respectively, by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have acute pancreatitis (Overview of the Legislative Instrument, paragraphs 1 and 2). The Statement of Principles imposes obligations on the parties it governs by requiring that the specified factors must be related to the service rendered by the person for a reasonable hypothesis to be raised connecting acute pancreatitis or death from acute pancreatitis with that service (section 5). It also requires the Repatriation Medical Authority to determine these Statements of Principles on the available sound medical-scientific evidence, and to revise them as necessary (subsection 196B(2) of the VEA). The Act includes potential consequences for breach, though specific offences, penalties, or civil/criminal consequences are not detailed within the Statement of Principles itself. However, general provisions within the VEA and MRCA provide for penalties for fraudulent claims or misrepresentation, which could include fines or imprisonment. The Act does not specify maximum penalties within the Statement of Principles but references the broader Acts for such details (subsection 196B(8) of the VEA). The compatibility statement confirms that this Legislative Instrument is compatible with human rights, does not derogate from any human rights, and promotes several human rights, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health (Statement of Compatibility with Human Rights, paragraphs 3 and 4).

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