Statement of Principles concerning acute rheumatic fever (Balance of Probabilities) (No. 54 of 2019)

Administered by Department of Veterans' Affairs

Legislation au F2019L00642 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

ACUTE RHEUMATIC FEVER

(BALANCE OF PROBABILITIES) (NO. 54 OF 2019)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning acute rheumatic fever (Balance of Probabilities) (No. 54 of 2019).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 24 of 2011 (Federal Register of Legislation No. F2011L00504) determined under subsection 196B(3) of the VEA concerning acute rheumatic fever.

3.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that acute rheumatic fever and death from acute rheumatic fever 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 rheumatic fever (Balance of Probabilities) (No. 54 of 2019).  This Instrument will in effect replace the repealed Statement of Principles.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 rheumatic fever or death from acute rheumatic fever 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 8 May 2018 concerning acute rheumatic fever 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 rheumatic fever' in subsection 7(2);
  • new factor in subsection 9(2) concerning 'a group A beta-haemolytic streptococcal infection of the skin or the pharynx', for acute rheumatic fever manifesting as isolated chorea or as indolent subclinical carditis only;
  • revising the factor in subsection 9(3) concerning 'crowded living or working conditions';
  • new definitions of 'MRCA' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definition of 'relevant service' in Schedule 1 - Dictionary; and
  • deleting the definition of 'group A beta-haemolytic streptococcal infection'.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to acute rheumatic fever in the Government Notices Gazette of 8 May 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 during 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 rheumatic fever as advertised in the Government Notices Gazette of 8 May 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. 54 of 2019

Kind of Injury, Disease or Death: Acute rheumatic fever

 

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).  Part XIA of the VEA requires the determination of these instruments outlining the factors linking 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 rheumatic fever;
  • 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 rheumatic fever 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. 24 of 2011; and
  • reflects developments in the available sound medical-scientific evidence concerning acute rheumatic fever 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 Rheumatic Fever (Balance of Probabilities) (No. 54 of 2019) was introduced to address the need for updated medical-scientific evidence regarding the connection between acute rheumatic fever and certain types of service rendered by individuals. Enacted under the authority of the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, this legislative instrument was determined by the Repatriation Medical Authority, which found that it is more probable than not that acute rheumatic fever and death from acute rheumatic fever can be linked to particular kinds of service. This Statement of Principles is intended to assist in the determination of claims under the aforementioned Acts by outlining the necessary factors for such a connection to be established, thereby facilitating the provision of medical treatment and compensation to eligible individuals. The instrument was developed following an investigation into acute rheumatic fever, which involved a comprehensive review of available medical-scientific evidence, and it serves to replace the previous Statement of Principles No. 24 of 2011, reflecting more recent scientific understanding.

Scope and Application

The Statement of Principles concerning acute rheumatic fever (Balance of Probabilities) (No. 54 of 2019) applies to the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. It pertains to individuals who have served in eligible war service, defence service, or peacetime service and who may have developed acute rheumatic fever or died from it. The Statement of Principles outlines the factors that must exist for it to be considered probable that the condition is connected to the service rendered. The legislation serves to facilitate claims and the assessment of such claims by the Repatriation Commission and Military Rehabilitation and Compensation Commission, respectively, while also ensuring that the review of these decisions is managed by the Veterans' Review Board and the Administrative Appeals Tribunal. The instrument does not specify any exclusions, exemptions, or thresholds but rather provides a framework based on available sound medical-scientific evidence. Any further extension or restriction of its application would typically be managed through subordinate instruments, as permitted by the Acts themselves.

Key Provisions

The main operative sections of the Statement of Principles concerning acute rheumatic fever (Balance of Probabilities) (No. 54 of 2019) involve the determination of specific factors that must exist for acute rheumatic fever or death from acute rheumatic fever to be considered connected with particular kinds of service under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) (sections 4-10). These factors include the nature of the service rendered, the conditions under which the service was performed, and the medical-scientific evidence supporting a connection between the service and the condition. This Statement of Principles aims to guide the Repatriation Commission in assessing claims and to facilitate the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal. The Act imposes obligations on various parties, including the Repatriation Medical Authority (the Authority), the Repatriation Commission, and claimants. The Authority must determine the Statement of Principles based on the available sound medical-scientific evidence, ensuring that the factors specified are necessary for a connection to be made between service and acute rheumatic fever. The Repatriation Commission must apply these principles when assessing claims under the VEA and MRCA. Claimants, in turn, must provide evidence that satisfies the criteria outlined in the Statement of Principles to substantiate their claims for medical treatment and compensation. Breach of the obligations under the VEA and MRCA can result in civil consequences for claimants, including the denial of claims if the required factors are not demonstrated. Additionally, while the Statement of Principles itself does not create specific offences or criminal penalties, any fraudulent claims or misrepresentations made during the claims process could lead to criminal charges under general laws concerning fraud and misrepresentation. The Authority’s determination of the Statement of Principles is subject to review and appeal processes, which provide mechanisms for addressing any perceived errors or injustices in the application of the principles.

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.