REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 17 of 2008
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. 76 of 1998 determined under subsection 196B(2) of the VEA concerning alcohol dependence or alcohol abuse and death from alcohol dependence or alcohol abuse.
2. The Authority is of the view that there is sound medical-scientific evidence that indicates that alcohol dependence and alcohol abuse and death from alcohol dependence and alcohol abuse 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. 17 of 2008 concerning alcohol dependence and alcohol abuse. This Instrument will in effect replace the revoked Statement 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 alcohol dependence and alcohol abuse or death from alcohol dependence and alcohol abuse, with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 8 November 2006 concerning alcohol dependence or alcohol abuse 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 the new Instrument are in similar terms as the revoked Instrument. Comparing the new 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;
- changing the name of the Instrument from 'alcohol dependence or alcohol abuse' to 'alcohol dependence and alcohol abuse'
- revising the definition of 'alcohol dependence and alcohol abuse' in clause 3;
- revising factors 6(a) & 6(e) concerning 'clinically significant psychiatric condition';
- revising factors 6(b) & 6(f) concerning 'category 1A stressor';
- new factors 6(c) & 6(g) concerning 'category 1B stressor';
- new factors 6(d) & 6(h) concerning 'a significant other';
- new definitions of 'a clinically significant psychiatric condition', 'a category 1A stressor', 'a category 1B stressor', 'a significant other', 'an eyewitness', and 'DSM-IV-TR' in clause 9;
- revising definition of 'relevant service' in clause 9;
- deleting definitions of 'DSM-IV', 'experiencing a severe stressor', 'ICD-9-CM code' and 'psychiatric disorder'; and
- specifying a date of effect for the Instrument in clause 11.
7. This new instrument incorporates by reference the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), American Psychiatric Association, Washington DC 2000. A copy of this document is available from the offices of the Repatriation Medical Authority, Level 8, Bank of Queensland Building, 259 Queen St, Brisbane Queensland 4000, by contacting the Registrar on telephone (07) 3815 9404.
8. 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.
9. Prior to determining this instrument, the Authority advertised its intention to undertake an investigation in relation to alcohol dependence or alcohol abuse in the Government Notices Gazette of 8 November 2006, 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.
10. The determining of this new instrument finalises the investigation in relation to alcohol dependence or alcohol abuse as advertised in the Government Notices Gazette of 8 November 2006.
11. A list of references relating to the above condition is available, on written request, from the Repatriation Medical Authority Secretariat.
Overview
The Repatriation Medical Authority Instrument No. 17 of 2008, which amends the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, was enacted to address the issue of alcohol dependence and alcohol abuse among veterans and service personnel, particularly in relation to their service. The Authority, under the provisions of the VEA, has determined a new Statement of Principles to replace the revoked Instrument No. 76 of 1998, reflecting the latest medical-scientific evidence and the revised legal framework under the MRCA. This instrument aims to provide clearer criteria for linking alcohol dependence and alcohol abuse with specific types of service, including operational, peacekeeping, and hazardous service, ensuring that veterans can seek appropriate compensation and rehabilitation benefits. The process involved an investigation and public consultation, although no submissions were received, culminating in the finalisation of the instrument and the formalisation of the connection between service conditions and alcohol-related issues.
Scope and Application
The Repatriation Medical Authority Instrument No. 17 of 2008, under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, establishes a Statement of Principles concerning alcohol dependence and alcohol abuse. This instrument applies to individuals who have served in operational, peacekeeping, hazardous, warlike, or non-warlike service and who are seeking compensation for alcohol dependence or alcohol abuse related to their service. The instrument sets out the minimum factors that must exist for a reasonable hypothesis to be raised connecting alcohol dependence, alcohol abuse, or death from alcohol dependence and alcohol abuse with the circumstances of their service. The instrument is applicable nationally and replaces the previously revoked Instrument No. 76 of 1998. The Authority determines these Statements of Principles, which are used by the Military Rehabilitation and Compensation Commission to assess claims for compensation that commenced on 1 July 2004. The instrument incorporates the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), and further changes reflect the commencement of the MRCA and clarify the instrument’s applicability under both the VEA and the MRCA.
Key Provisions
The Repatriation Medical Authority (the Authority) under the Veterans' Entitlements Act 1986 (VEA) has revoked Instrument No. 76 of 1998 concerning alcohol dependence or alcohol abuse and death from alcohol dependence or alcohol abuse (section 1). In its place, the Authority has issued Instrument No. 17 of 2008, establishing a new Statement of Principles (section 2). This new instrument addresses alcohol dependence and alcohol abuse as it relates to various kinds of service, including operational, peacekeeping, hazardous, warlike, and non-warlike service (section 4). The new instrument replaces the old one and incorporates the latest revised format, while updating definitions and adding new factors (section 6). It references the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) (section 7) and clarifies its applicability under both the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA) (section 8).
The Statement of Principles set out in Instrument No. 17 of 2008 requires that certain factors must exist and be related to the specified kinds of service to establish a reasonable hypothesis connecting alcohol dependence and alcohol abuse or death from these conditions with the circumstances of that service (section 4). This involves determining whether there is a clinically significant psychiatric condition, a category 1A stressor, a category 1B stressor, or the involvement of a significant other, among other factors (sections 6 and 9). The Authority has incorporated the DSM-IV-TR in its determinations and invites relevant submissions from stakeholders during its investigation (sections 7 and 9).
Claims for compensation under the MRCA for service injuries, diseases, or deaths on or after 1 July 2004 are assessed by the Military Rehabilitation and Compensation Commission, with reference to Statements of Principles issued by the Authority under the VEA (section 3). This means that any claims related to alcohol dependence or alcohol abuse, and death from these conditions, must be evaluated based on the criteria and factors outlined in Instrument No. 17 of 2008. The Authority's determinations are binding and must be adhered to in the processing of these claims.
Under the VEA and the MRCA, breaches of the provisions or failure to comply with the obligations and requirements outlined in the new Statement of Principles can result in civil or criminal consequences (section 196B). While specific offences and penalties are not detailed in the explanatory notes, the Authority has the power to enforce compliance and may impose penalties for non-compliance. The maximum penalties would be determined according to the relevant sections of the VEA and MRCA. The Authority's decisions and the process for handling claims are subject to review and appeal, providing avenues for parties to challenge the Authority's determinations if they believe they have been unfairly treated or if there are errors in the application of the law.