REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 48 of 2007
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. 14 of 1995, as amended by Instrument No. 189 of 1995, determined under subsection 196B(3) of the VEA concerning alkaptonuria and death from alkaptonuria.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that alkaptonuria and death from alkaptonuria 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, Instrument No. 48 of 2007 concerning alkaptonuria. 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 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) under the VEA;
peacetime service under the MRCA,
before it can be said that, on the balance of probabilities, alkaptonuria or death from alkaptonuria is connected with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 15 June 2005 concerning alkaptonuria in accordance with section 196G of the Act. 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 Instruments. 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;
- revising the definition of 'alkaptonuria' in clause 3;
- new factor 6(a) concerning 'cirrhosis of the liver';
- new factor 6(b) concerning 'moderate to severe renal failure';
- deleting the factor concerning 'physical trauma';
- new definitions of 'death from alkaptonuria'; 'ICD-10-AM code'; 'relevant service'; 'moderate to severe renal failure' and 'terminal event' in clause 9;
- deleting definitions of 'ICD code' and 'physical trauma' in 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 alkaptonuria in the Government Notices Gazette of 15 June 2005, 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. On 20 December 2006, the Authority wrote to organisations representing veterans, service personnel and their dependants regarding the proposed Instrument and the medical-scientific material considered by the Authority. This letter emphasised the deletion of factors relating to physical trauma. The Authority provided an opportunity to the organisations to make representations in relation to the proposed instrument prior to its determination. No submissions were received for consideration by the Authority.
10. The determining of this new instrument finalises the investigation in relation to alkaptonuria as advertised in the Government Notices Gazette of 15 June 2005.
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. 48 of 2007 was enacted to address the problem of establishing a connection between alkaptonuria and military service, superseding the previous Instrument No. 14 of 1995. This legislative instrument was introduced under subsection 196B(3) of the Veterans’ Entitlements Act 1986, with the objective of determining a Statement of Principles that outlines the factors necessary to establish a connection between alkaptonuria or death from alkaptonuria and specific types of military service, namely eligible war service, defence service, and peacetime service. The Authority determined this new instrument based on available sound medical-scientific evidence, leading to the revocation of the previous instrument and the incorporation of updated definitions and factors, such as cirrhosis of the liver and moderate to severe renal failure, while omitting others like physical trauma. The instrument also reflects the commencement of the Military Rehabilitation and Compensation Act 2004, ensuring that the Statement of Principles applies for both the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004.
Scope and Application
The Repatriation Medical Authority Instrument No. 48 of 2007, concerning alkaptonuria, applies to individuals who have rendered eligible war service, defence service, or peacetime service under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This legislation is applicable to claims for compensation concerning service injuries, service diseases, or service deaths occurring on or after 1 July 2004. The Instrument replaces the previous Statement of Principles revoked under subsection 196B(8) of the VEA, as amended by Instrument No. 189 of 1995. The new instrument is determined for the purposes of both the VEA and the MRCA, as clarified by subsection 196B(3A) of the VEA. The Authority has considered sound medical-scientific evidence in its determination, resulting in a revised Instrument format that includes new factors and definitions while deleting certain previous elements such as the ICD code and physical trauma. This Instrument is applicable nationally, with its scope extending to all relevant veterans and service personnel across Australia. There are no specific exclusions or exemptions outlined in the text, though the applicability of the Instrument is contingent upon the factors and definitions specified within it. Subordinate instruments may further extend or restrict the application of this Act, but no such provisions are detailed in the provided explanatory notes.
Key Provisions
The Repatriation Medical Authority (the Authority) has revoked Instrument No. 14 of 1995, as amended by Instrument No. 189 of 1995, under subsection 196B(8) of the Veterans’ Entitlements Act 1986 (VEA) (paragraph 1). This revocation was due to the Authority determining, pursuant to subsection 196B(3) of the VEA, a new Statement of Principles, Instrument No. 48 of 2007 concerning alkaptonuria, replacing the previous instruments (paragraph 2). This determination was based on the available medical-scientific evidence suggesting a probable connection between alkaptonuria, death from alkaptonuria, and particular kinds of service (paragraph 2).
The new Statement of Principles outlines the factors that must exist, and which of those factors must be related to specific types of service, including eligible war service, defence service, and peacetime service, to establish a connection with alkaptonuria or death from alkaptonuria (paragraph 4). The Authority arrived at this determination following an investigation into alkaptonuria, as required by section 196G of the VEA and announced in the Government Notices Gazette of 15 June 2005 (paragraph 5). The investigation involved a thorough examination of the available medical-scientific evidence (paragraph 5).
The new instrument incorporates several changes from the previous instruments. It adopts the latest revised Instrument format, deletes the ICD code from the Instrument header, revises the definition of 'alkaptonuria', and introduces new factors concerning 'cirrhosis of the liver' and'moderate to severe renal failure'. It also deletes the factor concerning 'physical trauma' and updates definitions such as 'death from alkaptonuria', 'ICD-10-AM code','relevant service', 'moderate to severe renal failure', and 'terminal event'. Additionally, it specifies a date of effect for the Instrument (paragraph 6). The Authority sought and considered submissions from various organisations and individuals with expertise in the field, but none were received (paragraphs 9 and 10).
The Authority is required to notify relevant parties of its intention to investigate and to seek submissions, as stipulated by section 196E of the VEA. The Authority must also ensure that the Statement of Principles is determined for the purposes of both the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA), reflecting the commencement of the MRCA (paragraph 7). Any breach of these obligations may have legal consequences, although specific penalties are not detailed in the explanatory notes provided.