Statement of Principles concerning alpha-1 antitrypsin deficiency No. 30 of 2015

Administered by Department of Veterans' Affairs

Legislation au F2014L01840 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

INSTRUMENT NO. 30 of 2015

 

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. 2 of 2007, determined under subsection 196B(3) of the VEA concerning alpha-1 antitrypsin deficiency.
  2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that alpha-1 antitrypsin deficiency and death from alpha-1 antitrypsin deficiency 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. 30 of 2015 concerning alpha-1 antitrypsin deficiency.  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 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, alpha-1 antitrypsin deficiency or death from alpha-1 antitrypsin deficiency is connected with the circumstances of that service.

5.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 2 May 2012 concerning alpha-1 antitrypsin deficiency 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 Instrument.  Comparing this Instrument and the revoked Instrument, the differences include:

  • revising the definition of 'alpha-1 antitrypsin deficiency' in clause 3;
  • new factor 6(a) concerning 'smoking', for clinical worsening only;
  • new definition of 'pack-years of cigarettes, or the equivalent thereof in other tobacco products' in clause 9;
  • revising the definition of 'relevant service' 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 alpha-1 antitrypsin deficiency in the Government Notices Gazette of 2 May 2012, 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.             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.

10.         The determining of this Instrument finalises the investigation in relation to alpha-1 antitrypsin deficiency as advertised in the Government Notices Gazette of 2 May 2012.

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. 30 of 2015

Kind of Injury, Disease or Death: Alpha-1 antitrypsin deficiency

 

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).

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 alpha-1 antitrypsin deficiency;
  • 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, alpha-1 antitrypsin deficiency is connected with the circumstances of eligible service rendered by a person, as set out in clause 4 of the Explanatory Notes;
  • replaces Instrument No. 2 of 2007; and
  • reflects developments in the available sound medical-scientific evidence concerning alpha-1 antitrypsin deficiency 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; and
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD).

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 Repatriation Medical Authority Instrument No. 30 of 2015, concerning alpha-1 antitrypsin deficiency, was enacted to address the gap in the existing framework for the assessment and compensation of veterans and Defence Force members suffering from alpha-1 antitrypsin deficiency, a condition that can be related to particular kinds of service. This legislative instrument was developed under the authority of the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, and its objective is to facilitate claims and assessments by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons. This instrument replaces the previous Instrument No. 2 of 2007, reflecting the latest medical-scientific evidence available. The Authority ensures that the instrument is compatible with human rights, promoting the rights of veterans, current and former Defence Force members, and their dependents by facilitating the assessment and determination of social security benefits and the enjoyment of the highest attainable standard of physical and mental health.

Scope and Application

The Repatriation Medical Authority Instrument No. 30 of 2015 under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 addresses the condition of alpha-1 antitrypsin deficiency, a medical condition that can be related to certain kinds of service. This Instrument applies to eligible persons who have served in various capacities, including eligible war service, defence service, and peacetime service, and who are now suffering from alpha-1 antitrypsin deficiency or have died from the condition. The Instrument sets out the factors that must be present, and which of those factors must be related to the service rendered, to determine a connection between the condition and the service. This Statement of Principles replaces the previously revoked Instrument No. 2 of 2007 and reflects the current sound medical-scientific evidence available to the Authority. The Instrument facilitates the assessment of claims for compensation and the provision of medical treatment, and ensures that the process is transparent and proportionate, thereby promoting the human rights of veterans and their dependants. The Instrument is compatible with human rights and does not derogate from any of the rights outlined in the relevant international instruments.

Key Provisions

The Repatriation Medical Authority, under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), has revoked Instrument No. 2 of 2007 and issued Instrument No. 30 of 2015 concerning alpha-1 antitrypsin deficiency (section 5). This instrument outlines the factors that must exist, and which of those factors must be related to specific kinds of service, to establish a connection between alpha-1 antitrypsin deficiency or death from alpha-1 antitrypsin deficiency and the service rendered (section 5). The Statement of Principles sets out the circumstances in which medical treatment and compensation can be extended to eligible persons with alpha-1 antitrypsin deficiency, facilitating claimants in making claims under the VEA and MRCA and the Repatriation Commission in assessing such claims (section 2). The Authority has considered sound medical-scientific evidence to determine the likelihood of a connection between alpha-1 antitrypsin deficiency and particular kinds of service (section 6). The obligations imposed by this instrument include the requirement for claimants to provide evidence that meets the factors outlined in the Statement of Principles for their claim to be assessed (section 5). The Repatriation Commission must then assess these claims in accordance with the criteria specified in the instrument. The instrument also facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal (section 2). Additionally, the Authority must ensure that the instrument complies with human rights and freedoms as recognised in international instruments (section 10). Breach of the provisions of this instrument can lead to civil consequences, including the denial of medical treatment and compensation for those who do not meet the specified criteria. The instrument does not explicitly outline criminal penalties for non-compliance, but it is implied that any fraudulent claims or misrepresentation of facts could lead to criminal charges under relevant legislation. The maximum penalties for such offences would be determined by the applicable criminal law, not specified in the instrument itself. The instrument is compatible with human rights as it does not derogate from and promotes various human rights, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health. It also facilitates the determination of claims relating to treatment and rehabilitation, thereby promoting the rights of persons with disabilities (section 4). The Authority has ensured that the instrument is in line with human rights by adhering to the requirements of the Human Rights (Parliamentary Scrutiny) Act 2011.

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