REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 73 of 2010
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. 247 of 1995, as amended by Instrument No. 11 of 1997, determined under subsection 196B(2) of the VEA concerning anal fissure.
2. The Authority is of the view that there is sound medical-scientific evidence that indicates that anal fissure and death from anal fissure 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. 73 of 2010 concerning anal fissure. 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 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 anal fissure or death from anal fissure, with the circumstances of that service.
5. This new Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 25 June 2008 concerning anal fissure 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 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 'anal fissure' in clause 3;
- revising factor 6(a) concerning 'trauma to the perianal area';
- revising factor 6(b) concerning 'human immunodeficiency virus';
- revising factor 6(c) concerning 'inflammatory bowel disease';
- revising factor 6(d) concerning 'constipation';
- new factor 6(e) concerning 'being treated with nicorandil or isotretinoin';
- previous factor concerning 'anal surgery' is now redundant as it is covered by revised factor concerning 'trauma to the perianal area';
- new definitions of 'death from anal fissure', 'ICD-10-AM code', 'relevant service', 'terminal event' and 'trauma to the perianal area' in clause 9;
- deleting definitions of 'being infected with HIV', 'constipation', 'Crohn's disease', 'ICD code', 'trauma to the perineum' and 'ulcerative colitis'; 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 anal fissure in the Government Notices Gazette of 25 June 2008, 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. The determining of this new Instrument finalises the investigation in relation to anal fissure as advertised in the Government Notices Gazette of 25 June 2008.
10. 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 Secretariat
GPO Box 1014
BRISBANE QLD 4001
Overview
The Repatriation Medical Authority Instrument No. 73 of 2010 was enacted to address the medical-scientific evidence indicating a relationship between anal fissure and certain kinds of service under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). The Authority revoked the previous Instrument No. 247 of 1995 concerning anal fissure and replaced it with this new instrument, which establishes a Statement of Principles that outlines the minimum factors required to connect anal fissure or death from anal fissure with particular service circumstances. The instrument was determined following an investigation and the review of available medical-scientific evidence. This new Instrument is intended to provide clarity and consistency in determining claims for compensation related to anal fissure, reflecting the latest format and definitions in line with the commencement of the MRCA.
Scope and Application
The Repatriation Medical Authority Instrument No. 73 of 2010, concerning anal fissure, applies to service personnel who have rendered operational, peacekeeping, or hazardous service under the Veterans' Entitlements Act 1986, as well as those who have engaged in warlike or non-warlike service under the Military Rehabilitation and Compensation Act 2004. This Instrument establishes a Statement of Principles that must be met for a reasonable hypothesis to be raised connecting anal fissure or death from anal fissure with the service rendered. This instrument is issued pursuant to the authority granted under the Veterans' Entitlements Act 1986 and applies to claims for compensation that commenced on 1 July 2004 under the Military Rehabilitation and Compensation Act 2004. The Authority has revoked Instrument No. 247 of 1995, as amended by Instrument No. 11 of 1997, and replaced it with this new Instrument, which reflects the latest revised Instrument format and incorporates changes to definitions and factors that relate to anal fissure. The Instrument does not specify any exclusions, exemptions, or thresholds, and its application may be extended or restricted through subordinate instruments.
Key Provisions
The Repatriation Medical Authority (the Authority) has revoked Instrument No. 247 of 1995, as amended by Instrument No. 11 of 1997, under subsection 196B(8) of the Veterans' Entitlements Act 1986 (VEA). This revocation is based on the Authority's assessment of sound medical-scientific evidence linking anal fissure and death from anal fissure to particular kinds of service (subsection 196B(2) of the VEA). A new Instrument No. 73 of 2010 has been issued, replacing the revoked instruments, which sets out the Statement of Principles for anal fissure. This Statement of Principles outlines the factors that must exist, and which must be related to specific service types, before a reasonable hypothesis can be raised connecting anal fissure or death from anal fissure with the service circumstances.
The new Instrument No. 73 of 2010 applies to various types of service under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), including operational, peacekeeping, and hazardous service under the VEA, and warlike and non-warlike service under the MRCA. These service types must be linked to the development of anal fissure or death from anal fissure for a claim to be considered valid. The Instrument also adopts the latest revised format, updates definitions, and clarifies terms such as 'death from anal fissure', 'ICD-10-AM code', 'relevant service', 'terminal event', and 'trauma to the perianal area'. The Instrument was determined following an investigation announced in the Government Notices Gazette of 25 June 2008, and no submissions were received during the investigation.
Under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, claims for compensation related to service injuries, diseases, or deaths on or after 1 July 2004 must be assessed by the Military Rehabilitation and Compensation Commission. These claims are determined based on the Statements of Principles issued by the Authority. The Authority is responsible for ensuring that the new Instrument No. 73 of 2010 aligns with the requirements of both Acts. The Authority advertised its intention to investigate anal fissure in the Government Notices Gazette of 25 June 2008 and invited submissions from relevant organisations and individuals. However, no submissions were received during the investigation.
The Authority's determination of Instrument No. 73 of 2010 concludes the investigation into anal fissure as advertised in the Government Notices Gazette of 25 June 2008. This Instrument replaces the previous revoked instruments and provides updated and clarified criteria for claims related to anal fissure. The Authority is required to determine Statements of Principles for conditions related to service, ensuring that these statements are based on sound medical-scientific evidence. The Authority's decisions must be consistent with the provisions of the VEA and MRCA. Additionally, the Authority must ensure that the new Instrument is accessible to relevant organisations and individuals, as outlined in subsection 196E(1)(a) to (c) of the VEA.