REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 74 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. 248 of 1995, as amended by Instrument No. 12 of 1997, determined under subsection 196B(3) of the VEA concerning anal fissure.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not 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(3) of the VEA a Statement of Principles, Instrument No. 74 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 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, anal fissure or death from anal fissure 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 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';
- 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. 74 of 2010, issued under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, was enacted to address the issue of establishing a causal link between anal fissure and specific types of military service. This legislative instrument revokes the previous Instrument No. 248 of 1995 concerning anal fissure, replacing it with a new Statement of Principles that considers the latest medical-scientific evidence. The Authority determined that anal fissure and death from anal fissure could be related to certain military services, thus the new Instrument delineates the factors necessary to establish such a connection. This includes setting out the required circumstances of service under the Veterans’ Entitlements Act and the Military Rehabilitation and Compensation Act. The Authority conducted an investigation and invited submissions, though none were received, leading to the finalisation of this Instrument to better address claims for compensation from 1 July 2004 onwards.
Scope and Application
The Repatriation Medical Authority Instrument No. 74 of 2010, under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, pertains to the determination of a Statement of Principles concerning anal fissure. This Act applies to individuals who have sustained anal fissure, or died from it, during specific kinds of service, namely eligible war service, defence service, and peacetime service. The Instrument governs the criteria that must exist for the condition to be deemed connected to the circumstances of the service, thereby impacting the eligibility for compensation claims under the respective Acts. The Statement of Principles is designed to replace the previously revoked Instrument No. 248 of 1995, which had similar purposes but is now outdated in light of new medical-scientific evidence. The Instrument’s reach is national, as it affects veterans and service personnel across Australia, and it is administered by the Repatriation Medical Authority. There are no specified exclusions, exemptions, or thresholds in the text, and the application of the Act is not extended or restricted through subordinate instruments.
Key Provisions
The Repatriation Medical Authority (the Authority) has issued Instrument No. 74 of 2010, revoking the previous Instrument No. 248 of 1995 concerning anal fissure. This new instrument, determined under subsection 196B(3) of the Veterans' Entitlements Act 1986 (VEA), establishes a Statement of Principles regarding the connection between anal fissure, including death from anal fissure, and certain types of military service. The Authority has concluded, based on available medical-scientific evidence, that it is more probable than not that anal fissure and death from anal fissure can be related to specific kinds of service. This Statement of Principles will apply to both eligible war service and defence service under the VEA, as well as peacetime service under the Military Rehabilitation and Compensation Act 2004 (MRCA).
Under this new instrument, the Authority has outlined the specific factors that must be present to establish a link between anal fissure or death from anal fissure and the service rendered. These factors must relate to the kinds of service specified in the VEA and MRCA. For instance, eligible war service (other than operational service), defence service (other than hazardous service), and peacetime service must be considered in the context of the medical condition in question. The instrument also revises certain definitions and adds new ones, such as clarifying the definition of 'anal fissure' and adding definitions for terms like 'death from anal fissure' and 'ICD-10-AM code'. It also incorporates the latest format for such instruments, which began in 2005, and specifies a date of effect for the instrument.
The obligations imposed by this instrument primarily concern the eligibility criteria for claims under the VEA and MRCA. Claimants must demonstrate that their anal fissure or death from anal fissure is connected with their service, as defined by the Statement of Principles. This involves proving that the relevant factors outlined in the instrument are met and are related to the type of service rendered. The Authority is responsible for determining whether these factors exist and are linked to the service, and this determination is based on the sound medical-scientific evidence available. Claimants and their representatives should ensure that all necessary evidence is provided to support their claims in line with these criteria.
Breach of the provisions outlined in the Statement of Principles, or misrepresentation in claims for compensation, could lead to civil or criminal consequences. Under the VEA and MRCA, penalties for providing false or misleading information in a claim can include fines and, in severe cases, imprisonment. The specific penalties depend on the nature and extent of the breach, but they can be significant, reflecting the seriousness of making false claims. Claimants are advised to ensure the accuracy of their submissions and the evidence they provide, as the Authority rigorously assesses all claims against the medical-scientific criteria set out in the Statement of Principles.