Statement of Principles concerning analgesic nephropathy (Reasonable Hypothesis) (No. 43 of 2025)

Administered by Department of Veterans' Affairs

Legislation au F2025L00497 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

ANALGESIC NEPHROPATHY

(REASONABLE HYPOTHESIS) (NO. 43 OF 2025)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1.              This is the Explanatory Statement to the Statement of Principles concerning analgesic nephropathy (Reasonable Hypothesis) (No. 43 of 2025).

Background

  1.              The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 77 of 2016 (Federal Register of Legislation No. F2016L01667) determined under subsection 196B(2) of the VEA concerning analgesic nephropathy.
  2.              The Authority is of the view that there is sound medical-scientific evidence that indicates that analgesic nephropathy and death from analgesic nephropathy 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 concerning analgesic nephropathy (Reasonable Hypothesis) (No. 43 of 2025).  This Instrument will in effect replace the repealed Statement of Principles.

Purpose and Operation

  1.              The Statement of Principles will be applied in determining claims under the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).
  2.              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;

 British nuclear test defence 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 analgesic nephropathy or death from analgesic nephropathy, with the circumstances of that service.  The Statement of Principles has been determined for the purposes of both the VEA and the MRCA.

  1.              This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 30 October 2024 concerning analgesic nephropathy 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.
  2.              The contents of this Instrument are in similar terms as the repealed Instrument.  Comparing this Instrument and the repealed Instrument, the differences include:
  • specifying a day of commencement for the Instrument in section 2;
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factor in subsection 9(1) concerning consuming phenacetin; and
  • deleting the definition of 'phenacetin'.

Consultation

  1.              Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to analgesic nephropathy in the Government Notices Gazette of 30 October 2024, 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, the Military Rehabilitation and Compensation 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 in relation to the investigation.

Human Rights

  1.              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.

Finalisation of Investigation

  1.          The determining of this Instrument finalises the investigation in relation to analgesic nephropathy as advertised in the Government Notices Gazette of 30 October 2024.

References

  1.          A list of references relating to the above condition is available on the Authority's website at: www.rma.gov.au. Any other document referred to in this Statement of Principles is available on request to the Repatriation Medical Authority at the following address:

              

Email:    info@rma.gov.au

Post:      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. 43 of 2025

Kind of Injury, Disease or Death: analgesic nephropathy

 

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(2) of the Veterans' Entitlements Act 1986 (the VEA) for the purposes of the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).  Part XIA of the VEA requires the determination of these instruments outlining the factors connecting particular kinds of injury, disease or death with service such being determined solely on the available sound medical-scientific evidence.

2. This Legislative Instrument:-

  • facilitates claimants in making, and the Repatriation Commission and the Military Rehabilitation and Compensation 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 analgesic nephropathy;
  • 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 as a minimum exist, before it can be said that a reasonable hypothesis has been raised, connecting analgesic nephropathy with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 77 of 2016; and
  • reflects developments in the available sound medical-scientific evidence concerning analgesic nephropathy 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, ICESCR; 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, ICESCR 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;
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD); and
  • ensuring that those rights "will be exercised without discrimination of any kind as to race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status" (Art 2, ICESCR).

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 Statement of Principles concerning analgesic nephropathy (Reasonable Hypothesis) (No. 43 of 2025) was enacted in 2025 by the Repatriation Medical Authority under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This legislative instrument addresses the gap in recognising the link between analgesic nephropathy and specific military service, aiming to facilitate claims and assessments for veterans and service members suffering from this condition. The Authority was prompted to establish this statement following an investigation into analgesic nephropathy, which considered the most recent sound medical-scientific evidence. This instrument replaces an earlier repealed statement of principles, updating the criteria to better reflect current understanding and ensuring compatibility with human rights as recognised in international instruments. The policy objective of this instrument is to streamline the process for assessing and approving claims related to analgesic nephropathy by clearly outlining the factors that must be present and related to certain types of military service. It ensures that claimants and the relevant authorities have a clear framework for determining eligibility for medical treatment and compensation, while also promoting human rights such as the right to social security, an adequate standard of living, and the highest attainable standard of health. This legislative instrument aims to enhance the quality of medico-scientific outcomes under the VEA and the MRCA, ensuring that claims are assessed with the most current and reliable evidence.

Scope and Application

The Statement of Principles concerning Analgesic Nephropathy (Reasonable Hypothesis) (No. 43 of 2025) applies to individuals making claims for medical treatment and compensation under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, specifically regarding service-related analgesic nephropathy. This legislative instrument outlines the minimum factors that must exist for a reasonable hypothesis to connect analgesic nephropathy or death from it with specific types of service, including operational, peacekeeping, hazardous, and British nuclear test defence service under the Veterans' Entitlements Act, and warlike and non-warlike service under the Military Rehabilitation and Compensation Act. The instrument is designed to assist in the assessment and review of claims by specifying the circumstances under which compensation may be awarded, replacing the previous Instrument No. 77 of 2016 and reflecting updated medical-scientific evidence. This legislative instrument is compatible with human rights, promoting the rights to social security, an adequate standard of living, and health for veterans and Defence Force members, without discrimination.

Key Provisions

The main operative sections of the Statement of Principles concerning analgesic nephropathy (Reasonable Hypothesis) (No. 43 of 2025) detail the factors that must be considered in order to establish a reasonable hypothesis connecting analgesic nephropathy or death from analgesic nephropathy with certain kinds of service (ss 4–6). This document outlines the specific service circumstances under which the reasonable hypothesis can be made, including operational, peacekeeping, hazardous, British nuclear test defence, warlike, and non-warlike services (s 5). The purpose of this document is to assist in the determination of claims under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) (s 3). The obligations imposed on parties include the requirement to consider the factors outlined in the document when assessing claims for analgesic nephropathy related to the specified service circumstances (ss 4–6). The document replaces the previous Instrument No. 77 of 2016 and incorporates updates based on the latest sound medical-scientific evidence (s 2). The Statement of Principles imposes several obligations on the parties involved. Claimants must provide evidence that aligns with the factors set out in the document to establish a reasonable hypothesis connecting their analgesic nephropathy to the service rendered (ss 4–6). The Repatriation Commission and the Military Rehabilitation and Compensation Commission are required to assess claims in light of these factors (s 3). The Veterans' Review Board and the Administrative Appeals Tribunal must also consider these factors when reviewing decisions related to such claims (s 3). The Repatriation Medical Authority is responsible for ensuring that the determination of this Instrument is based on sound medical-scientific evidence and is compatible with human rights (ss 2, 3, 10). There are no specific offences, penalties, or civil/criminal consequences outlined for breaches of this document itself. However, any breach of the requirements under the VEA or the MRCA in relation to the claims could lead to legal consequences under those respective Acts. For example, providing false information in a claim could result in penalties under the VEA, which may include fines or imprisonment (s 215, VEA). The compatibility of this document with human rights ensures that any actions taken under the VEA or MRCA will not infringe on the human rights of claimants or other affected parties (s 10).

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.