REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 56 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. 56 of 1995 determined under subsection 196B(3) of the VEA concerning polycystic kidney disease and death from polycystic kidney disease.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that autosomal dominant polycystic kidney disease and death from autosomal dominant polycystic kidney disease 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. 56 of 2007 concerning autosomal dominant polycystic kidney disease. 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) under the VEA;
peacetime service under the MRCA,
before it can be said that, on the balance of probabilities, autosomal dominant polycystic kidney disease or death from autosomal dominant polycystic kidney disease 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 polycystic kidney disease 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 Instrument. 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 'autosomal dominant polycystic kidney disease' in clause 3;
- deleting the factor concerning 'physical trauma';
- deleting the factor concerning 'renal infection';
- new definitions of 'death from autosomal dominant polycystic kidney disease'; 'ICD-10-AM code'; 'relevant service' and 'terminal event' in clause 6;
- deleting definitions of 'ICD code' and 'physical trauma' in clause 6; and
- specifying a date of effect for the Instrument in clause 8.
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 polycystic kidney disease 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 and renal infection. 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 polycystic kidney disease 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. 56 of 2007, enacted under the Veterans' Entitlements Act 1986, addresses the gap in the understanding and acknowledgment of the link between military service and the development of autosomal dominant polycystic kidney disease (ADPKD) and death from ADPKD. The Authority was prompted to revoke the previous Instrument No. 56 of 1995 after reviewing the available medical-scientific evidence, which indicated a probable connection between specific military services and ADPKD. This new instrument aims to replace the outdated statement and align with the current legislative framework, particularly under the Military Rehabilitation and Compensation Act 2004, which governs claims for compensation from 1 July 2004. The Authority's objective is to establish clear criteria for determining when ADPKD or death from ADPKD can be considered connected to military service, facilitating appropriate compensation claims. The Authority consulted relevant organisations and experts during its investigation but did not receive any submissions for consideration before finalising the instrument.
Scope and Application
The Repatriation Medical Authority (RMA) under the Veterans' Entitlements Act 1986 (VEA) has revised its approach to the connection between autosomal dominant polycystic kidney disease (ADPKD) and military service, revoking the previous Instrument No. 56 of 1995 and introducing Instrument No. 56 of 2007. This new instrument sets out the Statement of Principles, specifying the service-related factors necessary to establish a connection between ADPKD or death from ADPKD and service rendered under the VEA or the Military Rehabilitation and Compensation Act 2004 (MRCA). It applies to eligible war service, defence service, and peacetime service, thereby impacting veterans and service personnel who might claim compensation for conditions arising from their service. The instrument applies nationally within Australia, and its determination is effective for claims concerning injuries, diseases, or deaths occurring on or after 1 July 2004, aligning with the commencement of the MRCA. The new instrument replaces the previous one, reflecting updated medical-scientific evidence and the latest instrument format, with specific changes including the adoption of a revised format, deletion of certain factors, and specification of a date of effect. This instrument does not explicitly state exclusions, but its applicability is contingent on the service-related factors outlined within it.
Key Provisions
The Repatriation Medical Authority, under subsection 196B(8) of the Veterans’ Entitlements Act 1986 (VEA), has revoked Instrument No. 56 of 1995 concerning polycystic kidney disease and issued a new Instrument No. 56 of 2007, establishing a Statement of Principles for autosomal dominant polycystic kidney disease (ADPKD). This Statement of Principles is to replace the previous one and outlines the factors that must be related to certain types of service, such as eligible war service, defence service, and peacetime service, for ADPKD or death from ADPKD to be connected with service circumstances (sections 4, 7). The new instrument reflects the latest revised format and includes updated definitions, such as 'autosomal dominant polycystic kidney disease', 'death from autosomal dominant polycystic kidney disease', 'ICD-10-AM code', 'relevant service', and 'terminal event' (sections 5, 6).
The Statement of Principles imposed by this instrument serves to guide the Military Rehabilitation and Compensation Commission in determining claims for compensation under the Military Rehabilitation and Compensation Act 2004 (MRCA), specifically for claims of service injury, service disease, or service death that occurred on or after 1 July 2004. These claims are evaluated based on whether they meet the outlined factors in the Statement of Principles, as issued by the Authority under the VEA (section 3). The Authority’s determination is based on the sound medical-scientific evidence available, which it has reviewed and updated from its previous considerations (sections 2, 5).
The Repatriation Medical Authority conducted an investigation into polycystic kidney disease, as notified in the Government Notices Gazette of 15 June 2005, under section 196G of the VEA. During this investigation, the Authority did not receive any submissions for consideration. The Authority sought to gather expert opinions and invited submissions from various stakeholders, including the Repatriation Commission and organizations representing veterans, service personnel, and their dependants, but no submissions were received (sections 8, 9). This investigation culminated in the final determination of the new instrument, which was communicated to relevant organizations on 20 December 2006, with an opportunity for them to make representations (section 10). The Authority provided a list of references on the condition for written request, ensuring transparency and accessibility of the medical-scientific material considered (section 11).