Statement of Principles concerning bronchiolitis obliterans organising pneumonia (Balance of Probabilities) (No. 80 of 2018)

Administered by Department of Veterans' Affairs

Legislation au F2018L01179 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

BRONCHIOLITIS OBLITERANS ORGANISING PNEUMONIA

(BALANCE OF PROBABILITIES) (NO. 80 OF 2018)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning bronchiolitis obliterans organising pneumonia (Balance of Probabilities) (No. 80 of 2018).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 63 of 2009 (Federal Register of Legislation No. F2009L03226) determined under subsection 196B(3) of the VEA concerning bronchiolitis obliterans organising pneumonia.

3.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that bronchiolitis obliterans organising pneumonia and death from bronchiolitis obliterans organising pneumonia 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 concerning bronchiolitis obliterans organising pneumonia (Balance of Probabilities) (No. 80 of 2018).  This Instrument will in effect replace the repealed Statement of Principles.

Purpose and Operation

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

5.             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, bronchiolitis obliterans organising pneumonia or death from bronchiolitis obliterans organising pneumonia is connected with the circumstances of that service.  The Statement of Principles has been determined for the purposes of both the VEA and the MRCA.

6.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 19 October 2016 concerning bronchiolitis obliterans organising pneumonia 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.

7.             The contents of this Instrument are in similar terms as the repealed Instrument.  Comparing this Instrument and the repealed Instrument, the differences include:

  • adopting the latest revised Instrument format, which commenced in 2015;
  • specifying a day of commencement for the Instrument in section 2;
  • revising the definition of 'bronchiolitis obliterans organising pneumonia' in subsection 7(2);
  • revising the factors in subsections 9(1) & 9(9) concerning 'taking a drug';
  • new factors in subsections 9(2) & 9(10) concerning 'being treated with a drug';
  • revising the factors in subsections 9(4) & 9(12) concerning 'a course of therapeutic radiation';
  • revising the factors in subsections 9(5) & 9(13) concerning 'bronchial obstruction', by inclusion of a note;
  • new factors in subsections 9(6) & 9(14) concerning 'inhaling high concentrations of a substance with irritant properties';
  • revising the factors in subsections 9(7) & 9(15) concerning 'inhaling sulphur mustard';
  • new factors in subsections 9(8) & 9(16) concerning 'gastro-oesophageal reflux disease';
  • deleting the factors concerning 'inhaling fumes of Acramin FWN textile printing dye', as they are now covered by the factors in subsections 9(6) & 9(14) concerning ' inhaling high concentrations of a substance with irritant properties';
  • new definitions of 'MRCA', 'specified list of drugs' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definition of 'relevant service' in Schedule 1 - Dictionary; and
  • deleting the definitions of 'a course of therapeutic radiation' and 'a drug or a drug from a class of drugs from the specified list'.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to bronchiolitis obliterans organising pneumonia in the Government Notices Gazette of 19 October 2016, 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 13 April 2018, the Authority wrote to organisations representing veterans, service personnel and their dependants regarding the proposed Instruments concerning bronchiolitis obliterans organising pneumonia and the medical-scientific material considered by the Authority.  This letter emphasised the deletion of factors relating to anthrax vaccine and coronary artery bypass graft surgery from the Reasonable Hypothesis Instrument.  The Authority provided an opportunity to the organisations to make representations in relation to the proposed Instruments prior to their determination.  No submissions were received for consideration by the Authority.  Minor changes were made to the proposed Instruments following this consultation process.

Human Rights

10.         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

11.         The determining of this Instrument finalises the investigation in relation to bronchiolitis obliterans organising pneumonia as advertised in the Government Notices Gazette of 19 October 2016.

References

12.         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. 80 of 2018

Kind of Injury, Disease or Death: Bronchiolitis obliterans organising pneumonia

 

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 bronchiolitis obliterans organising pneumonia;
  • 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, bronchiolitis obliterans organising pneumonia is connected with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 63 of 2009; and
  • reflects developments in the available sound medical-scientific evidence concerning bronchiolitis obliterans organising pneumonia 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;
  • 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 bronchiolitis obliterans organising pneumonia (Balance of Probabilities) (No. 80 of 2018) was enacted to address the problem of determining the eligibility of veterans and other eligible persons for medical treatment and compensation related to bronchiolitis obliterans organising pneumonia. The legislation was introduced by the Repatriation Medical Authority (the Authority) under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). The policy objective of this legislation is to establish the circumstances in which bronchiolitis obliterans organising pneumonia or death from bronchiolitis obliterans organising pneumonia can be considered to be connected to the circumstances of eligible service. The Statement of Principles outlines the factors that must exist before it can be said that, on the balance of probabilities, the condition is connected with the service rendered by a person. This legislation aims to facilitate claimants in making, and the Repatriation Commission in assessing, claims under the VEA and MRCA respectively, and also outlines the factors which the current sound medical-scientific evidence indicates must exist before it can be said that, on the balance of probabilities, bronchiolitis obliterans organising pneumonia is connected with the circumstances of eligible service rendered by a person. The legislation also facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal, and replaces the previous Statement of Principles concerning bronchiolitis obliterans organising pneumonia, Instrument No. 63 of 2009. The new Statement of Principles reflects developments in the available sound medical-scientific evidence concerning bronchiolitis obliterans organising pneumonia which have occurred since the earlier instrument was determined. It 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, and does not derogate from any human rights. Instead, it promotes the human rights of veterans, current and former Defence Force members, as well as other persons such as their dependents.

Scope and Application

The Statement of Principles concerning bronchiolitis obliterans organising pneumonia (Balance of Probabilities) (No. 80 of 2018), determined under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, applies to veterans, current and former Defence Force members, and their dependents who may have contracted bronchiolitis obliterans organising pneumonia (BOOP) as a result of their service. This legislation establishes the specific circumstances and factors that must exist for a claimant to prove, on the balance of probabilities, that their BOOP or death from BOOP is connected to their service. The application of these principles is intended to facilitate the assessment and determination of claims for medical treatment and compensation under both the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. The legislation reflects updated medical-scientific evidence and replaces the previous Statement of Principles No. 63 of 2009. The Repatriation Medical Authority undertook a comprehensive investigation and consultation process before determining this instrument, ensuring its compatibility with human rights and promoting the rights of veterans and their dependents to social security, adequate living standards, and health benefits.

Key Provisions

The Statement of Principles concerning bronchiolitis obliterans organising pneumonia (Balance of Probabilities) (No. 80 of 2018) is a legislative instrument under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). It repeals Instrument No. 63 of 2009 and sets out the factors that must exist for it to be more probable than not that bronchiolitis obliterans organising pneumonia or death from this condition is connected with particular kinds of service (section 3). The Statement of Principles is applied in determining claims under the VEA and the MRCA (section 4). The service factors include eligible war service, defence service, and peacetime service (section 5). The determination of this Instrument finalises the investigation concerning bronchiolitis obliterans organising pneumonia as advertised in the Government Notices Gazette of 19 October 2016 (section 11). The Statement of Principles imposes obligations on claimants to provide evidence of their service and any related medical conditions, and on the Repatriation Commission to assess claims based on the factors outlined in the Statement of Principles (section 5). The Instrument facilitates claimants in making claims and the Repatriation Commission in assessing those claims by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have bronchiolitis obliterans organising pneumonia (section 2). The Instrument also facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal (section 2). The Statement of Principles is compatible with human rights and does not derogate from any human rights (section 10). There are no specific offences, penalties, or consequences outlined in the Explanatory Statement for breach of the Statement of Principles. However, the Instrument promotes the human rights of veterans, current and former Defence Force members, and other persons such as their dependents, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health (section 4). The Instrument also ensures that these rights "will be exercised without discrimination of any kind" (section 4). The compatibility with human rights suggests that any breach of the Statement of Principles could potentially lead to legal challenges on human rights grounds.

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