Statement of Principles concerning cerebral meningioma (Reasonable Hypothesis) (No. 1 of 2018)

Administered by Department of Veterans' Affairs

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

CEREBRAL MENINGIOMA

(REASONABLE HYPOTHESIS) (NO. 1 OF 2018)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning cerebral meningioma (Reasonable Hypothesis) (No. 1 of 2018).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), revokes Instrument No. 19 of 2009, as amended, determined under subsections 196B(2) and (8) of the VEA concerning cerebral meningioma.

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that cerebral meningioma and death from cerebral meningioma 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 cerebral meningioma (Reasonable Hypothesis) (No. 1 of 2018).  This Instrument will in effect replace the revoked 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 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 cerebral meningioma or death from cerebral meningioma, 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 cerebral meningioma 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 revoked Instrument.  Comparing this Instrument and the revoked 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 reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factor in subsection 9(1) concerning 'ionising radiation' by inclusion of a Note;
  • new factor in subsection 9(2) concerning 'being overweight or obese', for clinical onset only;
  • new factors in subsections 9(3) & 9(6) concerning 'being in the second or third trimester of pregnancy, or within the 30 days postpartum';
  • new factors in subsections 9(4) & 9(7) concerning 'being treated with a drug';
  • new factor in subsection 9(5) concerning 'hormone replacement therapy', for clinical onset only;
  • new definitions of 'being overweight or obese', 'being treated with a drug as specified', 'BMI', 'hormone replacement therapy', 'MRCA' and 'VEA' in Schedule 1 - Dictionary; and
  • revising the definition of 'relevant service' in Schedule 1 - Dictionary.

Incorporation

8.             The definition of "cumulative equivalent dose" contained in the Schedule 1 – Dictionary incorporates the Guide to calculation of 'cumulative equivalent dose' for the purpose of applying ionising radiation factors contained in Statements of Principles determined under Part XIA of the Veterans' Entitlements Act 1986 (Cth), Australian Radiation Protection and Nuclear Safety Agency, as in force on 2 August 2017.  This writing is incorporated pursuant to subsection 14(b) of the Legislation Act 2003. 

9.             A copy of this document is available to any person on the website of the Repatriation Medical Authority at http://www.rma.gov.au or from the Repatriation Medical Authority, Level 8, 259 Queen St, Brisbane, Queensland 4000, by contacting the Registrar on telephone (07) 3815 9404.

Consultation

10.         Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to cerebral meningioma 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.

Human Rights

11.         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

12.         The determining of this Instrument finalises the investigation in relation to cerebral meningioma as advertised in the Government Notices Gazette of 19 October 2016.

References

13.         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. 1 of 2018

Kind of Injury, Disease or Death: Cerebral meningioma

 

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).  Part XIA of the VEA requires the determination of these instruments outlining the factors linking 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 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 cerebral meningioma;
  • 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 cerebral meningioma with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 19 of 2009, as amended; and
  • reflects developments in the available sound medical-scientific evidence concerning cerebral meningioma 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 cerebral meningioma (Reasonable Hypothesis) (No. 1 of 2018) was introduced to address the need for an updated framework for assessing claims related to cerebral meningioma in veterans and Defence force members. Enacted by the Repatriation Medical Authority under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, this legislation aims to incorporate the latest medical-scientific evidence to ensure fair and accurate assessment of claims. The policy objective is to provide a clear set of factors that must exist to raise a reasonable hypothesis connecting cerebral meningioma with specific kinds of service, thereby facilitating the determination of benefits and compensation for eligible persons. This instrument replaces the previous Statement of Principles No. 19 of 2009, reflecting advancements in medical understanding and ensuring the provisions remain current and relevant. The Authority's investigation, notified in the Government Notices Gazette on 19 October 2016, led to the development of this Statement of Principles. It facilitates the assessment of claims under the relevant Acts by specifying the minimum factors that must be present, related to various types of service, to establish a connection between cerebral meningioma and the service rendered. This legislative instrument is designed to be compatible with human rights, promoting the rights of veterans, current and former Defence Force members, and their dependents, while ensuring that benefits are accessible without discrimination. The Authority has ensured that the instrument aligns with international human rights standards, thus upholding the rights to social security, an adequate standard of living, and the highest attainable standard of health.

Scope and Application

The Statement of Principles concerning cerebral meningioma (Reasonable Hypothesis) (No. 1 of 2018) applies to individuals who have served in the Australian Defence Force and are seeking compensation or medical treatment under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). The scope of the Act includes those who have rendered operational, peacekeeping, hazardous, and British nuclear test defence service, as well as warlike and non-warlike service, and it applies to all states and territories within Australia. The principles outlined in the Statement aim to establish a reasonable hypothesis connecting cerebral meningioma or death from cerebral meningioma with the circumstances of the service rendered by the individual. The Statement of Principles is determined by the Repatriation Medical Authority and reflects the latest sound medical-scientific evidence available. The Authority may extend or restrict the application of this instrument through subordinate instruments, which would then be incorporated into the main legislation. The purpose of the Statement of Principles is to facilitate the assessment and determination of claims under the VEA and the MRCA by outlining the factors that must exist to link cerebral meningioma with the service rendered by an individual. The Statement replaces the previously revoked Instrument No. 19 of 2009 and incorporates recent developments in medical-scientific evidence. The Authority consulted with relevant organisations and individuals during the investigation but did not receive any submissions. The Legislative Instrument is compatible with human rights as it does not derogate from and promotes various human rights, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health.

Key Provisions

The main operative sections of this Statement of Principles (No. 1 of 2018) concern the factors that must exist for a reasonable hypothesis to be raised connecting cerebral meningioma or death from cerebral meningioma with particular kinds of service, including operational service, peacekeeping service, hazardous service, British nuclear test defence service, warlike service, and non-warlike service under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). The determination of this Statement of Principles (subsection 196B(2) of the VEA) is based on sound medical-scientific evidence and replaces the previously revoked Instrument No. 19 of 2009, as amended. This Statement of Principles aims to facilitate claims and assessments under the VEA and MRCA by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have cerebral meningioma (clause 2 of the Explanatory Statement). The Statement of Principles imposes certain obligations and requirements on the parties and entities it governs. It specifies the minimum factors that must exist and be related to particular kinds of service to establish a reasonable hypothesis connecting cerebral meningioma or death from cerebral meningioma with the circumstances of that service (subsection 7(1) of the Statement of Principles). These factors include ionising radiation, being overweight or obese, being in the second or third trimester of pregnancy or within 30 days postpartum, being treated with a drug, and hormone replacement therapy. The Statement of Principles also outlines the types of service that may be considered relevant for the purposes of establishing a reasonable hypothesis (subsection 7(2) of the Statement of Principles). Additionally, it incorporates the Guide to calculation of 'cumulative equivalent dose' for the purpose of applying ionising radiation factors (subsection 14(b) of the Legislation Act 2003). There are no specific offences, penalties, or civil/criminal consequences for breach outlined in the Statement of Principles itself. However, any breach of the requirements or obligations imposed by the VEA or MRCA, in relation to claims and assessments under these Acts, may result in civil or criminal consequences as per the respective provisions of these Acts. For example, making a false or misleading statement in a claim for benefits under the VEA may result in a civil penalty of up to $22,200 or a criminal penalty of up to 100 penalty units (subsection 133A(1) of the VEA). Similarly, making a false or misleading statement in a claim for benefits under the MRCA may result in a civil penalty of up to $22,200 or a criminal penalty of up to 100 penalty units (subsection 249(1) of the MRCA). The maximum penalties for civil and criminal offences under the VEA and MRCA may be subject to change based on amendments to the Acts or relevant legislation. This Statement of Principles, determined under subsection 196B(2) of the VEA, serves to provide clarity and guidance for claimants and the Repatriation Commission in assessing claims under the VEA and MRCA. It ensures that the qualifying conditions for benefits are reasonable, proportionate, and transparent, promoting the human rights of veterans, current and former Defence Force members, and their dependents, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health. The compatibility of this Statement of Principles with human rights is further affirmed by its compatibility 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.

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