REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 7 of 2008
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. 33 of 1994, as amended by Instrument Nos. 223 of 1995 and 9 of 2002, determined under subsection 196B(2) of the VEA concerning cholelithiasis and death from cholelithiasis.
2. The Authority is of the view that there is sound medical-scientific evidence that indicates that cholelithiasis and death from cholelithiasis 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, Instrument No. 7 of 2008 concerning cholelithiasis. 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 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;
warlike service under the MRCA;
non-warlike service under the MRCA,
before it can be said that a reasonable hypothesis has been raised connecting cholelithiasis or death from cholelithiasis, with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 28 June 2006 concerning cholelithiasis 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 'cholelithiasis' in clause 3;
- revising factor 6(a) concerning 'being obese';
- new factor 6(b) concerning 'extreme weight loss';
- revising factor 6(c) concerning 'treatment with a drug';
- revising factor 6(d) concerning 'cirrhosis of the liver';
- revising factor 6(e) concerning 'haemolytic disease';
- new factor 6(f) concerning 'inflammatory bowel disease';
- revising factor 6(g) concerning 'ileal resection';
- revising factor 6(h) concerning 'type 2 diabetes mellitus'
- revising factor 6(i) concerning 'total parenteral nutrition';
- new factor 6(j) concerning 'being pregnant';
- revising factor 6(k) concerning 'oestrogen therapy';
- new factor 6(l) concerning 'spinal cord injury';
- new factor 6(m) concerning 'a partial or complete gastrectomy';
- new factor 6(n) concerning 'a foreign body in the biliary tract, or a mechanical obstruction';
- new factor 6(o) concerning 'clonorchiasis, fascioliasis, ascariasis or opisthorchiasis of the biliary tract';
- new factor 6(p) concerning 'bacterial infection of the biliary tract';
- revising definitions of 'relevant service' and 'total parenteral nutrition' in clause 9;
- new definitions of 'a drug from the specified list', 'a foreign body', 'a haemolytic disease', 'a mechanical obstruction of the biliary tract', 'being obese', 'death from cholelithiasis', 'fascioliasis', 'ICD-10-AM code', 'oestrogen therapy', 'rapid and extreme weight loss', 'spinal cord injury', 'terminal event', and 'type 2 diabetes mellitus' in clause 9;
- deleting definitions of 'chronic haemolysis', 'ICD code', 'obesity', and 'pigment stones'; 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 cholelithiasis in the Government Notices Gazette of 28 June 2006, 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 cholelithiasis as advertised in the Government Notices Gazette of 28 June 2006.
10. 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. 7 of 2008 amends the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 by revoking and replacing previous instruments concerning cholelithiasis and death from cholelithiasis. This legislative instrument responds to new medical-scientific evidence indicating that these conditions can be linked to specific types of military service. The Repatriation Medical Authority, acting under the Veterans' Entitlements Act 1986, has determined a new Statement of Principles to reflect these findings. The new instrument sets out the minimum factors that must exist to establish a connection between cholelithiasis or death from cholelithiasis and the service rendered by a person, covering various categories of service including operational, peacekeeping, hazardous, warlike, and non-warlike service. The Authority undertook an investigation into the condition, advertised in the Government Notices Gazette on 28 June 2006, and invited submissions from relevant stakeholders, though none were received. This new instrument incorporates revisions to definitions and factors, adopts the latest format, and specifies its effective date, ensuring clarity and consistency with the Military Rehabilitation and Compensation Act 2004.
Scope and Application
The Repatriation Medical Authority Instrument No. 7 of 2008, made under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), establishes a Statement of Principles concerning cholelithiasis. This Instrument applies to veterans and current or former service personnel who are seeking compensation for injuries, diseases, or deaths related to their service. The Act pertains to various types of service including operational, peacekeeping, hazardous, warlike, and non-warlike service. The Instrument specifies the minimum factors that must be related to the service to establish a connection between cholelithiasis or death from cholelithiasis and the service conditions. The scope of this Instrument is national, affecting individuals across Australia. While the Instrument sets out the criteria for claims, it does not explicitly state any exclusions or thresholds, but rather relies on the sound medical-scientific evidence available to the Authority. The Authority has the power to extend or restrict the application of this Instrument through subordinate instruments, ensuring the criteria remain current with evolving medical understanding.
Key Provisions
The main operative sections of the Repatriation Medical Authority Instrument No. 7 of 2008 under the Veterans’ Entitlements Act 1986 (VEA) and Military Rehabilitation and Compensation Act 2004 (MRCA) concern the creation of a new Statement of Principles regarding cholelithiasis (subsection 196B(2) of the VEA). This new Statement of Principles, which replaces the previously revoked Instrument No. 33 of 1994, outlines the factors that must exist to establish a connection between cholelithiasis or death from cholelithiasis and specific kinds of military service. These kinds of service include operational, peacekeeping, hazardous, warlike, and non-warlike service as defined under the VEA and MRCA (section 4). The new Instrument incorporates changes in format and terminology, while retaining the essence of the previous instruments.
The obligations and requirements imposed by this Act primarily concern the Repatriation Medical Authority's duty to establish Statements of Principles that accurately reflect current medical-scientific evidence. This involves conducting investigations, soliciting expert opinions, and ensuring that the factors outlined in the Statement of Principles are comprehensive and up-to-date. The Authority must also ensure that the new Statement of Principles is published and made available to relevant parties, including veterans, service personnel, and their dependants. Additionally, the Authority is required to advertise its intention to investigate and invite submissions from interested parties, although it appears no submissions were received in this instance.
Breaches of the provisions under the VEA and MRCA can result in civil or criminal consequences. While specific offences and penalties are not detailed within this explanatory statement, breaches of related legislation typically involve substantial penalties, including fines and imprisonment. Under the VEA, penalties for non-compliance with medical determinations and statements of principles can be severe, reflecting the seriousness of the issues concerning veterans' health and entitlements. Similarly, under the MRCA, failure to adhere to the provisions for claims and compensation can result in legal action and penalties as outlined in the Act.
The creation of this new Statement of Principles is a formal process that concludes the investigation into cholelithiasis as initially advertised in the Government Notices Gazette of 28 June 2006. This new Instrument aims to provide clarity and updated criteria for determining the connection between military service and cholelithiasis, ensuring that veterans and their families receive appropriate recognition and compensation. The Authority's role in this process is crucial, as it ensures that the legislative framework remains aligned with the latest medical-scientific evidence and that veterans' entitlements are accurately and fairly assessed.