Statement of Principles concerning chronic fatigue syndrome No. 11 of 2014

Administered by Department of Veterans' Affairs

Legislation au F2014L00013 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

INSTRUMENT NO. 11 of 2014

 

VETERANS’ ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

EXPLANATORY NOTES FOR TABLING

 

 

  1. The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), revokes Instrument No. 23 of 2003, determined under subsection 196B(2) of the VEA concerning chronic fatigue syndrome.

 

2.             The Authority is of the view that there is sound medical-scientific evidence that indicates that chronic fatigue syndrome and death from chronic fatigue syndrome 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. 11 of 2014 concerning chronic fatigue syndrome.  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;

 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 chronic fatigue syndrome or death from chronic fatigue syndrome, with the circumstances of that service.

 

5.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 18 May 2011 concerning chronic fatigue syndrome 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 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 2005;
  • deleting the ICD code from the Instrument header;
  • revising the definition of 'chronic fatigue syndrome' in clause 3;
  • revising factor 6(a) concerning 'an infection';
  • new factor 6(b) concerning 'a hostile or life-threatening environment';
  • new definitions of 'a hostile or life-threatening environment' and 'an infection as specified' in clause 9;
  • revising the definitions of 'ICD-10-AM code' and 'relevant service' in clause 9;
  • deleting the definitions of 'Coxiella burnetti (Q fever) infection' and 'Ross River virus infection'; 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 chronic fatigue syndrome in the Government Notices Gazette of 18 May 2011, 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.  Two submissions were received for consideration by the Authority during the investigation.

 

9.             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.

 

10.         The determining of this Instrument finalises the investigation in relation to chronic fatigue syndrome as advertised in the Government Notices Gazette of 18 May 2011.

 

11.         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. 11 of 2014

Kind of Injury, Disease or Death: Chronic fatigue syndrome

 

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 chronic fatigue syndrome;
  • 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 chronic fatigue syndrome with the circumstances of eligible service rendered by a person, as set out in clause 4 of the Explanatory Notes;
  • replaces Instrument No. 23 of 2003; and
  • reflects developments in the available sound medical-scientific evidence concerning chronic fatigue syndrome 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; and
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD).

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 Repatriation Medical Authority Instrument No. 11 of 2014 amends the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 to address the issue of chronic fatigue syndrome in veterans. The instrument revokes the previous Statement of Principles concerning chronic fatigue syndrome and replaces it with a new Statement of Principles based on the latest sound medical-scientific evidence. The 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 chronic fatigue syndrome. The instrument 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 chronic fatigue syndrome with the circumstances of eligible service rendered by a person. The instrument 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, the right to an adequate standard of living, and the right to the enjoyment of the highest attainable standard of physical and mental health. The instrument was enacted by the Repatriation Medical Authority and its policy objective is to provide a framework for the assessment and determination of compensation and benefits in relation to the treatment and rehabilitation of veterans and Defence Force members who have chronic fatigue syndrome. The instrument is compatible with human rights as it does not derogate from and promotes a number of human rights.

Scope and Application

The Repatriation Medical Authority Instrument No. 11 of 2014, issued under subsection 196B(8) of the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), revokes Instrument No. 23 of 2003 and establishes new criteria concerning chronic fatigue syndrome. This instrument applies to veterans, current and former Defence Force members, and their dependants who may be eligible for compensation or medical treatment related to chronic fatigue syndrome as a result of specific service rendered. The geographic reach of this legislation is national, affecting claimants across Australia. The instrument outlines the factors that must exist for a reasonable hypothesis to connect chronic fatigue syndrome with certain kinds of service, including operational, peacekeeping, hazardous, and British nuclear test defence service, as well as warlike and non-warlike service. The Authority ensures these criteria align with current medical-scientific evidence and reflect the latest understanding of the condition. The Authority has also ensured that this instrument promotes human rights, particularly the rights to social security, an adequate standard of living, and the highest attainable standard of physical and mental health, as well as the rights of persons with disabilities.

Key Provisions

The Repatriation Medical Authority (RMA) has determined a new Statement of Principles, Instrument No. 11 of 2014 concerning chronic fatigue syndrome, replacing the previously revoked Instrument No. 23 of 2003. This Instrument outlines the circumstances under which medical treatment and compensation can be extended to eligible persons with chronic fatigue syndrome. The Statement of Principles specifies the minimum factors that must exist and be related to particular types of service, such as operational, peacekeeping, hazardous, British nuclear test defence, warlike, and non-warlike service, to establish a connection between chronic fatigue syndrome and the service rendered (section 4). This Instrument also reflects the latest medical-scientific evidence and updates the format to align with the commencement of the Military Rehabilitation and Compensation Act 2004 (MRCA) (section 7). The obligations imposed on parties under this Act include ensuring that claims for compensation are assessed by the Military Rehabilitation and Compensation Commission, in accordance with Statements of Principles issued by the RMA (section 3). Claimants must provide evidence that links their chronic fatigue syndrome to their service, as outlined in the Statement of Principles, to qualify for benefits under the Veterans' Entitlements Act 1986 (VEA) and the MRCA. The RMA is responsible for determining the Statements of Principles based on sound medical-scientific evidence, and the Commission must use these Statements to assess claims. Additionally, the RMA must ensure that the process for determining these Statements is transparent and that relevant parties, such as veterans' organisations and experts, are given the opportunity to submit relevant evidence and opinions (section 8). There are no explicit offences, penalties, or consequences for breach detailed in the provided text; however, failure to comply with the requirements of the Act, such as providing incomplete or inaccurate information, may result in the rejection of a claim. The primary consequence of non-compliance would be the denial of compensation and medical treatment for chronic fatigue syndrome. While the text does not specify penalties, it is likely that such outcomes would be determined through the legal and administrative processes outlined in the VEA and the MRCA. The compatibility statement indicates that the Instrument promotes human rights by facilitating the assessment and determination of benefits and compensation, thereby ensuring that the qualifying conditions are reasonable, proportionate, and transparent (section 4).

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