Statement of Principles concerning chronic fatigue syndrome No. 12 of 2014

Administered by Department of Veterans' Affairs

Legislation au F2014L00015 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

INSTRUMENT NO. 12 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. 24 of 2003, determined under subsection 196B(3) of the VEA concerning chronic fatigue syndrome.

 

2.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not 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(3) of the VEA a Statement of Principles, Instrument No. 12 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 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, chronic fatigue syndrome or death from chronic fatigue syndrome is connected 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 definition of '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. 12 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 exist before it can be said that, on the balance of probabilities, chronic fatigue syndrome is connected with the circumstances of eligible service rendered by a person, as set out in clause 4 of the Explanatory Notes;
  • replaces Instrument No. 24 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. 12 of 2014, enacted under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, was introduced to address the issue of claims related to chronic fatigue syndrome (CFS) in veterans and service personnel. This legislative instrument revokes the previous Instrument No. 24 of 2003, replacing it with updated medical-scientific evidence and revised principles to better reflect the current understanding of CFS and its potential connection to service. The Authority determined this instrument following an investigation into CFS, taking into account the latest sound medical-scientific evidence. It outlines the circumstances and factors necessary to establish a connection between CFS and service, facilitating the assessment and review of claims for compensation under both the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. The instrument also ensures compatibility with human rights, promoting the rights to social security, adequate living standards, and health, while providing clarity and updated guidelines for the determination of CFS-related claims.

Scope and Application

The Repatriation Medical Authority Instrument No. 12 of 2014, concerning chronic fatigue syndrome, applies to individuals who have served in eligible war service, defence service, or peacetime service, as defined by the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This Instrument facilitates the process by which these individuals can claim compensation for chronic fatigue syndrome, which is connected to their service, by outlining the medical and scientific factors that must be present for such a connection to be accepted on the balance of probabilities. The Instrument applies to all relevant claims submitted on or after its effective date and replaces the previously revoked Instrument No. 24 of 2003. It is intended to ensure that the claims process is based on the most current medical-scientific evidence. The Instrument's jurisdiction spans the Commonwealth, covering all individuals who fall under the purview of the VEA and MRCA and who are affected by chronic fatigue syndrome related to their service. While the Instrument provides a framework for determining compensation claims, it does not explicitly state any exclusions or exemptions, leaving such determinations to the discretion of the Repatriation Commission and subsequent review bodies.

Key Provisions

The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), has revoked Instrument No. 24 of 2003 and issued Instrument No. 12 of 2014 concerning chronic fatigue syndrome. This new Instrument sets out the Statement of Principles that must be met for it to be said that, on the balance of probabilities, chronic fatigue syndrome is connected with the circumstances of eligible service rendered by a person. Specifically, claims for compensation under the Military Rehabilitation and Compensation Act 2004 (the MRCA) for chronic fatigue syndrome sustained on or after 1 July 2004 are determined by the Military Rehabilitation and Compensation Commission by reference to these Statements of Principles issued by the Authority. The Statement of Principles outlines the factors that must exist, and which of those factors must be related to eligible war service, defence service, or peacetime service before it can be said that chronic fatigue syndrome is connected with the circumstances of that service. These factors include an infection, a medical diagnosis, and the exclusion of other causes. The Instrument also revises definitions and adopts a new format to reflect the commencement of the MRCA and the latest sound medical-scientific evidence. The Authority has determined this Instrument following an investigation notified in the Government Notices Gazette of 18 May 2011, and 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. The Authority imposes obligations on parties and entities governed by the VEA and MRCA, including claimants and the Repatriation Commission, to facilitate the assessment and determination of claims for compensation related to chronic fatigue syndrome. The Authority must also ensure that the qualifying conditions for the benefit are'reasonable, proportionate, and transparent'. The Authority is required to facilitate the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal. There are no specific offences, penalties, or civil/criminal consequences mentioned for breach of the provisions of this Instrument. However, the Authority may take action against any party that fails to comply with the requirements of the VEA or MRCA, which could include denial of benefits or other administrative actions. The Authority is committed to ensuring that the process for determining and assessing claims for compensation is fair, transparent, and based on the best available medical-scientific evidence.

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