Statement of Principles concerning chronic venous insufficiency of the lower limb and varicose veins of the lower limb (Balance of Probabilities) (No. 8 of 2021)

Administered by Department of Veterans' Affairs

Legislation au F2021L00022 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

CHRONIC VENOUS INSUFFICIENCY OF THE LOWER LIMB AND VARICOSE VEINS OF THE LOWER LIMB

(BALANCE OF PROBABILITIES) (NO. 8 OF 2021)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning chronic venous insufficiency of the lower limb and varicose veins of the lower limb (Balance of Probabilities) (No. 8 of 2021).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 30 of 2012 (Federal Register of Legislation No. F2012L00461) determined under subsection 196B(3) of the VEA concerning chronic venous insufficiency of the lower limb. 

3.             The Authority, under subsection 196B(8) of the VEA, repeals Instrument No. 121 of 2011 (Federal Register of Legislation No. F2011L02138) determined under subsection 196B(3) of the VEA concerning varicose veins of the lower limb.

4.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that chronic venous insufficiency of the lower limb or varicose veins of the lower limb and death from chronic venous insufficiency of the lower limb or varicose veins of the lower limb 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 chronic venous insufficiency of the lower limb and varicose veins of the lower limb (Balance of Probabilities) (No. 8 of 2021).  This Instrument will in effect replace the repealed Statement of Principles.

Purpose and Operation

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

6.             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 venous insufficiency of the lower limb or varicose veins of the lower limb or death from chronic venous insufficiency of the lower limb or varicose veins of the lower limb 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.

7.             This new Instrument results from two discrete investigations notified by the Authority in the Government Notices Gazette of 7 May 2019 concerning chronic venous insufficiency of the lower limb and varicose veins of the lower limb, respectively, in accordance with section 196G of the VEA.  These investigations involved an examination of the available sound medical-scientific evidence for each condition.  The Authority concluded that it would determine Statements of Principles that cover both chronic venous insufficiency of the lower limb and varicose veins of the lower limb for two reasons.  Firstly, since chronic venous insufficiency of the lower limb and varicose veins of the lower limb are part of the continuum of chronic venous disease of the lower limb, the ease of use of the Statements of Principles is facilitated by having Instruments that cover both conditions rather than separate Instruments.  Secondly, the sound medical-scientific evidence demonstrates substantial overlap in the risk factors for the clinical onset and clinical worsening of these conditions.

8.             The contents of this Instrument are in similar terms as the repealed Instruments.  Comparing this Instrument and the repealed Instruments, 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 'chronic venous insufficiency of the lower limb' in subsection 7(2);
  • revising the definition of 'varicose veins of the lower limb' in subsection 7(3);
  • revising the reference to 'ICD-10-AM code' in subsection 7(5);
  • revising the factors in subsections 9(1) and 9(11) concerning having deep vein thrombosis within a deep vein that drains the affected lower limb;
  • revising the factors in subsections 9(2) and 9(12) concerning having chronic complete or partial obstruction of a vein that drains the affected lower limb;
  • revising the factors in subsections 9(4) and 9(14) concerning continuous standing;
  • revising the factors in subsections 9(5) and 9(15) concerning having chronic dysfunction of the calf muscle pump in the affected lower limb;
  • new factors in subsections 9(8) and 9(18) concerning having tricuspid valve regurgitation, in the presence of a pulsatile greater saphenous vein;
  • new factors in paragraphs 9(9)(b) and 9(19)(b) concerning having heart failure, for chronic venous insufficiency of the lower limb only;
  • revising the factors in paragraphs 9(9)(c) and 9(19)(c) concerning being obese, by the inclusion of a note;
  • new definitions of 'BMI', 'MRCA' and 'VEA' in Schedule 1 - Dictionary; and
  • revising the definitions of 'being obese' and 'deep vein that drains the affected lower limb' and 'relevant service' in Schedule 1 - Dictionary.

Consultation

9.             Prior to determining this Instrument, the Authority advertised its intention to undertake investigations in relation to chronic venous insufficiency of the lower limb and varicose veins of the lower limb, respectively, in the Government Notices Gazette of 7 May 2019, 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, the Military Rehabilitation and Compensation Commission, organisations and persons referred to in section 196E of the VEA, and any person having expertise in the field.  One submission was received for consideration by the Authority in relation to the investigation concerning varicose veins of the lower limb.

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 investigations in relation to chronic venous insufficiency of the lower limb and varicose veins of the lower limb, respectively, as advertised in the Government Notices Gazette of 7 May 2019.

References

12.         A list of references relating to the above condition is available on the Authority’s website at: www.rma.gov.au.  Any other document referred to in this Statement of Principles is available on request to the Repatriation Medical Authority at the following address:

              

  Email:    info@rma.gov.au

  Post:      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. 8 of 2021

Kind of Injury, Disease or Death: Chronic venous insufficiency of the lower limb and varicose veins of the lower limb

 

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(3) 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 connecting 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 and the Military Rehabilitation and Compensation 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 venous insufficiency of the lower limb or varicose veins of the lower limb;
  • 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 venous insufficiency of the lower limb or varicose veins of the lower limb 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. 30 of 2012 and Instrument No. 121 of 2011; and
  • reflects developments in the available sound medical-scientific evidence concerning chronic venous insufficiency of the lower limb and varicose veins of the lower limb which have occurred since that earlier instruments were 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.

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.