REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 21 of 2010
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. 67 of 1999 determined under subsection 196B(3) of the VEA concerning cluster headache syndrome and death from cluster headache syndrome.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that cluster headache and death from cluster headache 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. 21 of 2010 concerning cluster headache. 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) under the VEA;
peacetime service under the MRCA,
before it can be said that, on the balance of probabilities, cluster headache or death from cluster headache is connected with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 24 June 2009 concerning cluster headache 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 the new Instrument are in similar terms as the revoked Instrument. 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;
- changing the name of the Instrument from 'cluster headache syndrome' to 'cluster headache';
- revising the definition of 'cluster headache' in clause 3;
- revising factor 6(a) concerning 'treatment with glyceryl trinitrate or isosorbide mononitrate';
- deleting factor concerning 'trauma to the forehead, temple, or eye socket';
- deleting factor concerning 'alcohol dependence';
- revising definitions of 'ICD-10-AM code' and 'relevant service' in clause 9;
- deleting definitions of 'alcohol dependence', 'death from cluster headache syndrome' and 'trauma to the forehead, temple, or eye socket';
- new definition of 'death from cluster headache' in clause 9; 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 cluster headache syndrome in the Government Notices Gazette of 24 June 2009, 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. On 17 December 2009, the Authority wrote to organisations representing veterans, service personnel and their dependants regarding the proposed Instrument and the medical-scientific material considered by the Authority. This letter emphasised the deletion of factors relating to 'trauma' and 'alcohol dependence'. The Authority provided an opportunity to the organisations to make representations in relation to the proposed instrument prior to its determination. No submissions were received for consideration by the Authority.
10. The determining of this new instrument finalises the investigation in relation to cluster headache syndrome as advertised in the Government Notices Gazette of 24 June 2009.
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 Secretariat
GPO Box 1014
BRISBANE QLD 4001
Overview
The Repatriation Medical Authority Instrument No. 21 of 2010, enacted to address the relationship between cluster headache syndrome and military service, revokes the previous Instrument No. 67 of 1999 under subsection 196B(8) of the Veterans’ Entitlements Act 1986 (VEA). This new instrument was introduced to replace the outdated statement of principles, taking into consideration the latest medical-scientific evidence available. The Authority, under subsection 196B(3) of the VEA, has determined a new Statement of Principles concerning cluster headache, which outlines the factors that must exist for a connection to be established between cluster headache or death from cluster headache and particular kinds of service. This instrument also reflects the commencement of the Military Rehabilitation and Compensation Act 2004 (MRCA) and clarifies that the Statement of Principles is determined for the purposes of both the VEA and the MRCA.
The Authority, after an investigation and review of medical-scientific evidence, finalised the new instrument concerning cluster headache syndrome, which will now be used for determining claims for compensation related to cluster headache and death from cluster headache. The Authority ensured transparency by advertising its intention to investigate and inviting submissions from relevant organisations and individuals, although no submissions were received. The new instrument has been designed to adopt the latest format, revise definitions, and remove certain factors relating to trauma and alcohol dependence, providing a more comprehensive understanding of the connection between cluster headache and military service.
Scope and Application
The Repatriation Medical Authority Instrument No. 21 of 2010 under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 addresses the determination of Statements of Principles concerning cluster headache syndrome. This instrument applies to individuals who have rendered eligible war service, defence service, or peacetime service, as defined by the respective acts. It provides the criteria and factors that must exist for cluster headache or death from cluster headache to be considered connected with service, thus affecting eligibility for compensation. The instrument revokes the previously determined Instrument No. 67 of 1999 and replaces it with the current statement, which incorporates the latest medical-scientific evidence. The instrument’s geographic and jurisdictional reach extends to Commonwealth legislation, applying to claims made under the Veterans’ Entitlements Act 1986 for pre-2004 service and under the Military Rehabilitation and Compensation Act 2004 for service from 1 July 2004 onwards. The Authority has determined that certain factors previously considered, such as trauma and alcohol dependence, are no longer applicable in establishing a connection between service and cluster headache. The Authority’s decision is based on the sound medical-scientific evidence available, and no submissions were received during the investigation or consultation periods.
Key Provisions
The Repatriation Medical Authority (the Authority) under the Veterans' Entitlements Act 1986 (VEA) has revoked Instrument No. 67 of 1999 concerning cluster headache syndrome and death from cluster headache syndrome (subsection 196B(8) of the VEA). This revocation has led to the determination of a new Statement of Principles, Instrument No. 21 of 2010 concerning cluster headache, effective from the date of its determination (subsection 196B(3) of the VEA). This new instrument replaces the previously revoked one and outlines the factors that need to exist for cluster headache or death from cluster headache to be considered connected to particular kinds of service under the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA).
The obligations imposed by the Act require the Authority to consider sound medical-scientific evidence when determining if cluster headache or death from cluster headache can be related to service. This involves evaluating the latest available evidence, which led to the deletion of certain factors such as trauma to the forehead, temple, or eye socket and alcohol dependence from the new Instrument. The Authority must also ensure that the new Statement of Principles is accessible to relevant parties, including veterans and service personnel, and their representatives, providing them an opportunity to make representations before the final determination.
Breaching the obligations set forth by the VEA and the MRCA could result in legal consequences for both the Authority and claimants. The Authority may face challenges if it fails to consider the latest medical-scientific evidence or properly advertise its intention to investigate and gather submissions. Claimants who provide false or misleading information in their applications may face civil or criminal penalties, including fines or imprisonment. The maximum penalties for such offences depend on the severity and intent behind the breach, as outlined in the respective Acts.
The new Instrument No. 21 of 2010 sets out specific factors that need to exist for cluster headache or death from cluster headache to be connected to service under the VEA and MRCA. These factors include the type of service rendered and the relevant medical-scientific evidence. The Authority has clarified that the new Instrument adopts the latest revised format, which commenced in 2005, and has made several changes to the format and definitions to ensure clarity and consistency. The Authority has also emphasised that the new Statement of Principles has been determined for the purposes of both the VEA and the MRCA, as required by subsection 196B(3A) of the VEA.