REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 2 of 2011
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. 18 of 1997, determined under subsection 196B(3) of the VEA concerning coeliac disease.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that coeliac disease and death from coeliac disease 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. 2 of 2011 concerning coeliac disease. 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, coeliac disease or death from coeliac disease 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 25 June 2008 concerning coeliac disease 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 'coeliac disease' in clause 3;
- new factor 6(a) concerning 'being treated with interferon alpha';
- new factor 6(b) concerning 'being pregnant';
- new factor 6(c) concerning 'inability to maintain a gluten-free diet';
- revising factor 6(d) concerning 'inability to obtain appropriate clinical management';
- new definitions of 'death from coeliac disease', 'ICD-10-AM code' and 'terminal event' in clause 9;
- revising definition of 'relevant service' in clause 9;
- deleting definitions of 'gluten' and 'ICD code'; 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 coeliac disease in the Government Notices Gazette of 25 June 2008, 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 Instrument finalises the investigation in relation to coeliac disease as advertised in the Government Notices Gazette of 25 June 2008.
10. 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. 2 of 2011, under subsection 196B(8) of the Veterans’ Entitlements Act 1986, addresses the issue of coeliac disease and its connection to particular kinds of service. This legislation revokes Instrument No. 18 of 1997 and establishes a new Statement of Principles concerning coeliac disease, reflecting the latest medical-scientific evidence. The Repatriation Medical Authority, as the enacting body, determined this Instrument following an investigation into the condition and in accordance with section 196G of the VEA. The policy objective is to provide clarity and updated guidelines on the relationship between coeliac disease and service, ensuring that claims for compensation are assessed appropriately under both the Veterans’ Entitlements Act and the Military Rehabilitation and Compensation Act 2004. The new Instrument includes revised definitions, updated factors, and a specified date of effect to align with current practices and evidence.
Scope and Application
The Repatriation Medical Authority Instrument No. 2 of 2011 under the Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) addresses the connection between coeliac disease and specific types of military service, replacing the previous Instrument No. 18 of 1997. This Instrument applies to veterans and service personnel who have rendered eligible war service, defence service, or peacetime service, and who may have contracted coeliac disease or died from it. The Authority's determination under subsection 196B(3) of the VEA and section 196B(3A) of the MRCA sets out the factors that must be present to establish a probable connection between coeliac disease or death from it and the service rendered. This Instrument is applicable nationally within Australia, governing claims made under both the VEA and the MRCA for injuries or diseases related to service that commenced on or after 1 July 2004. The Authority's determination is made on the basis of available medical-scientific evidence, and while no submissions were received during the investigation, the finalised Instrument serves as a formal statement of principles for assessing claims related to coeliac disease in military service contexts.
Key Provisions
The Repatriation Medical Authority (RMA) has revoked Instrument No. 18 of 1997 concerning coeliac disease and determined a new Statement of Principles, Instrument No. 2 of 2011, under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (VEA). This new Instrument sets out the conditions that must exist, and which must be related to specific kinds of service, for it to be said that, on the balance of probabilities, coeliac disease or death from coeliac disease is connected with the circumstances of the service (section 4). The Statement of Principles is applicable to claims for compensation under both the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA) for service injuries, diseases, or deaths on or after 1 July 2004 (section 3). The new Instrument incorporates the latest revised format and includes several changes, such as the addition of new factors (e.g., being treated with interferon alpha, being pregnant, inability to maintain a gluten-free diet) and the revision of definitions (e.g., 'coeliac disease', 'death from coeliac disease').
The Statement of Principles imposes obligations on claimants to provide evidence that the factors specified in the Instrument are related to their service. For instance, claimants must demonstrate a connection between their coeliac disease and their service under the VEA or MRCA, as outlined in the Instrument. The Authority may also require medical evidence and other documentation to substantiate the claim. Additionally, the Instrument requires claimants to adhere to the definitions and conditions specified within it, including the necessity of maintaining a gluten-free diet where applicable.
Breach of the requirements outlined in the Statement of Principles may lead to civil or criminal consequences, depending on the nature of the non-compliance. Under the VEA, penalties for providing false or misleading information can result in fines and, in severe cases, imprisonment. The maximum penalty for providing false information under the VEA is generally a fine of up to $22,200 for individuals and $111,000 for corporations (section 234). Under the MRCA, penalties for similar offences can include fines and imprisonment, with the specific penalties depending on the gravity of the offence and the circumstances of the breach.
The Statement of Principles does not explicitly detail offences and penalties but refers to the overarching Acts—the VEA and MRCA—for related provisions. Claimants must ensure they provide accurate and complete information in accordance with the requirements of the Instruments and the Acts to avoid any potential penalties or consequences. The Authority may also take action against any person who fails to comply with the provisions of the Instrument, including the revocation of benefits or other administrative actions.