Statement of Principles concerning de Quervain tendinopathy (Reasonable Hypothesis) (No. 41 of 2019)

Administered by Department of Veterans' Affairs

Legislation au F2019L00242 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

DE QUERVAIN TENDINOPATHY

(REASONABLE HYPOTHESIS) (NO. 41 OF 2019)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning de Quervain tendinopathy (Reasonable Hypothesis) (No. 41 of 2019).

Background

2.             The Repatriation Medical Authority (the Authority) has determined, under subsection 196B(2) of the Veterans' Entitlements Act 1986 (the VEA), Statement of Principles concerning de Quervain tendinopathy (Reasonable Hypothesis) (No. 41 of 2019).

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that de Quervain tendinopathy and death from de Quervain tendinopathy can be related to particular kinds of service.  The Authority has therefore determined this Statement of Principles concerning de Quervain tendinopathy pursuant to subsection 196B(2) of the VEA.

Purpose and Operation

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

5.             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 de Quervain tendinopathy or death from de Quervain tendinopathy, with the circumstances of that service.  The Statement of Principles has been determined for the purposes of both the VEA and the MRCA.

6.             The Repatriation Commission, Military Rehabilitation and Compensation Commission, Veterans' Review Board or Administrative Appeals Tribunal cannot accept any claim for pension; or a claim for liability or compensation relating to de Quervain tendinopathy or death from de Quervain tendinopathy that was lodged on or after 1 June 1994 in the case of the VEA, or 1 July 2004 in the case of the MRCA respectively, unless this Statement of Principles upholds that claim (subsection 120A(3) of the VEA or subsection 338(3) of the MRCA).

7.             This new Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 4 September 2018 concerning stenosing tenosynovitis (in particular trigger finger/thumb and de Quervain tenosynovitis) in accordance with section 196G of the VEA.  The investigation involved an examination of the sound medical-scientific evidence available to the Authority.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to stenosing tenosynovitis (in particular trigger finger/thumb and de Quervain tenosynovitis) in the Government Notices Gazette of 4 September 2018, 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 during the investigation.

Human Rights

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.

Finalisation of Investigation

10.         The determining of this new Instrument finalises the investigation in relation to stenosing tenosynovitis (in particular trigger finger/thumb and de Quervain tenosynovitis) as advertised in the Government Notices Gazette of 4 September 2018.

References

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. 41 of 2019

Kind of Injury, Disease or Death: De Quervain tendinopathy

 

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).  Part XIA of the VEA requires the determination of these instruments outlining the factors linking 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 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 de Quervain tendinopathy;
  • facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal; and
  • 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 de Quervain tendinopathy with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement.

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.

Overview

The Statement of Principles concerning de Quervain tendinopathy (Reasonable Hypothesis) (No. 41 of 2019) is an instrument determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). This legislative instrument was introduced to address the need for a clear framework connecting de Quervain tendinopathy and its fatalities to specific types of military service, based on sound medical-scientific evidence. The instrument outlines the minimum factors required to establish a reasonable hypothesis linking de Quervain tendinopathy to the service rendered by a person, which includes operational, peacekeeping, hazardous, British nuclear test defence service under the VEA, and warlike or non-warlike service under the MRCA. It facilitates the assessment and determination of claims for benefits and compensation related to de Quervain tendinopathy by setting out these necessary factors, thus ensuring that claims lodged after the specified dates can only be upheld if they align with the criteria set by this Statement of Principles. The Authority ensured compatibility with human rights by affirming that the instrument promotes rather than derogates from various human rights, including the right to social security and the highest attainable standard of health. The Statement of Principles is designed to operate within the legislative framework of the VEA and MRCA, providing clarity and consistency in the processing of claims related to de Quervain tendinopathy. By determining these principles, the Repatriation Medical Authority aimed to improve the medico-scientific quality of outcomes under the Acts, ensuring that claimants receive appropriate consideration and benefits. The instrument reflects the Authority's commitment to basing its determinations on the best available medical-scientific evidence, thereby supporting the rights and welfare of veterans and Defence Force members.

Scope and Application

The Statement of Principles concerning de Quervain tendinopathy (Reasonable Hypothesis) (No. 41 of 2019) applies to veterans and current or former Defence Force members who have suffered from de Quervain tendinopathy, a condition of the tendons in the wrist and thumb. This Statement of Principles is determined under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, and sets out the factors that must be present to establish a reasonable hypothesis connecting the condition with specific types of service. These include operational, peacekeeping, hazardous, British nuclear test defence, warlike, and non-warlike service. The Statement of Principles is designed to facilitate claims for compensation and medical treatment, ensuring that such claims are assessed based on sound medical-scientific evidence. Any claim for pension or compensation related to de Quervain tendinopathy lodged after 1 June 1994 under the VEA or 1 July 2004 under the MRCA must be upheld by this Statement of Principles. This legislative instrument is compatible with human rights, promoting the rights of veterans, service personnel, and their dependents to social security, an adequate standard of living, and the highest attainable standard of physical and mental health, without discrimination.

Key Provisions

The main operative sections of this legislation are subsections 196B(2) and 196B(8) of the Veterans' Entitlements Act 1986 (VEA), which allow the Repatriation Medical Authority (the Authority) to determine Statements of Principles concerning particular injuries, diseases, or deaths related to military service. This specific Statement of Principles (No. 41 of 2019) pertains to de Quervain tendinopathy. It outlines the factors that must exist for a reasonable hypothesis to connect de Quervain tendinopathy or death from de Quervain tendinopathy with service rendered by a person, including operational, peacekeeping, hazardous, and British nuclear test defence service under the VEA, and warlike or non-warlike service under the Military Rehabilitation and Compensation Act 2004 (MRCA). Claims for pension or compensation regarding de Quervain tendinopathy or death from it, lodged after 1 June 1994 under the VEA or 1 July 2004 under the MRCA, cannot be accepted unless this Statement of Principles upholds the claim. The Act imposes several obligations and requirements on the parties it governs. The Repatriation Commission, Military Rehabilitation and Compensation Commission, Veterans' Review Board, or Administrative Appeals Tribunal must follow the factors set out in the Statement of Principles when assessing claims. This includes ensuring that the claim meets the criteria for a reasonable hypothesis connecting de Quervain tendinopathy with the relevant military service. Additionally, the Authority is required to ensure that the Statement of Principles is based on sound medical-scientific evidence. This involves conducting investigations, advertising the intention to investigate, and inviting submissions from relevant parties. Breach of the provisions in this legislation can lead to significant civil or criminal consequences. For instance, if a claim is lodged without meeting the criteria set out in the Statement of Principles, it may be rejected. Such rejections can be reviewed by the Veterans' Review Board or the Administrative Appeals Tribunal. Failure to comply with the requirements set out in the Statement of Principles can result in legal challenges or appeals. While the legislation does not specify maximum penalties for breaches, non-compliance can lead to the denial of benefits and compensation, which can have substantial impacts on the claimants. Additionally, if the Authority fails to base its determinations on sound medical-scientific evidence, it may face scrutiny or legal challenges regarding the validity of its decisions.

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