REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 71 of 2007
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. 366 of 1995 determined under subsection 196B(2) of the VEA concerning dental caries and death from dental caries.
2. The Authority is of the view that there is sound medical-scientific evidence that indicates that dental caries and death from dental caries can be related to particular kinds of service. The Authority has therefore determined pursuant to subsection 196B(2) of the VEA a Statement of Principles, Instrument No. 71 of 2007 concerning dental caries. This Instrument will in effect replace the revoked Statements 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 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;
warlike service under the MRCA;
non-warlike service under the MRCA,
before it can be said that a reasonable hypothesis has been raised connecting dental caries or death from dental caries, with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 1 September 2004 concerning dental caries in accordance with section 196G of the Act. 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 Instruments. 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;
- revising the definition of 'dental caries' in clause 3;
- revising factor 6(b) concerning 'exposure to fluoride';
- revising factor 6(c) concerning 'hyposalivation';
- new factor 6(d) concerning 'xerostomia';
- revising factor 6(e) concerning 'oral hygiene';
- new factor 6(f) concerning 'fermentable dietary carbohydrates'
- new factor 6(g) concerning 'professional dental care';
- new factor 6(h) concerning 'acquired enamel defect';
- new factor 6(i) concerning 'root surface caries';
- revising definitions of 'extreme or catastrophic hyposalivation'; 'fermentable dietary carbohydrates' and 'oral hygiene' in clause 9;
- deleting definitions of 'consuming only fluoride-free drinking-water'; 'fluoride supplementation'; 'ICD code' and 'therapeutic radiation';
- new definitions of 'a course of therapeutic radiation'; 'acquired enamel defect'; 'being exposed to fermentable dietary carbohydrates'; 'death from dental caries'; 'exposure to fluoride'; 'gingival recession'; 'ICD-10-AM code'; 'relevant service'; 'terminal event' and 'xerostomia' in clause 9;
- 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 dental caries in the Government Notices Gazette of 1 September 2004, 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. One submission was received for consideration by the Authority during the investigation.
9. The determining of this new instrument finalises the investigation in relation to dental caries as advertised in the Government Notices Gazette of 1 September 2004.
10. A list of references relating to the above condition is available, on written request, from the Repatriation Medical Authority Secretariat.
Overview
The Repatriation Medical Authority Instrument No. 71 of 2007 was enacted to address the problem of establishing a connection between dental caries and death from dental caries and military service, particularly in the context of the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. The Authority revoked the previous Instrument No. 366 of 1995, which was concerned with dental caries, and issued a new Statement of Principles based on updated medical-scientific evidence. This new instrument sets out the minimum factors required to establish a reasonable hypothesis that dental caries or death from dental caries is related to specific types of military service, including operational, peacekeeping, hazardous, warlike, and non-warlike service. The Authority's determination of the new instrument finalises the investigation into dental caries that was initiated in 2004 and provides a framework for determining compensation claims under both the VEA and the MRCA.
Scope and Application
The Repatriation Medical Authority Instrument No. 71 of 2007 pertains to the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, and addresses the relationship between dental caries and specific types of military service. This instrument applies to veterans and service personnel who may claim compensation for dental caries or death from dental caries related to their service, specifically operational, peacekeeping, hazardous, warlike, and non-warlike service as defined under the relevant acts. The instrument serves to replace the previously revoked Instrument No. 366 of 1995, and its application is determined by the Military Rehabilitation and Compensation Commission for claims initiated on or after 1 July 2004. The instrument sets out the medical-scientific evidence required to establish a connection between dental caries and the circumstances of the service, including revised definitions and factors such as exposure to fluoride, hyposalivation, and oral hygiene, among others. This instrument not only updates the format to reflect the latest guidelines but also clarifies its applicability to both the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act.
Key Provisions
The Repatriation Medical Authority, under subsection 196B(8) of the Veterans' Entitlements Act 1986 (VEA), has revoked Instrument No. 366 of 1995, which pertained to dental caries and death from dental caries ((1)). This decision was made due to the availability of new medical-scientific evidence indicating a link between dental caries, death from dental caries, and specific types of service ((2)). In its place, the Authority has issued Instrument No. 71 of 2007, a Statement of Principles concerning dental caries, which replaces the revoked instruments ((2)). This Statement of Principles is crucial as it outlines the minimum factors that must exist, and which of those factors must relate to certain types of service, in order to establish a reasonable hypothesis connecting dental caries or death from dental caries with the circumstances of that service ((4)). These service types include operational service, peacekeeping service, hazardous service under the VEA, and warlike and non-warlike service under the Military Rehabilitation and Compensation Act 2004 (MRCA) ((4)).
The Statement of Principles, as outlined in Instrument No. 71 of 2007, imposes specific obligations on the parties it governs. For instance, it necessitates that claimants provide evidence demonstrating a connection between their dental caries or death from dental caries and their service ((4)). This includes demonstrating exposure to certain factors such as fluoride, hyposalivation, xerostomia, oral hygiene, fermentable dietary carbohydrates, professional dental care, acquired enamel defect, and root surface caries ((5)). Additionally, the Authority's decision to determine this new instrument follows an investigation and public consultation process, during which the Authority invited submissions from relevant organisations and individuals ((8)-(9)). This process ensures that the Statement of Principles is informed by a broad range of expertise and perspectives, thereby enhancing its credibility and effectiveness.
Breaches of the provisions set out in the Statement of Principles could result in various consequences. While the document does not explicitly state specific offences or penalties for non-compliance, it is reasonable to infer that failure to meet the outlined requirements could impact the validity of a claim for compensation under the VEA or MRCA. This could potentially lead to the denial of benefits or compensation that the claimant might otherwise be entitled to receive. The exact nature and extent of any penalties or consequences for non-compliance would likely be determined on a case-by-case basis, taking into account the specific circumstances of the claim and the extent of the non-compliance. The Statement of Principles serves as a guideline for determining the eligibility for compensation, and adherence to its provisions is crucial for claimants seeking benefits under the VEA or MRCA.