Statement of Principles concerning dermatomyositis No. 9 of 2014

Administered by Department of Veterans' Affairs

Legislation au F2014L00008 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

INSTRUMENT NO. 9 of 2014

 

VETERANS’ ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

EXPLANATORY NOTES FOR TABLING

 

 

  1. The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), revokes Instrument No. 51 of 2005, determined under subsection 196B(2) of the VEA concerning dermatomyositis.

 

2.             The Authority is of the view that there is sound medical-scientific evidence that indicates that dermatomyositis and death from dermatomyositis 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. 9 of 2014 concerning dermatomyositis.  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 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 dermatomyositis or death from dermatomyositis, with the circumstances of that service.

 

5.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 18 May 2011 concerning dermatomyositis 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:

 

  • revising the definition of 'dermatomyositis' in clause 3;
  • revising factor 6(a) concerning 'a drug of the statin class';
  • revising factor 6(b) concerning 'D-penicillamine';
  • revising factor 6(c) concerning 'hydroxyurea', for amyopathic dermatomyositis only;
  • new factors 6(d) & 6(j) concerning 'a drug';
  • revising factor 6(e) concerning 'a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin';
  • revising factor 6(f) concerning 'a specified viral infection';
  • new factor 6(g) concerning 'a drug of the statin class', for clinical worsening;
  • new factor 6(h) concerning 'D-penicillamine', for clinical worsening;
  • new factor 6(i) concerning 'hydroxyurea', for amyopathic dermatomyositis only and for clinical worsening;
  • new factor 6(k) concerning 'a specified viral infection', for clinical worsening;
  • new definitions of 'a specified viral infection' and 'amyopathic dermatomyositis' in clause 9;
  • revising the definition of 'relevant service' in clause 9;
  • deleting the definition of 'a specified virus'; 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 dermatomyositis in the Government Notices Gazette of 18 May 2011, 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 concerning 'autoimmune disorders' was received for consideration by the Authority during the investigation.

 

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.

 

10.         The determining of this Instrument finalises the investigation in relation to dermatomyositis as advertised in the Government Notices Gazette of 18 May 2011.

 

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. 9 of 2014

Kind of Injury, Disease or Death: Dermatomyositis

 

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).

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 dermatomyositis;
  • 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 as a minimum exist, before it can be said that a reasonable hypothesis has been raised, connecting dermatomyositis with the circumstances of eligible service rendered by a person, as set out in clause 4 of the Explanatory Notes;
  • replaces Instrument No. 51 of 2005; and
  • reflects developments in the available sound medical-scientific evidence concerning dermatomyositis which have occurred since that earlier instrument was 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; and
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD).

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 Repatriation Medical Authority Instrument No. 9 of 2014, issued under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), addresses the issue of dermatomyositis in relation to military service. The Authority replaced the previous Instrument No. 51 of 2005 with this new instrument to reflect updated medical-scientific evidence concerning dermatomyositis. The new instrument specifies the circumstances under which medical treatment and compensation can be provided to eligible individuals who have contracted dermatomyositis, facilitating both claims and assessments. It also outlines the factors necessary to establish a connection between dermatomyositis and service rendered by a person, and it aligns with human rights by ensuring fair, reasonable, and transparent criteria for benefit eligibility. This legislative instrument ensures that compensation claims for dermatomyositis related to military service are assessed based on the most current medical evidence, thereby improving the quality of medico-scientific outcomes under the VEA and MRCA.

Scope and Application

The Repatriation Medical Authority Instrument No. 9 of 2014, as determined under subsection 196B(8) of the Veterans' Entitlements Act 1986, addresses the medical condition of dermatomyositis, replacing the previous Instrument No. 51 of 2005. This instrument applies to veterans, current and former members of the Defence Force, and their dependants who have contracted dermatomyositis, which is now recognised to be related to certain kinds of military service. The instrument delineates the types of service, including operational, peacekeeping, hazardous, British nuclear test defence service, warlike, and non-warlike service, under which a connection to dermatomyositis can be established. The instrument is applicable nationally, impacting all veterans and Defence Force members in Australia. It excludes those services not listed and is subject to the definitions and factors outlined within the instrument. The Authority's decision is influenced by sound medical-scientific evidence and aims to ensure that compensation and medical treatment are available to those who meet the specified criteria. This instrument also facilitates the review of decisions by the Veterans' Review Board and the Administrative Appeals Tribunal.

Key Provisions

The main operative sections of the Repatriation Medical Authority Instrument No. 9 of 2014, concerning dermatomyositis, establish the conditions under which a reasonable hypothesis can be raised connecting dermatomyositis or death from dermatomyositis with the service circumstances of veterans, as outlined in clause 4 of the explanatory notes (section 4). This instrument replaces the previous Instrument No. 51 of 2005 and reflects updates in the medical-scientific evidence available to the Authority. The Authority determines these conditions to facilitate the assessment of claims for compensation under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). The obligations imposed by the Act on the parties or entities it governs include the requirement for claimants to demonstrate that their dermatomyositis is related to their service under one of the specified categories, such as operational, peacekeeping, or warlike service (section 4). The Repatriation Commission must assess these claims against the criteria set out in the Statement of Principles. Furthermore, the Authority is mandated to continually review and update these criteria as new medical-scientific evidence becomes available, ensuring that the determination of claims remains accurate and fair. Breaches of the provisions outlined in this Act can lead to civil and criminal consequences. For example, providing false information in a claim can be considered a criminal offence, potentially leading to fines or imprisonment. The exact penalties are not specified in the explanatory notes but generally align with the penalties for similar offences under the VEA and MRCA. Additionally, the Authority has the power to review and revoke previous determinations if new evidence suggests that the original criteria no longer accurately reflect the medical-scientific understanding of dermatomyositis. These measures ensure that the legislative intent to provide fair and accurate compensation is upheld.

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