REPATRIATION MEDICAL AUTHORITY

INSTRUMENT NO. 24 of 2010

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. 290 of 1995 determined under subsection 196B(2) of the VEA concerning dislocation.

2.             The Authority is of the view that there is sound medical-scientific evidence that indicates that dislocation and death from dislocation 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. 24 of 2010 concerning dislocation.  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;

 warlike service under the MRCA;

 non-warlike service under the MRCA,

before it can be said that a reasonable hypothesis has been raised connecting dislocation or death from dislocation, with the circumstances of that service.

5.             This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 2 May 2007 concerning dislocation 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;
• revising the definition of 'dislocation' in clause 3;
• revising factor 6(a) concerning 'physical trauma';
• revising factor 6(b) concerning 'a disease process affecting the normal structural or functional relationship between the articulating surfaces of the affected joint';
• new factor 6(c) concerning 'damage to a soft tissue structure as specified';
• new factor 6(d) concerning 'laxity of the joint capsule or a stabilising ligament';
• new factor 6(e) concerning 'fracture, avulsion or bony defect';
• new factor 6(f) concerning 'biomechanical abnormality';
• new factor 6(g)(i) concerning 'an inflammatory or infectious condition involving the ear, nose or throat';
• new factor 6(g)(ii) concerning 'a surgical procedure involving the head or neck';
• new factor 6(h)(i) concerning 'tracheal intubation';
• new factor 6(h)(ii) concerning 'intravenous sedation';
• new factor 6(h)(iii) concerning 'an activity that involves wide opening of the mouth';
• deleting worsening factor concerning 'physical trauma';
• deleting worsening factor concerning 'a disease process affecting the normal structural or functional relationship between the articulating surfaces of the affected joint';
• new definitions of 'a biomechanical abnormality involving the affected joint', 'a soft tissue structure as specified', 'an activity that involves wide opening of the mouth', 'death from dislocation', 'ICD-10-AM code', 'neuropathic arthropathy', 'relevant service' and 'terminal event' in clause 9;
• revising definitions of 'a disease process affecting the normal structural or functional relationship between the articulating surfaces of the affected joint' and 'physical trauma to the affected joint' in clause 9;
• deleting definition of '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 dislocation in the Government Notices Gazette of 2 May 2007, 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 16 February 2010, 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 'suffering physical trauma' and 'suffering a disease process'. 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 dislocation as advertised in the Government Notices Gazette of 2 May 2007.

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