Statement of Principles concerning erectile dysfunction No. 17 of 2005

Administered by Department of Veterans' Affairs

Legislation au F2005L01461 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

INSTRUMENT NO. 17 of 2005

 

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. 97 of 1996 of 16 August 1996 and Instrument No. 16 of 2002 of 9 January 2002, each of which were determined under subsection 196B(2) of the VEA concerning impotence and death from impotence.

 

2.             The Authority is of the view that there is sound medical-scientific evidence that indicates that erectile dysfunction and death from erectile dysfunction 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. 17 of 2005 concerning erectile dysfunction.  This Instrument will in effect replace the revoked Statements of Principles concerning impotence and death from impotence.

 

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 erectile dysfunction or death from erectile dysfunction, with the circumstances of that service.

 

5.             This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 22 December 2004 concerning impotence 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 Instrument.  Comparing the new and the revoked Instruments, the differences include:

 

  • renaming the Instrument;
  • adopting the latest revised Instrument format, which commenced in 2003;
  • deleting the ICD code from the Instrument header;
  • rewording factors 5(a) and (y) relating to mood disorder or anxiety disorder, requiring the disorder to be clinically significant;
  • rewording factors 5(b) and (z) relating to smoking cigarettes or equivalent tobacco products, requiring smoking of at least ten pack years before clinical onset or worsening;
  • new factors 5(c) and (za) relating to hypertension;
  • new factors 5(d) and (zb) relating to obesity;
  • new factors 5(e) and (zc) relating to physical activity;
  • new factors 5(f) and (zd) relating to ischaemic heart disease;
  • a new factor 5(ze) relating to atherosclerotic peripheral vascular disease (at the time of the clinical worsening);
  • a new factor 5(zf) relating to non-aneurysmal aortic atherosclerotic disease (at the time of the clinical worsening);
  • a new factor 5(zg) relating to diabetes mellitus (at the time of the clinical worsening);
  • a new factor 5(zh) relating to therapeutic radiation (immediately before the clinical worsening);
  • a new factor 5(zi) relating to endocrinological disorders (at the time of the clinical worsening);
  • a new factor 5(zj) relating to trauma to the external genitals, perineum or pelvis (at the time of the clinical worsening);
  • rewording factors 5(m) and (zk) relating to traumatic injury involving the  spinal cord or cauda equina within the ninety days immediately before the clinical onset or worsening, and including trauma to the brain and surgical trauma;
  • a new factor 5(zl) relating to neurological disorders (at the time of the clinical worsening);
  • a new factor 5(zm) relating to cirrhosis of the liver (at the time of the clinical worsening);
  • a new factor 5(zn) relating to chronic renal failure (at the time of the clinical worsening);
  • a new factor 5(zo) relating to alcohol dependence or alcohol abuse (at the time of the clinical worsening);
  • rewording factors 5(r), (s), (zp) and (zq) relating to being treated with a drug, differentiating between treatment with certain classes of drugs and certain drugs;
  • rewording factors 5(t) and (zr) relating to low-flow priapism, requiring the condition to be present for a continuous period of four hours or more immediately before the clinical onset or worsening;
  • a new factor 5(zs) relating to Peyronie’s disease (before the clinical worsening);
  • a new factor 5(zt) relating to haemochromatosis (before the clinical worsening);
  • a new factor 5(zu) relating to malignant neoplasm of the reproductive organs (at the time of the clinical worsening);
  • new factors 5(x) and (zv) relating to organic solvents;
  • deleting the definitions of ‘alcoholic liver disease’, ‘aortic atherosclerotic disease’, ‘a specified psychiatric condition’, ‘atherosclerotic peripheral vascular disease’, ‘course of therapeutic radiation’, ‘damage to the spinal cord or cauda equina’, ‘DSM-IV’, ‘haemochromatosis’, ‘ICD code’, ‘pack-year’, ‘priapism’,’psychoactive substance abuse or dependence involving alcohol’, ‘suffering from blunt or penetrating trauma’, ‘therapeutic radiation’ and ‘undergoing a course of treatment with drugs identified in the Schedule’ in clause 8;
  • revising the definitions of ‘a specified endocrinological disorder’, ‘a specified neurological disorder’, ‘chronic renal failure’, ‘malignant neoplasm of the reproductive organs’, ‘Peyronie’s disease’ and ‘relevant service’ in clause 8;
  • including new definitions of  ‘a class of drug in Specified List 1’, ‘a course of therapeutic radiation’, ‘being obese’, ‘blunt or penetrating trauma’, ‘clinically significant’, ‘death from erectile dysfunction’, ‘drug in Specified List 2’, ‘low-flow priapism’, ‘MET’, ‘pack years of cigarettes, or the equivalent thereof in other tobacco products’, ‘specified organic solvents’ and ‘terminal event’  in clause 8; and
  • specifying a date of effect for the Instrument in clause 10.

 

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 impotence in the Government Notices Gazettes of 22 December 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, 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. No submissions were received for consideration by the Authority during the investigation.

 

9.             The determining of this new instrument finalises the investigation in relation to impotence as advertised in the Government Notices Gazettes of 22 December 2004.

 

10.         A list of references relating to the above condition is available, on written request, from the Repatriation Medical Authority Secretariat.

Overview

The Veterans’ Entitlements Act 1986 was enacted to provide a framework for the provision of benefits, services, and compensation to Australian Defence Force (ADF) veterans and their families. It addresses the need to recognise and compensate for disabilities and health conditions resulting from military service. The Military Rehabilitation and Compensation Act 2004 was enacted to provide for the rehabilitation and compensation of current and former members of the ADF who have sustained injuries or contracted diseases in the course of their service. This Act ensures that such individuals receive appropriate support and compensation. The Repatriation Medical Authority, under the authority of the Veterans’ Entitlements Act 1986, has determined Instrument No. 17 of 2005 to replace previous instruments concerning impotence and death from impotence. This new instrument, based on updated medical-scientific evidence, outlines the factors that must exist to establish a connection between erectile dysfunction or death from erectile dysfunction and specific types of military service. This legislative instrument was developed following an investigation into impotence, which involved reviewing available medical evidence and consulting relevant organisations and experts. The new instrument aims to accurately reflect the current understanding of erectile dysfunction and its potential links to military service, thereby ensuring that affected veterans receive appropriate recognition and support.

Scope and Application

The Repatriation Medical Authority Instrument No. 17 of 2005, under the Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), concerns erectile dysfunction and death from erectile dysfunction related to specific kinds of service, replacing the revoked Statements of Principles concerning impotence and death from impotence. This instrument applies to veterans and service personnel, including those who have served in operational, peacekeeping, hazardous, warlike, and non-warlike services, as defined by the VEA and MRCA. It mandates that certain factors must exist and be related to the relevant service types to establish a connection between erectile dysfunction or death from erectile dysfunction and the service circumstances. The Authority determined this instrument based on sound medical-scientific evidence, following an investigation advertised in the Government Notices Gazette on 22 December 2004. The instrument's provisions are applicable nationally within Australia, governed by the VEA and MRCA, and it sets out specific criteria for determining compensation claims related to erectile dysfunction.

Key Provisions

The Repatriation Medical Authority, under subsection 196B(8) of the Veterans’ Entitlements Act 1986, has revoked previous instruments concerning impotence and death from impotence, and introduced Instrument No. 17 of 2005, which now addresses erectile dysfunction. This new instrument replaces the earlier statements of principles regarding impotence and death from impotence (Section 2). The Statement of Principles outlines the minimum factors that must exist to establish a connection between erectile dysfunction or death from erectile dysfunction and specific types of service, including operational, peacekeeping, hazardous, warlike, and non-warlike service (Section 4). This new instrument results from an investigation into impotence, which was notified in the Government Notices Gazette of 22 December 2004 (Section 5). The Authority has considered the latest medical-scientific evidence available and has introduced several changes to the instrument, including renaming the instrument, adopting a new format, and adding or modifying factors that may contribute to erectile dysfunction (Section 6). The Act imposes several obligations on the parties involved. The Repatriation Medical Authority is responsible for determining Statements of Principles that outline the minimum conditions necessary to establish a connection between erectile dysfunction and particular types of service. The Authority must also ensure that the instrument is based on sound medical-scientific evidence and consider submissions from relevant organisations and experts during the investigation process (Section 8). Additionally, the Military Rehabilitation and Compensation Commission must determine claims for compensation under the Military Rehabilitation and Compensation Act 2004 by reference to the Statements of Principles issued by the Authority (Section 3). There are no specific offences, penalties, or consequences outlined in the explanatory notes for breaching the provisions of this legislation. However, the determination of the Statement of Principles and the subsequent claims for compensation are subject to the provisions of the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. These Acts may impose penalties or consequences for fraudulent claims or misrepresentation of facts in the claims process. The exact penalties and consequences would depend on the specific circumstances and provisions of these Acts.

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