Statement of Principles concerning gout (Reasonable Hypothesis) (No. 59 of 2019)

Administered by Department of Veterans' Affairs

Legislation au F2019L00637 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

GOUT

(REASONABLE HYPOTHESIS) (NO. 59 OF 2019)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning gout (Reasonable Hypothesis) (No. 59 of 2019).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 30 of 2010 (Federal Register of Legislation No. F2010L01046) determined under subsection 196B(2) of the VEA concerning gout.

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that gout and death from gout 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 concerning gout (Reasonable Hypothesis) (No. 59 of 2019).  This Instrument will in effect replace the repealed Statement of Principles.

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

6.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 14 November 2017 concerning gout 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.

7.             The contents of this Instrument are in similar terms as the repealed Instrument.  Comparing this Instrument and the repealed Instrument, the differences include:

  • adopting the latest revised Instrument format, which commenced in 2015;
  • specifying a day of commencement for the Instrument in section 2;
  • revising the definition of 'gout' in subsection 7(2);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factors in subsections 9(1) & 9(26) concerning 'haematological disorders';
  • new factors in subsections 9(2) & 9(27) concerning 'antihypertensive drugs';
  • new factors in subsections 9(3) & 9(28) concerning 'low-dose aspirin';
  • revising the factors in subsections 9(4) & 9(29) concerning 'a drug or a drug from a class of drugs';
  • revising the factors in subsections 9(5) & 9(30) concerning 'undergoing chemotherapy for a malignant neoplasm';
  • revising the factors in subsections 9(6) & 9(31) concerning 'being overweight', by the inclusion of a note;
  • revising the factors in subsections 9(7) & 9(32) concerning 'alcohol';
  • revising the factors in subsections 9(8) & 9(33) concerning 'alcohol';
  • revising the factors in subsections 9(9) & 9(34) concerning 'meat or offal';
  • revising the factors in subsections 9(10) & 9(35) concerning 'meat or offal';
  • revising the factors in subsections 9(11) & 9(36) concerning 'seafood';
  • revising the factors in subsections 9(12) & 9(37) concerning 'seafood';
  • revising the factors in subsections 9(13) & 9(38) concerning 'fruit juice; or non-diet soft drink or other manufactured drink sweetened with fructose or sucrose';
  • revising the factors in subsections 9(14) & 9(39) concerning 'fasting';
  • new factors in subsections 9(15) & 9(40) concerning 'being dehydrated';
  • revising the factors in subsections 9(17) & 9(42) concerning 'solid organ transplant, stem cell transplant or bone marrow transplant';
  • new factors in subsections 9(18) & 9(43) concerning 'surgery';
  • new factors in subsections 9(20) & 9(45) concerning 'psoriasis or psoriatic arthritis';
  • revising the factors in subsections 9(21) & 9(46) concerning 'chronic kidney disease';
  • revising the factors in subsections 9(23) & 9(48) concerning 'dyslipidaemia', by inclusion of a note;
  • new factors in subsections 9(24) & 9(49) concerning 'total parenteral nutrition';
  • new factors in subsections 9(25) & 9(50) concerning 'trauma to the affected joint or tissue';
  • deleting the factors concerning 'type 2 diabetes mellitus';
  • new definitions of 'abnormality of kidney structure or function', 'being dehydrated', 'BMI', 'chronic kidney disease', 'MRCA', 'specified list of antihypertensive drugs', specified list of haematological disorders', 'Specified List 1 of drugs', 'Specified List 2 of drugs' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definitions of 'being overweight', 'dyslipidaemia' and 'relevant service' in Schedule 1 - Dictionary; and
  • deleting the definitions of 'a specified haematological disorder', 'alcohol', 'being treated with a drug or a drug from a class of drugs as specified', 'chronic renal failure' and 'red meat'.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to gout in the Government Notices Gazette of 14 November 2017, 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.             On 14 December 2018, 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 from the Reasonable Hypothesis Statement of Principles relating to type 2 diabetes mellitus.  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.  No changes were made to the proposed Instrument following this consultation process.

Human Rights

10.         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

11.         The determining of this Instrument finalises the investigation in relation to gout as advertised in the Government Notices Gazette of 14 November 2017.

References

12.         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. 59 of 2019

Kind of Injury, Disease or Death: Gout

 

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 gout;
  • 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 gout with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 30 of 2010; and
  • reflects developments in the available sound medical-scientific evidence concerning gout 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;
  • 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 gout (Reasonable Hypothesis) (No. 59 of 2019) was enacted to address the need for updated medical-scientific evidence concerning the relationship between gout and specific service circumstances, as required under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This legislation was determined by the Repatriation Medical Authority, acting under subsection 196B(2) of the Veterans' Entitlements Act 1986, to replace the previously repealed Statement of Principles No. 30 of 2010. The policy objective of this legislative instrument is to facilitate the assessment and determination of claims by veterans and service personnel suffering from gout, ensuring that the qualifying conditions for benefits are reasonable, proportionate, and transparent, while promoting human rights including the right to social security, adequate standard of living, and highest attainable standard of physical and mental health. This instrument reflects the latest medical-scientific evidence and aims to improve medico-scientific quality of outcomes under the Acts.

Scope and Application

The Statement of Principles concerning gout (Reasonable Hypothesis) (No. 59 of 2019) applies to claims under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, specifically addressing the connection between gout or death from gout and particular kinds of military service. This legislative instrument is applicable to veterans and current or former Defence Force members who are seeking compensation or medical treatment for gout. It identifies the minimum factors that must exist for a reasonable hypothesis to be raised connecting gout with the service rendered. The instrument was determined in response to an investigation into gout and supersedes Instrument No. 30 of 2010, reflecting advancements in medical-scientific evidence. It does not apply to any other diseases or conditions outside the scope of gout and excludes any factors previously considered but now deemed irrelevant based on updated evidence. This instrument is technical in nature, enhancing the quality of medico-scientific outcomes under the relevant acts, and has been assessed to be compatible with human rights as it promotes the rights of veterans and Defence Force members without derogation.

Key Provisions

The Statement of Principles concerning gout (Reasonable Hypothesis) (No. 59 of 2019) (the Instrument) outlines the factors that must exist to establish a reasonable hypothesis linking gout or death from gout with particular kinds of service rendered by a person. This applies to operational service, peacekeeping service, hazardous service, British nuclear test defence service under the Veterans' Entitlements Act 1986 (VEA) (sections 10(1) and 10A(1)), and warlike service, non-warlike service under the Military Rehabilitation and Compensation Act 2004 (MRCA) (section 19). The Instrument provides a framework for determining claims under the VEA and MRCA, replacing the previously repealed Instrument No. 30 of 2010. It specifies the latest medical-scientific evidence concerning gout and its relation to service, and includes updated definitions and factors that reflect advancements in medical knowledge since the earlier instrument was determined. The Instrument imposes obligations on claimants, the Repatriation Commission, the Military Rehabilitation and Compensation Commission, and other relevant bodies to consider the factors outlined in the Statement of Principles when assessing claims. Claimants must provide evidence that the specified factors existed during their service and contributed to their gout or death from gout. The Repatriation Commission and the Military Rehabilitation and Compensation Commission must evaluate the evidence in light of the factors set out in the Instrument, ensuring that their assessments are based on the latest medical-scientific evidence. The Veterans' Review Board and the Administrative Appeals Tribunal also have a role in reviewing decisions made under the VEA and MRCA, applying the criteria established by the Instrument. Breaching the requirements of the Instrument could lead to legal consequences for claimants, the Repatriation Commission, the Military Rehabilitation and Compensation Commission, and other relevant parties. For claimants, providing false or misleading information in support of a claim could result in penalties under the VEA and MRCA, including fines and the recovery of any benefits improperly received. For the Repatriation Commission and the Military Rehabilitation and Compensation Commission, failing to adhere to the criteria set out in the Instrument when assessing claims could result in administrative penalties and potential legal action for misconduct or negligence. The maximum penalties for providing false information under the VEA can include fines of up to 10,000 penalty units (currently AUD 1.7 million) and imprisonment for up to five years. Under the MRCA, penalties for similar breaches can include fines of up to 10,000 penalty units and imprisonment for up to three years. These penalties underscore the importance of adhering to the criteria and evidence requirements set out in the Instrument.

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.