Statement of Principles concerning haemorrhoids (Balance of Probabilities) (No. 4 of 2017)

Administered by Department of Veterans' Affairs

Legislation au F2017L00005 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

HAEMORRHOIDS

(BALANCE OF PROBABILITIES) (NO. 4 OF 2017)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning haemorrhoids (Balance of Probabilities) (No. 4 of 2017).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), revokes Instrument No. 42 of 2008, determined under subsection 196B(3) of the VEA concerning haemorrhoids.

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that haemorrhoids and death from haemorrhoids can be related to particular kinds of service.  The Authority has therefore determined pursuant to subsection 196B(3) of the VEA a Statement of Principles concerning haemorrhoids (Balance of Probabilities) (No. 4 of 2017).  This Instrument will in effect replace the revoked 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 exist, and which of those factors must be related to the following kinds of service rendered by a person:

 eligible war service (other than operational service) under the VEA;

 defence service (other than hazardous service and British nuclear test defence service) under the VEA;

 peacetime service under the MRCA,

before it can be said that, on the balance of probabilities, haemorrhoids or death from haemorrhoids is connected 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 2 October 2015 concerning haemorrhoids 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 revoked Instrument.  Comparing this Instrument and the revoked 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 ICD-10-AM codes for 'haemorrhoids' in subsection 7(3);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factors in subsections 9(1) & 9(5) concerning 'being pregnant';
  • new factors in subsections 9(4) & 9(8) concerning 'chewing khat';
  • new factor in subsection 9(9) concerning 'fibre in food', for clinical worsening only;
  • new factor in subsection 9(10) concerning 'taking a drug from a class of drugs from the specified list of drugs', for haemorrhoidal bleeding only, and for clinical worsening only;
  • new definitions of 'anticoagulants', 'antiplatelet agents', 'fibre in food', 'MRCA', 'specified list of drugs' and 'VEA' in Schedule 1 - Dictionary; and
  • revising the definition of 'relevant service' in Schedule 1 - Dictionary.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to haemorrhoids in the Government Notices Gazette of 2 October 2015, 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.

Human Rights

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.

Finalisation of Investigation

10.         The determining of this Instrument finalises the investigation in relation to haemorrhoids as advertised in the Government Notices Gazette of 2 October 2015.

References

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. 4 of 2017

Kind of Injury, Disease or Death: Haemorrhoids

 

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 haemorrhoids;
  • 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 exist before it can be said that, on the balance of probabilities, haemorrhoids is connected with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 42 of 2008; and
  • reflects developments in the available sound medical-scientific evidence concerning haemorrhoids 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 haemorrhoids (Balance of Probabilities) (No. 4 of 2017) was determined by the Repatriation Medical Authority under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). This instrument addresses the gap in the existing legislative framework by revoking Instrument No. 42 of 2008 and providing updated medical-scientific evidence that establishes a link between haemorrhoids, death from haemorrhoids, and particular kinds of service, including eligible war service, defence service, and peacetime service. The Statement of Principles sets out the factors that must exist and be related to the service in question for it to be said that, on the balance of probabilities, haemorrhoids or death from haemorrhoids is connected with the circumstances of that service. The primary objective of this instrument is to facilitate the assessment and determination of claims under the VEA and the MRCA, ensuring that the qualifying conditions for benefits are reasonable, proportionate, and transparent. The Authority conducted an investigation into haemorrhoids, advertised its intention in the Government Notices Gazette on 2 October 2015, and invited submissions from relevant organisations and individuals. Although no submissions were received, the Authority determined the new Statement of Principles to reflect the latest medical-scientific evidence. This Legislative Instrument facilitates claimants in making claims and the Repatriation Commission in assessing them by specifying the circumstances in which medical treatment and compensation can be extended. It also improves the medico-scientific quality of outcomes under the VEA and the MRCA, while promoting various human rights, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health.

Scope and Application

The Statement of Principles concerning haemorrhoids (Balance of Probabilities) (No. 4 of 2017) applies to eligible persons who have haemorrhoids and are seeking compensation or medical treatment under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. These Acts cover eligible war service, defence service, and peacetime service, with the principles designed to establish a connection between haemorrhoids or death from haemorrhoids and the circumstances of such service. The Statement of Principles outlines the specific factors that must exist for such a connection to be made on the balance of probabilities, reflecting the latest sound medical-scientific evidence. The geographic and jurisdictional reach of this Instrument is national, impacting all eligible veterans and service personnel across Australia. The determination of this Instrument concludes the investigation into haemorrhoids that was initiated in October 2015 and replaces the previously revoked Instrument No. 42 of 2008, incorporating updated evidence and terminology. This Legislative Instrument is compatible with human rights, promoting rights such as social security, an adequate standard of living, and the highest attainable standard of physical and mental health. It ensures that the qualifying conditions for benefits are reasonable, proportionate, and transparent, and facilitates the assessment and determination of claims without discrimination. The Instrument reflects the latest medical-scientific evidence, ensuring that outcomes under the relevant Acts are of high medico-scientific quality.

Key Provisions

The main operative sections of this Statement of Principles concern haemorrhoids (Balance of Probabilities) (No. 4 of 2017), which replaces the previous Instrument No. 42 of 2008 (section 3). This new Statement of Principles is determined under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), and outlines the specific factors that must exist for it to be said, on the balance of probabilities, that haemorrhoids or death from haemorrhoids is connected with service rendered by a person (section 5). This Instrument specifies the factors that must exist in relation to eligible war service, defence service, and peacetime service before a connection can be established (section 5). It also revises the ICD-10-AM codes for 'haemorrhoids' and includes new factors such as chewing khat, fibre in food, and taking certain drugs (subsections 9(4) to 9(10)). Additionally, this Statement of Principles adopts the latest revised Instrument format, includes new definitions, and specifies a day of commencement (section 2 and Schedule 1 - Dictionary). The obligations and requirements imposed by this Statement of Principles include the facilitation of claims under the VEA and MRCA for eligible persons suffering from haemorrhoids (section 6). It provides a framework for the Repatriation Commission to assess such claims based on the specified factors and the available sound medical-scientific evidence. Furthermore, it outlines the conditions that must be met for haemorrhoids to be considered connected with service, thereby guiding the determination of compensation and benefits (section 5). The Authority is required to ensure that these instruments are compatible with human rights and freedoms as recognised in international instruments (section 9). For breaches of the provisions outlined in this Statement of Principles, there are no specific offences or penalties mentioned in the document. However, the determination of this Instrument finalises the investigation concerning haemorrhoids, and any claims not assessed in accordance with these factors may be subject to review by the Veterans' Review Board and the Administrative Appeals Tribunal (section 10). The Authority's decision to revoke the previous Instrument and determine this new Statement of Principles reflects the need to incorporate the latest medical-scientific evidence and ensure that the qualifying conditions for benefits are reasonable, proportionate, and transparent (section 4).

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