REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 55 of 2008
VETERANS’ ENTITLEMENTS ACT 1986
MILITARY REHABILITATION AND COMPENSATION ACT 2004
EXPLANATORY NOTES FOR TABLING
- The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans’ Entitlements Act 1986 (the VEA) revokes Instrument No. 44 of 1995, as amended by Instrument No. 10 of 1997, determined under subsection 196B(3) of the VEA concerning hepatitis C and death from hepatitis C.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that hepatitis C and death from hepatitis C 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, Instrument No. 55 of 2008 concerning hepatitis C. This Instrument will in effect replace the revoked Statements 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 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) under the VEA;
peacetime service under the MRCA,
before it can be said that, on the balance of probabilities, hepatitis C or death from hepatitis C is connected with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 8 November 2006 concerning hepatitis C 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 Instruments. 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 'hepatitis C' in clause 3;
- subsuming existing factors (a) to (e) into one factor 6(a) concerning 'being exposed to the hepatitis C virus';
- inserting new factor 6(b) concerning 'immunosuppressed state';
- inserting new factor 6(c) concerning 'being infected with hepatitis A, hepatitis B, hepatitis D or hepatitis E';
- inserting new factor 6(d) concerning 'alcohol';
- inserting new factor 6(e) concerning 'being obese';
- inserting new factor 6(f) concerning 'severe hepatic iron overload';
- inserting new factor 6(g) concerning 'being infected with Schistosoma mansoni or Schistosoma japonicum';
- inserting new definitions of "a specified body substance", "being exposed to the hepatitis C virus", "being in an immunosuppressed state", "being obese", "death from hepatitis C", "ICD-10-AM code", "iron overload", "relevant service", and "terminal event" in clause 9;
- deleting definitions of "blood product injection", "body fluids", "ICD code", "parenteral drug user", and "sexual intercourse"; 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 hepatitis C in the Government Notices Gazette of 8 November 2006, 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. The determining of this new instrument finalises the investigation in relation to hepatitis C as advertised in the Government Notices Gazette of 8 November 2006.
10. A list of references relating to the above condition is available, on written request, from the Repatriation Medical Authority Secretariat.
Overview
The Repatriation Medical Authority Instrument No. 55 of 2008, which revokes previous instruments concerning hepatitis C, was enacted under the Veterans’ Entitlements Act 1986 to address the growing body of medical evidence suggesting a probable connection between hepatitis C, death from hepatitis C, and specific types of military service. This instrument was developed by the Repatriation Medical Authority following an investigation into the matter, which involved examining available sound medical-scientific evidence. The new instrument replaces the previous Statements of Principles by setting out the factors that must exist, and which of those factors must be related to the service rendered by a person, for it to be said that, on the balance of probabilities, hepatitis C or death from hepatitis C is connected with the circumstances of that service. This includes the adoption of a revised Instrument format, the inclusion of new factors and definitions, and the specification of a date of effect for the Instrument. The policy objective of this instrument is to provide a clear framework for determining claims related to hepatitis C and death from hepatitis C in the context of military service.
Scope and Application
The Repatriation Medical Authority Instrument No. 55 of 2008 under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 pertains to the determination of Statements of Principles regarding hepatitis C. It applies to veterans and service personnel who have contracted hepatitis C or died from it, with the new instrument superseding the previously revoked Instrument No. 44 of 1995. This legislation is applicable to the Commonwealth of Australia, and it governs the circumstances under which hepatitis C or death from hepatitis C can be connected to specific kinds of service, such as eligible war service, defence service, and peacetime service. The instrument specifies the factors that must exist for such a connection to be established, including exposure to the hepatitis C virus and other relevant conditions such as being immunosuppressed or obese. The new instrument revises and updates the previous version, reflecting the latest medical-scientific evidence and the commencement of the Military Rehabilitation and Compensation Act 2004, which affects claims for compensation. The Authority determined this new instrument following an investigation and did not receive any submissions during the process. The instrument clarifies the determination of Statements of Principles for both the Veterans’ Entitlements Act and the Military Rehabilitation and Compensation Act.
Key Provisions
The Repatriation Medical Authority (RMA), as stipulated in subsection 196B(8) of the Veterans’ Entitlements Act 1986 (VEA), has revoked Instrument No. 44 of 1995, as amended by Instrument No. 10 of 1997, concerning hepatitis C and death from hepatitis C. This revocation is based on the latest medical-scientific evidence indicating a probable connection between hepatitis C and specific types of military service. The RMA has issued a new Statement of Principles, Instrument No. 55 of 2008, which replaces the revoked instruments. This new instrument outlines the factors that must be present to establish a link between hepatitis C or death from hepatitis C and the service rendered by a person. Such factors include exposure to the hepatitis C virus, being in an immunosuppressed state, infection with other hepatitis viruses, alcohol consumption, obesity, severe hepatic iron overload, and infection with Schistosoma mansoni or Schistosoma japonicum. The new instrument also details the types of service that may qualify, such as eligible war service, defence service, and peacetime service.
The new Statement of Principles imposes specific obligations on the parties involved. It requires that claims for compensation related to hepatitis C or death from hepatitis C must be substantiated by evidence that aligns with the factors and service types outlined in the instrument. This includes providing medical evidence that demonstrates a probable connection between the condition and the service rendered. Additionally, the Military Rehabilitation and Compensation Act 2004 (MRCA) mandates that claims for injuries or diseases sustained on or after 1 July 2004 must be evaluated by the Military Rehabilitation and Compensation Commission, with reference to the Statements of Principles issued by the RMA. This ensures that the claims are assessed consistently with the latest medical understanding and legislative requirements.
Failure to comply with the provisions of the new Statement of Principles and the associated legislative requirements can lead to various legal consequences. Although specific penalties are not detailed in the explanatory notes, breaches of the VEA and MRCA may result in civil or criminal penalties as prescribed by these Acts. The VEA and MRCA both provide for the imposition of fines and potential imprisonment for serious breaches. The exact penalties depend on the nature and severity of the breach, as well as any other relevant provisions of the Acts. It is crucial for claimants and the RMA to adhere to the established guidelines to avoid any adverse legal outcomes.