REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 14 of 2007
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. 58 of 1995 of 20 February 1995, determined under subsection 196B(3) of the VEA concerning hereditary spherocytosis and death from hereditary spherocytosis.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that hereditary spherocytosis and death from hereditary spherocytosis 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. 14 of 2007 concerning hereditary spherocytosis. 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, hereditary spherocytosis or death from hereditary spherocytosis 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 15 June 2005 concerning hereditary spherocytosis 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 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 'hereditary spherocytosis' in clause 3;
- new factor 6(a) concerning acute viral infection relating to the clinical worsening of hereditary spherocytosis;
- new factor 6(b) concerning infection or inflammatory disease process relating to the clinical worsening of hereditary spherocytosis;
- new factor 6(c) concerning pregnancy relating to the clinical worsening of hereditary spherocytosis;
- deleting the definition of 'ICD code';
- including new definitions of 'death from hereditary spherocytosis'; 'ICD-10-AM code', 'relevant service'; and 'terminal event', in clause 9; 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 hereditary spherocytosis in the Government Notices Gazette of 15 June 2005, 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 hereditary spherocytosis as advertised in the Government Notices Gazette of 15 June 2005.
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. 14 of 2007 was enacted to address the gap in the Veterans’ Entitlements Act 1986 concerning hereditary spherocytosis. This instrument was introduced by the Repatriation Medical Authority, pursuant to subsection 196B(3) of the Veterans’ Entitlements Act 1986, to replace Instrument No. 58 of 1995, which had been revoked. The Authority concluded that, based on the available medical-scientific evidence, there is a more than probable connection between hereditary spherocytosis, death from hereditary spherocytosis, and specific types of service. This new instrument sets out the Statement of Principles that must be met before hereditary spherocytosis or death from the condition can be considered related to the service rendered by a person, and it applies to claims for compensation made under the Military Rehabilitation and Compensation Act 2004.
Scope and Application
The Repatriation Medical Authority Instrument No. 14 of 2007, made under the Veterans’ Entitlements Act 1986, establishes a Statement of Principles concerning hereditary spherocytosis. This instrument applies to individuals who have rendered eligible war service, defence service, or peacetime service, and who are seeking compensation for service-related injuries, diseases, or deaths under the Veterans’ Entitlements Act or the Military Rehabilitation and Compensation Act 2004. It specifies the medical and service-related factors that must exist for hereditary spherocytosis or death from hereditary spherocytosis to be considered connected to service, effective from 1 July 2004. The instrument revokes the previous Statement of Principles, Instrument No. 58 of 1995, and incorporates updated medical and service definitions, as well as new factors such as acute viral infections, pregnancy, and inflammatory diseases, which may affect the clinical worsening of hereditary spherocytosis. The Authority determined this instrument based on available medical-scientific evidence and following an investigation advertised in the Government Notices Gazette on 15 June 2005, with no submissions received during the investigation process.
Key Provisions
The Repatriation Medical Authority ('the Authority') has revoked Instrument No. 58 of 1995 of 20 February 1995, which was determined under subsection 196B(3) of the Veterans’ Entitlements Act 1986 ('the VEA') concerning hereditary spherocytosis and death from hereditary spherocytosis. This revocation has led to the determination of a new Statement of Principles, Instrument No. 14 of 2007, which replaces the old instrument (subsection 196B(3) and (8) of the VEA). This new instrument is intended to reflect the latest medical-scientific evidence and will apply to claims under the VEA and the Military Rehabilitation and Compensation Act 2004 ('the MRCA') for injuries or diseases occurring on or after 1 July 2004.
The new Statement of Principles, Instrument No. 14 of 2007, outlines the factors that must exist for hereditary spherocytosis or death from hereditary spherocytosis to be considered connected with eligible war service, defence service, or peacetime service, as defined under the respective acts (section 4). This includes the addition of new factors related to acute viral infection, infection or inflammatory disease process, and pregnancy, which may relate to the clinical worsening of hereditary spherocytosis (clause 6). The instrument adopts the latest revised format and includes new definitions and specifications such as 'death from hereditary spherocytosis', 'ICD-10-AM code', 'relevant service', and 'terminal event' (clauses 3 and 9). The Authority has also clarified that this Statement of Principles applies for the purposes of both the VEA and the MRCA (subsection 196B(3A) of the VEA).
The Authority is required to determine Statements of Principles based on the sound medical-scientific evidence available. The Authority must advertise its intention to investigate a condition, such as hereditary spherocytosis, in the Government Notices Gazette and invite submissions from relevant parties (section 7). Although the Authority invited submissions during the investigation into hereditary spherocytosis, no submissions were received (section 8). The final determination of the Statement of Principles concludes the investigation.
For any party or entity affected by this new Statement of Principles, the primary obligation is to understand and adhere to the specified factors that connect hereditary spherocytosis or death from hereditary spherocytosis with the service rendered. This includes understanding the definitions and new factors introduced in Instrument No. 14 of 2007. Claims for compensation must be made in accordance with the provisions of the VEA and MRCA, with the Authority's Statement of Principles serving as the basis for determining liability.
Under the VEA and MRCA, failure to comply with the requirements of the new Statement of Principles could result in the denial of claims for compensation related to hereditary spherocytosis. There are no specific offences or penalties mentioned in the explanatory statement for breaches of this instrument, but non-compliance could lead to civil consequences such as the rejection of a claim for compensation. The maximum penalties for any related offences would be as prescribed under the relevant sections of the VEA and MRCA, which may include fines or imprisonment depending on the nature of the breach.