REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 7 of 2010
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. 51 of 1996, determined under subsection 196B(2) of the VEA concerning human T-cell lymphotropic virus type-1.
2. The Authority is of the view that there is sound medical-scientific evidence that indicates that human T-cell lymphotropic virus type-1 and death from human T-cell lymphotropic virus type-1 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. 7 of 2010 concerning human T‑cell lymphotropic virus type-1. This Instrument will in effect replace the revoked Statement 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 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 human T-cell lymphotropic virus type-1 or death from human T-cell lymphotropic virus type-1, with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 25 June 2008 concerning human T-cell lymphotropic virus type-1 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 Instrument. 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 'human T-cell lymphotropic virus type-1' in clause 3;
- subsuming existing factors (a) to (e) into one factor 6(a) concerning being exposed to human T-cell lymphotropic virus type-1;
- new definitions of "a specified body substance", "being exposed to human T-cell lymphotropic virus type-1", "death from human T-cell lymphotropic virus type-1", "ICD-10-AM code", and "terminal event" in clause 9;
- revising definition of "relevant service" in clause 9;
- deleting definitions of "blood product injection", "body fluids", "clinical evidence of infection with human T-cell lymphotropic virus type-1", "ICD code", "laceration", "parenteral drug user", "sexual intercourse", and "unprotected 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 human T-cell lymphotropic virus type-1 in the Government Notices Gazette of 25 June 2008, 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 human T-cell lymphotropic virus type-1 as advertised in the Government Notices Gazette of 25 June 2008.
10. 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 Secretariat
GPO Box 1014
BRISBANE QLD 4001
Overview
The Repatriation Medical Authority Instrument No. 7 of 2010, under the Veterans' Entitlements Act 1986, was introduced to address the need for an updated statement of principles concerning human T-cell lymphotropic virus type-1 (HTLV-1). This instrument replaces the previously revoked Instrument No. 51 of 1996. The Authority, acting under the authority of the VEA, determined this new Statement of Principles based on the latest medical-scientific evidence, which now recognises the connection between HTLV-1 and certain types of service. The Military Rehabilitation and Compensation Act 2004 provisions for claims for compensation commenced on 1 July 2004, and this new instrument aligns with these provisions, ensuring that claims for service injuries, diseases, or deaths on or after this date are assessed according to the updated principles. The instrument outlines the minimum factors that must exist, related to specific kinds of service, before a reasonable hypothesis can be raised that HTLV-1 or death from HTLV-1 is connected to service circumstances. The Authority undertook an investigation and notified the public of its intention to revise the Statement of Principles, inviting submissions from relevant parties, though none were received. This new instrument formalises the conclusion of the investigation and provides a comprehensive framework for determining claims related to HTLV-1.
Scope and Application
The Repatriation Medical Authority, pursuant to the Veterans' Entitlements Act 1986, has revoked Instrument No. 51 of 1996 and replaced it with Instrument No. 7 of 2010 concerning human T-cell lymphotropic virus type-1 (HTLV-1). This new instrument applies to veterans and their dependants who have contracted HTLV-1 or died from it, in relation to specific kinds of service, including operational, peacekeeping, hazardous, warlike, and non-warlike service. The instrument is designed to facilitate claims for compensation under the Military Rehabilitation and Compensation Act 2004 for those who have sustained a service injury, contracted a service disease, or died from a service-related condition on or after 1 July 2004. The Authority's determination of the Statement of Principles is based on sound medical-scientific evidence, and the instrument outlines the minimum factors that must exist to establish a reasonable hypothesis connecting HTLV-1 or death from HTLV-1 with the circumstances of the service. The instrument also reflects the latest revised format and incorporates definitions and clarifications to streamline the claims process.
Key Provisions
The Repatriation Medical Authority (RMA), as outlined in subsection 196B(8) of the Veterans' Entitlements Act 1986 (VEA), has revoked Instrument No. 51 of 1996 concerning human T-cell lymphotropic virus type-1 (HTLV-1), as determined under subsection 196B(2) of the VEA. In its place, the Authority has issued Instrument No. 7 of 2010, a new Statement of Principles related to HTLV-1, effective as of the date specified in clause 11 of the Instrument (subsections 196B(2) and 196B(8) of the VEA). This new Instrument will replace the revoked one. This new Statement of Principles sets out the factors that must exist for a reasonable hypothesis to be raised connecting HTLV-1 or death from HTLV-1 with specific kinds of service rendered by a person, including operational service, peacekeeping service, hazardous service under the VEA, warlike service, and non-warlike service under the Military Rehabilitation and Compensation Act 2004 (MRCA).
Under the VEA, the RMA determines Statements of Principles that serve as a guide for assessing claims for compensation under the MRCA for injuries, diseases, or deaths related to service. For claims under section 319 of the MRCA, such as those for service injuries sustained, diseases contracted, or deaths occurring on or after 1 July 2004, the Military Rehabilitation and Compensation Commission uses these Statements of Principles to determine liability (section 319 of the MRCA). The new Instrument No. 7 of 2010, therefore, plays a crucial role in these assessments by outlining the specific factors needed to establish a connection between HTLV-1 and the service rendered.
The obligations of the RMA under the VEA and the MRCA include determining Statements of Principles that reflect the latest medical-scientific evidence. In this case, the Authority undertook an investigation into HTLV-1, advertised its intention in the Government Notices Gazette of 25 June 2008, and invited submissions from relevant organisations and experts (subsection 196G of the VEA). Although no submissions were received, the Authority proceeded with its determination based on the available evidence. The Authority must ensure that the new Instrument accurately reflects the sound medical-scientific evidence regarding HTLV-1 and its connection to service, thus fulfilling its duty to provide clear guidelines for claims assessments.
The new Instrument No. 7 of 2010 includes several changes from the revoked Instrument No. 51 of 1996, such as adopting the latest revised Instrument format, revising definitions, and specifying a date of effect. These changes aim to clarify the criteria for establishing a connection between HTLV-1 and service, ensuring that the guidelines are up-to-date and comprehensive. Any breaches of the obligations imposed by the VEA and MRCA on the RMA, such as failing to determine accurate Statements of Principles based on sound evidence, could potentially lead to disputes over claims assessments. However, the explanatory notes do not specify any penalties for such breaches. Instead, the focus remains on ensuring that the guidelines provided by the RMA are as accurate and evidence-based as possible to facilitate fair and informed decisions regarding compensation claims.