Statement of Principles concerning hypertension (Balance of Probabilities) (No. 22 of 2022)

Administered by Department of Veterans' Affairs

Legislation au F2022L00259 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

Statement of Principles concerning

HYPERTENSION

(Balance of PROBABILITIES) (NO. 22 OF 2022)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning hypertension (Balance of Probabilities) (No. 22 of 2022).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 64 of 2013 (Federal Register of Legislation No. F2013L01651) determined under subsection 196B(3) of the VEA concerning hypertension.

3.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that hypertension and death from hypertension 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 hypertension (Balance of Probabilities) (No. 22 of 2022).  This Instrument will in effect replace the repealed Statement of Principles.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 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, hypertension or death from hypertension 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 5 January 2021 concerning hypertension 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 'hypertension' in subsection 7(2);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factors in subsections 9(1) and 9(19) concerning being overweight or obese;
  • revising the factors in subsections 9(2) and 9(20) concerning consuming alcohol;
  • revising the factors in subsections 9(3) and 9(21) concerning consuming salt;
  • revising the factors in subsections 9(4) and 9(22) concerning having renal artery stenosis;
  • revising the factors in subsections 9(5) and 9(23) concerning having a solid organ, stem cell or bone marrow transplant;
  • new factors in subsections 9(6) and 9(24) concerning having diabetes mellitus;
  • revising the factors in subsections 9(7) and 9(25) concerning having chronic kidney disease;
  • revising the factors in subsections 9(8) and 9(26) concerning having an endocrine disorder;
  • revising the factors in subsections 9(9) and 9(27) concerning having sleep apnoea;
  • revising the factors in subsections 9(11) and 9(29) concerning having an aneurysm of the renal artery, an arteriovenous fistula involving the blood supply of the kidney, or an arteriovenous malformation involving the blood supply of the kidney;
  • new factors in subsections 9(12) and 9(30) concerning having a clinically significant disorder of mental health as specified;
  • revising the factors in subsections 9(13) and 9(31) concerning taking a drug from the Specified List 1 of drugs;
  • revising the factors in subsections 9(14) and 9(32) concerning taking a drug from the Specified List 2 of drugs
  • revising the factors in subsections 9(15) and 9(33) concerning having glucocorticoid therapy;
  • new factors in subsections 9(16) and 9(34) concerning taking medroxyprogesterone acetate or megestrol acetate for a malignant disease or human immunodeficiency virus infection;
  • revising the factors in subsections 9(17) and 9(35) concerning inability to undertake any physical activity greater than 3 METs;
  • new factors in subsections 9(18) and 9(36) concerning being exposed to arsenic;
  • new definitions of 'albuminuria', 'being exposed to arsenic as specified', 'BMI', 'chronic kidney disease', 'clinically significant disorder of mental health as specified', 'glucocorticoid therapy as specified', 'MET', 'MRCA', 'paraganglioma', 'Specified List 1 of drugs', 'Specified List 2 of drugs', 'Specified List 3 of drugs', 'specified list of endocrine disorders' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definitions of 'being overweight or obese', 'equivalent glucocorticoid therapy', 'equivalent inhaled glucocorticoid', 'high or very high potency topical glucocorticoid', 'phaeochromocytoma' and 'relevant service' in Schedule 1 - Dictionary; and
  • deleting the definitions of 'a chronic renal disease or injury', 'a drug from Specified List 2', 'a drug or a drug from a class of drugs from Specified List 1', 'a mildly strenuous level of physical activity', 'a specified antineoplastic drug', 'a specified endocrine-related disorder', 'alcohol', 'chronic renal failure' and 'having glucocorticoid therapy as specified'.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to hypertension in the Government Notices Gazette of 5 January 2021, 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 in relation to 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 hypertension as advertised in the Government Notices Gazette of 5 January 2021.

References

11.         A list of references relating to the above condition is available on the Authority's website at: www.rma.gov.au. Any other document referred to in this Statement of Principles is available on request to the Repatriation Medical Authority at the following address:

              

Email:    info@rma.gov.au

Post:      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. 22 of 2022

Kind of Injury, Disease or Death: Hypertension

 

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(3) 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 connecting 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 and the Military Rehabilitation and Compensation 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 hypertension;
  • 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, hypertension 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. 64 of 2013; and
  • reflects developments in the available sound medical-scientific evidence concerning hypertension 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, ICESCR; 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, ICESCR 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 Hypertension (Balance of Probabilities) (No. 22 of 2022) was introduced to address the connection between hypertension and service rendered by veterans and Defence Force members under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This Statement of Principles was determined by the Repatriation Medical Authority under subsection 196B(3) of the Veterans' Entitlements Act 1986, and it replaces the previous Instrument No. 64 of 2013. It sets out the circumstances in which hypertension can be considered connected to service, based on the balance of probabilities and sound medical-scientific evidence. The purpose of this legislative instrument is to facilitate claims and assessments for medical treatment and compensation for eligible persons with hypertension and to promote the human rights of veterans and Defence Force members. The Statement of Principles outlines the factors that must exist, and which of those factors must be related to particular kinds of service, before it can be said that, on the balance of probabilities, hypertension or death from hypertension is connected with the circumstances of that service. This instrument was determined following an investigation into hypertension and the latest available medical-scientific evidence, which led the Authority to conclude that hypertension and death from hypertension can be related to particular kinds of service. The instrument specifies the circumstances under which compensation and benefits can be extended to eligible persons who have hypertension and reflects developments in the available medical-scientific evidence concerning hypertension since the previous instrument was determined.

Scope and Application

The Statement of Principles concerning hypertension (Balance of Probabilities) (No. 22 of 2022) applies to claims under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, specifically regarding veterans and current or former Defence Force members who may be suffering from hypertension. The Act sets out the medical factors that must exist for a claimant to establish a connection between their hypertension or death from hypertension and their service, thereby qualifying for medical treatment and compensation. The Act applies to eligible war service, defence service, and peacetime service, and it operates on a national level within Australia. The Instrument replaces a previous Statement of Principles (No. 64 of 2013) and incorporates revisions based on the latest medical-scientific evidence, including updated definitions and factors that may contribute to hypertension. The Authority has ensured that this legislation is compatible with human rights and does not derogate from any of them, while promoting the rights of veterans and Defence Force members to social security, an adequate standard of living, and the highest attainable standard of health. Subordinate instruments may further extend or restrict the application of the Statement of Principles by detailing specific medical conditions, treatments, or other factors relevant to hypertension in the context of military service. These subordinate instruments would be developed in accordance with the existing legislative framework and based on the most current medical-scientific evidence.

Key Provisions

The main operative sections of the Statement of Principles concerning hypertension (Balance of Probabilities) (No. 22 of 2022) under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 include the determination of factors that, on the balance of probabilities, connect hypertension with particular kinds of service rendered by a person. This involves specific kinds of service such as eligible war service, defence service, and peacetime service, as outlined in sections 5 and 6 of the Explanatory Statement. The Statement of Principles aims to provide a framework for assessing claims related to hypertension and death from hypertension, replacing the earlier Instrument No. 64 of 2013. The Act imposes several obligations and requirements on the parties it governs. The Repatriation Medical Authority is mandated to determine Statements of Principles based on the sound medical-scientific evidence available, ensuring these principles are compatible with human rights. The Authority must also advertise its intention to undertake investigations in the Government Notices Gazette and circulate notices to relevant organisations and individuals, inviting submissions. Additionally, the Authority is required to facilitate the assessment and determination of claims under the VEA and the MRCA by specifying the factors that must exist before it can be said that hypertension is connected with the circumstances of service rendered, as detailed in sections 4 and 5 of the Explanatory Statement. There are no specific offences, penalties, or civil/criminal consequences for breach outlined in the Statement of Principles itself. However, any failure to comply with the obligations and requirements set out in the VEA and the MRCA could potentially result in legal consequences under those Acts. For example, providing false information in a claim could lead to penalties under the VEA, including fines and imprisonment, as specified in section 240 of the Act. The maximum penalties for such offences are detailed in the respective sections of the VEA and the MRCA, but these are not explicitly stated in the Statement of Principles concerning hypertension. The focus of the Statement is on establishing the sound medical-scientific evidence and the factors that must exist to connect hypertension with particular kinds of service, rather than on penalising non-compliance.

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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.