Statement of Principles concerning hypertension (Reasonable Hypothesis) (No. 21 of 2022)

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Legislation au F2022L00258 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

HYPERTENSION

(REASONABLE HYPOTHESIS) (NO. 21 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 (Reasonable Hypothesis) (No. 21 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. 63 of 2013 (Federal Register of Legislation No. F2013L01652) determined under subsections 196B(2) and (8) of the VEA concerning hypertension.

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that hypertension and death from hypertension 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 concerning hypertension (Reasonable Hypothesis) (No. 21 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  This Instrument will in effect replace the repealed Statement of Principles.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 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;

 British nuclear test defence 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 hypertension or death from hypertension, 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(26) concerning being overweight or obese;
  • revising the factors in subsections 9(2) and 9(27) concerning consuming alcohol;
  • revising the factors in subsections 9(3) and 9(28) concerning consuming salt;
  • revising the factors in subsections 9(4) and 9(29) concerning having renal artery stenosis;
  • revising the factors in subsections 9(5) and 9(30) concerning having a solid organ, stem cell or bone marrow transplant;
  • new factors in subsections 9(6) and 9(31) concerning having diabetes mellitus;
  • revising the factors in subsections 9(7) and 9(32) concerning having chronic kidney disease;
  • revising the factors in subsections 9(8) and 9(33) concerning having an endocrine disorder;
  • revising the factors in subsections 9(9) and 9(34) concerning having sleep apnoea;
  • revising the factors in subsections 9(11) and 9(36) 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;
  • revising the factors in subsections 9(12) and 9(37) concerning having a clinically significant disorder of mental health as specified;
  • new factors in subsections 9(13) and 9(38) concerning having gout or hyperuricaemia;
  • revising the factors in subsections 9(14) and 9(39) concerning taking a drug from the Schedule 2 – Drugs;
  • revising the factors in subsections 9(15) and 9(40) concerning taking a drug from the Specified List 1 of drugs;
  • revising the factors in subsections 9(16) and 9(41) concerning having glucocorticoid therapy;
  • new factors in subsections 9(17) and 9(42) concerning taking medroxyprogesterone acetate or megestrol acetate for a malignant disease or human immunodeficiency virus infection;
  • revising the factors in subsections 9(18) and 9(43) concerning inability to undertake any physical activity greater than 3 METs;
  • revising the factors in subsections 9(19) and 9(44) concerning being exposed to arsenic, by the inclusion of a note;
  • new factors in subsections 9(20) and 9(45) concerning undergoing a course of therapeutic radiation for cancer;
  • new factors in subsections 9(21) and 9(46) concerning having received a cumulative equivalent dose of ionising radiation;
  • revising the factors in subsections 9(22) and 9(47) concerning inhaling, ingesting or having cutaneous contact with the phenoxy acid herbicides 2,4-dichlorophenoxyacetic acid (2,4-D) or 2,4,5-trichlorophenoxyacetic acid (2,4,5-T);
  • revising the factors in subsections 9(23) and 9(48) concerning inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD);
  • new factors in subsections 9(24) and 9(49) concerning inhaling, ingesting or having cutaneous contact with a dioxin-like polychlorinated biphenyl;
  • new factors in subsections 9(25) and 9(50) concerning inhaling ambient, chronically polluted air as specified;
  • new definitions of 'albuminuria', 'ambient, chronically polluted air as specified', 'BMI', 'chronic kidney disease', 'clinically significant disorder of mental health as specified', 'cumulative equivalent dose', 'glucocorticoid therapy as specified', 'hyperuricaemia', 'inhaling, ingesting or having cutaneous contact with a dioxin-like polychlorinated biphenyl', 'MET', 'MRCA', 'paraganglioma', 'Specified List 1 of drugs', 'Specified List 2 of drugs', 'specified list of endocrine disorders' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definitions of 'being exposed to arsenic as specified', 'being overweight or obese', 'equivalent glucocorticoid therapy', 'equivalent inhaled glucocorticoid', 'high or very high potency topical glucocorticoid', 'inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD)', 'phaeochromocytoma' and 'relevant service' in Schedule 1 - Dictionary;
  • new table of specified drugs in Schedule 2 - Drugs; and
  • deleting the definitions of 'a chronic renal disease or injury', 'a clinically significant psychiatric disorder from the specified list', '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', 'having glucocorticoid therapy as specified' and 'phenoxy acid herbicide from the specified list'.

Incorporation

8.             The definition of "cumulative equivalent dose" contained in the Schedule 1 – Dictionary incorporates the Guide to calculation of 'cumulative equivalent dose' for the purpose of applying ionising radiation factors contained in Statements of Principles determined under Part XIA of the Veterans' Entitlements Act 1986 (Cth), Australian Radiation Protection and Nuclear Safety Agency, as in force on 2 August 2017.  This writing is incorporated pursuant to subsection 14(b) of the Legislation Act 2003.

9.             A copy of this document is available to any person on the website of the Repatriation Medical Authority at www.rma.gov.au or from the Repatriation Medical Authority, Level 8, 480 Queen St, Brisbane, Queensland 4000, by contacting the Registrar on telephone (07) 3815 9404.

Consultation

10.         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

11.         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

12.         The determining of this Instrument finalises the investigation in relation to hypertension as advertised in the Government Notices Gazette of 5 January 2021.

References

13.         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. 21 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(2) 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 as a minimum exist, before it can be said that a reasonable hypothesis has been raised, connecting hypertension with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 63 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.

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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.