Statement of Principles concerning hyperthyroidism and thyrotoxicosis (Balance of Probabilities) (No. 6 of 2022)

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

HYPERTHYROIDISM AND THYROTOXICOSIS

(BALANCE OF PROBABILITIES) (NO. 6 OF 2022)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning hyperthyroidism and thyrotoxicosis (Balance of Probabilities) (No. 6 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. 28 of 2013 (Federal Register of Legislation No. F2013L00724) determined under subsection 196B(3) of the VEA concerning hyperthyroidism and thyrotoxicosis.

3.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that hyperthyroidism or thyrotoxicosis and death from hyperthyroidism or thyrotoxicosis 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 hyperthyroidism and thyrotoxicosis (Balance of Probabilities) (No. 6 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  This Instrument will in effect replace the repealed Statement of Principles.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, hyperthyroidism or thyrotoxicosis or death from hyperthyroidism or thyrotoxicosis 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 hyperthyroidism and thyrotoxicosis 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 'hyperthyroidism' in subsection 7(2);
  • revising the definition of 'thyrotoxicosis' in subsection 7(3);
  • revising the factors in subsections 9(1) and 9(12) concerning having iodine excess;
  • revising the factors in subsections 9(3) and 9(14) concerning taking amiodarone;
  • revising the factors in subsections 9(4) and 9(15) concerning taking a drug from the specified list of drugs;
  • new factors in subsections 9(5) and 9(16) concerning taking minocycline;
  • new factors in subsections 9(6) and 9(17) concerning taking a drug containing at least 10 milligrams of iodine;
  • revising the factors in subsections 9(8) and 9(19) concerning having a chorionic gonadotrophin-secreting neoplasm, by the inclusion of a note;
  • new factors in subsections 9(9) and 9(20) concerning having a primary or metastatic neoplasm involving the thyroid gland;
  • new factors in subsections 9(10) and 9(21) concerning having an acute precipitating event, for thyrotoxic crisis only;
  • revising the factors in paragraphs 9(11)(a) and 9(22)(a) concerning having struma ovarii, for thyrotoxicosis only;
  • new factors in paragraphs 9(11)(b) and 9(22)(b) concerning having metastatic thyroid carcinoma containing functional thyroid tissue, for thyrotoxicosis only;
  • revising the factors in paragraphs 9(11)(c) and 9(22)(c) concerning having a form of thyroiditis from the specified list of forms of thyroiditis, for thyrotoxicosis only;
  • revising the factors in paragraphs 9(11)(d) and 9(22)(d) concerning having trauma involving the thyroid gland, for thyrotoxicosis only;
  • revising the factors in paragraphs 9(11)(e) and 9(22)(e) concerning ingesting excess thyroid hormone, for thyrotoxicosis only;
  • deleting the factor concerning having an acute illness or undergoing surgery, for worsening only, as this is now covered by the factors in subsections 9(10) and 9(21) concerning having an acute precipitating event, for thyrotoxic crisis only;
  • new definitions of 'acute precipitating event', 'iodine excess', 'MRCA', 'specified list of drugs', 'specified list of forms of thyroiditis', 'thyrotoxic crisis' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definitions of 'chorionic gonadotrophin-secreting neoplasm', 'relevant service' and 'trauma involving the thyroid gland' in Schedule 1 - Dictionary; and
  • deleting the definitions of 'a drug or a drug from a class of drugs from the specified list', 'a specified form of thyroiditis' and 'having iodine excess'.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to hyperthyroidism and thyrotoxicosis 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 hyperthyroidism and thyrotoxicosis 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. 6 of 2022

Kind of Injury, Disease or Death: Hyperthyroidism and thyrotoxicosis

 

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 hyperthyroidism or thyrotoxicosis;
  • 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, hyperthyroidism or thyrotoxicosis 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. 28 of 2013; and
  • reflects developments in the available sound medical-scientific evidence concerning hyperthyroidism and thyrotoxicosis 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 Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) were enacted to provide support and compensation to veterans and current or former Defence Force members who have sustained injuries or illnesses as a result of their service. The gap this legislation aimed to address was the need for a comprehensive framework to determine the connection between service and specific injuries or illnesses, facilitating the provision of appropriate benefits and compensation. The Repatriation Medical Authority, under the authority vested in it by the VEA, introduced the Statement of Principles concerning hyperthyroidism and thyrotoxicosis (Balance of Probabilities) (No. 6 of 2022) to address the sound medical-scientific evidence indicating a probable connection between particular kinds of service and hyperthyroidism or thyrotoxicosis. This Statement of Principles outlines the factors that must exist, and which must be related to specific service conditions, before it can be said that, on the balance of probabilities, hyperthyroidism or thyrotoxicosis is connected with the circumstances of the service. It facilitates the assessment and determination of claims under the VEA and the MRCA, ensuring that eligible individuals receive the benefits and compensation they are entitled to.

Scope and Application

The Statement of Principles concerning hyperthyroidism and thyrotoxicosis (Balance of Probabilities) (No. 6 of 2022) applies to veterans and members of the Australian Defence Force who may have developed hyperthyroidism or thyrotoxicosis as a result of their service. This Statement of Principles is relevant under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, governing claims for medical treatment and compensation related to these conditions. It specifies the circumstances in which such conditions are considered connected to service, thereby facilitating the assessment and determination of claims. The Instrument applies across Australia and replaces the previous Statement of Principles No. 28 of 2013, reflecting the most recent medical-scientific evidence. The Instrument includes several revisions and additions to the definitions and factors considered, ensuring the criteria for claims remain current and comprehensive. Subordinate instruments may further extend or specify the application of this Act as necessary.

Key Provisions

The main operative sections of this legislation (Sections 4 and 5) establish the Statement of Principles concerning hyperthyroidism and thyrotoxicosis. These principles are designed to guide the assessment of claims under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). They specify the conditions that must exist for it to be determined, on the balance of probabilities, that hyperthyroidism or thyrotoxicosis is connected with service rendered by a person. The Statement of Principles outlines the types of service that must be related to these conditions, including eligible war service, defence service, and peacetime service. The provisions are intended to facilitate the assessment and determination of claims, ensuring that compensation and benefits are extended to those who meet the specified criteria. The Act imposes several obligations on the parties involved, primarily the Repatriation Medical Authority (the Authority) and claimants. The Authority must determine the Statement of Principles based on the available sound medical-scientific evidence, as required by subsection 196B(3) of the VEA. Claimants must provide evidence that satisfies the conditions set out in the Statement of Principles to be eligible for benefits under the VEA and MRCA. The Repatriation Commission and the Military Rehabilitation and Compensation Commission are also responsible for assessing claims in accordance with these principles. These obligations ensure a systematic and evidence-based approach to evaluating claims related to hyperthyroidism and thyrotoxicosis. There are no specific offences, penalties, or civil/criminal consequences outlined in this legislation for breach of its provisions. However, failure to comply with the requirements for claiming benefits under the VEA and MRCA could result in denial of claims. The legislation focuses on facilitating claims and ensuring that the conditions for entitlement are met based on sound medical-scientific evidence. The primary consequences of non-compliance would be the inability to receive compensation or benefits for hyperthyroidism or thyrotoxicosis related to service, unless the claimant can provide sufficient evidence to meet the criteria set out in the Statement of Principles.

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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.