Statement of Principles concerning hypothyroidism (Reasonable Hypothesis) (No. 3 of 2022)

Administered by Department of Veterans' Affairs

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

HYPOTHYROIDISM

(REASONABLE HYPOTHESIS) (NO. 3 OF 2022)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning hypothyroidism (Reasonable Hypothesis) (No. 3 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. 29 of 2013 (Federal Register of Legislation No. F2013L00728) determined under subsections 196B(2) and (8) of the VEA concerning hypothyroidism.

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that hypothyroidism and death from hypothyroidism 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 hypothyroidism (Reasonable Hypothesis) (No. 3 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  This Instrument will in effect replace the repealed Statement of Principles.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 hypothyroidism or death from hypothyroidism, 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 hypothyroidism 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 'hypothyroidism' in subsection 7(2);
  • revising the factors in subsections 9(1) and 9(22) concerning having iodine deficiency;
  • revising the factors in subsections 9(2) and 9(23) concerning having iodine excess;
  • revising the factors in subsections 9(4) and 9(25) concerning taking a drug from the specified list of drugs;
  • new factors in subsections 9(5) and 9(26) concerning taking minocycline;
  • revising the factors in subsections 9(6) and 9(27) concerning taking a drug containing at least 10 milligrams of iodine;
  • new factors in subsections 9(7) and 9(28) concerning taking amiodarone;
  • revising the factors in subsections 9(8) and 9(30) concerning being pregnant or within the 12 months postpartum;
  • revising the factors in subsections 9(9) and 9(31) concerning having a form of thyroiditis from the specified list of forms of thyroiditis;
  • revising the factors in subsections 9(11) and 9(33) concerning having received iodine-131 (radioactive iodine) treatment;
  • new factors in subsections 9(13) and 9(35) concerning having a disease involving the thyroid gland from the specified list of diseases;
  • new factors in subsections 9(15) and 9(37) concerning having a type 3 deiodinase-overexpressing neoplasm;
  • revising the factors in subsections 9(16) and 9(38) concerning having hypopituitarism involving deficiency of thyroid-stimulating hormone;
  • revising the factors in subsections 9(17) and 9(39) concerning having chronic kidney disease;
  • new factors in subsections 9(18) and 9(40) concerning having hepatitis C virus infection;
  • new factors in subsections 9(19) and 9(41) concerning being obese;
  • new factors in subsections 9(20) and 9(42) concerning posttraumatic stress disorder;
  • new factors in subsections 9(21) and 9(43) concerning having an acute precipitating event, for myxoedema coma only;
  • new factor in subsection 9(29) concerning taking a drug that increases the requirement of thyroid hormone replacement therapy, for clinical worsening only;
  • deleting the factors concerning having received ionising radiation, as these are covered by the factors in subsections 9(10) and 9(32) concerning undergoing a course of therapeutic radiation for cancer, where the thyroid gland was in the field of radiation;
  • deleting the factors concerning having a chronic infiltrative or infectious disease of the thyroid gland, as these are now covered by the factors in subsections 9(13) and 9(35) concerning having a disease involving the thyroid gland from the specified list of diseases;
  • new definitions of 'acute precipitating event', 'albuminuria', 'being obese', 'BMI', 'chronic kidney disease', 'iodine deficiency', 'iodine excess', 'MRCA', 'myxoedema coma', 'specified list of diseases', 'specified list of drugs', 'specified list of forms of thyroiditis' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definition of 'relevant service' in Schedule 1 - Dictionary; and
  • deleting the definitions of 'a chronic infiltrative or infectious disease', 'a drug or a drug from a class of drugs from the specified list', 'a specified form of thyroiditis', 'being iodine deficient', 'cumulative equivalent dose', 'having iodine excess' and 'the recommended iodine intake'.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to hypothyroidism 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 hypothyroidism 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. 3 of 2022

Kind of Injury, Disease or Death: Hypothyroidism

 

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 hypothyroidism;
  • 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 hypothyroidism with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 29 of 2013; and
  • reflects developments in the available sound medical-scientific evidence concerning hypothyroidism 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 hypothyroidism (Reasonable Hypothesis) (No. 3 of 2022) is an instrument determined by the Repatriation Medical Authority under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This instrument aims to establish the factors that must exist to raise a reasonable hypothesis connecting hypothyroidism or death from hypothyroidism with particular kinds of military service, thereby facilitating claims for medical treatment and compensation for eligible veterans and service members. This legislative instrument was introduced to address the evolving medical-scientific understanding of hypothyroidism and its relation to military service. The Authority determined this instrument following an investigation into hypothyroidism, as notified in the Government Notices Gazette of 5 January 2021. The instrument reflects the latest sound medical-scientific evidence and replaces the previous Instrument No. 29 of 2013. The primary objective of this instrument is to ensure that claims for benefits related to hypothyroidism are assessed fairly and accurately, in accordance with the most current medical-scientific evidence. By specifying the factors that must be present to establish a connection between hypothyroidism and military service, the instrument aids in the assessment of claims and the provision of appropriate benefits and compensation. Additionally, the instrument promotes several human rights, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health, by facilitating the assessment and determination of benefits for veterans and service members.

Scope and Application

The Statement of Principles concerning hypothyroidism (Reasonable Hypothesis) (No. 3 of 2022) applies to veterans, current and former Defence Force members, and other eligible persons who are seeking benefits under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). This Act identifies the factors that must exist to establish a reasonable hypothesis connecting hypothyroidism or death from hypothyroidism with certain kinds of military service, including operational, peacekeeping, hazardous, and British nuclear test defence service under the VEA, and warlike and non-warlike service under the MRCA. The Statement of Principles is determined by the Repatriation Medical Authority under the VEA and applies nationally within Australia. The application of this Act may be extended or restricted through subordinate instruments, but no exclusions, exemptions, or thresholds are explicitly stated in the text. The compatibility with human rights is affirmed, promoting various rights, including social security, adequate living standards, and health, without discrimination.

Key Provisions

The Statement of Principles concerning hypothyroidism (Reasonable Hypothesis) (No. 3 of 2022) outlines the circumstances in which hypothyroidism and death from hypothyroidism can be related to particular kinds of service, including operational service, peacekeeping service, hazardous service, British nuclear test defence service, warlike service, and non-warlike service (sections 2 and 5). The Statement of Principles sets out factors that must exist, and which of those factors must be related to the kinds of service mentioned, before it can be said that a reasonable hypothesis has been raised connecting hypothyroidism or death from hypothyroidism with the circumstances of that service (section 5). The Statement of Principles applies to claims under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) (section 4). The Statement of Principles imposes obligations on parties and entities governed by the VEA and MRCA. It requires claimants to provide evidence that the factors outlined in the Statement of Principles exist and are related to the service rendered (section 5). It also imposes obligations on the Repatriation Commission and the Military Rehabilitation and Compensation Commission to assess claims in accordance with the Statement of Principles (section 4). Furthermore, the Statement of Principles outlines the factors that must be considered in the review of decisions by the Veterans' Review Board and the Administrative Appeals Tribunal (section 4). The Statement of Principles does not impose any specific offences, penalties, or consequences for breach. However, it is important to note that the Statement of Principles is a technical instrument that improves the medico-scientific quality of outcomes under the VEA and MRCA (section 1). The Statement of Principles is compatible with human rights and promotes a number of human rights, including the right to social security, the right to an adequate standard of living, the right to the enjoyment of the highest attainable standard of physical and mental health, and the rights of persons with disabilities (section 4). The Statement of Principles does not derogate from any human rights and ensures that those rights "will be exercised without discrimination of any kind" (section 4). In summary, the Statement of Principles concerning hypothyroidism (Reasonable Hypothesis) (No. 3 of 2022) sets out the factors that must exist, and which of those factors must be related to particular kinds of service, before it can be said that a reasonable hypothesis has been raised connecting hypothyroidism or death from hypothyroidism with the circumstances of that service. The Statement of Principles applies to claims under the VEA and MRCA and imposes obligations on parties and entities governed by these Acts. The Statement of Principles is compatible with human rights and promotes a number of human rights.

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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.