REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 52 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. 60 of 1997 determined under subsection 196B(3) of the VEA concerning internal derangement of the knee.
- The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that internal derangement of the knee and death from internal derangement of the knee 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, Instrument No. 52 of 2010 concerning internal derangement of the knee. This Instrument will in effect replace the revoked Statement of Principles.
- 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.
- 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) under the VEA;
peacetime service under the MRCA,
before it can be said that, on the balance of probabilities, internal derangement of the knee or death from internal derangement of the knee is connected 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 internal derangement of the knee 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 'internal derangement of the knee' in clause 3;
- revising factors 6(a) & 6(c) concerning 'acute sprain';
- new factors 6(b) & 6(d) concerning 'acute meniscal tear';
- new definitions of 'death from internal derangement of the knee', 'ICD-10-AM code' and 'terminal event' in clause 9;
- revising the definition of 'relevant service' in clause 9;
- deleting the definition of 'ICD code'; 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 internal derangement of the knee 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. One submission was received for consideration by the Authority during the investigation.
9. The determining of this new Instrument finalises the investigation in relation to internal derangement of the knee 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. 52 of 2010, issued under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, aims to address the issue of internal derangement of the knee in service personnel by providing a new Statement of Principles. The Repatriation Medical Authority, exercising its powers under the Veterans’ Entitlements Act, revoked the previous Instrument No. 60 of 1997 in light of new medical-scientific evidence suggesting a probable link between internal derangement of the knee and certain types of military service. This new Instrument sets out the factors required for a service-related connection to be established, thereby facilitating compensation claims under the Military Rehabilitation and Compensation Act. The Authority's investigation, initiated in 2008, sought to incorporate the latest medical evidence and refine definitions and factors pertinent to the condition, thereby ensuring that the process for adjudicating on such claims is both scientifically grounded and legally robust.
Scope and Application
The Repatriation Medical Authority, under the Veterans' Entitlements Act 1986, has issued Instrument No. 52 of 2010, which pertains to the condition of internal derangement of the knee. This Instrument replaces the previously revoked Instrument No. 60 of 1997. It applies to individuals who have sustained internal derangement of the knee as a result of eligible war service (other than operational service), defence service (other than hazardous service), or peacetime service, as defined under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act 2004. The Instrument is applicable nationally, affecting all veterans, service personnel, and their dependants across Australia. The determination of the Statement of Principles is made to establish a connection between the condition and the service rendered, and it provides the necessary criteria for such a connection to be accepted on the balance of probabilities. The Instrument's scope is further clarified by the exclusion of certain types of service and the incorporation of the latest medical-scientific evidence available to the Authority. This legislative instrument ensures that claims for compensation regarding internal derangement of the knee, made on or after 1 July 2004, are assessed in accordance with the newly established principles by the Military Rehabilitation and Compensation Commission.
Key Provisions
The Repatriation Medical Authority (the Authority) under subsection 196B(8) of the Veterans’ Entitlements Act 1986 (VEA) has revoked Instrument No. 60 of 1997, which concerned internal derangement of the knee, and has issued a new Statement of Principles, Instrument No. 52 of 2010 ((1)-(2)). This new Instrument will replace the revoked one and is based on the latest sound medical-scientific evidence available to the Authority, which indicates that internal derangement of the knee and death from such a condition can be related to particular kinds of service ((2), (4)-(5)). The Statement of Principles outlines the factors that must exist and must be related to the service rendered by a person, for it to be said on the balance of probabilities that internal derangement of the knee or death from such a condition is connected with the circumstances of the service ((5)).
The Statement of Principles, as a part of the legislative framework, imposes several obligations and requirements on the parties involved. For example, it sets out the specific circumstances and service-related factors that need to be present for a claim to be considered valid. This includes the types of service that must be rendered by the person making the claim, such as eligible war service, defence service, or peacetime service ((5)). Additionally, the Authority is required to ensure that the new Instrument reflects the latest medical-scientific evidence and adopts a revised format that complies with the requirements of the Military Rehabilitation and Compensation Act 2004 (MRCA) ((6)-(7)). The Authority must also facilitate the process of reviewing and revising the Instrument as new evidence and changes in legislation dictate, ensuring that the legal framework remains up-to-date and reflective of current medical understanding.
Under the VEA and MRCA, breaches of the requirements set out in the Statement of Principles, such as providing false or misleading information, can result in both civil and criminal consequences. For civil breaches, the Authority may refuse to accept a claim or may cancel a payment already made. For criminal breaches, the maximum penalty for providing false or misleading information can include fines and imprisonment ((9)-(10)). The precise penalties depend on the nature and severity of the offence, as well as the specific provisions of the relevant Acts. The Authority and the Military Rehabilitation and Compensation Commission are tasked with ensuring compliance with these legislative requirements and with enforcing the penalties where necessary.