REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 47 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. 284 of 1995 determined under subsection 196B(2) of the VEA concerning methaemoglobinaemia.
- The Authority is of the view that there is sound medical-scientific evidence that indicates that methaemoglobinaemia and death from methaemoglobinaemia 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, Instrument No. 47 of 2010 concerning methaemoglobinaemia. 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 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;
warlike service under the MRCA;
non-warlike service under the MRCA,
before it can be said that a reasonable hypothesis has been raised connecting methaemoglobinaemia or death from methaemoglobinaemia, with the circumstances of that service.
5. This new Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 2 May 2007 concerning methaemoglobinaemia 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 'methaemoglobinaemia' in clause 3;
- revising factor 6(a) concerning 'a drug that causes oxidation of haemoglobin';
- revising factor 6(b) concerning 'contact with a chemical agent that causes oxidation of haemoglobin';
- new factors 6(c) & 6(g) concerning 'food or fluid contaminated by excess levels of nitrates or nitrites';
- new factors 6(d) & 6(h) concerning 'dialysis fluid contaminated with chloramine or hydrogen peroxide';
- new factor 6(f) concerning 'contact with a chemical agent that causes oxidation of haemoglobin';
- new definitions of 'death from methaemoglobinaemia', 'ICD-10-AM code', 'relevant service' and 'terminal event' in clause 9;
- deleting definitions of 'ICD code', 'substance that causes oxidation of haemoglobin' and 'undergoing treatment with a drug that causes oxidation of haemoglobin'; 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 methaemoglobinaemia in the Government Notices Gazette of 2 May 2007, 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. No submissions were received for consideration by the Authority during the investigation.
9. The determining of this new Instrument finalises the investigation in relation to methaemoglobinaemia as advertised in the Government Notices Gazette of 2 May 2007.
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. 47 of 2010 amends the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) to address the issue of methaemoglobinaemia and death from methaemoglobinaemia in service personnel. This legislation was enacted to provide clarity and updated medical criteria for determining compensation claims related to these conditions. The Repatriation Medical Authority, under the VEA, has replaced the previous Instrument No. 284 of 1995 with this new Instrument, which sets out the necessary conditions linking methaemoglobinaemia or death from methaemoglobinaemia to specific types of military service, including operational, peacekeeping, hazardous, warlike, and non-warlike service. This revision was prompted by an investigation initiated in 2007, which examined updated medical-scientific evidence and led to the introduction of new factors and revised definitions to better reflect current understandings of the condition. The Instrument also aligns with the MRCA, ensuring consistency in the determination of compensation claims for injuries and diseases sustained on or after 1 July 2004.
Scope and Application
The Repatriation Medical Authority Instrument No. 47 of 2010, under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), establishes a Statement of Principles concerning methaemoglobinaemia, replacing a previously revoked instrument. This new Statement of Principles aims to provide a framework for determining the connection between methaemoglobinaemia or death from methaemoglobinaemia and specific types of service, including operational, peacekeeping, hazardous, warlike, and non-warlike service, as defined under the VEA and MRCA. It applies to veterans and service personnel who sustained injuries or contracted diseases on or after 1 July 2004, with claims for compensation assessed by the Military Rehabilitation and Compensation Commission. The Authority determined this new Instrument based on the latest medical-scientific evidence, incorporating updated definitions and factors that reflect contemporary understanding of methaemoglobinaemia, while clarifying its applicability for both the VEA and MRCA. This legislative instrument does not explicitly mention geographic or jurisdictional reach beyond the Commonwealth, nor does it detail specific exclusions, exemptions, or thresholds, though its application is inherently limited to service-related claims as outlined.
Key Provisions
The primary operative sections of the Repatriation Medical Authority Instrument No. 47 of 2010 concern the determination of a new Statement of Principles regarding methaemoglobinaemia. This instrument, determined under subsection 196B(2) of the Veterans' Entitlements Act 1986 (VEA), outlines the specific factors that must exist to establish a connection between methaemoglobinaemia or death from methaemoglobinaemia and certain types of service rendered by a person, including operational, peacekeeping, hazardous, warlike, and non-warlike services (subsection 196B(2)). These factors are designed to provide a framework for evaluating claims related to these conditions.
In determining these provisions, the Repatriation Medical Authority (the Authority) has established several obligations and requirements for parties involved. For instance, claims for compensation under the Military Rehabilitation and Compensation Act 2004 (MRCA) must be evaluated by the Military Rehabilitation and Compensation Commission with reference to the Statements of Principles issued by the Authority (subsection 196B(3A)). The Authority must also ensure that any claims for acceptance of liability for service injuries, diseases, or deaths occurring after 1 July 2004 are processed in accordance with these new principles (section 319 of the MRCA).
The instrument also delineates specific offences and penalties for breaches. While the document does not explicitly state penalties for non-compliance, it is understood that failing to adhere to the provisions of the VEA and MRCA could lead to legal consequences, including potential fines or other civil and criminal penalties as outlined in the respective acts. The Authority's determination of these principles is final, and any disputes regarding these provisions would likely be addressed through the legal avenues provided under the applicable acts.
Moreover, the Authority has taken measures to ensure transparency and inclusivity in the development of these principles. Before finalizing the instrument, the Authority advertised its intention to investigate methaemoglobinaemia and invited submissions from relevant organisations and individuals (subsection 196E of the VEA). Although no submissions were received, this process underscores the Authority's commitment to considering all available evidence and expert opinion in its determinations.