REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 48 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. 285 of 1995 determined under subsection 196B(3) of the VEA concerning methaemoglobinaemia.
- The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that methaemoglobinaemia and death from methaemoglobinaemia 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. 48 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 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, methaemoglobinaemia or death from methaemoglobinaemia 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 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. 48 of 2010, enacted in 2010, addresses the need to update the medical-scientific evidence and criteria for determining the connection between methaemoglobinaemia and specific types of military service. This instrument was enacted under subsection 196B(3) of the Veterans’ Entitlements Act 1986 and relates to claims under the Military Rehabilitation and Compensation Act 2004. The Authority determined that methaemoglobinaemia and death from the condition could be related to particular kinds of service, prompting the creation of a new Statement of Principles to replace the revoked Instrument No. 285 of 1995. The new instrument clarifies the factors that must exist for a connection to be made between methaemoglobinaemia and service, including exposure to oxidising drugs, chemicals, contaminated food or fluids, and dialysis fluid. This instrument was developed following an investigation into methaemoglobinaemia, with no submissions received during the investigation phase.
Scope and Application
The Repatriation Medical Authority Instrument No. 48 of 2010, concerning methaemoglobinaemia, is applicable to veterans and service personnel who have rendered eligible war service, defence service, or peacetime service under the Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). Specifically, it governs claims for compensation related to methaemoglobinaemia or death from methaemoglobinaemia connected with such services. The Instrument is a national instrument, with its application extending across the Commonwealth of Australia. It supersedes the previously revoked Instrument No. 285 of 1995. The new Instrument includes several amendments to definitions and factors, reflecting the latest medical-scientific evidence, and it specifies that the Statement of Principles has been determined for the purposes of both the VEA and the MRCA. The Instrument does not explicitly state exclusions, exemptions, or thresholds, but it focuses on the relationship between methaemoglobinaemia or death from methaemoglobinaemia and the specified kinds of service.
Key Provisions
The main operative sections of this legislation (F2010L01661) revolve around the establishment and determination of a Statement of Principles concerning methaemoglobinaemia, which replaces a previously revoked instrument. Specifically, under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (VEA), the Repatriation Medical Authority (the Authority) has determined a new Statement of Principles, Instrument No. 48 of 2010, concerning methaemoglobinaemia (section 4). This new Instrument is intended to replace the previously revoked Instrument No. 285 of 1995, which had also addressed methaemoglobinaemia. The Statement of Principles sets out the factors that must exist for methaemoglobinaemia or death from methaemoglobinaemia to be connected with certain kinds of service, including eligible war service, defence service, and peacetime service (section 4). The new Instrument reflects the latest revised format and includes updated definitions, factors, and other revisions to ensure it is consistent with current medical-scientific evidence and legislative requirements.
The obligations and requirements imposed by the Act primarily fall on the Repatriation Medical Authority. The Authority is tasked with determining the Statement of Principles concerning methaemoglobinaemia based on the sound medical-scientific evidence available. This involves conducting an investigation, which was advertised in the Government Notices Gazette on 2 May 2007, and considering any submissions received from relevant parties (section 8). The Authority is also responsible for specifying the effective date of the Instrument and ensuring it is determined for the purposes of both the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA) (section 7). Additionally, the Authority must ensure that the Statement of Principles is clear, comprehensive, and reflective of the latest medical-scientific evidence.
In terms of offences, penalties, or civil/criminal consequences for breach, the legislation does not explicitly outline specific penalties for non-compliance with the Statement of Principles or the process for determining it. However, non-compliance with the provisions of the VEA or the MRCA could potentially result in legal consequences under those Acts. For instance, making a false or misleading statement in a claim for compensation under the MRCA could be an offence under section 326 of the MRCA, which carries a maximum penalty of 2,000 penalty units (section 326(2)). Similarly, there may be other civil or criminal consequences for breaches of the VEA or MRCA, although these would be governed by the specific provisions of those Acts rather than the Instrument itself.