REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 57 of 2009
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. 75 of 1999 determined under subsection 196B(3) of the VEA concerning migraine.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that migraine and death from migraine 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. 57 of 2009 concerning migraine. This Instrument will in effect replace the revoked Statement of Principles.
3. 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.
4. 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, migraine or death from migraine 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 30 August 2006 concerning migraine 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 'migraine' in clause 3;
- new factor 6(a) concerning 'treatment with glyceryl trinitrate or isosorbide mononitrate';
- revising definitions of 'ICD-10-AM code' and 'relevant service' in clause 9; 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 migraine in the Government Notices Gazette of 30 August 2006, 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. Three submissions were received for consideration by the Authority during the investigation.
9. The determining of this new instrument finalises the investigation in relation to migraine as advertised in the Government Notices Gazette of 30 August 2006.
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. 57 of 2009, concerning migraine, was enacted to address the need for updated medical evidence regarding the relationship between migraines and particular kinds of service under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. The instrument revokes the previous Instrument No. 75 of 1999 and establishes a new Statement of Principles to reflect the latest medical-scientific evidence. The Authority undertook an investigation, published in the Government Notices Gazette of 30 August 2006, inviting submissions from relevant organisations and experts. The new instrument specifies the factors that must exist and be related to eligible war service, defence service, or peacetime service to establish a connection between migraines and service. The Authority aims to ensure that claims for compensation related to migraines are assessed accurately and in accordance with the most current medical understanding.
Scope and Application
The Repatriation Medical Authority (Authority) has revoked Instrument No. 75 of 1999 concerning migraine and issued a new Statement of Principles, Instrument No. 57 of 2009, under the Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). This new instrument applies to veterans and service personnel who have sustained a service injury or contracted a service disease, including death from migraine, on or after 1 July 2004. The Statement of Principles outlines the factors that must be present and related to specific service types, such as eligible war service, defence service, and peacetime service, to establish a connection between migraine or death from migraine and the service circumstances. The Authority considered sound medical-scientific evidence in determining this new instrument, which replaces the revoked one, and clarifies the application of the Statement of Principles to both the VEA and the MRCA. The new instrument adopts a revised format, deletes the ICD code from the header, and revises several definitions and factors, including the addition of treatment with glyceryl trinitrate or isosorbide mononitrate as a new factor. The Authority invited submissions from relevant organisations and individuals during the investigation and received three submissions for consideration.
Key Provisions
The Repatriation Medical Authority, under the authority vested in it by the Veterans' Entitlements Act 1986 (VEA), has revoked Instrument No. 75 of 1999 concerning migraine and has issued a new Statement of Principles, Instrument No. 57 of 2009, based on sound medical-scientific evidence. This new instrument supersedes the previous one and sets out the factors that must exist to determine if, on the balance of probabilities, migraine or death from migraine is connected with certain kinds of military service, such as eligible war service, defence service, and peacetime service (sections 2 and 4). The changes in the new instrument include adopting a revised format, revising definitions, and specifying a date of effect (sections 6 and 7). The Authority advertised its intention to investigate migraine in the Government Notices Gazette of 30 August 2006, and invited submissions from relevant parties, including the Repatriation Commission and organisations representing veterans (section 8).
The obligations imposed by this legislation require the Repatriation Medical Authority to determine Statements of Principles concerning service-related conditions such as migraine, and to ensure these Statements are based on sound medical-scientific evidence. The Authority must also notify relevant parties of its intention to investigate and consider submissions from them. This process ensures that the criteria for linking a condition like migraine to military service are both medically justified and transparent. Furthermore, the Authority is tasked with finalising any investigation by determining a new Statement of Principles, as was done with Instrument No. 57 of 2009 (section 9). The new instrument is designed to assist the Military Rehabilitation and Compensation Commission in determining claims for compensation under the Military Rehabilitation and Compensation Act 2004 (MRCA) for injuries or diseases sustained or contracted on or after 1 July 2004 (section 3).
Breaching the obligations set out in the VEA and MRCA, or failing to adhere to the requirements for determining Statements of Principles, could have legal consequences. While specific penalties for breaches are not detailed in the explanatory notes, violations of legislative requirements can typically result in legal actions being taken against the parties involved. These actions may include civil penalties, enforcement actions, or other legal remedies. The Authority’s role in ensuring the accuracy and relevance of the Statements of Principles is crucial for the proper administration of veterans' entitlements and military rehabilitation and compensation claims.