REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 32 of 2011
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. 88 of 1996, determined under subsection 196B(3) of the VEA concerning obstructive nephropathy.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that obstructive and reflux nephropathy and death from obstructive and reflux nephropathy 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. 32 of 2011 concerning obstructive and reflux nephropathy. 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, obstructive and reflux nephropathy or death from obstructive and reflux nephropathy is connected with the circumstances of that service.
5. This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 25 June 2008 concerning obstructive nephropathy 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 this Instrument are in similar terms as the revoked Instrument. Comparing this Instrument and the revoked Instrument, the differences include:
- adopting the latest revised Instrument format, which commenced in 2005;
- deleting the ICD code from the Instrument header;
- changing the name of the Instrument to 'obstructive and reflux nephropathy';
- new definition of 'obstructive and reflux nephropathy' in clause 3;
- revising factors 6(a) & 6(f) concerning 'obstruction of the ureter or renal calyx';
- revising factors 6(b) & 6(g) concerning 'obstruction of the bladder outlet or urethra';
- new factors 6(c) & 6(h) concerning 'a renal or ureteric transplant';
- new factors 6(d) & 6(i) concerning 'functional obstruction of the ureter or renal calyx';
- new factors 6(e) & 6(j) concerning 'being treated with a drug from a class of drugs';
- new definitions of 'a drug from a class of drugs in the specified list', 'death from obstructive and reflux nephropathy', 'functional obstruction of the ureter or renal calyx', 'ICD-10-AM code', 'obstruction of the bladder outlet or urethra', 'obstruction of the ureter or renal calyx' and 'terminal event' in clause 9;
- revising definition of 'relevant service' in clause 9;
- deleting definitions of 'ICD code', 'obstruction of the bladder outlet', 'obstruction of the urethra' and 'obstruction of the renal pelvicalyceal system or ureter'; 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 obstructive nephropathy 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. No submissions were received for consideration by the Authority during the investigation.
9. The determining of this Instrument finalises the investigation in relation to obstructive nephropathy 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. 32 of 2011, issued under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, aims to address the problem of determining the relationship between obstructive and reflux nephropathy and particular kinds of service, particularly for veterans and their dependants. This legislative instrument revokes the previous Instrument No. 88 of 1996, which had dealt with obstructive nephropathy, and replaces it with a new Statement of Principles based on the latest available medical-scientific evidence. The Authority determined this new instrument to clarify the circumstances under which obstructive and reflux nephropathy, or death from these conditions, can be connected to specific types of service, including eligible war service, defence service, and peacetime service. The Authority conducted an investigation, notified in the Government Notices Gazette of 25 June 2008, and considered relevant submissions, though none were received in this instance. This new instrument ensures that claims for compensation, particularly those concerning service injuries or diseases sustained or contracted after 1 July 2004, are assessed in accordance with the updated medical evidence.
Scope and Application
The Repatriation Medical Authority Instrument No. 32 of 2011 under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 addresses the determination of obstructive and reflux nephropathy as service-related conditions. This instrument applies to eligible war service, defence service, and peacetime service, providing a framework for determining whether such conditions are connected to specific types of military service. The instrument is applicable nationwide within Australia and serves to replace the previously revoked Instrument No. 88 of 1996 concerning obstructive nephropathy. It establishes a Statement of Principles which outlines the factors necessary for linking obstructive and reflux nephropathy, or death from such conditions, to service circumstances. This instrument is instrumental in processing claims for compensation for service-related health conditions under the Military Rehabilitation and Compensation Act 2004. It was determined following an investigation into obstructive nephropathy, as announced in the Government Notices Gazette of 25 June 2008, and reflects the latest medical-scientific evidence. The Authority ensures that the instrument is accessible to relevant organisations and individuals, and it invites submissions from experts in the field during the investigation phase.
Key Provisions
The Repatriation Medical Authority, under section 196B(8) of the Veterans’ Entitlements Act 1986 (VEA), has revoked Instrument No. 88 of 1996 concerning obstructive nephropathy, and issued Instrument No. 32 of 2011 concerning obstructive and reflux nephropathy. This new Instrument is determined under section 196B(3) of the VEA and replaces the previous one, establishing a Statement of Principles that outlines the factors necessary to connect obstructive and reflux nephropathy, or death from these conditions, with service rendered by a person. This connection can be made with eligible war service (other than operational service), defence service (other than hazardous service), or peacetime service as defined under the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA) respectively.
The new Instrument imposes several obligations and requirements on the parties it governs. Firstly, it mandates that claims for compensation related to service injuries, service diseases, or service deaths that occurred on or after 1 July 2004, must be determined by the Military Rehabilitation and Compensation Commission. These claims must be assessed based on the Statements of Principles issued by the Authority pursuant to the VEA. Secondly, the Instrument stipulates that for a claim to be substantiated, it must be shown that obstructive and reflux nephropathy or death from these conditions are connected with the service rendered, on the balance of probabilities. This involves demonstrating that the factors outlined in the Statement of Principles are met and are related to the relevant types of service. The Authority has conducted an investigation into obstructive nephropathy, examining sound medical-scientific evidence, including evidence previously considered. This investigation led to the issuance of the new Instrument, which incorporates changes such as a revised Instrument format, new definitions, and updated factors concerning various medical conditions and treatments.
The Instrument also outlines potential consequences for breaches of its provisions. While specific offences and penalties are not detailed within the text, breaches of the requirements or obligations under the VEA and MRCA could lead to civil or criminal consequences. For instance, providing false information in a claim could result in penalties under the relevant Acts, which may include fines or other legal repercussions. The Authority’s determination of the Instrument and the Statement of Principles is intended to ensure that claims are assessed fairly and based on sound medical-scientific evidence, thereby protecting the integrity of the compensation process.
In summary, Instrument No. 32 of 2011 provides a comprehensive framework for assessing claims related to obstructive and reflux nephropathy, ensuring that such claims are evaluated against specific criteria and evidence. It sets out the necessary factors for linking these conditions to service and mandates that compensation claims be determined by the Military Rehabilitation and Compensation Commission. While the specific penalties for breaches are not detailed, the Instrument aims to uphold the integrity of the compensation process for veterans and service personnel.