Statement of Principles concerning otitic barotrauma (Reasonable Hypothesis) (No. 86 of 2020)

Administered by Department of Veterans' Affairs

Legislation au F2020L01404 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

OTITIC BAROTRAUMA

(REASONABLE HYPOTHESIS) (NO. 86 OF 2020)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning otitic barotrauma (Reasonable Hypothesis) (No. 86 of 2020).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 35 of 2012 (Federal Register of Legislation No. F2012L00945) determined under subsections 196B(2) and (8) of the VEA concerning otitic barotrauma.

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that otitic barotrauma and death from otitic barotrauma 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 concerning otitic barotrauma (Reasonable Hypothesis) (No. 86 of 2020).  This Instrument will in effect replace the repealed Statement of Principles.

Purpose and Operation

4.             The Statement of Principles will be applied in determining claims under the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).

5.             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;

 British nuclear test defence 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 otitic barotrauma or death from otitic barotrauma, with the circumstances of that service.  The Statement of Principles has been determined for the purposes of both the VEA and the MRCA.

6.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 29 October 2019 concerning otitic barotrauma 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.

7.             The contents of this Instrument are in similar terms as the repealed Instrument.  Comparing this Instrument and the repealed Instrument, the differences include:

  • adopting the latest revised Instrument format, which commenced in 2015;
  • specifying a day of commencement for the Instrument in section 2;
  • revising the definition of 'otitic barotrauma' in subsection 7(2);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factors in subsections 9(1) and 9(4) concerning experiencing a change in ambient barometric pressure as specified, by the inclusion of a note;
  • revising the factors in subsections 9(2) and 9(5) concerning being exposed to blast pressure from an explosion or lightning strike;
  • revising the factors in subsections 9(3) and 9(6) concerning receiving mechanical ventilation involving a face mask, by the inclusion of a note;
  • deleting the factors concerning breathing 100 percent oxygen as these are covered by the factors in subsections 9(1) and 9(4) concerning experiencing a change in ambient barometric pressure as specified;
  • deleting the factors concerning having eustachian tube dysfunction;
  • new definitions of 'MRCA' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definition of 'relevant service' in Schedule 1 - Dictionary; and
  • deleting the definition of 'eustachian tube dysfunction'.

 

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to otitic barotrauma in the Government  Notices Gazette of 29 October 2019, 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, the Military Rehabilitation and Compensation 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 in relation to the investigation.

9.             On 15 June 2020, the Authority wrote to organisations representing veterans, service personnel and their dependants regarding the proposed Instrument and the medical-scientific material considered by the Authority.  This letter emphasised the deletion of factors relating to having eustachian tube dysfunction within the 24 hours before the clinical onset of otitic barotrauma and having eustachian tube dysfunction within the 24 hours before the clinical worsening of otitic barotrauma.  The Authority provided an opportunity to the organisations to make representations in relation to the proposed Instrument prior to its determination. No submissions were received for consideration by the Authority. Minor changes were made to the proposed Instrument following this consultation process.

Human Rights

10.         This instrument is compatible with the Human Rights and Freedoms recognised or declared in the International Instruments listed in Section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.  A Statement of Compatibility with Human Rights follows.

Finalisation of Investigation

11.         The determining of this Instrument finalises the investigation in relation to otitic barotrauma as advertised in the Government Notices Gazette of 29 October 2019.

References

12.         A list of references relating to the above condition is available on the Authority’s website at: www.rma.gov.au. Any other document referred to in this Statement of Principles is available on request to the Repatriation Medical Authority at the following address:

              

  Email:    info@rma.gov.au

  Post:      The Registrar

Repatriation Medical Authority

GPO Box 1014

BRISBANE    QLD    4001

 


Statement of Compatibility with Human Rights

(Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011)

 

Instrument No.:   Statement of Principles No. 86 of 2020

Kind of Injury, Disease or Death: Otitic barotrauma

 

This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Overview of the Legislative Instrument

1. This Legislative Instrument is determined pursuant to subsection 196B(2) of the Veterans' Entitlements Act 1986 (the VEA) for the purposes of the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).  Part XIA of the VEA requires the determination of these instruments outlining the factors connecting particular kinds of injury, disease or death with service such being determined solely on the available sound medical-scientific evidence.

2. This Legislative Instrument:-

  • facilitates claimants in making, and the Repatriation Commission and the Military Rehabilitation and Compensation Commission in assessing, claims under the VEA and the MRCA respectively, by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have otitic barotrauma;
  • facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal;
  • outlines the factors which the current sound medical-scientific evidence indicates must as a minimum exist, before it can be said that a reasonable hypothesis has been raised, connecting otitic barotrauma with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 35 of 2012; and
  • reflects developments in the available sound medical-scientific evidence concerning otitic barotrauma which have occurred since that earlier instrument was determined. 

3. The Instrument is assessed as being a technical instrument which improves the medico-scientific quality of outcomes under the VEA and the MRCA. 

Human Rights Implications

4. This Legislative Instrument does not derogate from any human rights. It promotes the human rights of veterans, current and former Defence Force members as well as other persons such as their dependents, including:

  • the right to social security (Art 9, International Covenant on Economic, Social and Cultural Rights; Art 26, Convention on the Rights of the Child and Art 28, Convention on the Rights of Persons with Disabilities) by helping to ensure that the qualifying conditions for the benefit are 'reasonable, proportionate and transparent'[1];
  • the right to an adequate standard of living (Art 11, ICSECR; Art 27, CRC and Art 28, CRPD) by facilitating the assessment and determination of social security benefits;
  • the right to the enjoyment of the highest attainable standard of physical and mental health (Art 12, ICSECR and Art 25, CRPD), by facilitating the assessment and determination of compensation and benefits in relation to the treatment and rehabilitation of veterans and Defence Force members;
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD); and
  • ensuring that those rights "will be exercised without discrimination of any kind as to race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status" (Art 2, ICESCR).

Conclusion

This Legislative Instrument is compatible with human rights as it does not derogate from and promotes a number of human rights.

 

Repatriation Medical Authority

 

 

 

 

 

 

[1] In General Comment No. 19 (The right to social security), the Committee on Economic, Social and Cultural Rights said (at paragraph 24) this to be one of the elements of ensuring accessibility to social security.

Overview

The Statement of Principles concerning otitic barotrauma (Reasonable Hypothesis) (No. 86 of 2020) was enacted in 2020 by the Repatriation Medical Authority under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This legislation was introduced to address the need for an updated and medically-informed statement of principles to connect otitic barotrauma with particular kinds of service, thereby facilitating the assessment of claims for compensation and medical treatment by veterans and service personnel. The policy objective is to ensure that the qualifying conditions for benefits are reasonable, proportionate and transparent, thereby promoting human rights such as the right to social security, adequate standard of living, and the highest attainable standard of physical and mental health. The Authority has determined this Statement of Principles based on the latest sound medical-scientific evidence available, replacing the earlier Instrument No. 35 of 2012. The new Statement of Principles outlines the specific factors that must exist to raise a reasonable hypothesis connecting otitic barotrauma with the service rendered, including exposure to certain environmental pressures and mechanical ventilation. This legislative instrument promotes the rights of veterans, current and former Defence Force members, and their dependents by facilitating the assessment and determination of social security benefits, compensation, and medical treatment. It ensures these rights are exercised without discrimination, in accordance with international human rights standards.

Scope and Application

The Statement of Principles concerning otitic barotrauma (Reasonable Hypothesis) (No. 86 of 2020) applies to claims made under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. It pertains to veterans and current or former Defence Force members who have suffered from otitic barotrauma as a result of their service in specific contexts, such as operational, peacekeeping, hazardous, British nuclear test defence service, or warlike and non-warlike services. The Instrument is designed to establish a reasonable hypothesis connecting the condition of otitic barotrauma or death from otitic barotrauma with the service rendered by the affected person, ensuring that the minimum factors required for such a connection to be established are clearly outlined. The scope of the Instrument is national, impacting all veterans and Defence Force members across Australia. The Instrument reflects an updated format and incorporates revisions to definitions and factors concerning otitic barotrauma, replacing a previous Statement of Principles determined in 2012. The Authority has undertaken consultations with relevant organisations and stakeholders, although no submissions were received. The Instrument is compatible with human rights and promotes various rights, including social security, living standards, and health, without any derogation from these rights. This Statement of Principles serves to provide clarity and updated medical-scientific evidence regarding the eligibility criteria for claims related to otitic barotrauma, thereby facilitating the assessment and determination of benefits and compensation. The Instrument aims to ensure that the conditions for qualifying for benefits are reasonable, proportionate, and transparent, thereby upholding the rights of veterans, Defence Force members, and their dependents. The Instrument's provisions are intended to enhance the quality of outcomes under the relevant Acts by reflecting the latest available evidence and improving the assessment process for claimants.

Key Provisions

The main operative sections of the Statement of Principles concerning otitic barotrauma (Reasonable Hypothesis) (No. 86 of 2020) (the Instrument) detail the circumstances under which otitic barotrauma and death from otitic barotrauma can be reasonably hypothesised to be related to specific types of service. This is outlined in section 5, which specifies the factors that must exist, and which of those factors must be related to the types of service mentioned, to establish a connection between otitic barotrauma or death from otitic barotrauma and the service rendered. The Instrument (section 4) is applied in determining claims under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). It sets out the minimum factors that need to be present to establish a reasonable hypothesis connecting otitic barotrauma or death from otitic barotrauma with operational, peacekeeping, hazardous, British nuclear test defence, warlike, or non-warlike service. The Instrument imposes obligations on claimants, the Repatriation Commission, the Military Rehabilitation and Compensation Commission, and the Veterans' Review Board to adhere to the factors specified in the Statement of Principles when making or assessing claims related to otitic barotrauma. These parties are required to ensure that the claims are evaluated based on the sound medical-scientific evidence provided in the Instrument. The Instrument aims to ensure that the claims process is transparent, proportionate, and reasonable, thereby promoting the human rights of veterans, current and former Defence Force members, and their dependents. There are no specific offences, penalties, or civil/criminal consequences outlined in the Instrument for breach. However, failure to comply with the requirements set out in the Statement of Principles could potentially lead to the denial of claims under the VEA and the MRCA. The Instrument focuses on facilitating the assessment and determination of benefits and compensation for those who have suffered otitic barotrauma related to their service, ensuring that the process is in line with the available sound medical-scientific evidence. The compatibility of the Instrument with human rights is addressed in the Statement of Compatibility with Human Rights. The Instrument is considered compatible with human rights as it does not derogate from any human rights and promotes several human rights, including the right to social security, the right to an adequate standard of living, and the right to the enjoyment of the highest attainable standard of physical and mental health. The Instrument ensures that these rights are exercised without discrimination, as outlined in Article 2 of the International Covenant on Economic, Social and Cultural Rights. Overall, the Statement of Principles concerning otitic barotrauma (Reasonable Hypothesis) (No. 86 of 2020) aims to provide clarity and guidance in determining claims related to otitic barotrauma under the VEA and the MRCA, ensuring that the claims process is fair, transparent, and in line with the latest available sound medical-scientific evidence.

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