REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 23 of 2008
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. 89 of 1996 determined under subsection 196B(2) of the VEA concerning polymyalgia rheumatica and death from polymyalgia rheumatica.
2. The Authority is of the view that there is sound medical-scientific evidence that indicates that polymyalgia rheumatica and death from polymyalgia rheumatica 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. 23 of 2008 concerning polymyalgia rheumatica. 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 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 polymyalgia rheumatica or death from polymyalgia rheumatica, with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 28 June 2006 concerning polymyalgia rheumatica 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 'polymyalgia rheumatica' in clause 3;
- new definitions of 'death from polymyalgia rheumatica', 'ICD-10-AM code', and 'terminal event' in clause 6;
- revising definition of 'relevant service' in clause 6;
- deleting definition of 'ICD code'; and
- specifying a date of effect for the Instrument in clause 8.
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 polymyalgia rheumatica in the Government Notices Gazette of 28 June 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. 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 polymyalgia rheumatica as advertised in the Government Notices Gazette of 28 June 2006.
10. A list of references relating to the above condition is available, on written request, from the Repatriation Medical Authority Secretariat.
Overview
The Repatriation Medical Authority Instrument No. 23 of 2008 was enacted to address the issue of polymyalgia rheumatica and death from this condition in relation to military service. This instrument revokes the previous Instrument No. 89 of 1996 and introduces a new Statement of Principles, reflecting updated medical-scientific evidence. The Authority determined this new instrument under subsection 196B(2) of the Veterans' Entitlements Act 1986 (VEA) and it serves the purpose of replacing the previously revoked Statement of Principles. The instrument is designed to ensure that claims for compensation related to polymyalgia rheumatica are assessed in light of the latest medical evidence. The Authority conducted an investigation into the condition, advertised its intention in the Government Notices Gazette, and circulated notices to relevant organisations and individuals, though no submissions were received. This new instrument will apply for claims made under the VEA and the Military Rehabilitation and Compensation Act 2004.
Scope and Application
The Repatriation Medical Authority Instrument No. 23 of 2008, under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, pertains to the medical condition known as polymyalgia rheumatica, including death from this condition, and its potential relationship to various kinds of service such as operational, peacekeeping, hazardous, warlike, and non-warlike service. This instrument serves to replace the previously revoked Instrument No. 89 of 1996 and establishes a Statement of Principles that outlines the necessary conditions linking polymyalgia rheumatica or death from it to service circumstances. The application of this instrument is determined by the Military Rehabilitation and Compensation Commission for claims of compensation for injuries, diseases, or deaths occurring on or after 1 July 2004. The instrument applies to veterans and service personnel who have served under the specified conditions and have claimed or are claiming compensation related to polymyalgia rheumatica or death from it. The Repatriation Medical Authority has determined that the instrument applies nationally, and it is applicable to all relevant cases brought under the provisions of the VEA and MRCA. The Authority's decision to replace the previous instrument is based on new medical-scientific evidence, and the instrument includes updated definitions and formatting to align with current legislative practices.
Key Provisions
The key provisions of the legislation revolve around the replacement of an existing statement of principles concerning polymyalgia rheumatica and death from polymyalgia rheumatica, which was previously determined under the Veterans' Entitlements Act 1986 (VEA) but has now been revoked. In its place, the Repatriation Medical Authority (the Authority) has issued a new Statement of Principles, Instrument No. 23 of 2008, which aligns with the most recent medical-scientific evidence (section 2). This new instrument details the specific kinds of service that must be related to polymyalgia rheumatica or death from polymyalgia rheumatica to establish a reasonable hypothesis connecting the condition with the service rendered (section 4). These services include operational, peacekeeping, hazardous, warlike, and non-warlike service as defined under the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA).
The obligations imposed by this legislation on the parties involved primarily concern the accurate application of the new Statement of Principles when determining claims for compensation. For instance, the Military Rehabilitation and Compensation Commission must now reference this new instrument when assessing claims for service injuries, diseases, or deaths occurring after 1 July 2004 (section 3). The Authority is tasked with ensuring that the new instrument accurately reflects the latest medical-scientific evidence and is formatted in a way that clarifies its applicability under both the VEA and the MRCA (section 7). The Authority must also ensure that it has considered all relevant submissions and expert opinions during the investigation process, although in this case, no submissions were received (section 9).
In terms of consequences for breach or non-compliance, the legislation does not explicitly detail specific offences, penalties, or consequences. However, the Authority's role in issuing these Statements of Principles and the Commission's responsibility in applying them to compensation claims suggest that any failure to adhere to the provisions could potentially lead to disputes or legal challenges regarding the validity of compensation claims. The legislation underscores the importance of accurate and evidence-based medical determinations to ensure that veterans and their families receive the appropriate entitlements and support.