Statement of Principles concerning restless legs syndrome No. 21 of 2014

Administered by Department of Veterans' Affairs

Legislation au F2014L00308 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

INSTRUMENT NO. 21 of 2014

 

VETERANS’ ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

EXPLANATORY NOTES FOR TABLING

 

 

  1. The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans’ Entitlements Act 1986 (the VEA), revokes Instrument No. 34 of 2003, determined under subsection 196B(3) of the VEA concerning restless legs syndrome.

 

2.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that restless legs syndrome and death from restless legs syndrome 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. 21 of 2014 concerning restless legs syndrome.  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 and British nuclear test defence service) under the VEA;

 peacetime service under the MRCA,

 

before it can be said that, on the balance of probabilities, restless legs syndrome or death from restless legs syndrome 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 18 May 2011 concerning restless legs syndrome 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;
  • revising the definition of 'restless legs syndrome' in clause 3;
  • new factors 6(a) & 6(m) concerning 'diabetes mellitus';
  • revising factors 6(b) & 6(n) concerning 'iron deficiency';
  • revising factors 6(c) & 6(o) concerning 'chronic renal failure';
  • revising factors 6(d) & 6(p) concerning 'radiculopathy or peripheral neuropathy';
  • new factors 6(e) & 6(q) concerning 'spinal cord lesion';
  • revising factors 6(f) & 6(r) concerning 'being treated with a drug or a drug from a class of drugs';
  • new factors 6(g) & 6(s) concerning 'smoking';
  • new factors 6(h) & 6(t) concerning 'being obese';
  • new factors 6(i) & 6(u) concerning 'multiple sclerosis';
  • new factors 6(j) & 6(v) concerning 'a clinically significant psychiatric condition';
  • new factors 6(k) & 6(w) concerning 'a specified sleep disorder';
  • new factors 6(l) & 6(x) concerning 'being pregnant';
  • new definitions of 'a clinically significant psychiatric condition as specified', 'a drug or a drug from a class of drugs from the specified list', 'a specified sleep disorder', 'being obese' and 'pack-years of cigarettes, or the equivalent thereof in other tobacco products' in clause 9;
  • revising the definitions of 'chronic renal failure', 'iron deficiency' and 'relevant service' in clause 9;
  • deleting the definition of 'undergoing treatment with a drug from the specified list'; 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 restless legs syndrome in the Government Notices Gazette of 18 May 2011, 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.             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.

 

10.         The determining of this Instrument finalises the investigation in relation to restless legs syndrome as advertised in the Government Notices Gazette of 18 May 2011.

 

11.         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

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. 21 of 2014

Kind of Injury, Disease or Death: Restless legs syndrome

 

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(8) of the Veterans' Entitlements Act 1986 (the VEA) for the purposes of the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).

2. This Legislative Instrument:-

  • facilitates claimants in making, and the Repatriation 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 restless legs syndrome;
  • 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 exist before it can be said that, on the balance of probabilities, restless legs syndrome is connected with the circumstances of eligible service rendered by a person, as set out in clause 4 of the Explanatory Notes;
  • replaces Instrument No. 34 of 2003; and
  • reflects developments in the available sound medical-scientific evidence concerning restless legs syndrome 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; and
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD).

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 Repatriation Medical Authority Instrument No. 21 of 2014, enacted under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, addresses the need to clarify and update the medical-scientific evidence regarding restless legs syndrome and its relation to military service. This legislative instrument was enacted to provide a Statement of Principles concerning restless legs syndrome, replacing the previous Instrument No. 34 of 2003. The Repatriation Medical Authority, under subsection 196B(8) of the Veterans' Entitlements Act, determined this Statement of Principles based on the available sound medical-scientific evidence, to facilitate the assessment and determination of claims for compensation related to restless legs syndrome. The policy objective of this instrument is to ensure that claimants and the Repatriation Commission can effectively assess claims by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have restless legs syndrome. It also ensures compatibility with human rights, promoting the rights of veterans, current and former Defence Force members, and their dependents.

Scope and Application

The Repatriation Medical Authority Instrument No. 21 of 2014, issued under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), specifies the conditions under which veterans and current or former Defence Force members can claim compensation for restless legs syndrome (RLS). This Instrument applies to individuals who have served in eligible war service, defence service, or peacetime service, as defined by the VEA and MRCA. It replaces the previously revoked Instrument No. 34 of 2003 and incorporates updated medical-scientific evidence to better ascertain the connection between RLS and service circumstances. The Instrument outlines specific factors that must exist to establish a link between RLS and the service rendered, such as service-related iron deficiency or chronic renal failure, among other conditions. This legislative instrument facilitates both the claimants and the Repatriation Commission in assessing and reviewing claims, ensuring that the process is transparent, reasonable, and proportionate. It does not derogate from any human rights but promotes various rights, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health, thereby supporting veterans and their dependents in accessing necessary benefits and treatments.

Key Provisions

The Repatriation Medical Authority has established Instrument No. 21 of 2014, pursuant to subsection 196B(3) of the Veterans’ Entitlements Act 1986 (VEA), to outline a Statement of Principles regarding restless legs syndrome. This instrument replaces Instrument No. 34 of 2003 and is designed to clarify the circumstances under which a connection between restless legs syndrome and particular types of service can be recognised, thereby facilitating claims for compensation and medical treatment under both the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA). This instrument is particularly relevant for eligible war service, defence service, and peacetime service as defined in the respective acts. Under this new instrument, several obligations and requirements are imposed on the parties involved. Claimants must provide evidence that aligns with the specified factors outlined in the Statement of Principles to substantiate their claims for compensation related to restless legs syndrome. The Repatriation Commission is obligated to assess these claims based on the sound medical-scientific evidence provided, and the Military Rehabilitation and Compensation Commission must determine claims for compensation under the MRCA by reference to these Statements of Principles. The Veterans’ Review Board and the Administrative Appeals Tribunal also have the responsibility to review decisions related to these claims. Breaches of the provisions outlined in this instrument can lead to various legal consequences. While specific offences and penalties are not detailed in the explanatory notes, general principles of administrative law and the acts themselves would apply. For instance, providing false information or withholding relevant evidence could be considered fraudulent conduct, potentially leading to civil penalties or even criminal charges, depending on the severity of the breach. The maximum penalties for such offences would be consistent with those prescribed under the relevant sections of the VEA and MRCA. Additionally, failure to comply with the procedural requirements set forth in this instrument could result in the denial of claims or the overturning of decisions in favour of claimants. The instrument’s focus on sound medical-scientific evidence ensures that the determination of claims is based on rigorous and updated criteria, reflecting the latest understanding of restless legs syndrome. By specifying the factors that must exist and be related to particular types of service, the instrument aims to provide a transparent and fair process for claimants, thereby upholding human rights related to social security and health. This comprehensive approach ensures that claimants receive appropriate support and that the Repatriation Medical Authority’s decisions are both legally sound and ethically justifiable.

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