REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 19 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. 93 of 1995, determined under subsection 196B(2) of the VEA concerning rheumatic heart disease.
2. The Authority is of the view that there is sound medical-scientific evidence that indicates that rheumatic heart disease and death from rheumatic heart disease 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. 19 of 2011 concerning rheumatic heart disease. 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 rheumatic heart disease or death from rheumatic heart disease, with the circumstances of that service.
5. This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 2 May 2007 concerning rheumatic heart disease 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;
- revising the definition of 'rheumatic heart disease' in clause 3;
- revising factor 6(a) concerning 'acute rheumatic fever';
- revising factor 6(b) concerning 'group A beta-haemolytic streptococcal A infection';
- new factor 6(c) concerning 'acute rheumatic fever';
- new factor 6(d) concerning 'group A beta-haemolytic streptococcal A infection';
- new factor 6(e) concerning 'being pregnant';
- new definitions of 'death from rheumatic heart disease', 'group A beta-haemolytic streptococcal infection', 'ICD-10-AM code', 'relevant service' and 'terminal event' in clause 9;
- deleting definitions of 'ICD code', 'rheumatic fever' and 'streptococcal A infection'; 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 rheumatic heart disease in the Government Notices Gazette of 2 May 2007, 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 rheumatic heart disease as advertised in the Government Notices Gazette of 2 May 2007.
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. 19 of 2011, enacted under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, addresses the need for updated medical-scientific evidence concerning rheumatic heart disease in relation to service rendered by individuals. This instrument, which replaces Instrument No. 93 of 1995, is aimed at ensuring that the Statement of Principles accurately reflects current medical understanding and the specific circumstances of service that may be linked to the disease or its fatal outcomes. The instrument was determined after a comprehensive investigation, following the Authority's notice in the Government Notices Gazette of 2 May 2007, which sought submissions from relevant organisations and experts but received none. The Authority finalised this instrument to complete the investigation, updating the format and definitions to align with the commencement of the Military Rehabilitation and Compensation Act 2004, and clarifying that the Statement of Principles applies to both acts.
Scope and Application
The Repatriation Medical Authority Instrument No. 19 of 2011, concerning rheumatic heart disease, is a legislative instrument under the Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). It applies to veterans and service personnel who have served in various capacities, including operational, peacekeeping, hazardous, warlike, and non-warlike services, and who are seeking compensation for rheumatic heart disease or death from rheumatic heart disease related to their service. The instrument establishes a Statement of Principles that outlines the minimum factors required to establish a connection between the disease and the service, and these factors must be related to the specific type of service rendered. The instrument revokes the previous Instrument No. 93 of 1995, replacing it with updated medical-scientific evidence and a revised format in line with the latest Instrument standards. The Authority determined this instrument following an investigation and public consultation, and it is applicable for claims for compensation commenced on or after 1 July 2004, as per the MRCA. This instrument does not extend or restrict application through subordinate instruments, but its implementation is subject to the provisions of the VEA and MRCA.
Key Provisions
The Repatriation Medical Authority (the Authority) has determined a new Statement of Principles, Instrument No. 19 of 2011, concerning rheumatic heart disease, which replaces the previously revoked Instrument No. 93 of 1995 (section 2). This new instrument sets out the minimum factors that must exist for a reasonable hypothesis to be raised connecting rheumatic heart disease or death from rheumatic heart disease with the circumstances of service rendered by a person (section 4). The Statement of Principles outlines the types of service that may be considered, including operational, peacekeeping, hazardous, warlike, and non-warlike service (section 4). The Authority determined this Instrument after considering sound medical-scientific evidence, including evidence previously reviewed (sections 2 and 5).
The obligations imposed by the Act on the parties it governs include the requirement to provide evidence that meets the criteria set out in the Statement of Principles for claims related to rheumatic heart disease or death from rheumatic heart disease (section 4). The Authority is responsible for determining the Statement of Principles, which must be based on sound medical-scientific evidence (section 2). Claims for compensation for injuries sustained, diseases contracted, or deaths occurring on or after 1 July 2004 are assessed by the Military Rehabilitation and Compensation Commission using the Statements of Principles issued by the Authority (section 3). The Authority must also ensure that the new Instrument is consistent with the latest revised Instrument format and includes updated definitions and factors relevant to rheumatic heart disease (sections 6 and 7).
The Act imposes civil and criminal consequences for breaches of its provisions. For example, providing false or misleading information in a claim for compensation could result in civil penalties, including fines and reimbursement of benefits paid. Additionally, knowingly providing false or misleading information may also result in criminal penalties, including fines and imprisonment (section 319 of the Military Rehabilitation and Compensation Act 2004). The maximum penalties for these offences are set out in the respective Acts. The Authority must also ensure that the new Instrument is consistent with the latest revised Instrument format and includes updated definitions and factors relevant to rheumatic heart disease (sections 6 and 7).
Overall, the Repatriation Medical Authority Instrument No. 19 of 2011 provides a framework for determining claims related to rheumatic heart disease and death from rheumatic heart disease, based on sound medical-scientific evidence. The obligations and requirements imposed by the Act on the parties it governs, including the Authority and claimants, are designed to ensure that claims are assessed fairly and accurately. The civil and criminal consequences for breaches of the Act are intended to deter fraudulent or misleading behaviour and maintain the integrity of the compensation system.