REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 68 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. 32 of 2004 determined under subsection 196B(2) of the VEA concerning rheumatoid arthritis and death from rheumatoid arthritis.
2. The Authority is of the view that there is sound medical-scientific evidence that indicates that rheumatoid arthritis and death from rheumatoid arthritis 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. 68 of 2008 concerning rheumatoid arthritis. This Instrument will in effect replace the revoked Statements 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 rheumatoid arthritis or death from rheumatoid arthritis, with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 30 August 2006 concerning rheumatoid arthritis 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 'rheumatoid arthritis' in clause 3;
- revising factors 6(a) & 6(e) concerning 'smoking';
- revising factor 6(b) concerning 'silica';
- revising factors 6(d) & 6(h) concerning 'drugs';
- new factors 6(c) & 6(g) concerning 'mineral oil';
- new worsening factor 6(f) concerning 'silica';
- revising definitions of 'ICD-10-AM code' and 'seropositive rheumatoid arthritis' in clause 9;
- new definitions of 'a drug from specified list 1', 'a drug from specified list 2' and 'mineral oil' in clause 9;
- deleting definition of 'cigarettes per day, or the equivalent thereof in other tobacco products'; 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 rheumatoid arthritis in the Government Notices Gazette of 30 August 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. One submission was received for consideration by the Authority during the investigation.
9. On 8 August 2008, 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. 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.
10. The determining of this new instrument finalises the investigation in relation to rheumatoid arthritis as advertised in the Government Notices Gazette of 30 August 2006.
11. 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. 68 of 2008, under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), addresses the problem of establishing a clear link between rheumatoid arthritis and various kinds of military service. This legislative instrument revokes the previous Instrument No. 32 of 2004 and introduces a new Statement of Principles concerning rheumatoid arthritis, reflecting updated medical-scientific evidence. The Authority was mandated by subsection 196B(2) of the VEA to determine these Statements of Principles, ensuring that claims for compensation are assessed accurately based on the service rendered. The policy objective is to provide a framework for assessing the relationship between rheumatoid arthritis and service, ensuring that affected veterans can claim appropriate compensation.
Scope and Application
The Repatriation Medical Authority Instrument No. 68 of 2008, enacted under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, pertains to the recognition of rheumatoid arthritis and death from rheumatoid arthritis as service-related conditions for veterans and current or former members of the Australian Defence Force. This instrument applies to individuals who have served in operational, peacekeeping, hazardous, warlike, or non-warlike service, and who may claim compensation or other benefits for conditions related to their service. The instrument's jurisdiction spans nationally across Australia, governed by the Commonwealth, and it specifically addresses claims for compensation concerning service injuries, diseases, or deaths that occurred on or after 1 July 2004. This instrument replaces the previously revoked Instrument No. 32 of 2004, which also dealt with rheumatoid arthritis, but has been updated to reflect the latest medical-scientific evidence. The Authority has determined a new Statement of Principles, which outlines the minimum factors necessary to establish a connection between rheumatoid arthritis or death from rheumatoid arthritis and the service rendered by a person, contingent upon the type of service undertaken. The instrument has been revised to adopt the latest format, incorporate updated definitions, and specify certain factors related to the condition. Subordinate instruments may extend or clarify the application of this act, ensuring that it remains aligned with evolving medical understanding and legislative frameworks.
Key Provisions
The Repatriation Medical Authority (RMA), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (VEA), has revoked Instrument No. 32 of 2004 concerning rheumatoid arthritis and death from rheumatoid arthritis, and replaced it with a new Instrument No. 68 of 2008 (section 2). This new instrument, the Statement of Principles, is designed to provide a comprehensive set of criteria for determining whether rheumatoid arthritis or death from rheumatoid arthritis can be related to specific types of military service. The types of service in question include operational, peacekeeping, hazardous, warlike, and non-warlike service (section 4).
The new Statement of Principles outlines the minimum factors that must be present and linked to the relevant types of service for a reasonable hypothesis to be raised that the condition is related to the service (section 4). The Statement of Principles was developed following an investigation by the RMA into rheumatoid arthritis, as announced in the Government Notices Gazette on 30 August 2006, and includes revisions to various definitions and factors based on the latest medical-scientific evidence (sections 5 and 6). The new instrument not only adopts a revised format but also clarifies its applicability under both the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA) (section 7).
The RMA is obligated to determine Statements of Principles based on sound medical-scientific evidence and to consult with relevant organisations and individuals before finalising these statements (sections 2, 5, 8, and 9). This process ensures that the criteria set forth in the Statement of Principles are both evidence-based and inclusive of stakeholder input. Additionally, the RMA must advertise any proposed changes in the Government Notices Gazette and provide an opportunity for representations before finalising the instrument (section 9).
Any breach of the provisions outlined in the Statement of Principles could lead to legal challenges regarding the validity of compensation claims related to rheumatoid arthritis. While the explanatory notes do not specify penalties for non-compliance with the Statement of Principles, failure to adhere to the criteria set forth could result in denial of compensation claims under the VEA and MRCA. The seriousness of any civil or criminal consequences would depend on the specific circumstances of the breach and the jurisdiction's laws pertaining to administrative and legislative compliance.