REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 69 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. 33 of 2004 determined under subsection 196B(3) of the VEA concerning rheumatoid arthritis and death from rheumatoid arthritis.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not 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(3) of the VEA a Statement of Principles, Instrument No. 69 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 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) under the VEA;
peacetime service under the MRCA,
before it can be said that, on the balance of probabilities, rheumatoid arthritis or death from rheumatoid arthritis is connected 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(d) concerning 'smoking';
- revising factor 6(b) concerning 'silica';
- new worsening factor 6(e) concerning 'silica';
- new worsening factor 6(f) concerning 'interferon-α';
- deleting factors 6(c) & 6(f) concerning 'drugs';
- revising definitions of 'ICD-10-AM code' and 'seropositive rheumatoid arthritis' 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. This letter emphasised the deletion of factors relating to 'taking a drug which has been reported in a peer reviewed medical or scientific publication to have caused rheumatoid arthritis…….'. 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.