Statement of Principles concerning rotator cuff syndrome No. 39 of 2006

Administered by Department of Veterans' Affairs

Legislation au F2006L02755 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

STATEMENT OF PRINCIPLES NO. 39 of 2006

 

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. 83 of 1997 of 8 October 1997 determined under subsection 196B(2) of the VEA concerning rotator cuff syndrome and death from rotator cuff syndrome.

 

2.             The Authority is of the view that there is sound medical-scientific evidence that indicates that rotator cuff syndrome and death from rotator cuff syndrome 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. 39 of 2006 concerning rotator cuff syndrome.  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 rotator cuff syndrome or death from rotator cuff syndrome, with the circumstances of that service.

 

5.             This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 19 November 2003 concerning rotator cuff syndrome in accordance with section 196G of the Act. 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 Instruments.  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 for ‘rotator cuff syndrome’ in clause 3;
  • rewording factors 6(a) & 6(j) relating to ‘injury’;
  • rewording factors 6(b) & 6(k) relating to ‘repetitive or sustained activities’;
  • rewording factors 6(c) & 6(l) relating to ‘dialysis’;
  • rewording factors 6(d) & 6(m) relating to ‘using the upper limbs for transfer’;
  • rewording factors 6(e) & 6(n) relating to ‘anatomical narrowing’;
  • rewording factors 6(f) & 6(o) relating to ‘excess laxity’;
  • new factors 6(g) & 6(p) relating to ‘infection’;
  • new factors 6(h) & 6(q) relating to ‘rheumatoid arthritis’;
  • new factors 6(i) & 6(r) relating to ‘gout’;
  • revising the definitions for ‘anatomical narrowing of the subacromial space’; ‘excess laxity of the shoulder’; and ‘relevant service’ in clause 9;
  • including new definitions for ‘an injury to the affected shoulder’; ‘death from rotator cuff syndrome’; ‘dialysis-related amyloidosis’; ‘ ICD10-AM code’; and ‘terminal event’ in clause 9;
  • deleting definitions for ‘haemodialysis treatment’; and ‘trauma to the shoulder’ 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 rotator cuff syndrome in the Government Notices Gazettes of 19 November 2003, 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. Three submissions were received for consideration by the Authority.

 

9.             Following the commencement of the MRCA, the Authority published a “Further Notice of Investigations” in the Government Notices Gazette of 14 July 2004, extending the closing date for submissions in relation to the above mentioned investigation until 10 September 2004. The Authority again invited submissions from the Repatriation Commission, organisations and persons referred to in section 196E of the VEA (who include persons eligible to make a claim under the MRCA), as well as the Military Rehabilitation and Compensation Commission and any person having expertise in the field.

 

10.         The determining of this new instrument finalises the investigation in relation to rotator cuff syndrome as advertised in the Government Notices Gazettes of 19 November 2003.

 

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 Statement of Principles No. 39 of 2006, enacted under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, addresses the issue of rotator cuff syndrome and related deaths in veterans. The Repatriation Medical Authority, operating under the authority granted by the Veterans’ Entitlements Act 1986, revoked the previous Instrument No. 83 of 1997 and issued a new Statement of Principles to reflect updated medical-scientific evidence. This revision aims to provide clarity and updated criteria for determining the connection between rotator cuff syndrome, its severity, and specific types of military service, thereby ensuring that veterans can receive appropriate compensation and support. The enactment of this new instrument follows an investigation initiated by the Authority in 2003, and it is intended to replace the outdated principles with those that better reflect current medical understanding and service-related factors.

Scope and Application

The Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) are the legislative frameworks under which the Repatriation Medical Authority (the Authority) operates in determining eligibility for benefits for veterans and their dependants. The Authority has determined a new Statement of Principles, Instrument No. 39 of 2006 concerning rotator cuff syndrome, which supersedes the previously revoked Instrument No. 83 of 1997. This new instrument outlines the specific circumstances and conditions under which veterans and service personnel may be eligible for compensation or benefits related to rotator cuff syndrome or death from the condition, based on their service history. The instrument applies to operational, peacekeeping, and hazardous service under the VEA, and to warlike and non-warlike service under the MRCA, provided the service occurred on or after 1 July 2004, when the MRCA came into effect. Claims for compensation under section 319 of the MRCA are determined by the Military Rehabilitation and Compensation Commission, referencing the Statements of Principles issued by the Authority. The Authority's decision to determine this new instrument was preceded by public notice and consultation, allowing relevant stakeholders to provide submissions.

Key Provisions

The Repatriation Medical Authority, under subsection 196B(8) of the Veterans’ Entitlements Act 1986 (VEA), has revoked Instrument No. 83 of 1997 concerning rotator cuff syndrome and death from rotator cuff syndrome (subsection 196B(2) of the VEA). This revocation is due to the Authority's determination of a new Statement of Principles, Instrument No. 39 of 2006, based on sound medical-scientific evidence linking rotator cuff syndrome and death from this condition to specific types of service (subsection 196B(2) of the VEA). The new Instrument outlines the minimum factors necessary to establish a connection between the condition and the service rendered. These factors must relate to operational, peacekeeping, hazardous, warlike, or non-warlike service as defined under the VEA or the Military Rehabilitation and Compensation Act 2004 (MRCA). The new Statement of Principles imposes obligations on veterans or their representatives to provide evidence that meets the criteria set out in the Instrument. This includes demonstrating how the service rendered meets the specific factors outlined for the types of service mentioned. For claims related to compensation for injuries sustained on or after 1 July 2004, these claims are to be determined by the Military Rehabilitation and Compensation Commission, referencing the Statements of Principles issued by the Authority (section 319 of the MRCA). The Authority's determination process involved advertising its intention to investigate in the Government Notices Gazette of 19 November 2003, extending the submission period until 10 September 2004, and considering submissions received from relevant parties. Breach of the obligations under the new Statement of Principles could result in the denial of compensation claims related to rotator cuff syndrome or death from this condition. The legislation does not explicitly detail specific penalties for non-compliance with the new Statement of Principles. However, the failure to provide sufficient evidence or misrepresent facts could lead to the rejection of claims, resulting in the denial of benefits to which the claimant might otherwise be entitled. The implications of such denials could be significant, impacting the claimant's access to medical and financial support intended for service-related injuries.

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