REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 5 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. 29 of 2001, determined under subsection 196B(2) of the VEA concerning sensorineural hearing loss.
2. The Authority is of the view that there is sound medical-scientific evidence that indicates that sensorineural hearing loss and death from sensorineural hearing loss 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. 5 of 2011 concerning sensorineural hearing loss. 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 sensorineural hearing loss or death from sensorineural hearing loss, with the circumstances of that service.
5. This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 25 June 2008 concerning sensorineural hearing loss 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 'sensorineural hearing loss' in clause 3;
- revising factors 6(a) & 6(dd) concerning 'peak sound pressure level at the tympanic membrane';
- revising factors 6(b) & 6(ee) concerning 'sound pressure level at the tympanic membrane as an 8-hour time-weighted average';
- revising factors 6(c) & 6(ff) concerning 'otitic barotrauma or decompression sickness';
- revising factors 6(d) & 6(gg) concerning 'a course of treatment with a drug or a drug from a class of drugs';
- revising factors 6(e) & 6(hh) concerning 'a specified ototopical medication';
- new factors 6(f) & 6(ii) concerning 'taking aspirin, paracetamol or a nonsteroidal anti-inflammatory drug';
- revising factors 6(g) & 6(jj) concerning 'suppurative labyrinthitis';
- revising factors 6(h) & 6(kk) concerning 'chronic suppurative otitis media';
- revising factors 6(i) & 6(ll) concerning 'acute viral infection';
- revising factors 6(j) & 6(mm) concerning 'meningitis';
- revising factors 6(k) & 6(nn) concerning 'neurosyphilis';
- revising factors 6(l) & 6(oo) concerning 'tuberculosis';
- new factors 6(m) & 6(pp) concerning 'diphtheria';
- revising factors 6(n) & 6(qq) concerning 'leprosy';
- revising factors 6(o) & 6(rr) concerning 'Meniere's disease';
- revising factors 6(p) & 6(ss) concerning 'Paget's disease of bone';
- revising factors 6(q) & 6(tt) concerning 'a specified autoimmune disorder';
- new factors 6(r) & 6(uu) concerning 'multiple sclerosis';
- new factors 6(s) & 6(vv) concerning 'diabetes mellitus';
- revising factors 6(t) & 6(ww) concerning 'a hyperviscosity syndrome';
- revising factors 6(u) & 6(xx) concerning 'a lesion interrupting the supply of blood to the cochlea';
- revising factors 6(v) & 6(yy) concerning 'structural injury or physiological disruption to the inner ear or the auditory nerve';
- revising factors 6(w) & 6(zz) concerning 'a neoplasm that involves the auditory nerve';
- new factors 6(y) & 6(bbb) concerning 'inhaling, ingesting or having cutaneous contact with a specified organic solvent';
- new factors 6(z) & 6(ccc) concerning 'inhaling, ingesting or having cutaneous contact with lead or emissions containing lead';
- new factors 6(aa) & 6(ddd) concerning 'smoking cigarettes or the equivalent thereof in other tobacco products';
- new factors 6(bb) & 6(eee) concerning 'consuming alcohol';
- new factors 6(cc) & 6(fff) concerning 'being vaccinated with the measles-mumps vaccine';
- new definitions of 'a drug or a drug from a class of drugs from the specified list', 'a hyperviscosity syndrome', 'a specified autoimmune disorder', 'a specified ototopical medication', 'a specified organic solvent', 'alcohol', 'antineoplastic agents as specified', 'dB(A)', 'dB(C)', 'meningitis', 'neurosyphilis' and 'pack-years of cigarettes, or the equivalent thereof in other tobacco products' in clause 9;
- revising definitions of 'chronic suppurative otitis media', 'relevant service' and 'specified list of viruses' in clause 9;
- deleting definitions of 'adequate ear protection', 'an ototoxic drug from the specified list', 'bacterial meningitis', 'hyperviscosity syndrome', 'ICD-10-AM code', 'impulsive noise', 'Meniere's disease', 'neoplasm affecting the auditory apparatus', 'Paget's disease of the skull', 'perilymph fistula', 'systemic immune mediated disorder' and 'tuberculosis involving the temporal bone'; 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 sensorineural hearing loss in the Government Notices Gazette of 25 June 2008, 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. The determining of this Instrument finalises the investigation in relation to sensorineural hearing loss as advertised in the Government Notices Gazette of 25 June 2008.
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