Statement of Principles concerning sick sinus syndrome (Reasonable Hypothesis) (No. 66 of 2022)

Administered by Department of Veterans' Affairs

Legislation au F2022L00919 In force Legislative Instrument

Legislation content

EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

SICK SINUS SYNDROME

(REASONABLE HYPOTHESIS) (NO. 66 of 2022)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning sick sinus syndrome (Reasonable Hypothesis) (No. 66 of 2022).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 15 of 2014 (Federal Register of Legislation No. F2014L00020) determined under subsection 196B(2) of the VEA concerning sick sinus syndrome.

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that sick sinus syndrome and death from sick sinus 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 concerning sick sinus syndrome (Reasonable Hypothesis) (No. 66 of 2022).  This Instrument will in effect replace the repealed Statement of Principles.

Purpose and Operation

4.             The Statement of Principles will be applied in determining claims under the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).

5.             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;

 British nuclear test defence 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 sick sinus syndrome or death from sick sinus syndrome, with the circumstances of that service.  The Statement of Principles has been determined for the purposes of both the VEA and the MRCA.

6.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 9 March 2021 concerning sick sinus syndrome 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.

7.             The contents of this Instrument are in similar terms as the repealed Instrument.  Comparing this Instrument and the repealed Instrument, the differences include:

  • adopting the latest revised Instrument format, which commenced in 2015;
  • specifying a day of commencement for the Instrument in section 2;
  • revising the definition of 'sick sinus syndrome' in subsection 7(2);
  • including ICD-10-AM codes for 'sick sinus syndrome' in subsection 7(3);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factors in subsections 9(4) and 9(29) concerning having heart failure;
  • revising the factors in subsections 9(6) and 9(31) concerning having pericarditis;
  • new factors in subsections 9(8) and 9(33) concerning having non-infectious myocarditis;
  • new factors in subsections 9(9) and 9(34) concerning having viral myocarditis;
  • new factors in subsections 9(10) and 9(35) concerning having a non-viral infection of the myocardium;
  • deleting the factors concerning having myocarditis as those factors are now covered by subsections 9(8),9(33), 9(9), 9(34), 9(10) and 9(35);
  • new factors in subsections 9(11) and 9(36) concerning having infiltration of the myocardium;
  • revising the factors in subsections 9(12) and 9(37) concerning having a benign or malignant neoplasm;
  • revising the factors in subsections 9(13) and 9(38) concerning having a non-neoplastic lesion;
  • revising the factors in subsections 9(14) and 9(39) concerning having a thyroid condition;
  • new factors in subsections 9(15) and 9(40) concerning having an autoimmune disease;
  • deleting the factors concerning having a specified autoimmune, infiltrative or inflammatory disease as those factors are now covered by subsections 9(11), 9(36), 9(15) and 9(40);
  • revising the factors in subsections 9(16) and 9(41) concerning having obstructive sleep apnoea;
  • new factors in subsections 9(17) and 9(42) concerning having a mineral or electrolyte abnormality;
  • revising the factors in subsections 9(18) and 9(43) concerning having a thoracic surgical procedure or an invasive cardiac procedure;
  • new factors in subsections 9(19) and 9(44) concerning having a heart transplant;
  • revising the factors in subsections 9(20) and 9(45) concerning having a surgical procedure involving general or regional anaesthesia;
  • new factors in subsections 9(21) and 9(46) concerning having cardiac stereotactic ablative radiotherapy or cryotherapy;
  • revising the factors in subsections 9(22) and 9(47) concerning experiencing penetrating trauma to the heart;
  • new factors in subsections 9(23) and 9(48) concerning taking a drug from the specified list of drugs;
  • deleting the factor concerning being treated with a drug or drug from a class of drugs as those factors are now covered by subsections 9(23) and 9(48);
  • revising the factor in subsection 9(24) concerning undertaking strenuous physical activity;
  • new factors in subsections 9(25) and 9(49) concerning being envenomated by a snake;
  • deleting the factors concerning experiencing a powerful non-penetrating blow to the chest;
  • deleting the factors concerning having electrical injury;
  • new definitions of 'MRCA', 'obstructive sleep apnoea', 'specified list of autoimmune diseases', 'specified list of drugs', 'specified list of infiltrative diseases', 'specified list of mineral or electrolyte abnormalities', 'specified list of thyroid conditions', 'VEA' in Schedule 1 - Dictionary;
  • revising the definition of 'relevant service' in Schedule 1 – Dictionary; and
  • deleting the definitions of 'a drug or a drug from a class of drugs from the specified list' and 'a specified autoimmune, infiltrative or inflammatory disease'.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to sick sinus syndrome in the Government Notices Gazette of 9 March 2021, 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, the Military Rehabilitation and Compensation 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 in relation to the investigation.

9.             On 21 February 2022, 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 proposed deletion of factors relating to experiencing a powerful, non penetrating blow to the chest (onset and worsening), having electrical injury (onset and worsening).  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.  No changes were made to the proposed Instrument following this consultation process.

Human Rights

10.         This instrument is compatible with the Human Rights and Freedoms recognised or declared in the International Instruments listed in Section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.  A Statement of Compatibility with Human Rights follows.

Finalisation of Investigation

11.         The determining of this Instrument finalises the investigation in relation to sick sinus syndrome as advertised in the Government Notices Gazette of 9 March 2021.

References

12.         A list of references relating to the above condition is available on the Authority's website at: www.rma.gov.au. Any other document referred to in this Statement of Principles is available on request to the Repatriation Medical Authority at the following address:

              

Email:    info@rma.gov.au

Post:      The Registrar

Repatriation Medical Authority

GPO Box 1014

BRISBANE    QLD    4001

 


Statement of Compatibility with Human Rights

(Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011)

 

Instrument No.:   Statement of Principles No. 66 of 2022

Kind of Injury, Disease or Death: Sick sinus syndrome

 

This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Overview of the Legislative Instrument

1. This Legislative Instrument is determined pursuant to subsection 196B(2) of the Veterans' Entitlements Act 1986 (the VEA) for the purposes of the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).  Part XIA of the VEA requires the determination of these instruments outlining the factors connecting particular kinds of injury, disease or death with service such being determined solely on the available sound medical-scientific evidence.

2. This Legislative Instrument:-

  • facilitates claimants in making, and the Repatriation Commission and the Military Rehabilitation and Compensation Commission in assessing, claims under the VEA and the MRCA respectively, by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have sick sinus syndrome;
  • facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal;
  • outlines the factors which the current sound medical-scientific evidence indicates must as a minimum exist, before it can be said that a reasonable hypothesis has been raised, connecting sick sinus syndrome with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 15 of 2014; and
  • reflects developments in the available sound medical-scientific evidence concerning sick sinus syndrome which have occurred since that earlier instrument was determined. 

3. The Instrument is assessed as being a technical instrument which improves the medico-scientific quality of outcomes under the VEA and the MRCA. 

Human Rights Implications

4. This Legislative Instrument does not derogate from any human rights. It promotes the human rights of veterans, current and former Defence Force members as well as other persons such as their dependents, including:

  • the right to social security (Art 9, International Covenant on Economic, Social and Cultural Rights; Art 26, Convention on the Rights of the Child and Art 28, Convention on the Rights of Persons with Disabilities) by helping to ensure that the qualifying conditions for the benefit are 'reasonable, proportionate and transparent'[1];
  • the right to an adequate standard of living (Art 11, ICESCR; Art 27, CRC and Art 28, CRPD) by facilitating the assessment and determination of social security benefits;
  • the right to the enjoyment of the highest attainable standard of physical and mental health (Art 12, ICESCR and Art 25, CRPD), by facilitating the assessment and determination of compensation and benefits in relation to the treatment and rehabilitation of veterans and Defence Force members;
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD); and
  • ensuring that those rights "will be exercised without discrimination of any kind as to race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status" (Art 2, ICESCR).

Conclusion

This Legislative Instrument is compatible with human rights as it does not derogate from and promotes a number of human rights.

 

Repatriation Medical Authority

 

 

 

 

 

 

[1] In General Comment No. 19 (The right to social security), the Committee on Economic, Social and Cultural Rights said (at paragraph 24) this to be one of the elements of ensuring accessibility to social security.

Overview

The Statement of Principles concerning sick sinus syndrome (Reasonable Hypothesis) (No. 66 of 2022) is an instrument determined by the Repatriation Medical Authority under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). The Act aims to establish the principles that must be met to establish a reasonable hypothesis that sick sinus syndrome or death from the condition is related to particular kinds of service, thus facilitating claims for compensation and medical treatment under the VEA and MRCA. This instrument, which replaces an earlier one from 2014, reflects updated medical-scientific evidence and serves to clarify and refine the criteria for linking sick sinus syndrome to eligible service. The instrument was developed following an investigation initiated by the Authority in March 2021, with opportunities for consultation, though no submissions were received. The Authority ensured the instrument's compatibility with human rights, promoting the rights of veterans and others to social security, an adequate standard of living, and health benefits.

Scope and Application

The Statement of Principles concerning sick sinus syndrome (Reasonable Hypothesis) (No. 66 of 2022) applies to claims made under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) by veterans and members of the Defence Force, including current and former personnel, who have developed sick sinus syndrome. It outlines the medical and service-related factors that must be considered in assessing claims for compensation and treatment, ensuring these claims are grounded in sound medical-scientific evidence. The Act specifies that sick sinus syndrome can be reasonably hypothesised to be related to certain kinds of service, such as operational, peacekeeping, hazardous, and British nuclear test defence service under the VEA, as well as warlike and non-warlike service under the MRCA. The application of this Statement of Principles is national, as it applies to all veterans and Defence Force members across Australia, facilitating the assessment and review processes for compensation claims related to sick sinus syndrome. Any exclusions or exemptions are determined by the specific criteria outlined in the Statement of Principles, which focus on the connection between the condition and service, rather than excluding particular groups or circumstances. This legislative instrument replaces the previous Statement of Principles concerning sick sinus syndrome and reflects the most recent medical-scientific evidence available, ensuring that the assessment of claims remains current and scientifically robust.

Key Provisions

The Statement of Principles concerning sick sinus syndrome (Reasonable Hypothesis) (No. 66 of 2022) is the primary operative section of this legislation. It is determined under subsection 196B(2) of the Veterans' Entitlements Act 1986 (VEA) and outlines the circumstances in which sick sinus syndrome can be reasonably connected to certain types of service, specifically operational, peacekeeping, hazardous, and British nuclear test defence service under the VEA, and warlike and non-warlike service under the Military Rehabilitation and Compensation Act 2004 (MRCA). The Statement of Principles sets out the minimum factors that must exist, and which of those factors must be related to the specified types of service, before it can be said that a reasonable hypothesis has been raised connecting sick sinus syndrome or death from sick sinus syndrome with the circumstances of that service. The Act imposes obligations on the Repatriation Medical Authority (the Authority) to determine Statements of Principles based on sound medical-scientific evidence, and to ensure that these instruments facilitate claimants in making and the Repatriation Commission and the Military Rehabilitation and Compensation Commission in assessing claims under the VEA and the MRCA respectively. The Authority must also ensure that the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal is facilitated. The Authority is required to advertise its intention to undertake an investigation in relation to sick sinus syndrome in the Government Notices Gazette and consult with relevant organisations and individuals before determining the Statement of Principles. There are no specific offences, penalties, or civil/criminal consequences mentioned in the legislation for breach of the Statement of Principles. However, the legislation does state that it is compatible with the Human Rights and Freedoms recognised or declared in the International Instruments listed in Section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011. The Statement of Compatibility with Human Rights is attached to the Explanatory Statement and outlines how the legislation does not derogate from any human rights and promotes the human rights of veterans, current and former Defence Force members as well as other persons such as their dependents. The legislation does not contain any specific maximum penalties for breach. In summary, the main provisions of this legislation involve the determination of a Statement of Principles concerning sick sinus syndrome (Reasonable Hypothesis) (No. 66 of 2022) under the VEA and the MRCA, outlining the circumstances in which sick sinus syndrome can be reasonably connected to certain types of service. The legislation imposes obligations on the Authority to determine the Statement of Principles based on sound medical-scientific evidence, advertise its intention to undertake an investigation, and consult with relevant organisations and individuals before determining the Statement of Principles. The legislation does not contain any specific offences, penalties, or civil/criminal consequences for breach, but is compatible with the Human Rights and Freedoms recognised or declared in the International Instruments listed in Section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Legal classification tags

Area of Law
Veterans' Law
Military Law
Health Law
Instrument
Explanatory Statement
Concepts
Definitions & Interpretation
Reporting & Disclosure Obligations
Human Rights Law
Repeal & Amendment

Interactions

Authorises

All Versions

Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.