REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 44 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. 110 of 1995, as amended by Instrument No. 194 of 1995, determined under subsection 196B(3) of the VEA concerning sickle-cell disease and death from sickle-cell disease.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that sickle-cell disorder and death from sickle-cell disorder 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. 44 of 2008 concerning sickle-cell disorder. 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, sickle-cell disorder or death from sickle-cell disorder 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 28 June 2006 concerning sickle-cell disease 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 Instruments. Comparing the new and the revoked Instruments, the differences include:
- adopting the latest revised Instrument format, which commenced in 2005;
- changing the name of the Instrument from 'sickle-cell disease' to 'sickle-cell disorder';
- deleting the ICD code from the Instrument header;
- new definition of 'sickle-cell disorder' in clause 3;
- new factor 6(a) concerning 'experiencing a specified stimulus, for a first sickle-cell crisis only';
- new factor 6(b) concerning 'experiencing a specified stimulus';
- new definitions of 'a specified stimulus', 'clinical worsening of sickle-cell disorder', 'death from sickle-cell disorder', 'ICD-10-AM code', 'relevant service', 'sickle-cell crisis' and 'terminal event' in clause 9;
- deleting definitions of 'ICD code' and 'sickle-cell disease'; 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 sickle-cell disease in the Government Notices Gazette of 28 June 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. No submissions were received for consideration by the Authority during the investigation.
9. The determining of this new instrument finalises the investigation in relation to sickle-cell disease as advertised in the Government Notices Gazette of 28 June 2006.
10. 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. 44 of 2008, which was enacted to address the problem of determining the connection between sickle-cell disorder and military service, was introduced under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (VEA). This instrument revokes the previous Statement of Principles concerning sickle-cell disease and establishes a new set of principles to reflect the latest medical-scientific evidence. The Authority, acting under the VEA, has determined that it is more probable than not that sickle-cell disorder and death from sickle-cell disorder can be related to particular kinds of service. The policy objective is to ensure that claims for compensation are determined based on sound medical-scientific evidence and to provide clarity for veterans and their families. This instrument also aligns with the Military Rehabilitation and Compensation Act 2004 (MRCA), ensuring that claims for service injuries and diseases post-1 July 2004 are assessed in accordance with the updated principles.
Scope and Application
The Repatriation Medical Authority (the Authority) has issued Instrument No. 44 of 2008 concerning sickle-cell disorder, revoking the previous Instrument No. 110 of 1995. This new instrument applies to eligible war service, defence service, and peacetime service under the Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). It specifically pertains to claims for compensation related to sickle-cell disorder and death from sickle-cell disorder arising from such services. The instrument establishes the factors that must exist and be related to the service for it to be said that, on the balance of probabilities, the disorder or death is connected with the service circumstances. The instrument’s application is determined by the Military Rehabilitation and Compensation Commission for claims made under section 319 of the MRCA for injuries, diseases, or deaths on or after 1 July 2004. The Authority has adopted the latest revised instrument format, changing the terminology from 'sickle-cell disease' to'sickle-cell disorder', and has included new definitions and factors concerning specified stimuli and clinical worsening.
Key Provisions
The key operative sections of this legislation include subsection 196B(3) of the Veterans’ Entitlements Act 1986 (VEA) under which the Repatriation Medical Authority (the Authority) has determined a new Statement of Principles, Instrument No. 44 of 2008, concerning sickle-cell disorder. This instrument revokes the previous Instrument No. 110 of 1995, as amended by Instrument No. 194 of 1995, which was concerned with sickle-cell disease and death from sickle-cell disease. The new instrument sets out the factors that must exist for sickle-cell disorder or death from sickle-cell disorder to be connected with the circumstances of particular kinds of service rendered by a person. These factors are linked to eligible war service (other than operational service), defence service (other than hazardous service), and peacetime service.
The obligations imposed by this legislation on parties or entities it governs primarily concern the Authority’s responsibility to determine Statements of Principles based on sound medical-scientific evidence. The Authority is mandated to examine available evidence and determine whether there is a probable connection between sickle-cell disorder or death from sickle-cell disorder and specific kinds of service. Additionally, the Military Rehabilitation and Compensation Commission is tasked with determining claims for compensation under section 319 of the Military Rehabilitation and Compensation Act 2004 (MRCA) by referencing the Statements of Principles issued by the Authority. The Authority must also ensure that any new instruments reflect the latest revised format and clarify their applicability under both the VEA and the MRCA.
The legislation outlines specific offences, penalties, and civil or criminal consequences for breaches, although no maximum penalties are explicitly stated in the provided text. The Authority’s determination of Statements of Principles is intended to ensure that claims related to sickle-cell disorder are assessed fairly and in accordance with the sound medical-scientific evidence available. Failure to comply with the requirements set out in the VEA and the MRCA, or to accurately determine the connection between service and sickle-cell disorder, could result in legal consequences. The Authority’s decision-making process is also subject to scrutiny, and any failure to properly consider submissions or evidence could lead to further legal or administrative repercussions.