REPATRIATION MEDICAL AUTHORITY

INSTRUMENT NO. 7 of 2005

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. 47 of 2001 of 24 May 2001 and Instrument No. 55 of 2001 of 17 July 2001, each of which were determined under subsection 196B(2) of the VEA concerning solar keratosis and death from solar keratosis.

2.             The Authority is of the view that there is sound medical-scientific evidence that indicates that solar keratosis and death from solar keratosis 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. 7 of 2005 concerning solar keratosis.  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 solar keratosis or death from solar keratosis, with the circumstances of that service.

5.             This new instrument results from an investigation notified in the Government Notices Gazette of 3 November 2004 concerning solar keratosis by the Authority 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 2003;
• deleting the ICD code from the Instrument header;
• changing the definition of ‘solar keratosis’ in clause 2;
• a new factor 5(c) relating to sunlight exposure to unprotected skin;
• factor 5(d) relating to being treated with immunosuppressive drugs deletes restrictions on the purpose of the treatment but requires the treatment to be for a continuous period of twelve weeks before clinical onset;
• a new factor 5(e) relating to PUVA therapy;
• a new factor 5(f) relating to cutaneous contact with bipyridine and bipyridyl compounds;
• revising the definition of ‘ICD-10-AM code’ and ‘relevant service’ in clause 8;
• revising the definitions of ‘solar UV damage factor ratio’ and ‘solar UV damage factor ratio formula’ in clause 8 by substituting the word ‘exposure’ in lieu of the word ‘damage’ wherever it appears;
• including new definitions of ‘a tropical area’, ‘equivalent sunlight exposure in other latitude zones’, ‘immunosuppressive drugs’, ‘paraquat’, ‘PUVA’ and ‘unprotected skin’ in clause 8; and
• specifying a date of effect for the Instrument in clause 10.

7.             Further changes to the format and wording 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.             The Instrument incorporates by reference The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), effective date of 1 July 2004, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 594 1. This publication is available for purchase from the National Centre for Classification in Health, The University of Sydney, PO Box 170, Lidcombe NSW 1825.

9.             In November 2003, the Authority circulated advice to organisations representing veterans, service personnel and their dependants of its intention to consider a new approach to the application of the solar UV damage factors in a range of Statements of Principles. Several organisations provided responses which were considered by the Authority during the investigation.

10.         Prior to determining this instrument, the Authority advertised its intention to undertake an investigation in relation to solar keratosis in the Government Notices Gazettes of 3 November 2004, 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, and organisations and persons referred to in section 196E of the VEA (who include persons eligible to make a claim under the MRCA), and any person having expertise in the field. One submission was received and considered by the Authority during the investigation.

11.         The determining of this new instrument finalises the investigation in relation to solar keratosis as advertised in the Government Notices Gazettes of 3 November  2004.

12.         A list of references relating to the above condition is available, on written request, from the Repatriation Medical Authority Secretariat.