Statement of Principles concerning solar keratosis No. 8 of 2005

Administered by Department of Veterans' Affairs

Legislation au F2005L00409 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

INSTRUMENT NO. 8 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. 48 of 2001 of 24 May 2001 and Instrument No. 56 of 2001 of 17 July 2001, each of which were determined under subsection 196B(3) of the VEA concerning solar keratosis and death from solar keratosis.

 

2.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not 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(3) of the VEA a Statement of Principles, Instrument No. 8 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 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, solar keratosis or death from solar keratosis is connected 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(b) relating to sunlight exposure to unprotected skin;
  • factor 5(c) 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 twenty-four weeks before clinical onset;
  • a new factor 5(d) relating to PUVA therapy;
  • 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’, ‘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.

Overview

The Repatriation Medical Authority Instrument No. 8 of 2005, issued under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, addresses the issue of solar keratosis and death from solar keratosis in relation to particular kinds of service. The Authority, acting under the authority vested in it by the VEA, has determined a Statement of Principles concerning solar keratosis, revoking previous instruments from 2001. This new instrument is based on the latest medical-scientific evidence and aims to clarify the circumstances under which solar keratosis and death from solar keratosis can be connected to eligible war service, defence service, and peacetime service. The policy objective is to ensure that veterans and service personnel who have contracted solar keratosis or who have died from solar keratosis as a result of their service can make claims for compensation, with these claims being determined by the Military Rehabilitation and Compensation Commission from 1 July 2004.

Scope and Application

The Repatriation Medical Authority Instrument No. 8 of 2005, concerning solar keratosis, applies to veterans, service personnel, and their dependants who are eligible to make claims under the Veterans’ Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004. This instrument sets out the conditions under which solar keratosis or death from solar keratosis can be considered related to particular kinds of service, including eligible war service, defence service, and peacetime service. The instrument provides a Statement of Principles that details the factors that must exist and be related to the service in question for a claim to be accepted. This new instrument replaces previously revoked instruments concerning solar keratosis and incorporates the latest medical-scientific evidence, clarifying the connection between solar exposure and the specified conditions. The instrument also includes updated definitions and factors, such as the impact of immunosuppressive drugs and PUVA therapy, and references the International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM). The instrument is applicable nationally, reflecting the legislative reach of both the VEA and the MRCA.

Key Provisions

The key operative sections of this legislation are found in subsection 196B(3) of the Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). Under the VEA, the Repatriation Medical Authority (the Authority) has the power to determine Statements of Principles relating to particular diseases or conditions that may be connected to service rendered by veterans or service personnel. The Authority has used this power to revoke existing Instruments concerning solar keratosis and death from solar keratosis (subsection 196B(8) of the VEA), and to issue a new Instrument No. 8 of 2005 concerning solar keratosis (subsection 196B(3) of the VEA). Under the MRCA, claims for compensation for service injuries, diseases or deaths that commenced on or after 1 July 2004 are determined by the Military Rehabilitation and Compensation Commission, with reference to the Statements of Principles issued by the Authority (section 319 of the MRCA). The obligations and requirements imposed by the Act on the parties or entities it governs are primarily concerned with the determination and application of the Statements of Principles. The Authority is required to base its determinations on sound medical-scientific evidence, and to consider submissions from relevant organisations and individuals. The Authority must also ensure that its determinations are consistent with the International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM). The Military Rehabilitation and Compensation Commission is required to determine claims for compensation in accordance with the Statements of Principles issued by the Authority. The legislation does not explicitly state any offences, penalties or civil/criminal consequences for breach. However, the Authority and the Military Rehabilitation and Compensation Commission may face legal challenges if their determinations or decisions are found to be inconsistent with the provisions of the VEA, the MRCA or the Statements of Principles. In such cases, the courts may order the Authority or the Commission to review their determinations or decisions, or to make new determinations or decisions in accordance with the law. The maximum penalties for any offences under the VEA or the MRCA are not specified in the explanatory notes, but may be found in the relevant Acts.

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