Statement of Principles concerning steatohepatitis No. 80 of 2013

Administered by Department of Veterans' Affairs

Legislation au F2013L01900 Not in force Legislative Instrument

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REPATRIATION MEDICAL AUTHORITY

 

INSTRUMENT NO. 80 of 2013

 

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. 56 of 2005, determined under subsection 196B(3) of the VEA concerning steatohepatitis.

 

2.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that steatohepatitis and death from steatohepatitis 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. 80 of 2013 concerning steatohepatitis.  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 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 and British nuclear test defence service) under the VEA;

 peacetime service under the MRCA,

 

before it can be said that, on the balance of probabilities, steatohepatitis or death from steatohepatitis is connected with the circumstances of that service.

5.             This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 18 May 2011 concerning steatohepatitis 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:

  • new definition of 'steatohepatitis' in clause 3;
  • new factor 6(b) concerning 'waist circumference';
  • revising factor 6(d) concerning 'dyslipidaemia';
  • revising factor 6(f) concerning 'consuming alcohol' for men;
  • revising factor 6(g) concerning 'consuming alcohol' for women;
  • revising factor 6(i) concerning 'rapid weight loss';
  • new factor 6(j) concerning 'lipodystrophy';
  • new definitions of 'dyslipidaemia' and 'lipodystrophy' in clause 9;
  • revising the definitions of 'rapid weight loss' and 'relevant service' in clause 9;
  • deleting the definition of 'hypertriglyceridaemia' in clause 9; 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 steatohepatitis in the Government Notices Gazette of 18 May 2011, 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.             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.

10.         The determining of this Instrument finalises the investigation in relation to steatohepatitis as advertised in the Government Notices Gazette of 18 May 2011.

11.         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

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. 80 of 2013

Kind of Injury, Disease or Death: Steatohepatitis

 

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(8) of the Veterans' Entitlements Act 1986 (the VEA) for the purposes of the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).

2. This Legislative Instrument:-

  • facilitates claimants in making, and the Repatriation 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 steatohepatitis;
  • 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 exist before it can be said that, on the balance of probabilities, steatohepatitis is connected with the circumstances of eligible service rendered by a person, as set out in clause 4 of the Explanatory Notes;
  • replaces Instrument No. 56 of 2005; and
  • reflects developments in the available sound medical-scientific evidence concerning steatohepatitis 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, ICSECR; 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, ICSECR 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; and
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD).

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 Repatriation Medical Authority Instrument No. 80 of 2013, enacted under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, addresses the issue of steatohepatitis and its connection to service-related circumstances. This legislative instrument revokes Instrument No. 56 of 2005 and establishes new criteria for the determination of steatohepatitis claims, reflecting the latest medical-scientific evidence available. The Repatriation Medical Authority, exercising its powers under the Veterans’ Entitlements Act, determined this Statement of Principles to facilitate the assessment of claims and provide clarity on the medical conditions that need to be met for a connection to be made between steatohepatitis and service. The policy objective is to ensure that veterans, current and former Defence Force members, and their dependents receive appropriate compensation and medical treatment for conditions related to their service. This legislative instrument is designed to improve the quality of medico-scientific outcomes under the Acts by incorporating new definitions and factors related to steatohepatitis, such as waist circumference and lipodystrophy, while clarifying the conditions under which service-related claims can be made. The instrument also ensures compatibility with human rights, promoting the rights to social security, an adequate standard of living, and the highest attainable standard of physical and mental health, as well as the rights of persons with disabilities.

Scope and Application

The Repatriation Medical Authority Instrument No. 80 of 2013, concerning steatohepatitis, applies to veterans, current and former members of the Australian Defence Force, and their dependents, facilitating claims for medical treatment and compensation under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This Instrument specifies the medical and service-related criteria that must be met for steatohepatitis to be considered connected with service, providing a framework for the Repatriation Commission to assess claims. It replaces the previous Instrument No. 56 of 2005 and incorporates updates based on the latest medical-scientific evidence. The Instrument is designed to ensure that the qualifying conditions for benefits are reasonable, proportionate, and transparent, thereby promoting human rights such as the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health. The scope of this legislation is national, affecting all eligible persons across Australia who seek benefits related to steatohepatitis under the specified acts.

Key Provisions

The Repatriation Medical Authority (the Authority), pursuant to subsection 196B(8) of the Veterans’ Entitlements Act 1986 (the VEA), has revoked Instrument No. 56 of 2005 and issued Instrument No. 80 of 2013 concerning steatohepatitis. This new instrument outlines the factors that must exist for it to be considered, on the balance of probabilities, that steatohepatitis or death from steatohepatitis is connected to eligible war service, defence service, or peacetime service. The instrument is determined for the purposes of both the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA). Claims for compensation for injuries or diseases sustained on or after 1 July 2004 are assessed by the Military Rehabilitation and Compensation Commission against these new principles. The obligations imposed by this Act primarily concern the assessment of claims for medical treatment and compensation related to steatohepatitis. The Authority is required to facilitate claimants in making and the Repatriation Commission in assessing claims under the VEA and the MRCA by specifying the circumstances in which benefits can be extended. The Authority must also outline the factors that must exist for steatohepatitis to be considered connected to service, which are set out in clause 4 of the Explanatory Notes. The new instrument replaces the revoked Instrument No. 56 of 2005 and incorporates updates based on the latest medical-scientific evidence. There are no specific offences, penalties, or consequences outlined in the text for breaches of this legislation. However, it is implicit that any failure to comply with the requirements of the new Instrument No. 80 of 2013 could result in the denial of claims for compensation or medical treatment for those affected by steatohepatitis. The instrument's purpose is to ensure that claims are assessed fairly and based on sound medical-scientific evidence, thus protecting the rights of veterans and service personnel to receive appropriate benefits and treatment.

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