Statement of Principles concerning subarachnoid haemorrhage (Balance of Probabilities) (No. 68 of 2019)

Administered by Department of Veterans' Affairs

Legislation au F2019L00948 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

SUBARACHNOID HAEMORRHAGE

(BALANCE OF PROBABILITIES) (NO. 68 OF 2019)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning subarachnoid haemorrhage (Balance of Probabilities) (No. 68 of 2019).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), repeals Instrument No. 68 of 2010 (Federal Register of Legislation No. F2010L02307) determined under subsection 196B(3) of the VEA concerning subarachnoid haemorrhage.

3.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that subarachnoid haemorrhage and death from subarachnoid haemorrhage 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 concerning subarachnoid haemorrhage (Balance of Probabilities) (No. 68 of 2019).  This Instrument will in effect replace the repealed Statement of Principles.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 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, subarachnoid haemorrhage or death from subarachnoid haemorrhage is connected 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 14 November 2017 concerning subarachnoid haemorrhage 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 had 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 'subarachnoid haemorrhage' in subsection 7(2);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factor in subsection 9(1) concerning 'physical activity', by the inclusion of a note;
  • new factor in subsection 9(2) concerning 'concussion or moderate to severe traumatic brain injury';
  • revising the factor in subsection 9(5) concerning 'smoking';
  • new factor in subsection 9(6) concerning 'antithrombotic therapy';
  • revising the factor in subsection 9(7) concerning 'taking at least 700 milligrams of aspirin';
  • revising the factor in subsection 9(8) concerning 'infective intracranial vasculitis';
  • revising the factor in subsection 9(9) concerning 'inflammatory vascular disease';
  • revising the factor in subsection 9(10) concerning 'alcohol', for males, by the inclusion of a note;
  • revising the factor in subsection 9(11) concerning 'alcohol', for females, by the inclusion of a note;
  • revising the factor in subsection 9(12) concerning 'a drug from the specified list of drugs';
  • new factor in subsection 9(14) concerning 'an acquired disorder resulting in impaired haemostasis';
  • deleting the factor concerning 'cerebral trauma', as it is subsumed by the factor in subsection 9(2) concerning 'concussion or moderate to severe traumatic brain injury';
  • deleting the factors concerning 'anticoagulant therapy' and 'thrombolytic therapy', as they are subsumed by the factor in subsection 9(6) concerning 'antithrombotic therapy';
  • deleting the factor concerning 'intracranial dissecting aneurysm';
  • deleting the factor concerning 'statin medication';
  • new definitions of 'antithrombotic therapy', 'MRCA', 'specified list of drugs', 'specified list of inflammatory vascular diseases' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definitions of 'pack-year of cigarettes, or the equivalent thereof in other tobacco products' and 'relevant service' in Schedule 1 - Dictionary; and
  • deleting the definitions of 'a drug from the specified list', 'alcohol', 'an inflammatory vascular disease', 'anticoagulant therapy', 'intracranial dissecting aneurysm', 'intracranial infective vasculitis due to a specified infection', 'moderate to severe cerebral trauma' and 'thrombolytic therapy'.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to subarachnoid haemorrhage in the Government Notices Gazette of 14 November 2017, 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 during the investigation.

9.             On 21 February 2019, 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 deletion of factors relating to intracranial dissecting aneurysm and statin medication.  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.  Minor 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 subarachnoid haemorrhage as advertised in the Government Notices Gazette of 14 November 2017.

References

12.         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. 68 of 2019

Kind of Injury, Disease or Death: Subarachnoid haemorrhage

 

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(3) 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 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 subarachnoid haemorrhage;
  • 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, subarachnoid haemorrhage is connected with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement;
  • replaces Instrument No. 68 of 2010; and
  • reflects developments in the available sound medical-scientific evidence concerning subarachnoid haemorrhage 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;
  • 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 subarachnoid haemorrhage (Balance of Probabilities) (No. 68 of 2019) is an instrument determined under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. Enacted by the Repatriation Medical Authority, the purpose of this legislative instrument is to outline the circumstances under which medical treatment and compensation can be extended to eligible persons who have subarachnoid haemorrhage. It sets out the factors that must exist, and which of those factors must be related to particular kinds of service, before it can be said that, on the balance of probabilities, subarachnoid haemorrhage or death from subarachnoid haemorrhage is connected with the circumstances of that service. This instrument replaces Instrument No. 68 of 2010, reflecting developments in the available sound medical-scientific evidence concerning subarachnoid haemorrhage. The instrument promotes various human rights, including the right to social security, the right to an adequate standard of living, and the right to the enjoyment of the highest attainable standard of physical and mental health, without discrimination.

Scope and Application

The Statement of Principles concerning subarachnoid haemorrhage (Balance of Probabilities) (No. 68 of 2019) applies to veterans and service personnel who may have experienced subarachnoid haemorrhage as a result of their service. This legislation is governed under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). The primary application of this legislation is to determine the eligibility for claims of veterans and service personnel who may have suffered from subarachnoid haemorrhage, or death from subarachnoid haemorrhage, as a result of their service. The legislation specifies the factors that must exist, and which of those factors must be related to particular kinds of service, in order to establish a connection between the service and the condition. The legislation has a national jurisdictional reach, applying across Australia. The determination of this Instrument is based on the sound medical-scientific evidence available to the Repatriation Medical Authority. The Authority has determined that on the balance of probabilities, subarachnoid haemorrhage and death from subarachnoid haemorrhage can be related to particular kinds of service, and as such, this Statement of Principles has been determined to replace the previously repealed Instrument No. 68 of 2010. The legislation does not contain any specific exclusions or thresholds. However, the factors set out in the Statement of Principles must be related to the kinds of service mentioned in the legislation in order to establish a connection between the service and the condition.

Key Provisions

The Statement of Principles concerning subarachnoid haemorrhage (Balance of Probabilities) (No. 68 of 2019) outlines the circumstances in which a claimant can assert a connection between their subarachnoid haemorrhage and service rendered under the Veterans' Entitlements Act 1986 (VEA) or the Military Rehabilitation and Compensation Act 2004 (MRCA). This document is a replacement for Instrument No. 68 of 2010, and it incorporates updates based on the latest medical-scientific evidence. The primary operative sections of this Statement of Principles (section 5) establish the factors that must exist and must be related to specific types of service in order to conclude that subarachnoid haemorrhage or death from subarachnoid haemorrhage is connected with the service on the balance of probabilities. These factors include physical activity, concussion, moderate to severe traumatic brain injury, smoking, antithrombotic therapy, aspirin intake, infective intracranial vasculitis, inflammatory vascular disease, alcohol consumption, and certain drugs. The obligations imposed by this Act on the parties primarily involve providing sufficient evidence that the specified factors are met. Claimants must provide medical evidence linking their subarachnoid haemorrhage to the service they rendered, ensuring that each required factor is substantiated. The Repatriation Commission and the Military Rehabilitation and Compensation Commission are obligated to assess these claims based on the criteria outlined in the Statement of Principles. They must ensure that the claims are evaluated thoroughly and fairly, taking into account all relevant medical-scientific evidence. In terms of consequences for non-compliance or breaches, the Statement of Principles does not explicitly outline specific offences or penalties within its text. However, under the VEA and the MRCA, there are provisions for penalties related to false claims or misrepresentation of facts. Under the VEA, for instance, providing false information can result in civil or criminal penalties, including fines and imprisonment, depending on the severity of the offence. Similarly, under the MRCA, penalties for fraud or providing false information can also include fines and imprisonment. The exact penalties would be determined by the courts based on the specific circumstances of each case.

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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.