REPATRIATION MEDICAL AUTHORITY

INSTRUMENT NO. 11 of 2010

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. 71 of 1996, as amended by Instrument No. 177 of 1996, determined under subsection 196B(2) of the VEA concerning suicide or attempted suicide.

2.             The Authority is of the view that there is sound medical-scientific evidence that indicates that suicide and attempted suicide and death from attempted suicide 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. 11 of 2010 concerning suicide and attempted suicide.  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 suicide and attempted suicide or death from attempted suicide, with the circumstances of that service.

5.             This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 8 November 2006 concerning suicide or attempted suicide 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;
• deleting the ICD code from the Instrument header;
• changing the name of the Instrument from "suicide or attempted suicide" to "suicide and attempted suicide";
• revising the definitions of 'suicide' and 'attempted suicide' in clause 3;
• revising factor 6(a) concerning 'prisoner-of-war';
• revising factor 6(b) concerning 'psychiatric disorder as specified';
• revising factor 6(c) concerning 'category 1A stressor';
• revising factor 6(d) concerning 'category 1B stressor';
• revising factor 6(g) concerning 'category 2 stressor';
• new factor 6(e) concerning 'a significant other who experiences a category 1A stressor';
• new factor 6(f) concerning 'the death of a significant other';
• new factor 6(h) concerning 'bullying';
• new factor 6(i) concerning 'severe childhood abuse';
• new factor 6(j) concerning 'relocation to a residential aged care facility';
• new factor 6(k) concerning 'attempting suicide or performing self-injurious acts';
• new factor 6(l) concerning 'medical illness or injury';
• new factor 6(m) concerning 'epilepsy';
• new factor 6(n) concerning 'chronic pain';
• new factor 6(o) concerning 'academic examination or other academic assessment';
• new factor 6(p) concerning 'antidepressant therapy';
• new factor 6(q) concerning 'a drug or a drug from a class of drugs';
• new factor 6(r) concerning 'appropriate clinical management';
• new definitions of 'a category 1A stressor', 'a category 1B stressor', 'a category 2 stressor', 'a drug or a drug from a class of drugs in Specified List 1', 'a psychiatric disorder as specified', 'a severe level of disability', 'a significant other', 'an eyewitness', 'chronic pain', 'death from attempted suicide', 'DSM-IV-TR', 'obsessive-compulsive disorder', 'performing self-injurious acts', 'phobic anxiety', 'severe childhood abuse', 'substance-induced anxiety disorder' and 'terminal event' in clause 9;
• revising definition of 'relevant service' in clause 9;
• deleting definitions of 'borderline personality disorder', 'depression', 'DSM-IV', 'ICD code', 'post-traumatic stress disorder', 'psychoactive substance abuse or dependence involving alcohol', 'schizophrenia' and 'severe psychosocial stressor'; and
• specifying a date of effect for the Instrument in clause 11.

7.             This new instrument incorporates by reference the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), American Psychiatric Association, Washington DC 2000.  A copy of this document is available from the offices of the Repatriation Medical Authority, Level 8, Bank of Queensland Building, 259 Queen St, Brisbane Queensland 4000, by contacting the Registrar on telephone (07) 3815 9404.

8.             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.

9.             Prior to determining this instrument, the Authority advertised its intention to undertake an investigation in relation to suicide or attempted suicide in the Government Notices Gazette of 8 November 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.

10.         The determining of this new instrument finalises the investigation in relation to suicide or attempted suicide as advertised in the Government Notices Gazette of 8 November 2006.

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 Secretariat

GPO Box 1014

BRISBANE    QLD    4001