Statement of Principles concerning systemic sclerosis (Balance of Probabilities) (No. 26 of 2018)

Administered by Department of Veterans' Affairs

Legislation au F2018L00195 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

SYSTEMIC SCLEROSIS

(BALANCE OF PROBABILITIES) (NO. 26 OF 2018)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning systemic sclerosis (Balance of Probabilities) (No. 26 of 2018).

Background

2.             The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), revokes Instrument No. 65 of 2009, determined under subsection 196B(3) of the VEA concerning systemic sclerosis.

3.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that systemic sclerosis and death from systemic sclerosis 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 systemic sclerosis (Balance of Probabilities) (No. 26 of 2018).  This Instrument will in effect replace the revoked 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, systemic sclerosis or death from systemic sclerosis 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 19 October 2016 concerning systemic sclerosis 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.

7.             The contents of this Instrument are in similar terms as the revoked Instrument.  Comparing this Instrument and the revoked 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 'systemic sclerosis' in subsection 7(2);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • new factor in subsection 9(7) concerning 'being treated with 15 milligrams or more per day of prednisone, or equivalent oral glucocorticoid therapy', for clinical worsening of systemic sclerosis manifesting as scleroderma renal crisis only;
  • new definitions of 'equivalent oral glucocorticoid therapy', 'MRCA', 'scleroderma renal crisis' and 'VEA' in Schedule 1 - Dictionary; and
  • revising the definition of 'relevant service' in Schedule 1 – Dictionary.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to systemic sclerosis in the Government Notices Gazette of 19 October 2016, 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.

Human Rights

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.

Finalisation of Investigation

10.         The determining of this Instrument finalises the investigation in relation to systemic sclerosis as advertised in the Government Notices Gazette of 19 October 2016.

References

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. 26 of 2018

Kind of Injury, Disease or Death: Systemic sclerosis

 

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).  Part XIA of the VEA requires the determination of these instruments outlining the factors linking 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 systemic sclerosis;
  • 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, systemic sclerosis 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. 65 of 2009; and
  • reflects developments in the available sound medical-scientific evidence concerning systemic sclerosis 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 systemic sclerosis (Balance of Probabilities) (No. 26 of 2018) was enacted to address the relationship between systemic sclerosis and certain kinds of military service, thereby facilitating the assessment and determination of claims for compensation and medical treatment under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This legislative instrument was determined by the Repatriation Medical Authority, acting under the authority granted by the Veterans' Entitlements Act 1986. The policy objective of this instrument is to ensure that claims for compensation and medical treatment related to systemic sclerosis are assessed in a manner that is consistent with the latest sound medical-scientific evidence, thereby improving the quality of outcomes for claimants. The instrument replaces a previous statement of principles concerning systemic sclerosis, reflecting new evidence and adopting a revised format to align with recent legislative changes. It specifies the factors that must exist and be related to particular kinds of service for a claim to be considered valid. By setting out these criteria, the instrument aims to facilitate the assessment process for claimants and the review of decisions by relevant authorities, while also promoting the human rights of veterans and service members by ensuring that the qualifying conditions for benefits are reasonable, proportionate, and transparent.

Scope and Application

The Statement of Principles concerning systemic sclerosis (Balance of Probabilities) (No. 26 of 2018) applies to veterans, current and former Defence Force members, and other eligible persons who may be seeking medical treatment and compensation for systemic sclerosis under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. The Act sets out the factors that must exist and be related to certain kinds of service to determine if systemic sclerosis or death from systemic sclerosis is connected with the circumstances of that service. This Statement of Principles replaces the previously revoked Instrument No. 65 of 2018 and incorporates the latest available medical-scientific evidence regarding systemic sclerosis. It facilitates both the making and assessment of claims by specifying the required circumstances, and it also aids in the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal. This legislative instrument does not derogate from any human rights and promotes several human rights, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health, without discrimination.

Key Provisions

The Statement of Principles concerning systemic sclerosis (Balance of Probabilities) (No. 26 of 2018) outlines the medical conditions under which systemic sclerosis and death from systemic sclerosis can be considered related to particular kinds of service. Specifically, section 5 of the Statement of Principles sets out the factors that must exist and must be related to eligible war service, defence service, and peacetime service before it can be said that systemic sclerosis or death from systemic sclerosis is connected with the circumstances of that service. These factors include the onset of the disease, the duration of service, and the exposure to certain environmental conditions that are believed to contribute to the development of the disease. The Statement of Principles imposes obligations on claimants and the Repatriation Commission to adhere to the factors outlined in the document when assessing claims under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. Claimants must provide evidence that the factors specified in the Statement of Principles are met, while the Repatriation Commission must evaluate the evidence provided against the criteria established in the Statement of Principles. The Veterans' Review Board and the Administrative Appeals Tribunal are also tasked with reviewing decisions made under the Acts, ensuring that they comply with the Statement of Principles. Breaches of the provisions outlined in the Statement of Principles may result in civil or criminal consequences, although specific penalties are not detailed within the explanatory statement. The maximum penalties for offences under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 can vary widely depending on the nature and severity of the offence, and are not specifically addressed in relation to the Statement of Principles. The overarching aim is to ensure that claims are assessed fairly and in accordance with the sound medical-scientific evidence available, which includes the latest research and understanding of systemic sclerosis and its connection to service. In conclusion, the Statement of Principles concerning systemic sclerosis (Balance of Probabilities) (No. 26 of 2018) provides a framework for determining the eligibility of veterans and service members for compensation related to systemic sclerosis. It requires claimants and the Repatriation Commission to adhere to specific medical and service-related criteria, ensuring that benefits are awarded based on sound medical-scientific evidence. While specific penalties for breaches are not outlined in the explanatory statement, the overarching legislative framework provides for civil and criminal sanctions where necessary.

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