REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 2 of 2010
VETERANS’ ENTITLEMENTS ACT 1986
MILITARY REHABILITATION AND COMPENSATION ACT 2004
EXPLANATORY NOTES FOR TABLING
- The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans’ Entitlements Act 1986 (the VEA), revokes Instrument No. 77 of 1999, determined under subsection 196B(3) of the VEA concerning tension-type headache.
2. The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that tension-type headache and death from tension-type headache 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. 2 of 2010 concerning tension-type headache. 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) under the VEA;
peacetime service under the MRCA,
before it can be said that, on the balance of probabilities, tension-type headache or death from tension-type headache is connected with the circumstances of that service.
5. This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 30 April 2008 concerning tension-type headache 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 Instrument. 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;
- revising the definition of 'tension-type headache' in clause 3;
- new factor 6(a) concerning frequent tension-type headache in migraine and cluster headache sufferers and taking a drug or a combination of drugs;
- new factor 6(b) concerning taking a drug or a combination of drugs;
- new factor 6(c) concerning undergoing treatment with glyceryl trinitrate or isosorbide mononitrate;
- new definitions of "a drug or a combination of drugs, as specified in list 1", "a drug or a combination of drugs, as specified in list 2", "a triptan", "combination analgesic medication", and "frequent tension-type headache", in clause 9;
- revising definitions of "ICD-10-AM code" and "relevant service" 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 tension-type headache in the Government Notices Gazette of 30 April 2008, 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. One submission was received for consideration by the Authority during the investigation.
9. The determining of this new instrument finalises the investigation in relation to tension-type headache as advertised in the Government Notices Gazette of 30 April 2008.
10. 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
Overview
The Repatriation Medical Authority Instrument No. 2 of 2010 was enacted to address the issue of tension-type headache and death from tension-type headache in relation to certain kinds of service under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This legislative instrument, introduced by the Repatriation Medical Authority under subsection 196B(3) of the VEA, revokes the previous Instrument No. 77 of 1999 and establishes a new Statement of Principles concerning tension-type headache. The policy objective is to provide a comprehensive framework for determining whether such conditions are connected with the circumstances of eligible war service, defence service, or peacetime service, based on sound medical-scientific evidence. The new instrument reflects the latest format and includes revised definitions and additional factors to ensure clarity and accuracy in the assessment process.
Scope and Application
The Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 are the foundational legislations governing the determination of Statements of Principles concerning service-related conditions, including tension-type headache. The Repatriation Medical Authority, under the authority vested in it by the Veterans' Entitlements Act, has issued Instrument No. 2 of 2010, which revokes the previous Instrument No. 77 of 1999 concerning tension-type headache. This new instrument is applicable to individuals who have served in eligible war service (other than operational service), defence service (other than hazardous service), or peacetime service, and who may be suffering from tension-type headache or have died from it, where there is a connection to their service. The geographic reach of these Acts is nationwide, as they are Commonwealth legislations. The Authority has determined the new Statement of Principles based on sound medical-scientific evidence, setting out the specific factors that must exist for a connection to be established between tension-type headache and the service rendered. The Military Rehabilitation and Compensation Commission assesses claims for compensation on or after 1 July 2004 in accordance with these Statements of Principles. The new Instrument incorporates revisions to the definition of terms, new factors, and updated definitions to reflect the latest medical understanding and the commencement of the Military Rehabilitation and Compensation Act.
Key Provisions
The Repatriation Medical Authority, exercising its powers under subsection 196B(8) of the Veterans’ Entitlements Act 1986 (VEA), has revoked Instrument No. 77 of 1999 concerning tension-type headache. In its place, the Authority has determined a new Statement of Principles, Instrument No. 2 of 2010, under subsection 196B(3) of the VEA. This new instrument outlines the factors that must exist, and which of those factors must be related to certain kinds of service, for it to be said that, on the balance of probabilities, tension-type headache or death from tension-type headache is connected with the circumstances of that service (section 4).
The obligations imposed by this Act are primarily on the Repatriation Medical Authority. The Authority must ensure that the determination of the new Statement of Principles is based on the sound medical-scientific evidence available. It is required to advertise its intention to undertake an investigation in relation to the condition in the Government Notices Gazette and to circulate a copy of the notice to relevant organisations and individuals. The Authority must also invite submissions from interested parties, including the Repatriation Commission, organisations representing veterans and service personnel, and any person with expertise in the field (section 8). The Authority’s determination of the new Statement of Principles concludes the investigation into tension-type headache that was advertised in the Government Notices Gazette of 30 April 2008 (section 9).
There are no specific offences or penalties outlined in the legislation itself. However, the consequences for non-compliance with the obligations under the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA) could involve legal challenges to the Authority's decisions or claims for compensation. The Authority's determinations are subject to judicial review, and parties dissatisfied with the Authority's decisions may seek recourse through the courts. Additionally, the MRCA provides for compensation claims to be assessed and determined by the Military Rehabilitation and Compensation Commission, which may result in disputes over the acceptance of liability for service injuries, diseases, or deaths (section 3).
The new Instrument No. 2 of 2010, while similar in content to the revoked Instrument No. 77 of 1999, includes several changes to its format and content. These changes reflect the latest revised Instrument format, the commencement of the MRCA, and the incorporation of new medical-scientific evidence. The Instrument specifies factors related to the service that must exist for a connection to tension-type headache to be established, including the definition and types of tension-type headache, and the circumstances under which a person may have taken certain drugs or undergone specific treatments (section 6). These factors are critical in determining whether a claim for compensation related to tension-type headache is eligible under the VEA or the MRCA.