Statement of Principles concerning thoracic outlet syndrome (Reasonable Hypothesis) (No. 47 of 2022)

Administered by Department of Veterans' Affairs

Legislation au F2022L00681 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

THORACIC OUTLET SYNDROME

(REASONABLE HYPOTHESIS) (NO. 47 OF 2022)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning thoracic outlet syndrome (Reasonable Hypothesis) (No. 47 of 2022).

Background

2.             The Repatriation Medical Authority (the Authority) has determined, under subsection 196B(2) of the Veterans' Entitlements Act 1986 (the VEA), Statement of Principles concerning thoracic outlet syndrome (Reasonable Hypothesis) (No. 47 of 2022).

3.             The Authority is of the view that there is sound medical-scientific thoracic outlet syndrome evidence that indicates that thoracic outlet syndrome and death from thoracic outlet syndrome can be related to particular kinds of service.  The Authority has therefore determined this Statement of Principles concerning thoracic outlet syndrome pursuant to subsection 196B(2) of the VEA.

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 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;

 British nuclear test defence 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  thoracic outlet syndrome or death from thoracic outlet syndrome, with the circumstances of that service.  The Statement of Principles has been determined for the purposes of both the VEA and the MRCA.

6.             The Repatriation Commission, Military Rehabilitation and Compensation Commission, Veterans' Review Board or Administrative Appeals Tribunal cannot accept any claim for pension; or a claim for liability or compensation relating to thoracic outlet syndrome or death from thoracic outlet syndrome that was lodged on or after 1 June 1994 in the case of the VEA, or 1 July 2004 in the case of the MRCA respectively, unless this Statement of Principles upholds that claim (subsection 120A(3) of the VEA or subsection 338(3) of the MRCA).

7.             This new Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 6 July 2021 concerning thoracic outlet syndrome in accordance with section 196G of the VEA.  The investigation involved an examination of the sound medical-scientific evidence available to the Authority.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to thoracic outlet syndrome in the Government Notices Gazette of 6 July 2021, 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 in relation to 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 new Instrument finalises the investigation in relation to thoracic outlet syndrome as advertised in the Government Notices Gazette of 6 July 2021.

References

11.         A list of references relating to the above condition is available on the Authority's website at: www.rma.gov.au. Any other document referred to in this Statement of Principles is available on request to the Repatriation Medical Authority at the following address:

              

Email:    info@rma.gov.au

Post:      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. 47 of 2022

Kind of Injury, Disease or Death:  Thoracic outlet syndrome

 

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(2) 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 and the Military Rehabilitation and Compensation 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 thoracic outlet syndrome;
  • facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal; and
  • outlines the factors which the current sound medical-scientific evidence indicates must as a minimum exist, before it can be said that a reasonable hypothesis has been raised, connecting thoracic outlet syndrome with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement.

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, ICESCR; 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, ICESCR 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 thoracic outlet syndrome (Reasonable Hypothesis) (No. 47 of 2022) was determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans' Entitlements Act 1986. This legislative instrument aims to facilitate the assessment of claims for compensation and medical treatment related to thoracic outlet syndrome for eligible veterans and Defence Force members by setting out the minimum factors that must exist to establish a reasonable hypothesis connecting the condition with service rendered. The Statement of Principles applies to claims made under both the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, ensuring that any claim lodged on or after 1 June 1994 or 1 July 2004, respectively, must be supported by this Statement of Principles to be considered. The determination of this instrument follows an investigation into thoracic outlet syndrome announced in the Government Notices Gazette of 6 July 2021, which involved examining available sound medical-scientific evidence. This legislative instrument is designed to ensure that claims for thoracic outlet syndrome are assessed fairly and transparently, in accordance with the best available medical-scientific evidence, thereby promoting the human rights of veterans, current and former Defence Force members, and their dependents by facilitating access to social security, an adequate standard of living, and the highest attainable standard of physical and mental health. Additionally, it ensures that these rights are exercised without discrimination, in line with international human rights standards.

Scope and Application

The Statement of Principles concerning thoracic outlet syndrome (Reasonable Hypothesis) (No. 47 of 2022), as determined by the Repatriation Medical Authority under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, sets out the minimum factors that must exist to establish a reasonable hypothesis linking thoracic outlet syndrome or death from thoracic outlet syndrome with particular kinds of service rendered by a person, including operational, peacekeeping, hazardous, British nuclear test defence, warlike, and non-warlike service. This Statement of Principles is applicable to determining claims under the VEA and the MRCA and cannot be overridden by the Repatriation Commission, Military Rehabilitation and Compensation Commission, Veterans' Review Board, or Administrative Appeals Tribunal unless it upholds the claim. This legislative instrument is intended to facilitate both the claimants in making claims and the Commissions in assessing them by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have thoracic outlet syndrome. The 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.

Key Provisions

The main operative sections of this legislation (section 4) establish a Statement of Principles concerning thoracic outlet syndrome (Reasonable Hypothesis) (No. 47 of 2022). This Statement of Principles sets out the factors that must exist and must be related to certain types of service to establish a reasonable hypothesis connecting thoracic outlet syndrome or death from thoracic outlet syndrome with the service rendered by a person. These types of service include operational, peacekeeping, hazardous, and British nuclear test defence service under the Veterans' Entitlements Act 1986 (VEA), and warlike and non-warlike service under the Military Rehabilitation and Compensation Act 2004 (MRCA). This Statement of Principles applies to claims lodged on or after 1 June 1994 under the VEA and 1 July 2004 under the MRCA. The Statement of Principles imposes specific obligations on the parties involved in claims related to thoracic outlet syndrome. For claimants, it means that to be eligible for a claim under the VEA or MRCA, the claim must be supported by evidence that aligns with the factors outlined in the Statement of Principles. The Repatriation Commission, Military Rehabilitation and Compensation Commission, Veterans' Review Board, and Administrative Appeals Tribunal are obligated to assess claims against these factors to determine eligibility for pension, liability, or compensation. The legislation ensures that these bodies cannot accept any claim for thoracic outlet syndrome or death from thoracic outlet syndrome unless it is upheld by the Statement of Principles. The legislation sets out consequences for non-compliance with the provisions concerning thoracic outlet syndrome. Under subsection 120A(3) of the VEA and subsection 338(3) of the MRCA, claims for pension or compensation related to thoracic outlet syndrome or death from thoracic outlet syndrome that were lodged on or after the specified dates, and not supported by the Statement of Principles, cannot be accepted. This restriction ensures that only claims that meet the medical-scientific criteria outlined in the Statement of Principles are considered valid, thereby maintaining the integrity of the claims process. There are no specific criminal or civil penalties mentioned in the legislation for non-compliance with these provisions, but the exclusion of unsupported claims serves as a significant deterrent.

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