REPATRIATION MEDICAL AUTHORITY

STATEMENT OF PRINCIPLES NO. 35 of 2005

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. 48 of 2002 of 4 June 2002 and Instrument No. 79 of 2002 of 21 November 2002, each of which were determined under subsection 196B(2) of the VEA concerning thoracic spondylosis.

2.             The Authority is of the view that there is sound medical-scientific evidence that indicates that thoracic spondylosis and death from thoracic spondylosis can be related to particular kinds of service. The Authority has therefore determined, pursuant to subsection 196B(2) of the VEA, Statement of Principles concerning thoracic spondylosis No. 35 of 2005.  This Instrument will in effect replace the revoked Statements of Principles.

3.             Pursuant to the provisions of the VEA and the Military Rehabilitation and Compensation Act 2004 (‘the MRCA’), claims for pension under the VEA or compensation under the MRCA are determined by the Repatriation Commission or 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 thoracic spondylosis or death from thoracic spondylosis, with the circumstances of that service.

5.             This new instrument results from an investigation notified in the Government Notices Gazettes of 25 February 2004 and 14 July 2004 concerning thoracic spondylosis by the Authority, 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 title and format of this new Instrument has been varied, including a new titling clause 1, headnote to clause 2 and the renumbering of subsequent clauses. These changes have been introduced in order to assist users in locating the appropriate Instrument when searching the Federal Register of Legislative Instruments.

7.             The contents of the new Instrument are in similar terms as the revoked Instruments.  Comparing the new and the revoked Instruments, the differences include:

• rewording factors 6(e) and (n) relating to having a condition of the thoracic spine from the specified list of spinal conditions;
• deleting the previously included factors relating to permanent ligamentous instability of the thoracic spine;
• deleting the previously included factors relating to repetitive or persistent flexion, extension or twisting of the thoracic spine;
• deleting the previously included factors relating to flying in high performance aircraft;
• rewording the definition of ‘trauma to the thoracic spine’ to include exposure to positive G forces of two or more;
• rewording factors 6(i) and (r) relating to carrying or lifting loads, requiring that the act must be undertaken whilst bearing weight on the thoracic spine;
• including a new factor 6(t) relating to inability to obtain appropriate clinical management;
• deleting the definition of ‘disordered joint mechanics’, ‘high performance aircraft’ and ‘permanent ligamentous instability’ in clause 9;
• revising the definition of ‘ICD-10-AM code’, ‘inflammatory joint disease’, ‘relevant service’ and ‘trauma to the thoracic spine’ in clause 9;
• including a new definition of ‘lifting loads’ and ‘the specified list of spinal conditions’ in clause 9; and
• specifying a date of effect for the Instrument in clause 11.

8.             Further changes to the format and wording 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.             The Instrument refers to, but does not incorporate by reference, The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), effective date of 1 July 2004, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 594 1. This publication is available for purchase from the National Centre for Classification in Health, The University of Sydney, PO Box 170, Lidcombe NSW 1825.

10.         Prior to determining this instrument, the Authority advertised its intention to undertake an investigation in relation to thoracic spondylosis in the Government Notices Gazettes of 25 February 2004 and 14 July 2004, and circulated a copy of the notices to organisations representing veterans, service personnel and their dependants. The Authority invited submissions from the Repatriation Commission, the Military Rehabilitation and Compensation Commission, and organisations and persons referred to in section 196E of the VEA (who include persons eligible to make a claim under the MRCA), and any person having expertise in the field. Five submissions were received and considered by the Authority during the investigation.

11.         On 16 August 2005, the Authority wrote to organisations representing veterans, service personnel and their dependants regarding the proposed Instrument, the medical-scientific material considered by the Authority and drawing attention to the non-inclusion of the factors relating to permanent ligamentous instability of the thoracic spine; repetitive or persistent flexion, extension or twisting of the thoracic spine; and flying in high performance aircraft in the proposed new instrument. The Authority provided an opportunity to the organisations to make representations in relation to the proposed instrument prior to its determination. One representations was received and considered by the Authority prior to finalising the investigation.

12.         The determining of this new instrument finalises the investigation in relation to thoracic spondylosis as advertised in the Government Notices Gazette of 25 February 2004 and 14 July 2004.

13.         A list of references relating to the above condition is available, on written request, from the Repatriation Medical Authority Secretariat.