Statement of Principles concerning thromboangiitis obliterans (Balance of Probabilities) (No. 29 of 2017)

Administered by Department of Veterans' Affairs

Legislation au F2017L00464 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

THROMBOANGIITIS OBLITERANS

(BALANCE OF PROBABILITIES) (NO. 29 OF 2017)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning thromboangiitis obliterans (Balance of Probabilities) (No. 29 of 2017).

Background

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

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that thromboangiitis obliterans and death from thromboangiitis obliterans 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 thromboangiitis obliterans (Balance of Probabilities) (No. 29 of 2017).  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, thromboangiitis obliterans or death from thromboangiitis obliterans 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 3 May 2016 concerning thromboangiitis obliterans 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 'thromboangiitis obliterans' in subsection 7(2);
  • revising the reference to 'ICD-10-AM code' in subsection 7(4);
  • revising the factors in subsections 9(1) & 9(2) concerning 'smoking', by the inclusion of a note;
  • new definitions of 'MRCA' and 'VEA' in Schedule 1 - Dictionary;
  • revising the definitions of 'pack-year of cigarettes, or the equivalent thereof in other tobacco products' and 'relevant service' in Schedule 1 - Dictionary; and
  • deleting the definition of 'pack years of cigarettes, or the equivalent thereof in other tobacco products'.

Consultation

8.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to thromboangiitis obliterans in the Government Notices Gazette of 3 May 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 thromboangiitis obliterans as advertised in the Government Notices Gazette of 3 May 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. 29 of 2017

Kind of Injury, Disease or Death: Thromboangiitis obliterans

 

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 thromboangiitis obliterans;
  • 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, thromboangiitis obliterans 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. 8 of 2009; and
  • reflects developments in the available sound medical-scientific evidence concerning thromboangiitis obliterans 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 thromboangiitis obliterans (Balance of Probabilities) (No. 29 of 2017) was introduced by the Repatriation Medical Authority under subsection 196B(8) of the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). This legislative instrument addresses the need to clarify the connection between thromboangiitis obliterans, also known as Buerger's disease, and specific kinds of service rendered by individuals, particularly veterans and service personnel. The Authority determined this Statement of Principles after examining sound medical-scientific evidence, leading to the revocation of Instrument No. 8 of 2009. The primary objective of this instrument is to outline the factors necessary for establishing a connection between thromboangiitis obliterans and the service circumstances, thereby facilitating the assessment and review of claims for compensation and medical treatment under the VEA and MRCA. This legislative instrument ensures that the benefits are provided based on reasonable, proportionate, and transparent qualifying conditions, promoting the social security and health rights of veterans, current and former Defence Force members, and their dependents.

Scope and Application

The Statement of Principles concerning thromboangiitis obliterans (Balance of Probabilities) (No. 29 of 2017) applies to eligible persons who are seeking medical treatment and compensation for thromboangiitis obliterans under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. This Instrument outlines the factors that must exist for thromboangiitis obliterans or death from thromboangiitis obliterans to be considered connected with certain kinds of service, specifically eligible war service, defence service, and peacetime service. The Statement of Principles facilitates the assessment and determination of claims by the Repatriation Commission and the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal. It replaces the previously revoked Instrument No. 8 of 2019 and incorporates the latest medical-scientific evidence available to the Repatriation Medical Authority. The 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, by ensuring that these rights are exercised without discrimination.

Key Provisions

The main sections of this Statement of Principles detail the circumstances under which thromboangiitis obliterans (TAO) may be connected to certain kinds of service rendered by a person, specifically eligible war service, defence service, and peacetime service. According to section 5 of the Explanatory Statement, these provisions outline the factors that must exist and be related to the service in question for TAO or death from TAO to be considered connected to that service on the balance of probabilities. This Statement of Principles applies to claims under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). The Statement of Principles imposes specific obligations on claimants and the Repatriation Commission in the assessment of claims for TAO. Claimants must provide evidence that links their TAO to their service, with the factors outlined in the Statement of Principles. The Repatriation Commission, in turn, is required to assess the validity of these claims based on the evidence provided and the criteria specified in the Statement of Principles. There are no specific offences, penalties, or consequences for breach outlined in this Statement of Principles itself. However, the determination of these principles is crucial in the assessment of claims under the VEA and MRCA. Failure to adhere to the criteria set out in the Statement of Principles could result in the denial of claims for benefits and compensation related to TAO. The actual enforcement and penalties for non-compliance would be governed by the provisions of the VEA and MRCA, rather than this Statement of Principles. The Repatriation Medical Authority is tasked with ensuring that this Statement of Principles is compatible with the human rights and freedoms recognised in international instruments. The compatibility statement confirms that this instrument does not derogate from any human rights and promotes several rights, including the right to social security, an adequate standard of living, and the highest attainable standard of physical and mental health. It ensures that these rights are exercised without discrimination, thereby supporting the human rights of veterans and their dependents.

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