REPATRIATION MEDICAL AUTHORITY

INSTRUMENT NO. 30 of 2009

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. 82 of 1995 determined under subsection 196B(3) of the VEA concerning trigeminal neuropathy.

2.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that trigeminal neuropathy and death from trigeminal neuropathy 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. 30 of 2009 concerning trigeminal neuropathy.  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, trigeminal neuropathy or death from trigeminal neuropathy 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 trigeminal neuropathy 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 'trigeminal neuropathy' in clause 3;
• revising factor 6(a) concerning 'multiple sclerosis';
• revising factor 6(b) concerning 'mass lesion';
• revising factor 6(e) concerning 'dental or surgical procedure';
• revising factor 6(f) concerning 'traumatic injury';
• revising factor 6(m) concerning 'treated with a drug' (this revised factor includes previous factor for 'hydroxystilbamidine isethionate');
• new factor 6(r) concerning 'multiple sclerosis';
• new factor (s) concerning 'mass lesion';
• new factors 6(c) & (t) concerning 'haematological malignancy or lymphoproliferative disorder';
• new factors 6(d) & (u) concerning 'cerebrovascular accident';
• new factor 6(v) concerning 'dental or surgical procedure';
• new factor 6(w) concerning 'traumatic injury';
• new factor 6(g) & (x) concerning 'inflammatory connective tissue disease';
• new factors 6(h) & (y) concerning 'osseous lesion';
• new factors 6(i) & (z) concerning 'viral, bacterial or protozoal infection';
• new factors 6(j) & (aa) concerning 'localised infection';
• new factors 6(k) & (bb) concerning 'herpes zoster';
• new factors 6(l) & (cc) concerning 'systemic disease';
• new factor 6(dd) concerning 'treated with a drug';
• new factors 6(n) & (ee) concerning 'inhaling, ingesting or having cutaneous contact';
• new factors 6(o) & (ff) concerning 'acute intoxication';
• new factors 6(p) & (gg) concerning 'therapeutic radiation';
• new factors 6(q) & (hh) concerning 'radiofrequency ablation';
• new definitions of 'a benign osseous lesion', 'a chemical substance from the specified list', 'a course of therapeutic radiation', 'a drug from the specified list', 'a haematological malignancy or lymphoproliferative disorder from the specified list', 'a localised infection from the specified list', 'a mass lesion', 'a systemic disease from the specified list', 'a traumatic injury to the affected trigeminal nerve', 'a viral, bacterial or protozoal infection from the specified list', 'acute intoxication', 'an inflammatory connective tissue disease from the specified list', 'death from trigeminal neuropathy', 'radiofrequency ablation', 'relevant service' and 'terminal event' in clause 9;
• deleting definitions of 'ICD code', 'multiple sclerosis' and 'tumour'; 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 trigeminal neuropathy 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.  No submissions were received for consideration by the Authority during the investigation.

9.             The determining of this new instrument finalises the investigation in relation to trigeminal neuropathy 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