REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 3 of 2011
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. 124 of 1996, determined under subsection 196B(2) of the VEA concerning varicocele.
2. The Authority is of the view that there is sound medical-scientific evidence that indicates that varicocele and death from varicocele can be related to particular kinds of service. The Authority has therefore determined pursuant to subsection 196B(2) of the VEA a Statement of Principles, Instrument No. 3 of 2011 concerning varicocele. 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 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 varicocele or death from varicocele, with the circumstances of that service.
5. This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 25 June 2008 concerning varicocele 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 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 2005;
- deleting the ICD code from the Instrument header;
- revising the definition of 'varicocele' in clause 3;
- revising factors 6(a) & 6(g) concerning 'occlusion or narrowing of the ipsilateral testicular vein';
- revising factors 6(b) & 6(h) concerning 'occlusion or narrowing of the inferior vena cava';
- revising factors 6(c) & 6(i) concerning 'having occlusion or narrowing of the right renal vein';
- revising factors 6(d) & 6(j) concerning 'having occlusion or narrowing of the left renal vein';
- new factors 6(e) & 6(k) concerning 'having a nephrectomy';
- new factors 6(f) & 6(l) concerning 'having an arterio-venous fistula between any of the arteries of the testis and a vein of the pampiniform plexus';
- new factor 6(m) concerning 'undertaking physical activity';
- new definitions of 'arteries of the testis', 'death from varicocele', 'ICD-10-AM code', 'MET', 'occlusion or narrowing' and 'terminal event' in clause 9;
- revising definition of 'relevant service' in clause 9;
- deleting definitions of 'ICD code' and 'suffering occlusion or narrowing'; 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 varicocele in the Government Notices Gazette of 25 June 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 Instrument finalises the investigation in relation to varicocele as advertised in the Government Notices Gazette of 25 June 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. 3 of 2011 was enacted to address the medical condition of varicocele and its relation to service in the Australian Defence Force. This Instrument, determined under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), revokes the previous Instrument No. 124 of 1996 concerning varicocele. The Authority has established a new Statement of Principles that sets out the factors necessary to link varicocele or death from varicocele to specific types of military service. The Authority's determination follows an investigation into the sound medical-scientific evidence regarding varicocele, which was advertised in the Government Notices Gazette on 25 June 2008. The policy objective of this Instrument is to ensure that claims for compensation related to varicocele are assessed in accordance with the most recent medical-scientific evidence.
Scope and Application
The Repatriation Medical Authority (the Authority), under subsection 196B(8) of the Veterans' Entitlements Act 1986 (the VEA), has revoked Instrument No. 124 of 1996 and issued a new Statement of Principles, Instrument No. 3 of 2011 concerning varicocele. This new Instrument is intended to replace the previously revoked one and outlines the factors that must exist to establish a reasonable hypothesis linking varicocele or death from varicocele with certain types of service. The Statement of Principles applies to operational, peacekeeping, and hazardous services under the VEA, as well as warlike and non-warlike services under the Military Rehabilitation and Compensation Act 2004 (MRCA). This Instrument was determined by the Authority following an investigation notified in the Government Notices Gazette of 25 June 2008, examining the latest sound medical-scientific evidence available. The Instrument has been revised to adopt a new format, update definitions, and specify a date of effect. Claims for compensation under section 319 of the MRCA, for injuries or diseases sustained on or after 1 July 2004, are now determined by the Military Rehabilitation and Compensation Commission using Statements of Principles issued by the Authority under the VEA.
Key Provisions
The main operative sections of the legislation, particularly section 2, revoke the previous Instrument No. 124 of 1996 concerning varicocele, which was determined under the Veterans' Entitlements Act 1986 (VEA). In its place, the Repatriation Medical Authority (the Authority) has determined a new Statement of Principles, Instrument No. 3 of 2011, concerning varicocele. This new instrument outlines the medical and service-related factors that must exist for a reasonable hypothesis to be raised connecting varicocele or death from varicocele with the circumstances of service rendered by a person. This Statement of Principles is now applicable for both the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA), as clarified in section 7.
Section 4 of the legislation details the obligations imposed on parties, including the requirement that claims for compensation related to service injuries, service diseases, or service deaths on or after 1 July 2004 be determined by the Military Rehabilitation and Compensation Commission, in accordance with Statements of Principles issued by the Authority. The Statement of Principles specifies the minimum factors that must be related to operational, peacekeeping, hazardous, warlike, or non-warlike service before a connection to varicocele or death from varicocele can be considered. The Authority's determination process, as described in section 5, involved an investigation and examination of medical-scientific evidence, culminating in the creation of this new Instrument.
The legislation also outlines the consequences of non-compliance or breaches. Under section 196G of the VEA, the Authority has the authority to investigate and determine the applicability of conditions such as varicocele to service circumstances. Failure to adhere to the requirements set out in the Statement of Principles or to submit relevant evidence as required could potentially result in the denial of compensation claims. While specific penalties are not detailed in the explanatory notes, breaches of legislative requirements generally may lead to legal consequences, including the potential for civil or criminal penalties, depending on the severity and intent of the breach.
In conclusion, the legislation sets forth a comprehensive framework for determining and adjudicating claims related to varicocele and death from varicocele, ensuring that claimants must meet specific medical and service-related criteria. The Authority's role in revoking outdated instruments and determining new Statements of Principles underscores its responsibility in providing accurate and up-to-date guidance for both claimants and the Commission. The obligations placed on claimants to provide evidence in line with the Statement of Principles are critical to the fair and effective administration of veterans' entitlements and compensation.