REPATRIATION MEDICAL AUTHORITY
INSTRUMENT NO. 120 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. 70 of 1998, determined under subsection 196B(2) of the VEA concerning varicose veins of the lower limb.
- The Authority is of the view that there is sound medical-scientific evidence that indicates that varicose veins of the lower limb and death from varicose veins of the lower limb 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. 120 of 2011 concerning varicose veins of the lower limb. This Instrument will in effect replace the revoked Statement of Principles.
- 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.
- 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 varicose veins of the lower limb or death from varicose veins of the lower limb, with the circumstances of that service.
5. This Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 24 June 2009 concerning varicose veins of the lower limb 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 'varicose veins of the lower limb' in clause 3;
- revising factors 6(a) & 6(g) concerning 'thrombosis';
- revising factors 6(b) & 6(h) concerning 'complete or partial obstruction';
- revising factors 6(c) & 6(i) concerning 'being pregnant';
- revising factors 6(d) & 6(j) concerning 'an acquired arteriovenous fistula';
- new factors 6(e) & 6(k) concerning 'non-ambulatory standing';
- new factors 6(f) & 6(l) concerning 'a varicosity of an abdominal or pelvic vein';
- new definition of 'ICD-10-AM code' in clause 9;
- revising definitions of 'a deep vein draining the affected lower limb' and 'relevant service' in clause 9;
- deleting definition of 'ICD-9-CM code'; 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 varicose veins of the lower limb in the Government Notices Gazette of 24 June 2009, 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. Two submissions were received for consideration by the Authority during the investigation.
9. The determining of this Instrument finalises the investigation in relation to varicose veins of the lower limb as advertised in the Government Notices Gazette of 24 June 2009.
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. 120 of 2011, concerning varicose veins of the lower limb, was enacted in response to a gap in the existing legislation that did not sufficiently address the relationship between varicose veins and specific types of military service. The Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) were the primary pieces of legislation affected by this instrument, which was enacted by the Repatriation Medical Authority under the authority granted by subsection 196B(2) of the VEA. The policy objective was to revise the Statement of Principles to reflect the latest medical-scientific evidence, thereby ensuring that veterans could more readily claim compensation for varicose veins related to their service. This revision aimed to provide a clearer framework for determining liability for service injuries and diseases, including varicose veins of the lower limb, that are connected to particular kinds of military service.
Scope and Application
The Repatriation Medical Authority Instrument No. 120 of 2011 under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 addresses varicose veins of the lower limb, replacing the previously revoked Instrument No. 70 of 1998. This Statement of Principles applies to veterans and their dependants who served in various capacities, including operational, peacekeeping, hazardous, British nuclear test defence, warlike, and non-warlike service, and aims to establish a connection between such service and varicose veins of the lower limb or death from these veins. The Instrument is applicable nationally in Australia and is used by the Military Rehabilitation and Compensation Commission to determine claims for compensation for injuries sustained on or after 1 July 2004. The Instrument delineates specific factors and conditions that must exist to establish a reasonable hypothesis linking the condition to the service rendered, and it incorporates the latest revised format and updates to medical definitions and criteria since its previous iteration.
Key Provisions
The Repatriation Medical Authority (RMA) has determined a new Statement of Principles, Instrument No. 120 of 2011, under subsection 196B(2) of the Veterans' Entitlements Act 1986 (VEA), which supersedes Instrument No. 70 of 1998 concerning varicose veins of the lower limb. This new instrument outlines the minimum factors necessary to establish a reasonable hypothesis that varicose veins of the lower limb, or death from such condition, are related to specific types of military service (s. 4). The types of service include operational, peacekeeping, hazardous, British nuclear test defence, warlike, and non-warlike services under the VEA and MRCA.
The new Statement of Principles lists the factors that must exist to establish a connection between varicose veins of the lower limb or death from such condition and military service. This includes detailed factors concerning thrombosis, complete or partial obstruction, pregnancy, acquired arteriovenous fistula, non-ambulatory standing, and varicosity of an abdominal or pelvic vein (s. 6). Additionally, the definition of 'varicose veins of the lower limb' has been revised, and new definitions and revisions have been made to terms such as 'ICD-10-AM code', 'a deep vein draining the affected lower limb', and'relevant service' (s. 9).
The RMA is required to ensure that the Statement of Principles reflects the latest medical-scientific evidence available and that the necessary investigations and consultations have been conducted, as evidenced by the investigation announced in the Government Notices Gazette of 24 June 2009 (s. 5, 8). Submissions from relevant organisations and individuals were invited and considered during the investigation, leading to the final determination of this new instrument (s. 9). The RMA is also obligated to provide a list of references relating to the condition to any person or organisation referred to in subsection 196E(1)(a) to (c) of the VEA upon written request (s. 10).
Failure to comply with the provisions of the Statement of Principles or the requirements set forth in the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA) may result in legal consequences for the parties involved. Specifically, any breach of the legislative requirements or misrepresentation of facts in compensation claims could lead to civil or criminal penalties. Under the VEA, penalties for providing false or misleading information can include fines of up to $19,920 for individuals and $99,600 for bodies corporate, as per section 207 of the VEA. Additionally, under the MRCA, penalties for offences such as fraudulent claims can include fines of up to $55,500 for individuals and $277,500 for bodies corporate, as per section 333 of the MRCA.