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4.5.1 Overview of Medical Connections to Service

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What are Statements of Principles?

The Statements of Principles (SoPs[glossary:):] are legislative instruments that provide exclusive factors determined by the Repatriation Medical Authority [glossary:(:]RMA[glossary:):] to be the cause of certain diseases, injuries or deaths, based on sound medical-scientific evidence. SoPs are based on the most up to date national and international medical-scientific knowledge. There are two SoPs for each medical condition, one for operational and war-like service and one for other eligible service.    

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Statements of Principles

Section 4.5.2

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How are SoPs used?

The SoPs alone determine what factors can be said to cause a medical condition that is the subject of a claim for disability pension. A veteran or dependant can look at the list of factors listed in SoP as causing a condition and see if any might be applicable to their particular circumstances. All decision-makers must decide whether any of the factors in the SoP for the condition being investigated apply to the person making the claim, and whether the factor(s) are related to the person's service.     

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How are Statements of Principles made and used?

Section 4.5.3

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Investigation and review of Statements of Principles by the RMA

The RMA investigates requests for new SoPs or changes to existing SoPs either formally or  informally. It can also investigate on its own initiative. A review of an existing SoP, or the decision not to issue a SoP, may be based on new medical research or on a medical opinion.     

Review of RMA decisions on Statements of Principles by the SMRC

The Specialist Medical Review Council [glossary:(:]SMRC[glossary:):] can review a formal decision on a SoP. The SMRC is required to review all the information that was available to the RMA when it determined a SoP or chose not to issue a SoP in respect of a medical condition. Oral and written submissions that address the information that was available to the RMA may also be considered in the review.     


Statement of Principles means:

  • a Statement of Principles determined by the RMA under section 196B of the VEA; or
  • a determination made by the Repatriation Commission under section 180A of the VEA; or
  • a Statement of Principles concerning a particular kind of injury or disease made available to the VRB by the Repatriation Commission under paragraph 138(2)(a) of the VEA.

 

 

Statement of Principles means:

  • a Statement of Principles determined by the RMA under section 196B of the VEA; or
  • a determination made by the Repatriation Commission under section 180A of the VEA; or
  • a Statement of Principles concerning a particular kind of injury or disease made available to the VRB by the Repatriation Commission under paragraph 138(2)(a) of the VEA.

 

 

The RMA is a panel of five medical and scientific experts appointed by the Minister for Veterans' Affairs after consultation with the ex-service and veteran community.

The role of the RMA is:

 

 

The RMA is a panel of five medical and scientific experts appointed by the Minister for Veterans' Affairs after consultation with the ex-service and veteran community.

The role of the RMA is:

 

 

According to subsection 5D(1), disease means:

  • any physical or mental ailment, disorder, defect or morbid condition (whether of sudden onset or gradual development), or
  • the recurrence of such an ailment, disorder, defect or morbid condition,

but does not include:

  • the aggravation of such an ailment, disorder, defect or morbid condition, or
  • a temporary departure from:

the normal physiological state, or

the accepted ranges of physiological or biochemical measures,

that results from normal physiological stress (for example, the effect of exercise on blood pressure) or the temporary effect of extraneous agents (for example, alcohol on blood cholesterol levels).

According to subsection 5D(1), an injury means any physical or mental injury (including the recurrence of a physical or mental injury) but does not include:

  • a disease, or
  • the aggravation of a physical or mental injury.

According to subsection 5AB(2), information about a particular kind of injury, disease, or death is taken to be sound medical evidence if the information:

  • is consistent with material relating to medial science that has been published in a medical or scientific publication and has been, in the opinion of the RMA, subjected to a peer review process, or
  • in accordance with generally accepted medical practice, would serve as the basis for the diagnosis and management of medical condition.

Information about how that kind of injury, disease or death may be caused must meet the applicable criteria for assessing causation currently applied in the field of epidemiology.

 

 

Operational service is generally service performed:

  • outside Australia,
  • during war like operations in which Australian Defence Forces were involved, and
  • in areas where the incurred level of risk is considered above that of normal peacetime conditions.

Refer to section 6 of the VEA through to 6F of the VEA for a full explanation of operational service.

Warlike service is defined in Subsection 5C(1) VEA to mean:

  • service in the Defence Force of a kind determined in writing by the Minister for Defence to be warlike service.

See also definition of war like operations.

Eligible war service is:

  •  operational service, or
  •  continuous full-time service (not being operational service) as a member of the Australian Defence Force (ADF) during World War 1, or
  •  continuous full-time service (not being operational service) as a member of the Australian Defence Force during World War 2, being service that commenced before 1 July 1947, or
  •  continuous full-time service (not being operational service) as a member of the Interim Forces during World War 2, being service on or after 1 July 1947, or
  •  been employed on a ship as an Australian Mariner during World War 2, to 29 October 1945.

Section 7 of the VEA provides a full definition of eligible war service.

 

 

Disability pension, for the purposes of service pension and income support supplement, means:

  • a pension paid for incapacity from war caused conditions, or peacetime, peacekeeping or hazardous service caused conditions (other than a war widow's or orphan's pension); or
  • temporary incapacity allowance; or
  • any other payment in respect of incapacity or death resulting from war or war-like operations in which the Crown has been engaged [usually paid by another Commonwealth country].

For the purposes of Part VI of the VEA, a reference to a veteran is taken to be a reference to:

  • a veteran as defined in subsection 5C(1) of the VEA;
  • a member of the Forces as defined in subsection 68(1) of the VEA; or
  • a member of a Peacekeeping Force as defined in subsection 68(1) of the VEA.

For the purposes of Part VII of the VEA, according to subsection 5C(1), veteran means a person (including a deceased person):

  • who is taken to have rendered eligible war service, or
  • in respect of whom a pension is, or pensions are, payable under subsection 13(6) and
  • in Part III and Part VIIC of the VEA includes a person who is:

 

 

The SMRC is an independent statutory body that is able to review the decisions the the Repatriation Medical Authority (RMA) makes about Statement of Principles (SoPs). The SMRC will consider all of the material that was available to the RMA and any material that the review applicant wants to make available. There are no legal questions decided by the SMRC and no lawyers may address the SMRC. The SMRC decides whether it would have made a different decision than the RMA on the basis of the same sound medical-scientific evidence. Refer to sections 196V and 196W.

 

 

The SMRC is an independent statutory body that is able to review the decisions the the Repatriation Medical Authority (RMA) makes about Statement of Principles (SoPs). The SMRC will consider all of the material that was available to the RMA and any material that the review applicant wants to make available. There are no legal questions decided by the SMRC and no lawyers may address the SMRC. The SMRC decides whether it would have made a different decision than the RMA on the basis of the same sound medical-scientific evidence. Refer to sections 196V and 196W.