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CM5030 Guideline for Claims Assessors on Smoking and Alcohol Related Conditions and Military Service
REPATRIATION COMMISSION GUIDELINE
GUIDELINE FOR CLAIMS ASSESSORS ON SMOKING AND ALCOHOL RELATED CONDITIONS AND MILITARY SERVICE
This Guideline reflects the work of the Joint Departmental and Ex-Service Organisation Working Party on Alcohol and Tobacco held in 1998 and a decision by the Repatriation Commission to issue a Guideline for the benefit of decision-makers.
While there was substantial agreement on the issues there remain matters that were not agreed to by the Repatriation Commission. The principal matter that was not agreed to by the Repatriation Commission was the argument that the temporal connection of service life with alcohol consumption is enough to establish ‘habit’ as the cause of alcohol use. This is relevant to Point 4 in the Alcohol section of the Guideline. However, the Repatriation Commission agreed that arguments put to delegates that are outside the Guideline must still be considered for substance and medical and scientific support.
This Guideline should be considered when deciding claims where smoking and/or alcohol are given as factors. The Guideline is not an instruction to Commission delegates.
In accordance with Commission Guideline CM5017 concerning the application of Section 120 of the VEA, delegates must decide the issues for themselves on the basis of all the material available to them and approaching each case on its own merits.
Repatriation Commission Guideline CM 5030
1. Smoking is strongly addictive.
2. There is evidence that military populations smoke more than civilian populations. Service life contains many potential links to smoking. Stress, peer pressure, availability and boredom are among them.
3. Because of service culture, slow changes to community attitudes, and the lack of proscription of smoking in the military, little weight should be given to the effect of anti-smoking warnings and of bans on smoking in certain places in the community as a whole. These considerations should not be, of themselves, sufficient to cause a claim to fail.
4. After investigation, all available material should be assessed in its context and given weight accordingly, whether self-reported, first-hand observation, hearsay, previous reports/medical histories, or smoking questionnaires from earlier claims. It is possible that the smoking history obtained in a claim will contradict an earlier one in which a smoking habit1 was denied. An explanation of such a contradiction should, where possible, be considered.
5. After an investigation is complete, there needs to be material that points to the commencement or increase of smoking on service, that is, a temporal (time) link between smoking and service.
6. If the temporal link exists, in OPERATIONAL SERVICE CASES, a causal link between smoking and service can frequently be inferred. This link (see point 2 above) depends on the particular circumstances of the individual.
7. If the temporal link exists, in NON-OPERATIONAL SERVICE CASES, material positively supporting the claimed causal connection (see point 2 above) to service is needed in addition to the temporal connection.
8. A psychiatric disability may lead to the commencement of smoking. That psychiatric disability needs to be causally connected to service (the McKenna case).
9. In both OPERATIONAL AND NON-OPERATIONAL SERVICE CASES, the question of the effect of an apparent break in the smoking history may arise. As a general rule, for all forms of service, the resumption of smoking within two years of cessation can be taken to be a recommencement of the former smoking habit. Where smoking recommences after two years the material assembled after investigation would have to point to a service-based reason for recommencement for the claim to be able to be accepted.
Legislative Prescriptions Relating To Smoking Claims
1. The VEA now provides that a claim relating to smoking that commenced or increased after 1 January 1998 cannot be found to be service related. In these cases, the level of smoking should be taken to be that which existed at 31 December 1997. This applies to all veterans and members of the ADF.
2. Members of the ADF who enlisted in the ADF on or after 7 April 1991 are not eligible to claim under the VEA for conditions resulting from peacetime service unless they were medically discharged before 7 April 1994. This ineligibility covers all claims, including those that are smoking-related. These claimants are covered under the Safety, Rehabilitation and Compensation Act 1988.
1. Alcohol consumption does not necessarily result in addiction or dependence.
2. The terms contained in the Diagnostic and Statistical Manual of Mental Disorders (DSM) should be used when describing alcohol-related disorders.
3. Service-related Psychoactive Substance Abuse (PSA) is not the sole means of satisfying the alcohol factors within Statements of Principles. In the absence of PSA each case should be assessed on its merits.2
4. The consumption of alcohol can be related to service in one or more of the following ways:
- Alcohol consumed during eligible or operational (including warlike and non-warlike) service and as a causal result of that service;
- As a part of service related Psychoactive Substance Abuse involving alcohol;
- As a part of a service-related psychiatric condition; or
- Alcohol used as “self-medication” or coping as part of a service-related condition.
5. Evidence of these connections, or the absence of such evidence, should be contained in the reasons for any decision made.
6. Material that indicates any history of alcohol consumption prior to service may argue against both a temporal and causal connection with service.
Legislative Prescriptions Relating To Alcohol Claims
7. Unless they were medically discharged before 7 April 1994, veterans who enlisted in the ADF on or after 7 April 1991 are not eligible to claim under the VEA for conditions resulting from peacetime service. This ineligibility covers all claims, including those that are alcohol-related. These Veterans may claim under the Safety, Rehabilitation and Compensation Act 1988.
15 April 1999