DATE OF ISSUE: 7 JUNE 1994
BUDGET 1994 - CHANGES AFFECTING COMPENSATION MATTERS
PURPOSE
This Instruction provides information on the initiatives announced in the Budget on 10 May 1994.
The initiatives are:
The Repatriation Medical Authority
Vietnam Veterans' Mortality Study
Training and Information Program
Age Adjustment in GARP Tables
Automatic Eligibility for Funeral Benefits
Mariners -Repeal of the SWP&A Act - Benefits under the VEA
Reimbursement of VRB Applicant's Medical Report Costs
Special And Intermediate Rate DP - Eligibility After Age 65
THE REPATRIATION MEDICAL AUTHORITY
The 1994/95 Budget announced the decision to establish the Repatriation Medical Authority (RMA). Its function will be to determine Statements of Principles (SoPs) codifying causes of death and the various disabilities suffered by veterans. The Repatriation Commission will also have limited power to determine SoPs in certain circumstances.
SoPs will be disallowable statutory instruments binding decision-makers at all levels, including the Repatriation Commission, the Veterans' Review Board, the A.A.T. and the Courts. In directing decision-makers, they will set out the minimum factors relevant to disease causation and which of those factors must be related to service.
The initiative will not change the fundamental nature of the standards of proof and is intended to amplify the “reasonable hypothesis” test so as to exclude those maverick medical opinions previously relied upon by claimants or appellants.
The RMA will be established on the date of Royal Assent.
Determination of Claims
Claims lodged prior to 1 June 1994 are not affected by the new arrangements and, regardless of the date on which they are decided, are to be determined on the rules as they now exist (refer D.I. B61/93 - "The Decision-making Process").
Until the date of Royal Assent (expected early July), those claims lodged on or after
1 June 1994 which have reached the determination stage, should also be determined under the existing rules.
When Royal Assent is given to the changes to the VEA, SoPs will become binding on all undetermined claims lodged on or after 1 June 1994. Further instructions on processing these claims will follow.
Further information is available from Dave Goldrick (06) 289 6786.
VIETNAM VETERANS MORTALITY STUDY
This study will commence later in 1994 and will ascertain the rate of death from all causes, particularly suicide and cancer which are of continuing concern to Vietnam veterans.
Since the mid 1980s, the Department has been collecting information of the mortality of Vietnam veterans. This process will be enhanced by comparing nominal rolls of Vietnam veterans with information from the state registries of death and other epidemiological sources. The death rate will be compared with the expected rates of death for a similar population of Australians.
As an additional benefit, the study will provide an accurate and comprehensive geographic and demographic atlas of Australia's Vietnam veteran population, today and in the future.
This will allow the Department to better tailor and target its services to areas of greatest need.
All action on this initiative is being taken within Central Office. For further information contact Dr Keith Horsley (06) 289 6329.
TRAINING AND INFORMATION PROGRAM
The Baume Committee reviewing the Veterans' Compensation System recommended, in Chapter 5 of their report “A Fair Go”, that the impact of advocates' work on the decision making system should be recognised and that DVA should co-ordinate a national training program focussing on case management and presentation.
It is known that the quality and resources of advocacy services being provided by ex-service organisations have generally not been of an acceptable standard to deal with changes such as were announced in the Budget.
A Training and Information Program (TIP) is being created to train and resource welfare officers and advocates of ex service organisations most of who are volunteers. It will comprise of the following:
a national training program developed and conducted by the Department in co‑operation with the ex-service organisations, VRB and AAT. Courses will be developed for welfare officers, advocates and potential trainers in the ex-service community. The courses will focus on such relevant areas as interviewing and advocacy skills, preparation of written submissions and examination of the changing entitlements under the VEA and significant court and tribunal decisions.
development and provision of resources such as training hand outs, information kits, a bi‑monthly newsletter to keep welfare officers and advocates informed of relevant changes in veterans' affairs law and policy, and a training manual to assist members of ex service organisations who will be trained to conduct training courses for their volunteers;
development and provision of a computer program specifically tailored to the needs of the welfare officer or advocate. This would be similar to the Department's CCPS program although in a much simpler form;
the provision of office space and essential equipment in Departmental offices for the establishment of a "shop front" advice service staffed by ex-service advocates and welfare officers on a roster basis;
a pool of funds to augment existing “in-house” training programs already provided by ex-service organisations providing a free service.
All action to implement this initiative is being taken by Derek Emerson-Elliot in Central Office (06) 289 6577.
GUIDE TO ASSESSMENT OF RATES OF VETERANS' PENSIONS (GARP)
GARP has already a small number of tables which include adjustment for ageing. It is intended to extend the principle of age adjustment to other GARP tables, initially to those for aural and musculoskeletal disabilities. Tables of adjustment in respect to these conditions will be incorporated into CCPS and, where relevant, will apply to all determinations of disability pension rates made on or after 1 July 1994, regardless of the date of lodgement of the application or claim to which they refer.
The opportunity has also been taken to introduce a new table to better assess disfigurement and there will be improved provisions for assessing gender specific disability.
Existing Pensions and Pension Increases
A non-reduction principle will apply to existing pensions. However, the revised tables will apply to assessments of pension after further disabilities are accepted and to applications for increase in pension rate. If the rate of pension calculated under the new tables is higher than the rate previously assessed, the veteran's pension will be increased to the higher rate. Otherwise the veteran will remain on the same rate of pension.
Consultation
In keeping with the past changes to GARP, there will be consultation with the ex-service community and monitoring of the effects of the changes.
Departmental Instructions will be issued as the tables are changed. For further information contact Jeff Kelly (06) 289 6786.
AUTOMATIC ELIGIBILITY FOR FUNERAL BENEFITS
The Funeral Benefit is designed to partly defray the cost of a funeral and payment of the benefit is intended to be made to the person who incurred the cost of the funeral.
Funeral benefits are already paid for a large percentage of POWs and veterans who received EDA because they qualify under the present rules. However, in some instances a claim has had to be made to have the death accepted as war-caused simply for the purpose of paying a Funeral Benefit.
Section 99A of the VEA will be amended to provide automatic eligibility for a funeral benefit to the estate of a veteran who:
was receiving Extreme Disablement Adjustment at the time of his death, or
was a former Prisoner of War.
Commencement
This initiative will apply to veterans in these categories who die on or after 1 January 1995. Claims for those who die prior to this date will be processed under the present rules.
The inclusion of these additional categories in section 99A of the VEA will remove the existing anomaly where Funeral Benefits can be paid in only some cases where a War Widow/ers pension is automatically granted.
Procedural & Systems
Administrative procedures remain unchanged from Departmental Instruction No: B44/92 dated 18 September 1992.
Systems Management & Support Section in Central Office will be amending the Death Processing System to include, in the advices for these cases, the text for Funeral Benefits that is currently being used for veterans eligible under s.99A.
New Financial Accounting System Codes
Payment will continue to be made through FAS. The new table of codes are:
Description |
Account No. |
|
S100 |
Dependants / War Widows |
39500 |
S 99 (1)(e) |
Death at Hospital or Institution |
39510 |
S 99 (1)(d) |
Indigent Circumstances |
39520 |
S 99 (1)(a) |
Service related death |
39540 |
S 99A |
TPI & Specific Disability Pension |
39530 |
S 99A |
Ex Prisoners of War |
39550 |
S 99A |
EDA Recipients |
39555 |
S 99(4)(b) |
Removal of body |
39560 |
Further enquiries should be directed to Perry Phillips (06) 289 6483.
MARINERS -REPEAL OF THE SWP&A ACT -BENEFITS UNDER THE VEA
The SWP&A Act was passed in 1940 to provide compensatory payments to Australian mariners and their dependants. The basis for payment of disability and war widows pensions under this Act is death or incapacity suffered by an Australian merchant mariner as a direct result of detention by the enemy or a war injury sustained in the course of his employment during World War II.
Compensation under the VEA is more generous because the disability does not have to be a “war injury” that was the direct result of enemy action as is the case in the SWP&A Act.
In 1989 an "Inquiry into the Needs of Australian Mariners and Commonwealth and Allied Veterans and Allied Mariners" concluded that "as far as practicable, World War II Australian merchant mariners be given the same rights and benefits as veterans of the Australian Defence Forces under the VEA". (Recommendation 3.100)
The Baume Committee reviewing the Veterans' Compensation System made the same recommendation in Chapter 9 of their report entitled “A Fair Go”.
Repeal of SWP&A Act
With effect from 1 July 1994, the Seamen's War Pension & Allowances Act (SWP&AA) and associated statutory regulations will be repealed and those mariners who were eligible under that Act will become eligible under the Veterans' Entitlements Act (VEA) on the same basis as veterans.
Draft legislation has been prepared which will preserve the existing rights of mariners. Benefits under the VEA will be extended by amendments to the definitions eligible war service (section 7) and operational service (section 6).
Determination of Claims & Appeals
Claims and appeals commenced under the SWP&A Act will, on 1 July 1994, be deemed to have been made under the VEA and determined according to the VEA.
Consequently determination of outstanding claims under the SWP&A Act, other than those which can be accepted, should be deferred until the new provisions are enacted.
File Prefix
The file prefix “SWP” should be retained and continued to be used for any new files raised for claims by Australian mariners. The prefix will be used in data extract exercises to monitor the effects of the new provisions as required by the Department of Finance.
Allied Mariners
Compensation is provided under Australian legislation only for Australian Mariners. Allied mariners may be eligible for income support - the Service Pension - under the VEA but their compensation is the responsibility of other governments.
Further enquiries should be directed to Perry Phillips (06) 289 6483.
REIMBURSEMENT OF VRB APPLICANT'S MEDICAL REPORT COSTS
The cost of documentary medical evidence obtained at the primary level by successful claimants/applicants may be reimbursed under the provisions of s.19(8) VEA. At the Administrative Appeals Tribunal, such costs are met through Legal Aid grants.
No provision has existed to reimburse such costs for claimants/applicants at the Veterans' Review Board, nor in the vast majority of cases are Legal Aid grants available to VRB applicants.
Following a recommendation of the Baume Committee's review of the Veterans' Compensation System the VEA will be amended to enable applicants to the VRB to be reimbursed:
for the costs of “relevant documentary evidence” obtained after the primary decision, and
for reasonable travelling expenses incurred in obtaining such evidence.
This will allow reimbursement of the cost of “relevant documentary evidence” up to a total of $425 for each disability in the decision that the VRB has been asked to review.
This change will apply to cases outstanding at the VRB on 1 July 1994 and to all VRB applications lodged on or after this date.
|
Example: |
Total Cost of Report/s. |
Maximum Reimbursement. |
|
First Condition |
3 Reports |
$300 |
$300 |
Second Condition |
1 Report |
$500 |
$425 |
Third Condition |
2 Reports |
$450 |
$425 |
Total Reimbursement |
$1150 |
Procedural
Reimbursement can only be made where a right of appeal exists and an application for review has been made to the VRB. The VRB application must either be outstanding at the VRB on 1 July 1994 or lodged after that date.
It will not be necessary for the VRB application to have been determined before reimbursement can be made. A claim for reimbursement may also be accepted after a VRB application has been withdrawn, for example when an applicant discontinues the case because the further medical opinion supports the primary decision.
The term “relevant documentary evidence” will have the same meaning as in section 19(9) of the VEA, ie:
“... certificates, reports or other documents from a medical practitioner, or from a hospital or similar institution in which the claimant or applicant had received medical treatment, in support of the claim or application, being certificates, reports or documents reasonably used in support of the claim or application;...”
A DMO's opinion should be sought if it is not obvious that the additional evidence relates to the condition that is the subject of the VRB application.
The additional “relevant documentary evidence” must have been obtained after the date of notification of the relevant primary decision. This will be determined by reference to the receipt date if the applicant has paid for the material or the invoice date if payment is outstanding.
Reimbursement may be paid against original receipts which should be supplied with the application. If the applicant presents an outstanding invoice, payment should be made to the provider of the additional evidence. There is no provision for advances or prepayment of this benefit.
Travelling expenses may be reimbursed according to the rates and conditions prevailing for travel under Section 132.
Application Forms
When amended, the VEA will require that applications for this benefit be made on a form approved by the Repatriation Commission. A form is now being designed for this purpose. Claims for travelling expenses should be made on form D800.
Delegations
State Program Managers have been asked to notify Central Office of the position numbers which require delegation to approve payment of this benefit.
Payment Procedures
Payment will be made through the Financial Accounting System(FAS). Accounting codes will be advised separately.
Claim Monitoring
As part of the evaluation process the Department of Finance requires an account of the cost of this benefit. This will be achieved by a report generated from FAS produced in Central Office.
Further enquiries should be directed to Perry Phillips (06) 289 6483.
SPECIAL AND INTERMEDIATE RATE DP - ELIGIBILITY AFTER AGE 65
Section 24(1)(c) of the Act already contains a criterion designed to preclude veterans who had retired from being granted pensions at the special or intermediate rate. However some claims have been submitted on the basis of assertions that, although the normal working life of the veteran had ceased, there was an intention to commence a new business or occupation.
The Veterans' Entitlements Act will be amended so that no grants of special or intermediate rate pensions will be granted to veterans over 65 years of age unless:
the veteran was engaged in remunerative work after the age of 65 years; and
that remunerative work was in the same business in which the veterans had been working for ten continuous years; and
the work was the last remunerative work immediately prior to the claim or application for increase.
The change will apply to claims for pension or pension increases lodged on or after
1 June 1994. There will be no effect on grants or increases in pension within the General Rate (0%-100%) or on the Extreme Disablement Adjustment.
A further instruction concerning the implementation of this initiative through the Compensation Claims Processing System will follow.
Further enquiries should be directed to Perry Phillips (06) 289 6483.
A W ASHFORD
NATIONAL PROGRAM DIRECTOR (BENEFITS)