Veterans' Entitlements (Provisional Access to Medical Treatment) Determination 2017
Instrument 2017 No. R20
The Repatriation Commission, under paragraphs 88A(1)(a) and (d) of the Veterans’ Entitlements Act 1986 (the Act) makes the following instrument.
Dated this 26th of June 2017
The Seal of the ) Repatriation Commission ) SEAL was affixed hereto in the ) presence of: )
Simon Lewis C Orme MA Kelly ………………………………………………………………………………………………………………………….. SIMON LEWIS CRAIG ORME Major General Mark Kelly DSC AM CSC AO DSC PRESIDENT DEPUTY PRESIDENT COMMISSIONER
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Part 1-Introduction
1 Name
This instrument is the Veterans' Entitlements (Provisional Access to Medical Treatment) Determination 2017.
2 Commencement
This instrument commences, or is taken to have commenced, on 1 July 2017.
3 Authority
This instrument is made under paragraphs 88A(1)(a) and (d) of the Veterans’ Entitlements Act 1986.
4 Purpose
The purpose of this instrument is to enable a person within a class specified in Part 2 to receive treatment (provisional treatment) for a specified condition during the period from the time the person has made a claim for liability under the MRCA, or a defence-related claim under the SRCA (or if the DRCA is in force, a defence-related claim under the DRCA) and before liability for that claim has been determined.
Provisional treatment is available in respect of claims made on or after 1 July 2017 and before 1 April 2019 for a 2-year trial period from 1 July 2017 to 30 June 2019.
Entitlement to provisional treatment for a specified condition under this instrument will however cease on the making of a determination at primary level, or on application for review or appeal, to refuse liability for the claim in respect of the specified condition.
5 Definitions
In this instrument:
Act means the Veterans’ Entitlements Act 1986.
cadet has the same meaning as it has in section 5 of the MRCA.
Commission means the body corporate known as the Military Rehabilitation and Compensation Commission established under section 361 of the MRCA.
declared member has the same meaning as it has in section 5 of the MRCA.
DRCA means the Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 created upon enactment of the Safety, Rehabilitation and Compensation Legislation Amendment (Defence Force) Bill 2016.
former member has the same meaning as it has in section 5 of the MRCA.
member has the same meaning as it has in section 5 of the MRCA.
member of the Defence Force has the same meaning as it has in the MRCA.
MRCA means the Military Rehabilitation and Compensation Act 2004.
part-time Reservist has the same meaning as it has in section 5 of the MRCA.
Pharmaceutical Benefits Scheme means the scheme for the provision of pharmaceutical benefits prepared by the Repatriation Commission under section 91 of the Act (the Repatriation Pharmaceutical Benefits Scheme) or the determination made by the Commission under paragraph 286(1)(c) of the MRCA (the MRCA Pharmaceutical Benefits Scheme), as applicable.
Private Patient Principles means the principles determined by the Repatriation Commission under section 90A of the Act (the Repatriation Private Patient Principles) or the determination made by the Commission under paragraph 286(1)(b) of the MRCA (the MRCA Private Patient Principles), as applicable.
specified condition – see section 6.
SRCA means the Safety, Rehabilitation and Compensation Act 1988.
Statement of Principles means a determination made by the Repatriation Medical Authority, for the purposes of the Act and the MRCA, under subsection 196B(3) of the Act.
Treatment Principles means the document prepared by the Repatriation Commission under section 90 of the Act (the Treatment Principles), or the determination made by the Commission under paragraph 286(1)(a) of the MRCA (the MRCA Treatment Principles), as applicable.
6 Meaning of specified condition
In this instrument, a specified condition means a condition listed in column 1 of the table in this section.
Each specified condition in column 1 has the meaning given in the provision of the Statement of Principles, as in force from time to time, listed in column 2 for the corresponding condition, or the meaning given in any subsequent Statement of Principles, as in force from time to time, for that condition.
Column 1 |
Column 2 | |
1. | Achilles Tendinopathy and Bursitis | subsection 7(2) of the Statement of Principles concerning Achilles Tendinopathy and Bursitis (Balance of Probabilities) (No. 97 of 2015) |
2. | Chondromalacia Patella
| paragraph 3(b) of the Statement of Principles concerning Chondromalacia Patella (Balance of Probabilities) (No. 80 of 2010) |
3. | Cut, Stab, Abrasion and Laceration
| subsection 7(2) of the Statement of Principles concerning Cut, Stab, Abrasion and Laceration (Balance of Probabilities) (No. 54 of 2016) |
4. | Dislocation
| paragraph 3(b) of the Statement of Principles concerning Dislocation (Balance of Probabilities) (No. 25 of 2010) |
5. | Fracture
| subsection 7(2) of the Statement of Principles concerning Fracture (Balance of Probabilities) (No. 95 of 2015) |
6. | Internal Derangement of the Knee
| paragraph 3(b) of the Statement of Principles concerning Internal Derangement of the Knee (Balance of Probabilities) (No. 52 of 2010) |
7. | Intervertebral Disc Prolapse
| subsection 7(2) of the Statement of Principles concerning Intervertebral Disc Prolapse (Balance of Probabilities) (No. 44 of 2016) |
8. | Joint Instability
| paragraph 3(b) of the Statement of Principles concerning Joint Instability (Balance of Probabilities) (No. 33 of 2010) |
9. | Labral Tear
| paragraph 3(b) of the Statement of Principles concerning Labral Tear (Balance of Probabilities) (No. 95 of 2010) |
10. | Lumbar Spondylosis
| paragraph 3(b) of the Statement of Principles concerning Lumbar Spondylosis (Balance of Probabilities) (No. 63 of 2014) |
11. | Non-melanotic Malignant Neoplasm of the Skin
| subsection 7(2) of the Statement of Principles concerning Non-melanotic Malignant Neoplasm of the Skin (Balance of Probabilities) (No. 8 of 2016) |
12. | Osteoarthritis
| paragraph 3(b) of the Statement of Principles concerning Osteoarthritis (Balance of Probabilities) (No. 14 of 2010) |
13. | Plantar Fasciitis
| paragraph 3(b) of the Statement of Principles concerning Plantar Fasciitis (Balance of Probabilities) (No. 52 of 2015) |
14. | Rotator Cuff Syndrome
| paragraph 3(b) of the Statement of Principles concerning Rotator Cuff Syndrome (Balance of Probabilities) (No. 101 of 2014) |
15. | Sensorineural Hearing Loss
| paragraph 3(b) of the Statement of Principles concerning Sensorineural Hearing Loss (Balance of Probabilities) (No. 6 of 2011) |
16. | Shin Splints
| paragraph 3(b) of the Statement of Principles concerning Shin Splints (Balance of Probabilities) (No. 10 of 2015) |
17. | Solar Keratosis
| paragraph 3(b) of the Statement of Principles concerning Solar Keratosis (Balance of Probabilities) (No. 74 of 2012) |
18. | Sprain and Strain
| paragraph 3(b) of the Statement of Principles concerning Sprain and Strain (Balance of Probabilities) (No. 95 of 2011) |
19. | Thoracic Spondylosis
| paragraph 3(b) of the Statement of Principles concerning Thoracic Spondylosis (Balance of Probabilities) (No. 65 of 2014) |
20. | Tinnitus
| paragraph 3(b) of the Statement of Principles concerning Tinnitus (Balance of Probabilities) (No. 34 of 2012) |
Part 2 - Specified classes of person
7 Former members, part-time reservists etc.
For paragraphs 88A(1)(a) and (d) of the Act, the following class of person is specified:
(1) A person who:
(a) on or after 1 July 2017 and before 1 April 2019, makes:
(i) a defence-related claim within the meaning of section 141 of the SRCA, or, if the DRCA is in force, a defence-related claim within the meaning of section 141 of the DRCA; or
(ii) a claim under paragraph 319(1)(a) of the MRCA; and
(b) that claim relates to one or more specified conditions; and
(c) prior to making the claim, the person had rendered defence service within the meaning of paragraph 6(1)(d) of the MRCA; and
(d) at the time of making the claim, the person is either:
(i) a former member, part-time Reservist, cadet or declared member; or
(ii) a member of the Defence Force who, after the claim is made and before 1 April 2019, becomes a former member.
(2) A person specified in subparagraph (1)(d)(ii) is included in the class only from the time that person becomes a former member.
8 Current full-time ADF members
For paragraphs 88A(1)(a) and (d) of the Act, the following class of person is specified:
A person who:
(a) on or after 1 July 2017 and before 1 April 2019 makes a claim under paragraph 319(1)(a) of the MRCA; and
(b) that claim relates to one or more specified conditions; and
(c) at the time of making the claim, the person is a member who is entitled to medical and dental treatment under section 49 of the Defence Regulation 2016; and
(d) in respect of whom, the Commission has made a determination under paragraph 279(d) of the MRCA that it is more appropriate to provide treatment for the person’s injury or disease under Part 3 of Chapter 6 of the MRCA than to provide treatment under section 49 of the Defence Regulation 2016.
Part 3 - Specified treatment
9 Treatment
For the classes of persons specified in Part 2 of this instrument, the following kind of treatment is specified:
(1) Treatment that:
(a) can be applied to a specified condition, under, and subject to:
- the Treatment Principles; or
- the Pharmaceutical Benefits Scheme; or
- the Private Patient Principles; or
- an arrangement between the Repatriation Commission and a health care provider pursuant to Part V of the Act; and
(b) is appropriate having regard to the nature of the claim and the specified conditions involved in that claim; and
(c) is provided within the 2-year trial period from 1 July 2017 to 30 June 2019.
(2) Entitlement to treatment for a specified condition under this instrument ceases on the making of a determination at primary level, or on application for review or appeal, to refuse liability in respect of the specified condition.