Introduction to the RMA – Repatriation Medical Authority



SUMMARY OF CHANGES:INSTRUMENT NOS. 36 to 43 OF 2017Statements of Principles (SOPs) Nos. 36 to 43 of 2017 were signed by the Chairperson of the Repatriation Medical Authority (the Authority) on 30 June 2017. The Instruments have been lodged and registered with the Federal Register of Legislation, pursuant to section 15G of the Legislation Act 2003 (Legislation Act). The day of commencement as specified in each of the Statements of Principles is 31 July 2017. In accordance with the Legislation Act, the Office of Parliamentary Counsel must generally deliver a legislative instrument for laying before each House of the Parliament within six sitting days of that House after the instrument is registered with the instrument’s registered explanatory statement. The Instruments and the associated Explanatory Statements registered with the Federal Register of Legislation are available from: of each Instrument, the associated Explanatory Statement and a list of references relating to each Instrument, are available in accordance with the Veterans' Entitlements Act 1986 (the VEA), on written request from the RMA Secretariat.The 'User Guide to the RMA Statements of Principles' explains the meaning and purpose of each section of the new SOP template which commenced in 2015. This document is available on the Authority's website further information contact:The RegistrarRepatriation Medical AuthorityGPO Box 1014Brisbane Qld 4001T +61 7 3815 9404F +61 7 3815 9412E info@.au7 July 2017SUMMARY OF CHANGESInstr. No.TitleDate of CommencementICD-10-AM CodesREVOCATIONS36 & 37/2017labral tear31/07/2017Nil38 & 39/2017accommodation disorder31/07/2017H52.540 & 41/2017sickle-cell disorder31/07/2017D57DETERMINATIONS42 & 43/2017femoroacetabular impingement syndrome31/07/2017NilSUMMARY OF CHANGES36 & 37/2017labral tearThese Instruments result from an investigation notified by the Authority in the Government Notices Gazette of 10 January 2017 concerning labral tear 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.The contents of these Instruments are in similar terms as the revoked Instruments. Comparing these Instruments and the revoked Instruments, the differences include:For RH & BoP SoPs (Instrument Nos. 36 & 37/2017)adopting the latest revised Instrument format, which commenced in 2015;specifying a day of commencement for the Instrument in section 2;revising the definition of 'labral tear' in subsection 7(2);revising the factor in subsection 9(2) concerning 'performing forceful and repetitive motions', with the inclusion of two notes, and with the factor now relating to the hip joint as well as the shoulder joint, for clinical onset only; new factor in subsection 9(3) concerning 'being in the third trimester of pregnancy', for labral tear of the hip joint only, for clinical onset only;new definitions of 'MRCA' and 'VEA' in Schedule 1 - Dictionary; andrevising the definition of 'relevant service' in Schedule 1 - Dictionary.The determining of these Instruments finalises the investigation in relation to labral tear as advertised in the Government Notices Gazette of 10 January 2017.38 & 39/2017accommodation disorderThese Instruments result from an investigation notified by the Authority in the Government Notices Gazette of 3 May 2016 concerning accommodation disorder 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.The contents of these Instruments are in similar terms as the revoked Instruments. Comparing these Instruments and the revoked Instruments, the differences include:For RH & BoP SoPs (Instrument Nos. 38 & 39/2017)adopting the latest revised Instrument format, which commenced in 2015;specifying a day of commencement for the Instrument in section 2;revising the definition of 'accommodation disorder' in subsection 7(2);revising the reference to 'ICD-10-AM code' in subsection 7(4);revising the factor in subsection 9(1) concerning 'an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle', by the inclusion of a note;new factors in subsections 9(2) & 9(7) concerning 'concussion';new factors in subsections 9(3) & 9(8) concerning 'moderate to severe traumatic brain injury';new factors in subsections 9(4) & 9(9) concerning 'being treated with atropine or an atropine-like drug, where the drug cannot be ceased or substituted'; new factors in subsections 9(5) & 9(10) concerning 'being treated with a drug, or a drug from a class of drugs';new factor in subsection 9(6) concerning 'an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle', for clinical worsening;new definitions of 'atropine-like drug', 'MRCA', 'specified list of drugs' and 'VEA' in Schedule 1 - Dictionary; andrevising the definitions of 'an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle' and 'relevant service' in Schedule 1 – Dictionary.The determining of these Instruments finalises the investigation in relation to accommodation disorder as advertised in the Government Notices Gazette of 3 May 2016.40 & 41/2017sickle-cell disorderThese Instruments result from an investigation notified by the Authority in the Government Notices Gazette of 2 October 2015 concerning sickle-cell disorder 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.The contents of these Instruments are in similar terms as the revoked Instruments. Comparing these Instruments and the revoked Instruments, the differences include:For RH SoP (Instrument No. 40/2017)adopting the latest revised Instrument format, which commenced in 2015;specifying a day of commencement for the Instrument in section 2;revising the definition of 'sickle-cell disorder' in subsection 7(2);revising the reference to 'ICD-10-AM code' in subsection 7(4);revising the factor in subsection 9(1) concerning 'a stimulus from Specified List 1 of stimuli', for clinical worsening only;revising the factor in subsection 9(2) concerning 'a stimulus from Specified List 2 of stimuli', for clinical worsening only;new factor in subsection 9(3) concerning 'smoking', for clinical worsening only;new factor in subsection 9(4) concerning 'second-hand smoke', for clinical worsening only;new factor in subsection 9(5) concerning 'corticosteroids', for clinical worsening only;new factor in subsection 9(6) concerning 'symptomatic asthma', for clinical worsening only;deleting the factor concerning 'experiencing a specified stimulus', for a first sickle-cell crisis only, for clinical onset;new definitions of 'a change in ambient temperature', 'being exposed to second-hand smoke', 'MRCA', 'pack-year of cigarettes, or the equivalent thereof in other tobacco products', 'puerperal period', 'Specified List 1 of stimuli', 'Specified List 2 of stimuli' and 'VEA' in Schedule 1 - Dictionary;revising the definitions of 'clinical worsening of sickle-cell disorder' and 'relevant service' in Schedule 1 - Dictionary; anddeleting the definition of 'a specified stimulus'.For BoP SoP (Instrument No. 41/2017)adopting the latest revised Instrument format, which commenced in 2015;specifying a day of commencement for the Instrument in section 2;revising the definition of 'sickle-cell disorder' in subsection 7(2);revising the reference to 'ICD-10-AM code' in subsection 7(4);revising the factor in subsection 9(1) concerning 'a stimulus from Specified List 1 of stimuli', for clinical worsening only;revising the factor in subsection 9(2) concerning 'a stimulus from Specified List 2 of stimuli', for clinical worsening only;new factor in subsection 9(3) concerning 'smoking', for clinical worsening only;new factor in subsection 9(4) concerning 'second-hand smoke', for clinical worsening only;new factor in subsection 9(5) concerning 'corticosteroids', for clinical worsening only;deleting the factor concerning 'experiencing a specified stimulus', for a first sickle-cell crisis only, for clinical onset;new definitions of 'a change in ambient temperature', 'being exposed to second-hand smoke', 'MRCA', 'pack-year of cigarettes, or the equivalent thereof in other tobacco products', 'puerperal period', 'Specified List 1 of stimuli', 'Specified List 2 of stimuli' and 'VEA' in Schedule 1 - Dictionary;revising the definitions of 'clinical worsening of sickle-cell disorder' and 'relevant service' in Schedule 1 - Dictionary; anddeleting the definition of 'a specified stimulus'.On 10 February 2017, the Authority wrote to organisations representing veterans, service personnel and their dependants regarding the proposed Instruments and the medical-scientific material considered by the Authority. This letter emphasised the deletion of factors relating to experiencing a specified stimulus, for a first sickle-cell crisis only, for clinical onset. The Authority provided an opportunity to the organisations to make representations in relation to the proposed Instruments prior to their determination. No submissions were received for consideration by the Authority. Following this consultation process, the definition of 'sickle cell crisis' was included, and minor typographical changes were made to the proposed Instruments.The determining of these Instruments finalises the investigation in relation to sickle-cell disorder as advertised in the Government Notices Gazette of 2 October 2015.42 & 43/2017femoroacetabular impingement syndromeNew ConditionThe determining of these new Instruments finalises the investigation in relation to femoro-acetabular impingement syndrome as advertised in the Government Notices Gazette of 10 January 2017. ................
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