In 1994 the Australian government introduced legislation to reform the process of decision-making about disease causation. The aim was to create a more equitable and consistent system of dealing with claims for disability pensions received from Australian veterans and their dependants. One of the outcomes of the legislative reform was the formation of the Repatriation Medical Authority (RMA) which is an independent statutory authority responsible to the Minister for Veterans’ Affairs.

The RMA consists of a panel of five practitioners eminent in fields of medical science. Their role is to determine Statements of Principles (SOPs) for any disease, injury or death that could be related to military service, based on sound medical-scientific evidence. The SOPs state the factors which “must” or “must as a minimum” exist to cause a particular kind of disease, injury or death. The Canadian equivalent of the Australian SOPs is the Entitlement Eligibility Guidelines (EEGs).

The SOPs are binding on the various decision makers. The matters of fact relating to an individual veteran’s case, including the nature of service and any connection between eligible service and the factors in the SOPs, are still determined, however, by the various decision makers which include the Repatriation Commission, the Military Rehabilitation and Compensation Commission, the Veterans’ Review Board and the Administrative Appeals Tribunal.

At their meeting of April 14, 2010, the RMA determined SOPs for a number of conditions including, cluster headache, Alzheimer-type dementia and non-Hodgkin’s lymphoma. The RMA also amended the SOPs for lumbar spondylosis, depressive disorder and anxiety disorder.

The RMA meets regularly to review and update the SOPs. In Canada, Veterans Affairs Canada has no such mechanism. The VAC Entitlement Eligibility Guidelines, according to VAC’s website, are based on evidence from credible and peer-reviewed medical research and literature. A major source of the review with respect to the medical-scientific research on causation and aggravation was from the Australian Department of Veterans Affairs. Also reviewed and of equal importance were medical texts, journals and other sources of information deemed reliable and reflective of accepted medical theory and practice at the time of writing of the guidelines.

VAC recognizes that medicine is an ever-changing science and because of the rapidity of such change, the guidelines are not purported to be fully comprehensive commentaries on any given condition. The reality is that the last substantive non-administrative amendment to the EEGs was published in 2006. The RMA has published an SOP for alcohol dependence and alcohol abuse since 2008. The RMA reviews their SOPs on a quarterly basis. VAC’s EEG dealing with alcohol dependence is still in draft form. Other countries like the United States also have more proactive tools to determine veterans’ eligibility for benefits.

In 2008, the U.S. Department of Veterans Affairs has determined that veterans with Amyotrophic Lateral Sclerosis (ALS) are eligible for full health care and disability benefits. VAC is still studying this issue.