Veterans Medical and Other Treatment

Contributed by Robin Creyke and Peter Sutherland and current to July 2018.

Medical Treatment - VEA

The Commission may provide medical and other treatment for eligible veterans under Part V VEA. A veteran of a Commonwealth country, or an allied country is not a ‘veteran’ for this purpose. Treatment comprises:

• Restoration or maintenance of physical or mental health;
• Alleviating suffering;
• Ensuring social well-being by:
  • Providing accommodation, medical procedures, nursing care, social or domestic assistance or transport;
  • Supplying renewal, maintenance and repair of artificial replacements, surgical and other aids and appliances; and
  • Provision of diagnostic and counselling services.

For a discussion of treatment, see Re Beh and Repatriation Commission [1994] AATA 159; (1994) 35 ALD 138 and Re Germain and Repatriation Commission [2015] AATA 473; (2015) 146 ALD 452. Treatment Principles set out the criteria for treatment of a particular kind or class, of treatment, and there are also Repatriation Private Treatment Principles setting out the circumstances in which treatment will be provided to veterans as private patients.

Eligibility for different standards of treatment are evidenced by possession of a Gold Card, a White Card, or an Orange Card. The Gold Card covers treatment and health services for all conditions; the White Card covers treatment for specified conditions only; and the Orange Card provides pharmaceutical benefits for eligible Commonwealth and allied veterans and mariners. Disability and service pensioners are eligible for a treatment card.

Eligibility for conditions including cancer, tuberculosis, PTSD, alcohol use disorder or substance use disorder is available regardless of whether the veteran is entitled to treatment for other conditions. Treatment is backdated 3 months from the date of application permitting reimbursement of treatment costs incurred during this period.

Review of VEA treatment decisions

There is no right of internal review, or external review by the VRB or the AAT of decisions relating to medical treatment under the VEA. A decision can be judicially reviewed by the Federal Court. A decision that a person is not a ‘veteran’ for treatment purposes is not reviewable by the AAT.

Medical Treatment - MRCA

In Chapter 6 MRCA, Part 2 “Compensation for Treatment Costs” provides for reimbursement to an injured member of the costs of treatment which it was reasonable for the member to obtain in the circumstances. The amount of compensation is the amount the MRCC considers reasonable but it must not be more than the amount actually incurred in obtaining treatment: s 276(1). Reimbursement of treatment costs under Pt 2 is based on s 16 SRCA and is referred to as “Treatment Pathway 1”.

Part 3 “Entitlement to provision of treatment” in Chapter 6 MRCA provides for direct provision of treatment through the use of Repatriation Health Cards and arrangements with hospitals for treatment. This method of provision of treatment is based on treatment arrangements under the VEA and is referred to as “Treatment Pathway 2”.

Over time, the Department is moving towards the use of Health Cards and arrangements with health service providers for most of its treatment and health support for veterans, whether under the MRCA, the VEA or SRCA/DRCA.

The provision of treatment under the MRCA is governed by Principles made under s 286 of the Act:

• MRCA Treatment Principles (MRCC 53 of 2013; F2013L02016);
• MRCA Private Patient Principles 2004 (MRCC 33/2015; F2015L01339);
• MRCA Pharmaceutical Benefits Scheme (MRCC 44/2013; F2013L02012).