Submissions

Frequently Asked Questions

Who can make a submission to the Specialist Medical Review Council?

Eligible persons and organisations may make a written submission to the Specialist Medical Review Council (the Council). A person having expertise in a field relevant to the review may also make a written submission.

Written submissions should refer to the information that was available to the RMA, which is relevant to the Council’s review, rather than on an individual Repatriation case.

An eligible individual or organisation who makes a written submission, or their representative/s, may appear before the Council to make an oral submission complementing the written submission.

When should submissions be made to the Specialist Medical Review Council?

Submissions can only be made about current reviews.

The Council must publish in the Australian Government Gazette a notice of its intention to carry out a review. That notice specifies the date by which all submissions must be received.

Details of current reviews and submission dates can be viewed here.

How to make a submission to the SMRC?

Your submission provides you with the opportunity to comment on the information that was available to the RMA and which in your view supports your contentions. That information will be provided to you by the SMRC. Please contact the Secretariat before making a submission.

Please use the form below to make your submission to the Specialist Medical Review Council.

• Downloading Guidelines and a Submission Form.
• or by sending an email to: SMRC.registrar@smrc.gov.au

What information can the Review Council consider?

In carrying out its review, the Council must consider all the information that was available to the RMA when it made the decision being reviewed.

The Secretariat will provide you with access to this information. Please contact the Secretariat for details of this information.

The information that was available to the RMA when it made the decision under review is the only information the Council may review. If there is new information presented to the Council, or about which it is aware, it is possible for the Council to bring this to the attention of the RMA. A review council cannot, however, use new information to direct the RMA to amend the Statement of Principles under review.

Can submitters ask for legal assistance?

While you may seek legal or medical expert advice when preparing a submission, eligible persons and organisations may not be represented before the Specialist Medical Review Council by a legal practitioner, and submissions may not be made on legal matters.

Will submissions be kept confidential?

In preparing your submission, please be aware that under 196ZD(1) of the VEA, the Review Council may make any submissions it receives available to other parties to the review. It may also refer to, or publish, part or all of the contents of submissions in its decision document.

An author of a submission can request that all or part of the submission should remain confidential, by indicating this clearly on the front of the submission. You could also consider presenting any confidential information in an appendix to the submission to allow the body of the submission to be published.

Can I get help in making my Submission?

The Council’s secretariat staff can assist you with any questions you may have and to provide advice on how to complete a submission. Staff cannot assist you with the content of a submission however. You may wish to ask your ex-services organisation or your treating clinician for help when preparing your submission.  

Contact the Specialist Medical Review Council  at SMRC.Registrar@smrc.gov.au providing your number and asking staff to call you.

Submission Guidelines

Submissions should be structured, informative and relevant. Where medical-scientific information is submitted, it would assist the Council if:

• the articles or reports focus on causation; and
• the sources quoted are the result of a medical-scientific literature search concerning the causes of the particular injury, disease or death; and
• the material quoted or referred to, is footnoted or referenced; and
• abstracts of relevant material are attached to the submission.

Sound Medical-Scientific Evidence

Both the RMA and the SMRC must base their decisions on sound medical-scientific evidence as defined in the Veterans’ Entitlement Act (VEA), Section 5AB which states:.

1. Information about a particular kind of injury, disease or death is taken to be sound medical-scientific evidence if:
   1. the information:
      1. is consistent with material relating to medical science that has been published in a medical or scientific publication and has been, in the opinion of the Repatriation Medical Authority, subjected to a peer review process; or
      2. in accordance with generally accepted medical practice, would serve as the basis for the diagnosis and management of a medical condition; and
   2. in the case of information about how that kind of injury, disease or death may be caused—meets the applicable criteria for assessing causation currently applied in the field of epidemiology.

Quality of evidence

In assessing studies, the SMRC looks for sound medical-scientific evidence that:

• is well-designed;
• provides enough information;
• is not merely hypothesis generating exercises from large databases;
• has adequate outcome measurements; and
• has no other faults in the methodology

Websites

Website articles are not SMSE if they are opinion based, not subject to peer review, or do not meet the applicable criteria for assessing causation currently applied in the field of epidemiology.

Animal Studies

Animal studies may sometimes support the biological plausibility of an association. However, results from animal studies may not be generalisable to humans and are at best used as initial research that may indicate a need for further studies on human subjects or to demonstrate possible biological mechanisms.

Laboratory Studies

Laboratory-based studies of human cells are used in medical research for exploring potential pathological mechanisms, such as examining inflammatory responses to toxins. Processes occurring at the cellular level can be misleading as many other processes contribute to human health effects. While such studies may demonstrate biological mechanisms or generate further research, only some would lead to further discoveries, and they can often produce a range of conflicting results.

Such studies can be material that epidemiologists would consider appropriate to take into account, but the weight attached to their results when considering causes of diseases varies, and is generally relatively low compared to human studies.

Note: If you provide material which is not relevant and authoritative, this may take more time for the Council to process, lengthening the time of the review, even though it ultimately cannot be taken into account.

Accessing the Information

To assist you with your response you will be provided with access to the RMA’s information.

Please contact the Secretariat for details.

New information

You may be aware of other medical-science which was not before the RMA.

Such information is called 'new information' and cannot be used to determine the review (i.e. it cannot be used to decide whether any amendments should be made to the Statements of Principles). Only available information can be used to determine the review.

‘New information’ may include relevant information published before or after the date that the RMA determined the SoPs under review, including during the time the SMRC undertakes the review. 

In appropriate circumstances, the Review Council can consider new information for the different purpose of deciding whether there seems to be sound medical-scientific evidence apparently not previously considered by the RMA, which would justify a recommendation to the RMA that it conduct a fresh investigation into the injury, disease or death, taking the new information into account.

Any such direction or recommendation should only be made if the Council forms the view that the new information:

• comprises sound medical-scientific evidence as defined in section 5AB(2) of the VEA, being information which epidemiologists would consider appropriate to take into account; which
• in the Council's view 'touches on' (is relevant to) the contended factors; and
• has been evaluated by the Council according to epidemiological criteria.

Suggested Format

In making any written submission it would assist the SMRC if you were able to:

- satisfy the requirements of s.5AB(2) of the VEA, including how you say the information does/does not meet the applicable criteria for assessing causation currently applied in the field of epidemiology, for example, by reference to the Bradford Hill (copy attached) or other epidemiological criteria.

1. List the factors that you think cause (or do not cause) the condition;
2. Briefly describe any literature search you may have conducted;
3. List the author, title, and RMA number of any information to which you refer;
4. Set out reasons in support of your views, specifically how you say the information does or does not support your contentions;

It would also assist the SMRC, if in any analysis of the information, you were able to refer to the results of the studies and the facts, and not to the authors’ opinions or interpretations of the data in the studies.

Please footnote all medical-scientific material that you refer to or discuss and, if you have referred to sound medical-scientific evidence in the submission, attach an Appendix of References. This attachment should contain abstracts of the articles and other references that you have referred to in your submission.

For further details see The Process of Review.