{"id":"F2026L00146","name":"Statement of Principles concerning accommodation disorder (Balance of Probabilities) (No. 22 of 2026)","slug":"statement-of-principles-concerning-accommodation-disorder-balance-of-probabilities-no-22-of-2026","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443155,"registerId":"F2026L00146-fast-fetch-1775958066101","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning accommodation disorder (Balance of Probabilities) (No. 22 of 2026)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nACCOMMODATION DISORDER  (Balance of Probabilities)\n\n(No. 22 of 2026)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 20 February 2026\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\n\n \n\n   \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n \n\n\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning accommodation disorder (Balance of Probabilities) (No. 22 of 2026).\n\n1.                Commencement\n\n\n              This instrument commences on 23 March 2026.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning accommodation disorder (Balance of Probabilities) (No. 39 of 2017) (Federal Register of Legislation No. F2017L00889) made under subsection 196B(3) of the VEA is repealed.\n\n1.                Application\n\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about accommodation disorder and death from accommodation disorder.\n\n\nMeaning of accommodation disorder\n\n1.           For the purposes of this Statement of Principles, accommodation disorder:\n  1.           means the inability to adjust the lens of the eye to various distances or an inability to sustain such an adjustment; and\n  2.           excludes:\n    1.             accommodative excess; and\n    2.          processes primarily affecting the lens (presbyopia and cataract) or shape of the eyeball (myopia, hypermetropia, astigmatism); and\n    3.        reversible paralysis of ciliary muscle function by means of pharmacological agents, except where such agents cannot be ceased or substituted.\n2.           While accommodation disorder attracts ICD‑10‑AM code H52.5, in applying this Statement of Principles the meaning of accommodation disorder is that given in subsection (2).\n3.           For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.\n\n\nDeath from accommodation disorder\n\n1.           For the purposes of this Statement of Principles, accommodation disorder, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's accommodation disorder.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that accommodation disorder and death from accommodation disorder can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.\n\n1.                Factors that must exist\n\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, accommodation disorder or death from accommodation disorder is connected with the circumstances of a person's relevant service:\n\n1.           having an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle of the affected eye, at the time of clinical onset or clinical worsening;\n\n\nNote: an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle is defined in the Schedule 1 – Dictionary.\n\n1.           having concussion at the time of clinical onset or clinical worsening;\n2.           having moderate to severe traumatic brain injury at the time of clinical onset or clinical worsening;\n3.           taking atropine or an atropine-like medication, where the medication cannot be ceased or substituted, at the time of clinical onset or clinical worsening;\n\n\nNote: atropine-like medication is defined in the Schedule 1 - Dictionary.\n\n1.           taking a medication from the specified list, where the medication cannot be ceased or substituted, at the time of clinical onset or clinical worsening;\n\n\nNote: medication from the specified list is defined in the Schedule 1 – Dictionary.\n\n1.           taking a medication at the time of clinical onset or clinical worsening which is associated with:\n  1.           the development of accommodation disorder during medication therapy; and\n  2.           the cessation of accommodation disorder upon discontinuing medication therapy;\n2.           inability to obtain appropriate clinical management for accommodation disorder before clinical worsening.\n\n\n1.            Relationship to service\n  1.           The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.\n  2.           The clinical worsening aspect of factors set out in section 9 apply only to material contribution to, or aggravation of, accommodation disorder where the person's accommodation disorder was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 9 applies in relation to a person; and\n2.           that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;\n\n\nthen the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\n \n\n \n\nSchedule 1 - Dictionary  \n\nNote:               See Section 6\n\n1               Definitions\n\nIn this instrument:\n\n                               accommodation disorder—see subsection 7(2).\n\n                               an injury or disorder affecting the function of the oculomotor nerve or ciliary muscle means any pathological process affecting:\n\n(a)          the brain stem or the oculomotor nerve anywhere along its course (including the oculomotor nucleus, fascicles, subarachnoid space, cavernous sinus or orbit) that leads to a disturbance in the oculomotor nerve function; or\n\n(b)          ciliary muscle function;\n\n                               and causing impairment of accommodation.\n\n                                atropine-like medication means a medication having properties similar to atropine (that is, antagonising the effects of acetylcholine at parasympathetic nerve endings).\n\nNote 1: Examples of atropine-like drugs include antispasmodic agents (for example, scopolamine), drugs used to treat overactive bladder (for example, oxybutynin), eye drops used to facilitate examination of the fundus of the eye (for example, cyclopentolate), antipsychotic agents (for example, chlorpromazine, haloperidol, clozapine), tricyclic antidepressants (for example, amitriptyline, doxepin), sedative antihistamines (for example, clemastine, diphenhydramine), the anti-depressant maprotiline, and the anti-Parkinson medications benzatropine, biperiden, procyclidine and trihexyphenidyl.\n\nNote 2: Typical symptoms and signs of atropine-like drugs are dry mouth, blurred vision, sensitivity to light, dilated pupils, lack of sweating, and rapid heartbeat.\n\n                               medication from the specified list means:\n\n(a)          amfepramone;\n\n(b)          beclomethasone dipropionate;\n\n(c)          benzylpenicillin;\n\n(d)          betamethasone dipropionate;\n\n(e)          biperiden;\n\n(f)           budesonide;\n\n(g)          carbachol;\n\n(h)          carbamazepine;\n\n(i)            chloramphenicol;\n\n(j)            chloroquine;\n\n(k)          chlorpromazine hydrochloride;\n\n(l)            cortisone acetate;\n\n(m)        cyclopentolate hydrochloride;\n\n(n)          dexamethasone;\n\n(o)          diacetylmorphine;\n\n(p)          disopyramide phosphate;\n\n(q)          dronabinol;\n\n(r)           emetine (ipecac);\n\n(s)           ethanechol;\n\n(t)            fesoterodine fumarate;\n\n(u)          fludrocortisone acetate;  \n\n(v)          fluorometholone;\n\n(w)        fluphenazine hydrochloride;\n\n(x)          fluticasone propionate;\n\n(y)          hydrocortisone;\n\n(z)          hydromorphone hydrochloride;\n\n(aa)       hydroxyamphetamine;\n\n(bb)      hydroxychloroquine;\n\n(cc)       hyoscine butylbromide;\n\n(dd)      hyoscine hydrobromide;\n\n(ee)       hyoscine methobromide;\n\n(ff)        ipratropium;\n\n(gg)      isoniazid;\n\n(hh)      lithium;\n\n(ii)         lysergic acid diethylamide;\n\n(jj)         mescaline;\n\n(kk)      methacholine (systemic administration only);\n\n(ll)         methylprednisolone;\n\n(mm) morphine sulfate;\n\n(nn)      oxcarbazepine;\n\n(oo)      oxybutynin chloride;\n\n(pp)      oxymorphone hydrochloride;\n\n(qq)      perphenazine;\n\n(rr)        pilocarpine;\n\n(ss)        pimozide;\n\n(tt)         pralidoxime chloride;\n\n(uu)      prednisolone;\n\n(vv)      prednisone;\n\n(ww)  primidone;\n\n(xx)      prochlorperazine;\n\n(yy)      procyclidine hydrochloride;\n\n(zz)       promethazine hydrochloride;\n\n(aaa)   psilocybin;\n\n(bbb)  rimexolone;\n\n(ccc)   solifenacin succinate;\n\n(ddd)  telithromycin;\n\n(eee)   thiethylperazine;\n\n(fff)      tioridazine hydrochloride;\n\n(ggg)  topiramate;\n\n(hhh)  triamcinolone acetonide;\n\n                               MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                               relevant service means:\n\n(a)          operational service under the VEA;\n\n(b)          peacekeeping service under the VEA;\n\n(c)          hazardous service under the VEA;\n\n(d)          British nuclear test defence service under the VEA;\n\n(e)          warlike service under the MRCA; or\n\n(f)           non-warlike service under the MRCA.\n\nNote: MRCA and VEA are defined in the Schedule 1 - Dictionary\n\n                               terminal event means the proximate or ultimate cause of death and includes the following:\n\n(a)           pneumonia;\n\n(b)           respiratory failure;\n\n(c)           cardiac arrest;\n\n(d)           circulatory failure; or\n\n(e)           cessation of brain function.\n\n                               VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a straightforward re-enactment and update of an existing Statement of Principles (replacing No. 39 of 2017). It maintains the same scope — determining compensation eligibility for accommodation disorder in veterans — without expanding into new areas. The medication list has been updated and expanded, but this reflects current medical knowledge rather than scope creep."},"complexity_factors":["Extensive defined terms in Schedule 1 (8 definitions including complex medical concepts like 'oculomotor nerve' and 'ciliary muscle')","Long enumerated list of 72 specific medications in the 'medication from the specified list' definition","Cross-references between multiple Acts (VEA and MRCA) and requires understanding of different service types (operational, peacekeeping, hazardous, etc.)","Nested exclusions in section 7(2) — three specific carve-outs from the definition of accommodation disorder","Conditional logic requiring medication to be 'cannot be ceased or substituted' for certain factors","Dual application structure — applies to both clinical onset AND clinical worsening with different rules for each","Incorporation by reference to external medical classification system (ICD-10-AM Tenth Edition)"],"plain_english_summary":"This rulebook sets how Australian veterans and defence personnel can qualify for compensation for accommodation disorder (difficulty focusing the eye). It establishes a seven-factor medical checklist — meeting one factor and linking it to service can support a claim — and clarifies exclusions like age-related presbyopia, cataracts, and routine refractive errors.\n\nReplacing the 2017 guidance, it updates medical evidence so service-related focusing problems are assessable for veterans’ benefits while keeping clear limits on what qualifies."},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2017 Statement of Principles (s4) and replaces it with updated definitions, exclusions and an expanded list of qualifying medications and medical factors (s7; Schedule 1). It also explicitly includes death contributed to by accommodation disorder and ties entitlement to factors documented at clinical onset or worsening (s7; s9; s10), indicating a change in the criteria and evidentiary framing that determine when relevant service is established."},"complexity_factors":["Technical medical definitions and exclusions (oculomotor nerve, ciliary muscle; exclusion of presbyopia/cataract/myopia/hypermetropia/astigmatism) (s7(2); Schedule 1).","Detailed, lengthy specified medication list with many drug classes that can trigger or be associated with accommodation disorder (Schedule 1).","Evidentiary timing requirement — factors must be present at the time of clinical onset or clinical worsening, which affects proof and record‑keeping (s9).","Requirement to establish a causal nexus between a qualifying factor and relevant service (s10), creating a legal-technical link for entitlement decisions.","Cross-references to other Statements of Principles where overlapping injuries/diseases are implicated, introducing dependency on other instruments (s11).","Application across two statutory schemes (VEA and MRCA), and repeal of a prior Statement of Principles, affecting scope and transitional considerations (s4; s5)."],"plain_english_summary":"Updates the Repatriation Medical Authority's Statement of Principles for accommodation disorder to set when the condition (and death from it) can be connected to veterans' relevant service. It defines the disorder, excludes certain lens/shape conditions, and lists medical causes and medication exposures as qualifying factors.\n\nEntitlement requires clinical evidence documented at the time of clinical onset or worsening (s9). Claimants must establish at least one qualifying factor and a causal nexus between that factor and their relevant service (s10)."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-accommodation-disorder-balance-of-probabilities-no-22-of-2026","history":"/api/acts/statement-of-principles-concerning-accommodation-disorder-balance-of-probabilities-no-22-of-2026/history","analysis":"/api/acts/statement-of-principles-concerning-accommodation-disorder-balance-of-probabilities-no-22-of-2026/analysis","conflicts":"/api/acts/statement-of-principles-concerning-accommodation-disorder-balance-of-probabilities-no-22-of-2026/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-accommodation-disorder-balance-of-probabilities-no-22-of-2026/important-cases","documents":"/api/acts/statement-of-principles-concerning-accommodation-disorder-balance-of-probabilities-no-22-of-2026/documents"}}