{"id":"F2023L00496","name":"Statement of Principles concerning alpha-1 antitrypsin deficiency (Balance of Probabilities) (No. 34 of 2023)","slug":"statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-balance-of-probabilities-no-34-of-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441838,"registerId":"F2023L00496-fast-fetch-1775957027455","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning alpha-1 antitrypsin deficiency (Balance of Probabilities) (No. 34 of 2023)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 22.10.0\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nALPHA-1 ANTITRYPSIN DEFICIENCY (Balance of Probabilities)\n\n(No. 34 of 2023)\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 24 April 2023.\n\n \n\n \n\n \n\n \n\n \n\n| The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:
|\n| --- |\n|
Professor Terence Campbell AM
Chairperson
|\n\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\n1 Name\n\nThis is the Statement of Principles concerning alpha-1 antitrypsin deficiency (Balance of Probabilities) (No. 34 of 2023).\n\n2 Commencement\n\n This instrument commences on 23 May 2023.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning alpha-1 antitrypsin deficiency No. 30 of 2015 (Federal Register of Legislation No. F2014L01840) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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\n6 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about alpha-1 antitrypsin deficiency and death from alpha-1 antitrypsin deficiency.\n\nMeaning of alpha-1 antitrypsin deficiency\n\n(2) For the purposes of this Statement of Principles, alpha-1 antitrypsin deficiency means a genetic disorder of plasma protein metabolism which involves reduced serum levels of alpha-1 antitrypsin.\n\nNote: Common clinical manifestations include emphysema and cirrhosis of the liver.\n\nDeath from alpha-1 antitrypsin deficiency\n\n(3) For the purposes of this Statement of Principles, alpha-1 antitrypsin deficiency, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's alpha-1 antitrypsin deficiency.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that alpha-1 antitrypsin deficiency and death from alpha-1 antitrypsin deficiency 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\n9 Factors that must exist\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, alpha-1 antitrypsin deficiency or death from alpha-1 antitrypsin deficiency is connected with the circumstances of a person's relevant service:\n\n(1) having smoked tobacco products in an amount of at least 5 pack-years before the clinical worsening of alpha-1 antitrypsin deficiency;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(2) inability to obtain appropriate clinical management for alpha-1 antitrypsin deficiency.\n\n10 Relationship to service\n\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\n(2) The factors set out in subsections 9(1) and 9(2) apply only to material contribution to, or aggravation of, alpha-1 antitrypsin deficiency where the person's alpha-1 antitrypsin deficiency was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nIn this Statement of Principles:\n\n(1) if a factor referred to in section 9 applies in relation to a person; and\n\n(2) 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\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 alpha-1 antitrypsin deficiency—see subsection 7(2).\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n one pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.\n\nNote 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.\n\nNote 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.\n\n relevant service means:\n\n(a) eligible war service (other than operational service) under the VEA;\n\n(b) defence service (other than hazardous service and British nuclear test defence service) under the VEA; or\n\n(c) peacetime service under the MRCA.\n\nNote: MRCA and VEA are also 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":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the same narrow scope as its 2015 predecessor and other Statements of Principles. It addresses only the specific medical condition (alpha-1 antitrypsin deficiency) and the limited circumstances under which it can be service-connected for veterans' compensation. There is no evidence of scope creep; the instrument follows the standard RMA template for determining liability for genetic conditions under the veterans' compensation scheme."},"complexity_factors":["Short document: approximately 3 pages with 11 operative sections","Only 7 defined terms in the Dictionary (Schedule 1)","Simple conditional structure: only 2 alternative factors in section 9 (smoking or lack of treatment)","Single cross-reference mechanism in section 11 (referencing other Statements of Principles)","Limited nesting: section 10 contains one condition limiting application to pre-existing conditions only","Standardised template format common to all Repatriation Medical Authority Statements of Principles"],"plain_english_summary":"This instrument sets when alpha‑1 antitrypsin deficiency — a pre‑existing genetic lung/liver condition — can be treated as service‑related for compensation claims by veterans and current/former defence members. It replaces the 2015 rules and allows claims only for aggravation of an existing condition, not causation.\n\nA successful claim requires at least one factor: prior smoking of at least 5 pack‑years before deterioration, or inability to obtain appropriate medical treatment."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals Statement No. 30 of 2015 (section 4) and replaces it with the current criteria. The replacement sets explicit qualifying factors (smoking ≥5 pack‑years or inability to obtain appropriate clinical management) and requires those factors to be related to the person's relevant service for VEA (section 5) and MRCA claims. It therefore changes the operative test claimants must meet and the evidentiary focus to exposure, treatment access, and service connection (sections 7–11; Schedule 1)."},"complexity_factors":["Cross‑reference to other legislation and definitions (VEA, MRCA, relevant service) that determine applicability (sections 3, 5; Schedule 1).","Evidentiary standard and causation framework: uses the civil standard 'balance of probabilities' for medical causation (section 8).","Quantified exposure metric for smoking (5 pack‑years) with specific calculation rules and tobacco‑equivalents in the Dictionary, creating precise proof requirements (section 9(1); Schedule 1).","Open‑ended medical/discretionary criterion 'inability to obtain appropriate clinical management' which requires factual proof and administrative evaluation (section 9(2)).","Service‑relation constraint that factors must be 'related to the relevant service' and only apply where the condition was suffered or contracted before or during (but did not arise out of) service, introducing a temporal and causal nuance (section 10).","Interaction with other Statements of Principles: if a factor refers to another covered injury/disease, the other Statement applies as in force, creating dependency across instruments (section 11).","Repeal and replacement of the 2015 Statement requires stakeholders to map prior findings to the new criteria (section 4)."],"plain_english_summary":"This instrument replaces the prior Statement of Principles and sets the medical‑legal test for linking alpha‑1 antitrypsin deficiency (and deaths from it) to Australian defence service for VEA and MRCA claims. A claim meets the balance‑of‑probabilities test only if at least one listed factor applies (smoking ≥5 pack‑years before clinical worsening, or inability to obtain appropriate clinical management) and that factor is related to the claimant’s relevant service. It requires evidence of exposure, treatment access, and service connection."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-balance-of-probabilities-no-34-of-","history":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-balance-of-probabilities-no-34-of-/history","analysis":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-balance-of-probabilities-no-34-of-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-balance-of-probabilities-no-34-of-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-balance-of-probabilities-no-34-of-/important-cases","documents":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-balance-of-probabilities-no-34-of-/documents"}}