{"id":"F2023L00495","name":"Statement of Principles concerning alpha-1 antitrypsin deficiency (Reasonable Hypothesis) (No. 33 of 2023)","slug":"statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-reasonable-hypothesis-no-33-of-202","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441839,"registerId":"F2023L00495-fast-fetch-1775957027489","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 (Reasonable Hypothesis) (No. 33 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 (Reasonable Hypothesis)\n\n(No. 33 of 2023)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) 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 (Reasonable Hypothesis) (No. 33 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning alpha-1 antitrypsin deficiency No. 29 of 2015 (Federal Register of Legislation No. F2014L01837) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that alpha-1 antitrypsin deficiency and death from alpha-1 antitrypsin deficiency can be related to relevant service rendered by veterans, members of Peacekeeping Forces, 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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting alpha-1 antitrypsin deficiency or death from alpha-1 antitrypsin deficiency 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(2) 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) 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 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 its original narrow scope. It is a standard Repatriation Medical Authority Statement of Principles that applies the established 'reasonable hypothesis' framework to a single medical condition (alpha-1 antitrypsin deficiency). The 2023 version replaces the 2015 version without expanding beyond the original purpose of determining service connection factors for this specific genetic disorder."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 7 defined terms in the Dictionary (Schedule 1)","Simple binary test structure: only 2 alternative factors in section 9","Minimal cross-referencing — primarily internal references to the Dictionary and parent Acts","No nested exceptions or conditional logic beyond the basic 'at least one factor' requirement","Straightforward application limited to aggravation of pre-existing condition (section 10(2))","Single purpose instrument: establishes one specific medical connection test for one specific condition"],"plain_english_summary":"This instrument sets the medical rule for whether Australian veterans and current/former defence personnel with alpha‑1 antitrypsin deficiency (or death from it) can get compensation. It applies to claims under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004.\n\nIt applies a \"reasonable hypothesis\" test to worsening of a pre‑existing genetic condition, requiring either a qualifying smoking history (≥5 pack‑years before worsening) or lack of medical care. It replaces and updates the 2015 guidance."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the earlier Statement of Principles No. 29 of 2015 (s.4) and replaces it with the current criteria. It now specifies two discrete qualifying factors (≥5 pack‑years smoking before clinical worsening; inability to obtain appropriate clinical management) and clarifies that those factors only operate as material contribution or aggravation where the condition was suffered or contracted before or during, but did not arise out of, relevant service (s.9; s.10(2)). The exact differences from the 2015 instrument cannot be determined from this document alone."},"complexity_factors":["Causation standard framed as a 'reasonable hypothesis' and operationalised via specified factors (s.8–9).","Defined technical terms and cross-references concentrated in Schedule 1 (alpha‑1 antitrypsin deficiency, pack‑year, relevant service, terminal event, VEA, MRCA).","Quantified exposure threshold (minimum 5 pack‑years) plus conversion and calculation rules (s.9(1); Schedule 1).","Clinical criteria that require medical judgment (eg. 'inability to obtain appropriate clinical management'; death from terminal event) (s.7(2)–(3); s.9(2); Schedule 1).","Application limited to material contribution or aggravation where the disease was suffered/contracted before or during (but did not arise out of) service, adding a temporal/causal nuance (s.10(2)).","Interaction with other Statements of Principles where overlapping injuries/diseases exist (s.11).","Instrument-level actions: repeal of the 2015 Statement and commencement timing (s.2–4), and constrained application to specific claim provisions (s.5)."],"plain_english_summary":"This Statement of Principles sets the medical criteria the Repatriation Medical Authority uses to decide if alpha‑1 antitrypsin deficiency (including death) can be connected to a person’s military service for claims under the Veterans' Entitlements Act or the MRCA. It requires at least one qualifying factor — smoking of 5 or more pack‑years before clinical worsening, or inability to obtain appropriate clinical management — and that the factor be related to the person’s relevant service. It repeals the 2015 Statement."},"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-alpha-1-antitrypsin-deficiency-reasonable-hypothesis-no-33-of-202","history":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-reasonable-hypothesis-no-33-of-202/history","analysis":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-reasonable-hypothesis-no-33-of-202/analysis","conflicts":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-reasonable-hypothesis-no-33-of-202/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-reasonable-hypothesis-no-33-of-202/important-cases","documents":"/api/acts/statement-of-principles-concerning-alpha-1-antitrypsin-deficiency-reasonable-hypothesis-no-33-of-202/documents"}}