{"id":"F2025L01629","name":"Statement of Principles concerning bruxism (Reasonable Hypothesis) (No. 7 of 2026)","slug":"statement-of-principles-concerning-bruxism-reasonable-hypothesis-no-7-of-2026","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443108,"registerId":"F2025L01629-fast-fetch-1775958027965","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning bruxism (Reasonable Hypothesis) (No. 7 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\nBRUXISM  (Reasonable Hypothesis)\n\n(No. 7 of 2026)\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    19 December 2025\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   \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 bruxism (Reasonable Hypothesis) (No. 7 of 2026).\n\n1.                Commencement\n\n\n              This instrument commences on 19 January 2026.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning bruxism (Reasonable Hypothesis) (No. 91 of 2016) (Federal Register of Legislation No. F2016L01672) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\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\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 bruxism and death from bruxism.\n\n\nMeaning of bruxism\n\n1.           For the purposes of this Statement of Principles, bruxism means a disorder of jaw muscle activity characterised by repetitive, involuntary clenching or grinding of the teeth or by bracing or thrusting of the mandible, occurring during wakefulness or sleep.\n2.           While bruxism attracts ICD‑10‑AM code G47.63 or F45.8, in applying this Statement of Principles the meaning of bruxism 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 bruxism\n\n1.           For the purposes of this Statement of Principles, bruxism, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's bruxism.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that bruxism and death from bruxism 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\n1.                Factors that must exist\n\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 bruxism or death from bruxism with the circumstances of a person's relevant service:\n\n1.           experiencing a moderate to severe traumatic brain injury within the 30 days before clinical onset or clinical worsening;\n2.           having a clinically significant neurological condition as specified at the time of the clinical onset or clinical worsening;\n\n\nNote: clinically significant neurological condition as specified is defined in the Schedule 1 - Dictionary.\n\n1.           having one of the following clinically significant disorders of mental health at the time of clinical onset or clinical worsening:\n  1.            anxiety disorder;\n  2.            depressive disorder;\n  3.            posttraumatic stress disorder;\n\n\nNote: clinically significant disorder of mental health is defined in the Schedule 1 dictionary.\n\n1.           taking any of the following at the time of the clinical onset or clinical worsening;\n  1.           amphetamines or amphetamine derivatives, including methamphetamine, 3,4-methylenedioxymethamphetamine (ecstasy or MDMA);\n  2.           antipsychotics;\n  3.           cocaine;\n  4.           dexamphetamine;\n  5.           flunarizine;\n  6.            levodopa;\n  7.           methylphenidate;\n  8.           selective serotonin reuptake inhibitors;\n  9.             serotonin and noradrenaline (norepinephrine) reuptake inhibitors;\n2.           consuming an average of at least 30 grams of alcohol per day for a continuous period of 6 months before the clinical onset or clinical worsening;\n\n\nNote: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink\n\n1.           consuming an average of at least 6 cups of caffeinated coffee per day, daily during the 6 months before clinical onset or clinical worsening;\n2.           having gastro-oesophageal reflux disease at the time of the clinical onset or clinical worsening;\n3.           inability to obtain appropriate clinical management for bruxism 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 subsection 9 apply only to material contribution to, or aggravation of, bruxism where the person's bruxism 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(2) 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                               bruxism—see subsection 7(2).\n\n                               clinically significant disorder of mental health means a disorder of mental health which is of sufficient severity to warrant ongoing management.\n\nNote: To warrant ongoing management does not require that any actual management was received or given for the condition.\n\n                                clinically significant neurological condition as specified means one of the following conditions:\n\n(a)          cerebrovascular accident;\n\n(b)          craniocervical dystonia;\n\n(c)          Huntington's chorea;\n\n(d)          multiple sclerosis;\n\n(e)          Parkinson disease and Secondary Parkinsonism; \n\n(f)           subarachnoid haemorrhage; or\n\n(g)          subdural haematoma.\n\nNote: craniocervical dystonia is also defined in the Schedule 1 - Dictionary.\n\n                               craniocervical dystonia means cervical, facial, cranial or oromandibular dystonia, including spasmodic torticollis.\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":{"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"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the standard scope of Repatriation Medical Authority Statements of Principles. It replaces the 2016 version (No. 91 of 2016) with updated medical evidence but does not expand beyond the established purpose of determining service-related causation for specific medical conditions. The structure and application provisions remain consistent with the legislative framework established under section 196B(2) of the Veterans' Entitlements Act 1986."},"complexity_factors":["Moderate cross-referencing between the main body and Schedule 1 dictionary (8 defined terms)","Nested definitions requiring lookup (e.g., 'clinically significant neurological condition as specified' contains a list of 7 specific conditions, one of which—craniocervical dystonia—is itself defined)","Conditional logic requiring temporal relationships (e.g., 'within 30 days before', 'continuous period of 6 months before')","Dual legislative framework application (VEA and MRCA with different service categories)","Specific quantitative thresholds (30g alcohol/day, 6 cups coffee/day) requiring calculation standards","Exception handling for clinical worsening versus initial onset (section 10(2))","Circular reference mechanism in section 11 linking to other Statements of Principles"],"plain_english_summary":"This instrument sets when Australian Defence Force members and veterans can claim compensation for bruxism (teeth grinding or jaw clenching) as being related to their service. It applies under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 and updates prior guidance with current evidence.\n\nIt lists medical factors that create a “reasonable hypothesis” linking bruxism to service—including recent traumatic brain injury, certain neurological or mental disorders, some medications, heavy alcohol or caffeine use, GERD, or inadequate treatment—so eligible veterans can access treatment and compensation under clear, evidence-based rules."},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the earlier Statement of Principles concerning bruxism (No. 91 of 2016) (see section 4), so it replaces the prior legal instrument. The current text defines bruxism, includes death from bruxism, specifies a set of medical and exposure factors and temporal windows, and ties application to claims under the VEA (s120A) and MRCA (s338) (see sections 5, 7, 9 and Schedule 1). Without the prior Statement text provided here, specific direction or magnitude of any substantive change from the 2016 instrument cannot be determined from this instrument alone."},"complexity_factors":["Multiple medical criteria and categories to interpret (neurological conditions, mental‑health disorders, substance and medication lists, GERD) (see section 9 and Schedule 1).","Temporal linkage and onset/worsening rules (e.g. 30‑day window for traumatic brain injury; 6‑month periods for substance/alcohol/caffeine) (see section 9).","Requirement that listed factors be shown to be related to 'relevant service' and distinction between clinical onset and clinical worsening (see section 10).","Cross‑reference to other Statements of Principles where a factor is itself an injury/disease covered elsewhere (see section 11).","Defined terms and qualifiers that affect application (definitions in Schedule 1, ICD‑10‑AM code reference) and notes that modify interpretation (see Schedule 1 and section 7).","Repeal and replacement of a prior Statement (No. 91 of 2016), requiring practitioners/assessors to track the current instrument in force (see section 4).","Quantitative standards embedded (alcohol grams per day, caffeinated coffee cups, ICD code reference, Australian Standard drink definition) that impose evidentiary demands (see section 9 and section 7(3)).","Inclusion of death from bruxism and definition of 'terminal event' broadens types of outcomes assessors must consider (see sections 7 and Schedule 1)."],"plain_english_summary":"This Statement of Principles sets the medical and causal tests a veteran must meet to link bruxism (repetitive jaw clenching or teeth grinding) — and death where bruxism contributed — to their military service for claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. It lists the clinical factors (e.g. recent moderate–severe traumatic brain injury, specified neurological or mental‑health conditions, certain drugs/substances, sustained high alcohol/caffeine intake, GERD, or lack of appropriate management) that must be related to the person’s relevant service."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-bruxism-reasonable-hypothesis-no-7-of-2026","history":"/api/acts/statement-of-principles-concerning-bruxism-reasonable-hypothesis-no-7-of-2026/history","analysis":"/api/acts/statement-of-principles-concerning-bruxism-reasonable-hypothesis-no-7-of-2026/analysis","conflicts":"/api/acts/statement-of-principles-concerning-bruxism-reasonable-hypothesis-no-7-of-2026/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-bruxism-reasonable-hypothesis-no-7-of-2026/important-cases","documents":"/api/acts/statement-of-principles-concerning-bruxism-reasonable-hypothesis-no-7-of-2026/documents"}}