{"id":"F2025L00496","name":"Statement of Principles concerning cervical dystonia (spasmodic torticollis) (Balance of Probabilities) (No. 42 of 2025)","slug":"statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-balance-of-probabilities-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442814,"registerId":"F2025L00496-fast-fetch-1775957745776","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning cervical dystonia (spasmodic torticollis) (Balance of Probabilities) (No. 42 of 2025)","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\nCERVICAL DYSTONIA (SPASMODIC TORTICOLLIS)  (Balance of Probabilities)\n\n(No. 42 of 2025)\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 15 April 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\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 cervical dystonia (spasmodic torticollis) (Balance of Probabilities) (No. 42 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 19 May 2025.\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 spasmodic torticollis No. 64 of 2016 (Federal Register of Legislation No. F2016L01139) 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 cervical dystonia (spasmodic torticollis) and death from cervical dystonia (spasmodic torticollis).\n\n\nMeaning of cervical dystonia (spasmodic torticollis)\n\n1.           For the purposes of this Statement of Principles, cervical dystonia (spasmodic torticollis):\n  1.           means a chronic focal dystonia characterised by sustained or intermittent involuntary neck muscle contractions, causing repetitive movements or abnormal movements or postures of the head, neck, and shoulders; and\n  2.           excludes:\n    1.             drug-induced dystonia;\n    2.          generalised or hemidystonia;\n    3.        paroxysmal dystonia;\n    4.         congenital dystonia;\n    5.           dystonia resulting from a neurological disorder;\n    6.         dystonia resulting from a structural lesion of the brain or cervical cord; and\n    7.      dystonia resulting from a local lesion of the cervical region.\n\n\nNote: A percentage of patients with cervical dystonia may have other focal or segmental (affecting adjacent body parts) dystonias.\n\n1.           While cervical dystonia (spasmodic torticollis) attracts ICD‑10‑AM code G24.3, in applying this Statement of Principles the meaning of cervical dystonia (spasmodic torticollis) is that given in subsection (2).\n2.           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 cervical dystonia (spasmodic torticollis)\n\n1.           For the purposes of this Statement of Principles, cervical dystonia (spasmodic torticollis), in relation to a person, includes death from a terminal event or condition that was contributed to by the person's cervical dystonia (spasmodic torticollis).\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 cervical dystonia (spasmodic torticollis) and death from cervical dystonia (spasmodic torticollis) 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, cervical dystonia (spasmodic torticollis) or death from cervical dystonia (spasmodic torticollis) is connected with the circumstances of a person's relevant service:\n\n1.           inability to obtain appropriate clinical management for cervical dystonia (spasmodic torticollis) 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 factor set out in subsection 9(1) applies only to material contribution to, or aggravation of, cervical dystonia (spasmodic torticollis) where the person's cervical dystonia (spasmodic torticollis) 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                               cervical dystonia (spasmodic torticollis)—see subsection 7(2).\n\n                             MRCA means the Military Rehabilitation and Compensation Act 2004.\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 replaces the 2016 Statement of Principles for the same condition (spasmodic torticollis). The scope remains tightly focused on establishing the medical criteria for linking cervical dystonia to veterans' service. The narrow 'single factor' approach (inability to obtain clinical management) appears consistent with the original intent of these instruments — to provide specific, evidence-based pathways for compensation rather than broad entitlements. No significant scope creep is evident."},"complexity_factors":["Short document (approximately 1,500 words)","Only 5 defined terms in the Dictionary (cervical dystonia, MRCA, relevant service, terminal event, VEA)","Single causal factor in section 9 (inability to obtain appropriate clinical management)","Minimal cross-referencing — only refers to the VEA and MRCA for service definitions","Clear exclusion list in section 7(2)(b) with 7 specific exclusions","Simple conditional structure: one factor must exist + must relate to service + special rule for pre-existing conditions"],"plain_english_summary":"This instrument updates the rules for claiming compensation for cervical dystonia, narrowly defining the condition (and excluding drug‑induced, congenital, or brain‑injury causes) and replacing a 2016 policy. It applies to veterans and current/former defence members claiming under the VEA or MRCA for specified non‑hazardous or peacetime service. Crucially, the only service link allowed is inability to obtain appropriate medical treatment during service, making successful claims difficult without clear evidence."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2016 Statement of Principles (s4) and replaces it with new criteria. The operative scope now requires at least one specific factor (inability to obtain appropriate clinical management before clinical worsening) to establish connection (s9(1)), sets explicit exclusions to the meaning of cervical dystonia (s7(2)), and clarifies inclusion of death via terminal events (s7(4) and Schedule 1). Relationship‑to‑service limitations for material contribution/aggravation are restated (s10(2))."},"complexity_factors":["Medical definition with multiple explicit exclusions (drug‑induced, generalised, paroxysmal, congenital, neurological disorder causes, structural brain/cervical cord lesion, local cervical lesion) — s7(2).","Single statutory causal factor required that is factual and open to evidential dispute: 'inability to obtain appropriate clinical management before clinical worsening' — s9(1).","Relation‑to‑service nuance: factor only applies for material contribution/aggravation where condition pre‑existed or was suffered before/during but did not arise out of service — s10(2).","Inclusion of death from the condition via contribution to a terminal event, requiring medical causation analysis — s7(4) and Schedule 1 (terminal event).","Interaction with other Statements of Principles where factors refer to other injuries/diseases, creating interdependence and interpretive complexity — s11.","Reference to ICD‑10‑AM code without relying solely on it, adding an indexing layer to medical classification — s7(3).","Repeal of prior 2016 Statement of Principles may require transitional or comparative interpretation for existing claims — s4."],"plain_english_summary":"This instrument sets the medical criteria the Repatriation Medical Authority uses to decide, on the balance of probabilities, whether cervical dystonia (spasmodic torticollis) or death from it is connected to a person’s service for claims under the Veterans' Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004. It affects veterans and serving members making those claims. It defines the condition (with specific exclusions) and requires at least one factor — inability to obtain appropriate clinical management before clinical worsening — and includes death via a terminal event."},"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-cervical-dystonia-spasmodic-torticollis-balance-of-probabilities-","history":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-balance-of-probabilities-/history","analysis":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-balance-of-probabilities-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-balance-of-probabilities-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-balance-of-probabilities-/important-cases","documents":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-balance-of-probabilities-/documents"}}