{"id":"F2025L00495","name":"Statement of Principles concerning cervical dystonia (spasmodic torticollis) (Reasonable Hypothesis) (No. 41 of 2025)","slug":"statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-reasonable-hypothesis-no-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442815,"registerId":"F2025L00495-fast-fetch-1775957745811","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) (Reasonable Hypothesis) (No. 41 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)  (Reasonable Hypothesis)\n\n(No. 41 of 2025)\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 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   \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) (Reasonable Hypothesis) (No. 41 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(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning spasmodic torticollis No. 63 of 2016 (Federal Register of Legislation No. F2016L01136) 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 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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that cervical dystonia (spasmodic torticollis) and death from cervical dystonia (spasmodic torticollis) 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 cervical dystonia (spasmodic torticollis) or death from cervical dystonia (spasmodic torticollis) with the circumstances of a person's relevant service:\n\n1.           having trauma to the neck, head, or shoulders which results in local symptoms lasting for at least 2 weeks, within the 1 year before clinical onset;\n\n\nNote: Mechanisms of trauma include motor vehicle accidents, whiplash, assault, falls, and heavy lifting.\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(2) 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(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                               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)          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":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2016 Statement (section 4) and replaces it with a new Statement that defines the condition, lists exclusions, and specifies two discrete factors that raise a reasonable hypothesis for service connection (sections 7–9). It therefore alters the substantive criteria and evidentiary triggers used when assessing claims under the VEA/MRCA (section 5), and adds express treatment of death from the condition via terminal events (section 7(4) and Schedule)."},"complexity_factors":["Precise medical definition with multiple exclusions (Schedule 1; section 7(2)), requiring medical evidence to match the statutory meaning.","Low evidentiary trigger: a 'reasonable hypothesis' standard is raised only if at least one enumerated factor exists (section 9), which is a narrower, structured test than open causation.","Temporal and symptom-duration requirement for trauma (trauma within 1 year and local symptoms ≥2 weeks) imposes specific evidentiary burdens on claimants (section 9(1)).","Service-relationship constraints limit application to relevant service and specify material contribution/aggravation rules where condition pre-existed (section 10).","Interplay with other Statements of Principles requires cross-reference to other instruments when factors refer to other injuries/diseases (section 11).","Repeal of the 2016 instrument and replacement by this instrument creates a discontinuity claimants and decision-makers must track (section 4).","Inclusion of death via terminal events requires causal linkage between the dystonia and listed terminal events (section 7(4) and Schedule definitions).","Application limited to statutory claims under the VEA/MRCA (section 5), so private clinical findings must be mapped to legal criteria for entitlement decisions."],"plain_english_summary":"This instrument replaces the prior Statement and sets the medical and legal rules for linking cervical dystonia (spasmodic torticollis) — including death from it — to a veteran’s relevant service. It defines the condition and exclusions, and requires at least one of two specified factors to raise a reasonable hypothesis of service connection: trauma to neck/head/shoulders with local symptoms lasting ≥2 weeks within one year before clinical onset, or inability to obtain appropriate clinical management before clinical worsening. It applies to claims under the VEA and MRCA."},"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":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the same narrow scope as its 2016 predecessor. It remains a specific medical-determination instrument for a single condition (cervical dystonia) under the Repatriation Medical Authority's statutory framework. The update reflects new medical evidence and revised definitions but does not expand the instrument's purpose beyond determining service connection for this specific disorder."},"complexity_factors":["Short, focused instrument (approximately 1,500 words) dealing with a single medical condition","Only 7 defined terms in the Dictionary (Schedule 1), with straightforward definitions","Simple binary structure: two factors in section 9, with clear 'at least one must exist' logic","Limited cross-referencing — primarily internal references to the Dictionary and standard references to the VEA and MRCA","Seven specific exclusions in the definition (section 7(2)(b)) create some conditional complexity but are clearly enumerated","Single nested condition in section 10(2) limiting the second factor to pre-existing conditions","No delegated legislation, regulations, or subordinate instruments referenced beyond the parent Acts"],"plain_english_summary":"This instrument updates the policy for awarding compensation for cervical dystonia to current and former Australian Defence Force members and veterans under the VEA and MRCA. It narrows what counts as cervical dystonia and excludes cases caused by drugs, birth defects, brain injury, or other neurological disease. Compensation is limited to cases where the condition is linked to significant neck/head/shoulder trauma or to worsening from lack of access to care during service. It also confirms death from the condition can be compensable."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-reasonable-hypothesis-no-","history":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-reasonable-hypothesis-no-/history","analysis":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-reasonable-hypothesis-no-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-reasonable-hypothesis-no-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-reasonable-hypothesis-no-/important-cases","documents":"/api/acts/statement-of-principles-concerning-cervical-dystonia-spasmodic-torticollis-reasonable-hypothesis-no-/documents"}}