{"id":"F2023L01164","name":"Statement of Principles concerning Charcot-Marie-Tooth disease (Reasonable Hypothesis) (No. 88 of 2023)","slug":"statement-of-principles-concerning-charcot-marie-tooth-disease-reasonable-hypothesis-no-88-of-2023","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442054,"registerId":"F2023L01164-fast-fetch-1775957175674","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning Charcot-Marie-Tooth disease (Reasonable Hypothesis) (No. 88 of 2023)","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\n\n \n\nStatement of Principles\n\nconcerning\n\nCHARCOT-MARIE-TOOTH DISEASE (Reasonable Hypothesis)\n\n(No. 88 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 25 August 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:
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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 Charcot-Marie-Tooth disease (Reasonable Hypothesis) (No. 88 of 2023).\n\n2 Commencement\n\n This instrument commences on 26 September 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 Charcot-Marie-Tooth disease No. 21 of 2015 (Federal Register of Legislation No. F2014L01827) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 Charcot-Marie-Tooth disease and death from Charcot-Marie-Tooth disease.\n\nMeaning of Charcot-Marie-Tooth disease\n\n(2) For the purposes of this Statement of Principles, Charcot-Marie-Tooth disease means one of a group of genetic disorders of myelin structure or axon function which results in chronic peripheral motor and sensory neuropathies.\n\nNote: Clinical manifestations include progressive distal muscle weakness and atrophy starting in the feet and legs, gait disturbance and absent stretch reflexes.\n\n(3) While Charcot-Marie-Tooth disease attracts ICD‑10‑AM code G60.0, in applying this Statement of Principles the meaning of Charcot-Marie-Tooth disease is that given in subsection (2).\n\n(4) 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\nDeath from Charcot-Marie-Tooth disease\n\n(5) For the purposes of this Statement of Principles, Charcot-Marie-Tooth disease, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's Charcot-Marie-Tooth disease.\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 Charcot-Marie-Tooth disease and death from Charcot-Marie-Tooth disease 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 Charcot-Marie-Tooth disease or death from Charcot-Marie-Tooth disease with the circumstances of a person's relevant service:\n\n(1) taking a drug that cannot be ceased or substituted in the long term and which is associated in the individual with the clinical worsening of Charcot-Marie-Tooth disease during drug therapy and either:\n\n(a) the improvement of Charcot-Marie-Tooth disease within 3 months of discontinuing or tapering drug therapy; or\n\n(b) the clinical worsening of Charcot-Marie-Tooth disease on rechallenge with the same drug or another drug from the same class of drugs; and\n\nwhere the drug was being taken at the time of the clinical worsening of Charcot-Marie-Tooth disease;\n\n(2) inability to obtain appropriate clinical management for Charcot-Marie-Tooth disease before the clinical worsening of Charcot-Marie-Tooth disease.\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, Charcot-Marie-Tooth disease where the person's Charcot-Marie-Tooth disease 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 Charcot-Marie-Tooth disease—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_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"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the same scope as its predecessor (No. 21 of 2015). It continues to address only the aggravation or material contribution to pre-existing Charcot-Marie-Tooth disease, not causation of the disease itself, which is appropriate given CMT's genetic etiology. The 2023 revision appears to be a standard reissue updating the ICD-10-AM reference and medical evidence base, without expansion into new claim types or beneficiary categories."},"complexity_factors":["Limited length (approximately 1,500 words across 11 sections plus a short dictionary)","Only 5 defined terms in the dictionary (Charcot-Marie-Tooth disease, MRCA, relevant service, terminal event, VEA)","Simple conditional structure: two alternative factors in section 9, with clear 'at least one must exist' logic","Single nested condition in section 9(1) requiring both drug causation and temporal relationship","Cross-references limited to the Dictionary and external legislation (VEA, MRCA) — no internal cross-referencing maze","Clear delineation between the disease definition (genetic neuropathy) and service connection factors","No exceptions to exceptions; straightforward application rules in sections 10-11"],"plain_english_summary":"This rulebook sets the medical test for whether Australian veterans or defence personnel with genetic Charcot‑Marie‑Tooth disease (CMT) can get compensation under the Veterans’ Entitlements Act or Military Rehabilitation and Compensation Act. It does not treat service as causing CMT, but sets criteria for when service—notably long‑term drug reactions or lack of proper care—could have worsened the condition or contributed to death. It replaces the 2015 guidance and updates the evidentiary standard."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2015 Statement (s4) and replaces it with a Statement that confines a ‘reasonable hypothesis’ to two specific qualifying factors (drug‑related clinical worsening or inability to obtain appropriate management) and to material contribution/ aggravation of pre‑existing or service‑acquired (but not service‑caused) CMT (s9–10). That repeal-and-replace structure indicates a change in scope; the new text narrows the conditions under which service connection may be reasonably hypothesised by specifying concrete clinical tests and a temporal/causation limitation."},"complexity_factors":["Limited substantive content: only two primary qualifying factors (s9) reduce legal complexity compared with multi‑factor instruments.","Interplay with other laws and claims processes: applies to claims under VEA and MRCA and references other Statements of Principles (s5, s11).","Medical definitions and evidence standards: relies on clinical concepts (worsening, improvement within 3 months, rechallenge, terminal event) that require medical assessment (s7(2), s9(1), Schedule 1).","Temporal and causation constraint: applies only to material contribution/aggravation where disease pre‑existed or arose during service but not out of service (s10(2)), which introduces a discrete legal threshold.","Repeal and replacement of prior instrument creates administrative transition issues (s4) for existing claims and precedent reliance.","Cross‑referenced coding: cites ICD‑10‑AM code G60.0 but defines its own operative meaning for CMT (s7(3)–(4)), requiring attention to classification versus statutory definition."],"plain_english_summary":"This instrument, made by the Repatriation Medical Authority (s3), replaces the 2015 Statement and sets the medical test for linking Charcot‑Marie‑Tooth disease (CMT) to a person’s relevant service for claims under the VEA or MRCA (s4–5). It defines CMT clinically (s7) and says a reasonable hypothesis is raised only where specified factors are present—primarily drug‑related clinical worsening with recovery or rechallenge, or inability to obtain appropriate clinical management—and where service materially contributed to or aggravated pre‑existing disease (s9–10)."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-charcot-marie-tooth-disease-reasonable-hypothesis-no-88-of-2023","history":"/api/acts/statement-of-principles-concerning-charcot-marie-tooth-disease-reasonable-hypothesis-no-88-of-2023/history","analysis":"/api/acts/statement-of-principles-concerning-charcot-marie-tooth-disease-reasonable-hypothesis-no-88-of-2023/analysis","conflicts":"/api/acts/statement-of-principles-concerning-charcot-marie-tooth-disease-reasonable-hypothesis-no-88-of-2023/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-charcot-marie-tooth-disease-reasonable-hypothesis-no-88-of-2023/important-cases","documents":"/api/acts/statement-of-principles-concerning-charcot-marie-tooth-disease-reasonable-hypothesis-no-88-of-2023/documents"}}