{"id":"F2020L00209","name":"Statement of Principles concerning chronic multisymptom illness (Balance of Probabilities) (No. 4 of 2020)","slug":"statement-of-principles-concerning-chronic-multisymptom-illness-balance-of-probabilities-no-4-of-202","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440396,"registerId":"F2020L00209-fast-fetch-1775956037858","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning chronic multisymptom illness (Balance of Probabilities) (No. 4 of 2020)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nCHRONIC MULTISYMPTOM ILLNESS (Balance of Probabilities)\n\n(No. 4 of 2020)\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 28 February 2020\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 Nicholas Saunders AO
Chairperson
|\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 Factor that must exist\n\n10 Relationship to service\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n\n\n\n1 Name\n\nThis is the Statement of Principles concerning chronic multisymptom illness (Balance of Probabilities) (No. 4 of 2020).\n\n2 Commencement\n\n This instrument commences on 23 March 2020.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning chronic multisymptom illness No. 56 of 2014 (Federal Register of Legislation No. F2014L00525) made under subsection 196B(3) of the VEA is repealed.\n\nNote: The Statement of Principles concerning chronic multisymptom illness (No. 56 of 2014) was determined following an investigation concerning Gulf War syndrome which commenced on 31 October 2012. Although that investigation concerned the health of Gulf War veterans, the Statement of Principles concerning chronic multisymptom illness (Balance of Probabilities) (No. 4 of 2020) applies to all veterans and serving members with relevant service who have an illness which meets the definition.\n\n5 Application\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\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 chronic multisymptom illness and death from chronic multisymptom illness.\n\nMeaning of chronic multisymptom illness\n\n(2) For the purposes of this Statement of Principles, chronic multisymptom illness means a condition characterised by multiple somatic symptoms which has been diagnosed by a specialist physician or a psychiatrist and which meets the following criteria:\n\n1. There are one or more current symptoms from two of the following three categories:\n\n\n(i) fatigue;\n\n(ii) mood-cognition: feeling depressed, difficulty remembering or concentrating, feeling moody, feeling anxious, trouble finding words or difficulty sleeping; or\n\n(iii) musculoskeletal: joint pain, joint stiffness or muscle pain; and\n\nB. The collection of symptoms relied upon to make the diagnosis is distressing and results in significant disruption of social and occupational functioning; and\n\nC. The collection of symptoms relied upon to make the diagnosis must have persisted for at least six consecutive months.\n\nDeath from chronic multisymptom illness\n\n(3) For the purposes of this Statement of Principles, chronic multisymptom illness, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's chronic multisymptom illness.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that chronic multisymptom illness and death from chronic multisymptom illness 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\n9 Factor that must exist\n\nThe factor that must exist before it can be said that, on the balance of probabilities, chronic multisymptom illness or death from chronic multisymptom illness is connected with the circumstances of a person's relevant service is inability to obtain appropriate clinical management for chronic multisymptom illness.\n\n10 Relationship to service\n\nThe existence in a person of the factor referred to in section 9, applies only to material contribution to, or aggravation of, chronic multisymptom illness where the person's chronic multisymptom illness was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n chronic multisymptom illness—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":{"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2014 Gulf War–centred Statement and extends the Statement of Principles to all veterans and serving members with \"relevant service\" (s 4 and note). It introduces a specific legal gateway—\"inability to obtain appropriate clinical management\"—as the necessary factor for connection (s 9) and confines service relationship to material contribution or aggravation where the illness existed before or during but did not arise out of service (s 10)."},"complexity_factors":["Medical diagnostic requirements rely on a specialist physician or psychiatrist and subjective thresholds (symptom categories, \"distressing\" and \"significant disruption\", six months) (s 7(2))","Causal gateway is non-standard: the statutory factor is inability to obtain appropriate clinical management, which is evidentially and legally difficult to establish (s 9)","Causation framing limits application to material contribution or aggravation where the illness was suffered before or during but did not arise out of service, creating a nuanced temporal/causal test (s 10)","Interplay with two statutes (VEA and MRCA) and specific claim provisions (s 5; notes referencing s 120B VEA and s 339 MRCA) increases procedural complexity for claimants","Replaces a prior Gulf War–focused Statement and broadens application to all veterans/serving members with relevant service—changing prior scope and precedent (s 4 and note)","Death linkage uses proximate/ultimate terminal events (e.g. pneumonia, respiratory failure), requiring combined medical and death-causation analysis (s 7(3); Schedule 1)","Administrative discretion and interpretation by decisionmakers (RMA sets the Statement; Department applies it) can produce inconsistent evidentiary expectations across cases (Authority; s 8)","Proof standard is balance of probabilities, but the medical and documentary evidence required to meet the statutory factor can be burdensome for claimants and clinicians"],"plain_english_summary":"This instrument sets the medical test used to decide whether chronic multisymptom illness is linked to a veteran’s or serving member’s \"relevant service\" for claims under the Veterans’ Entitlements Act or the MRCA. The Repatriation Medical Authority prescribes a specialist diagnosis (symptoms from two of three categories, six months’ duration, and significant functional disruption) and requires inability to obtain appropriate clinical management as the gateway to finding material contribution or aggravation of the illness by service. It affects claimants, the Department that adjudicates entitlements, and clinicians whose records supply evidence."},"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":true,"description":"The original 2014 Statement of Principles emerged from a specific investigation into Gulf War syndrome and was initially understood to address Gulf War veterans. This 2020 instrument explicitly broadens the scope to apply to 'all veterans and serving members with relevant service' who meet the diagnostic criteria, regardless of which conflict or peacekeeping operation they served in. The Note in section 4 makes this expansion explicit, transforming what began as a Gulf War-specific instrument into a general compensation pathway for chronic multisymptom illness across the entire veteran population."},"complexity_factors":["Short document (approximately 1,500 words)","Only 5 defined terms in the Dictionary (chronic multisymptom illness, MRCA, relevant service, terminal event, VEA)","Single causal factor required (section 9), with no nested exceptions or alternative pathways","Clear structure with numbered sections and plain language definitions","Limited cross-referencing—primarily internal references to the Dictionary and two parent Acts","Narrow application scope limited by specific service exclusions (operational service, hazardous service, British nuclear test defence service)"],"plain_english_summary":"This law sets medical rules for claiming compensation for chronic multisymptom illness—persistent fatigue, mood/cognitive problems, and muscle/joint pain—requiring symptoms from at least two categories for six months and specialist diagnosis. It applies to eligible veterans and certain current/former defence members where the condition existed before or during service and was worsened by service. Compensation is only payable if service prevented appropriate medical treatment, raising the threshold for claims."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-chronic-multisymptom-illness-balance-of-probabilities-no-4-of-202","history":"/api/acts/statement-of-principles-concerning-chronic-multisymptom-illness-balance-of-probabilities-no-4-of-202/history","analysis":"/api/acts/statement-of-principles-concerning-chronic-multisymptom-illness-balance-of-probabilities-no-4-of-202/analysis","conflicts":"/api/acts/statement-of-principles-concerning-chronic-multisymptom-illness-balance-of-probabilities-no-4-of-202/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-chronic-multisymptom-illness-balance-of-probabilities-no-4-of-202/important-cases","documents":"/api/acts/statement-of-principles-concerning-chronic-multisymptom-illness-balance-of-probabilities-no-4-of-202/documents"}}