{"id":"F2022L01133","name":"Statement of Principles concerning epilepsy (Balance of Probabilities) (No. 85 of 2022)","slug":"statement-of-principles-concerning-epilepsy-balance-of-probabilities-no-85-of-2022","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441499,"registerId":"F2022L01133-fast-fetch-1775956783095","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning epilepsy (Balance of Probabilities) (No. 85 of 2022)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 22.10.0\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nEPILEPSY (Balance of Probabilities)\n\n(No. 85 of 2022)\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 23 August 2022\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 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 epilepsy (Balance of Probabilities) (No. 85 of 2022).\n\n2 Commencement\n\n This instrument commences on 19 September 2022.\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 epilepsy No. 76 of 2013 (Federal Register of Legislation No. F2013L01895) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 epilepsy and death from epilepsy.\n\nMeaning of epilepsy\n\n(2) For the purposes of this Statement of Principles, epilepsy:\n\n(a) means a chronic, recurring, paroxysmal brain dysfunction due to sudden, abnormal, excessive neuronal discharge manifesting with seizures; and\n\n(b) includes status epilepticus, generalised epilepsy and focal epilepsy; and\n\n(c) excludes:\n\n(i) movement disorders such as restless legs syndrome, periodic limb movement disorder, chorea and tics;\n\n(ii) muscle dystonia or spasms associated with tetanus, drugs or chemical poisons;\n\n(iii) psychogenic seizures;\n\n(iv) seizures occurring during electroconvulsive therapy; and\n\n(v) spontaneous movements occurring with syncope, vertigo or migraine.\n\nDeath from epilepsy\n\n(3) For the purposes of this Statement of Principles, epilepsy, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's epilepsy.\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 epilepsy and death from epilepsy 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 Factors that must exist\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, epilepsy or death from epilepsy is connected with the circumstances of a person's relevant service:\n\n(1) having a moderate to severe traumatic brain injury before the clinical onset of epilepsy;\n\n(2) having concussion within the 20 years before the clinical onset of epilepsy;\n\n(3) having an electrical injury of the brain before the clinical onset of epilepsy;\n\nNote: Electrical injury of the brain excludes transcranial magnetic stimulation and electroconvulsive therapy.\n\n(4) having a surgical procedure which involves a craniotomy or cranioplasty before the clinical onset of epilepsy;\n\n(5) having brain radiotherapy to treat primary or secondary brain neoplasia or to treat brain arteriovenous malformation before the clinical onset of epilepsy;\n\n(6) having an hypoxic cerebral insult within the 30 days before the clinical onset of epilepsy;\n\nNote: hypoxic cerebral insult is defined in the Schedule 1 – Dictionary.\n\n(7) having a central nervous system vascular lesion from the specified list of central nervous system vascular lesions within the 10 years before the clinical onset of epilepsy;\n\nNote: specified list of central nervous system vascular lesions is defined in the Schedule 1 – Dictionary.\n\n(8) having autoimmune encephalitis at the time of the clinical onset of epilepsy;\n\nNote 1: Examples of diseases that can cause autoimmune encephalitis include granulomatosis with polyangiitis (Wegener granulomatosis), Hashimoto encephalopathy, multiple sclerosis, neuromyelitis optica, paraneoplastic neurological syndrome and systemic lupus erythematosus.\n\nNote 2: autoimmune encephalitis is defined in the Schedule 1 – Dictionary.\n\n(9) having an infection of the brain or meninges within the 5 years before the clinical onset of epilepsy;\n\n(10) having infection with human immunodeficiency virus at the time of the clinical onset of epilepsy;\n\n(11) having septicaemia at the time of the clinical onset of epilepsy;\n\n(12) having an intracranial space-occupying lesion before the clinical onset of epilepsy;\n\nNote: intracranial space-occupying lesion is defined in the Schedule 1 – Dictionary.\n\n(13) having dementia as specified at the time of the clinical onset of epilepsy;\n\nNote: dementia as specified is defined in the Schedule 1 – Dictionary.\n\n(14) having a medical condition affecting the brain from the specified list of medical conditions at the time of the clinical onset of epilepsy;\n\nNote: specified list of medical conditions is defined in the Schedule 1 – Dictionary.\n\n(15) having obstructive sleep apnoea at the time of the clinical onset of epilepsy;\n\n(16) having tetramine poisoning before the clinical onset of epilepsy;\n\n(17) having type 1 diabetes mellitus at the time of the clinical onset of epilepsy;\n\nNote: type 1 diabetes mellitus is defined in the Schedule 1 – Dictionary.\n\n(18) consuming at least 150 kilograms of alcohol within the 10 years before the clinical onset of epilepsy;\n\nNote: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.\n\n(19) for death from epilepsy only, being exposed to a specific sensory stimulus or a specific repetitive task resulting in a reflex seizure immediately before death from epilepsy;\n\nNote: reflex seizure, specific repetitive task and specific sensory stimulus are defined in the Schedule 1 – Dictionary.\n\n(20) having a moderate to severe traumatic brain injury before the clinical worsening of epilepsy;\n\n(21) having concussion within the 20 years before the clinical worsening of epilepsy;\n\n(22) having an electrical injury of the brain before the clinical worsening of epilepsy;\n\nNote: Electrical injury of the brain excludes transcranial magnetic stimulation and electroconvulsive therapy.\n\n(23) having a surgical procedure which involves a craniotomy or cranioplasty before the clinical worsening of epilepsy;\n\n(24) having brain radiotherapy to treat primary or secondary brain neoplasia or to treat brain arteriovenous malformation before the clinical worsening of epilepsy;\n\n(25) having an hypoxic cerebral insult within the 30 days before the clinical worsening of epilepsy;\n\nNote: hypoxic cerebral insult is defined in the Schedule 1 – Dictionary.\n\n(26) having a central nervous system vascular lesion from the specified list of central nervous system vascular lesions within the 10 years before the clinical worsening of epilepsy;\n\nNote: specified list of central nervous system vascular lesions is defined in the Schedule 1 – Dictionary.\n\n(27) having autoimmune encephalitis at the time of the clinical worsening of epilepsy;\n\nNote 1: Examples of diseases that can cause autoimmune encephalitis include granulomatosis with polyangiitis (Wegener granulomatosis), Hashimoto encephalopathy, multiple sclerosis, neuromyelitis optica, paraneoplastic neurological syndrome and systemic lupus erythematosus.\n\nNote 2: autoimmune encephalitis is defined in the Schedule 1 – Dictionary.\n\n(28) having an infection of the brain or meninges within the 5 years before the clinical worsening of epilepsy;\n\n(29) having infection with human immunodeficiency virus at the time of the clinical worsening of epilepsy;\n\n(30) having septicaemia at the time of the clinical worsening of epilepsy;\n\n(31) having an intracranial space-occupying lesion before the clinical worsening of epilepsy;\n\nNote: intracranial space-occupying lesion is defined in the Schedule 1 – Dictionary.\n\n(32) having dementia as specified at the time of the clinical worsening of epilepsy;\n\nNote: dementia as specified is defined in the Schedule 1 – Dictionary.\n\n(33) having a medical condition affecting the brain from the specified list of medical conditions at the time of the clinical worsening of epilepsy;\n\nNote: specified list of medical conditions is defined in the Schedule 1 – Dictionary.\n\n(34) having obstructive sleep apnoea at the time of the clinical worsening of epilepsy;\n\n(35) having tetramine poisoning before the clinical worsening of epilepsy;\n\n(36) having type 1 diabetes mellitus at the time of the clinical worsening of epilepsy;\n\nNote: type 1 diabetes mellitus is defined in the Schedule 1– Dictionary.\n\n(37) having moderate to severe alcohol use disorder, including alcohol dependence, at the time of the clinical worsening of epilepsy;\n\nNote: moderate to severe alcohol use disorder is defined in the Schedule 1 – Dictionary.\n\n(38) consuming at least 150 kilograms of alcohol within the 10 years before the clinical worsening of epilepsy;\n\nNote: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.\n\n(39) inability to use continuous positive airway pressure (CPAP) ventilation for diagnosed sleep apnoea, at the time of the clinical worsening of epilepsy;\n\n(40) inability to obtain appropriate clinical management for epilepsy.\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(20) to 9(40) apply only to material contribution to, or aggravation of, epilepsy where the person's epilepsy 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(3) 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\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n autoimmune encephalitis means a diffuse brain injury due to autoimmune inflammation of the brain.\n\n dementia as specified means one of the following forms of dementia:\n\n(a) Alzheimer dementia;\n\n(b) Creutzfeldt-Jakob disease with dementia;\n\n(c) dementia pugilistica;\n\n(d) frontotemporal dementia;\n\n(e) Huntington's chorea with dementia;\n\n(f) neurocognitive disorder with Lewy bodies;\n\n(g) Parkinson's disease with dementia;\n\n(h) vascular dementia; or\n\n(i) any other type of dementia.\n\n epilepsy—see subsection 7(2).\n\n hypoxic cerebral insult means an event which results in either a decreased rate of cerebral blood flow or decreased oxygen content of cerebral arterial blood for a sustained period.\n\n intracranial space-occupying lesion means a pathological entity occupying volume within the cranial cavity, including intracranial aneurysm, neoplasm and abscess.\n\n iron overload means an accumulation of excess iron in tissues and organs which has been confirmed by elevated ferritin or transferrin saturation levels.\n\nNote: Causes include haemochromatosis and blood transfusions.\n\n moderate to severe alcohol use disorder means a psychiatric disorder characterised by a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least 4 of the following criteria, occurring within a 12-month period:\n\n(a) alcohol is often taken in larger amounts or over a longer period than was intended;\n\n(b) there is a persistent desire or unsuccessful efforts to cut down or control alcohol use;\n\n(c) a great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects;\n\n(d) craving, or a strong desire or urge to use alcohol;\n\n(e) recurrent alcohol use resulting in a failure to fulfil major role obligations at work, school, or home;\n\n(f) continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol;\n\n(g) important social, occupational, or recreational activities are given up or reduced because of alcohol use;\n\n(h) recurrent alcohol use in situations in which it is physically hazardous;\n\n(i) alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol; or\n\n(j) tolerance, defined by either:\n\n(i) a need for markedly increased amounts of alcohol to achieve intoxication or desired effect; or\n\n(ii) a markedly diminished effect with continued use of the same amount of alcohol.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n reflex seizure means a seizure that is consistently and repeatedly triggered by a specific stimulus or a specific repetitive task.\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 specific repetitive task means the specific task involving intense concentration which has in this person consistently and repeatedly triggered their reflex seizures. The specific task includes playing video games.\n\n specific sensory stimulus means the specific stimulus which has in this person consistently and repeatedly triggered their reflex seizures. The specific stimulus may be a visual, auditory, autonomic, somatosensory, olfactory, gustatory or vestibular stimulus, such as intermittent photic stimulation, reading or hearing music.\n\n specified list of central nervous system vascular lesions means:\n\n(a) cerebral venous thrombosis;\n\n(b) cerebrovascular accident;\n\n(c) subarachnoid haemorrhage; or\n\n(d) subdural haematoma.\n\n specified list of medical conditions means:\n\n(a) Creutzfeldt-Jakob disease;\n\n(b) Huntington's chorea;\n\n(c) iron overload;\n\n(d) Parkinson's disease and secondary parkinsonism;\n\n(e) posterior reversible encephalopathy syndrome;\n\n(f) sarcoidosis; or\n\n(g) sickle-cell disease.\n\nNote: iron overload is 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 type 1 diabetes mellitus means a form of diabetes mellitus caused by complete or near-total insulin deficiency and requiring daily administration of insulin.\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"},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the prior Statement of Principles (No. 76 of 2013) and replaces it with an updated, stand‑alone Statement that applies to claims under VEA section 120B and MRCA section 339. It sets out an updated list of qualifying medical factors, time-limits for their relevance, explicit exclusions, and death-specific triggers; and it distinguishes factors that establish causation from those that apply to material contribution or aggravation where epilepsy pre‑existed service."},"complexity_factors":["Technical medical terminology and diagnoses (epilepsy subtypes, autoimmune encephalitis, hypoxic cerebral insult, intracranial lesions, etc.)","Multiple discrete temporal windows for different factors (e.g. 30 days, 5 years, 10 years, 20 years, 10 kg/150 kg alcohol threshold over 10 years)","Large enumerated list of alternative qualifying factors (sections 9(1)–9(39)) requiring claim-by-claim matching","Cross-references to other Statements of Principles where an identified factor is itself covered elsewhere (section 11)","Different legal treatments for material contribution/aggravation versus causation (section 10(2))","Defined exclusions and precision on what is excluded (e.g. psychogenic seizures, electroconvulsive therapy) creating bright-line boundaries","Specific measurable thresholds and clinical management conditions (alcohol consumption metric, CPAP inability, inability to obtain appropriate management)","Interaction with two statutes (VEA and MRCA) and statutory standard of proof (balance of probabilities)"],"plain_english_summary":"This instrument replaces the earlier Statement of Principles and sets the medical criteria for linking epilepsy (including death from epilepsy) to a veteran’s relevant service on the balance of probabilities. It lists specific medical events, conditions and exposure thresholds (with defined time windows) that, if present and related to service, satisfy the statutory connection needed for claims under the Veterans’ Entitlements Act and the Military Rehabilitation and Compensation Act."},"kimi_summary":{"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Repatriation Medical Authority Statements of Principles. It follows the standard template structure (name, commencement, authority, repeal, application, definitions, factors, relationship to service) that has been used consistently since the 1990s. The content updates medical factors based on current evidence but does not expand beyond the original purpose of determining service connection for epilepsy claims. It replaces the 2013 version (No. 76 of 2013) on a like-for-like basis."},"complexity_factors":["40 distinct factors with varying time limits (30 days, 5 years, 10 years, 20 years, or no limit)","Dual structure: factors 1-19 for 'clinical onset' (new epilepsy), factors 20-40 for 'clinical worsening' (aggravation of existing epilepsy)","18 defined terms in Schedule 1, including nested definitions (e.g., 'dementia as specified' lists 9 sub-types; 'moderate to severe alcohol use disorder' has 10 diagnostic criteria)","Cross-references to other Statements of Principles (section 11) for conditions like traumatic brain injury or dementia","Specific exclusions within definitions (e.g., electrical injury excludes transcranial magnetic stimulation; epilepsy excludes psychogenic seizures and movement disorders)","Complex quantitative threshold: '150 kilograms of alcohol' calculated at 10g per standard drink","Conditional logic in section 10(2): factors 20-40 only apply if epilepsy existed before or during service but didn't arise from service","Specific inclusion for death claims: factor 19 covers reflex seizures triggered by sensory stimuli or repetitive tasks (e.g., video games) immediately before death"],"plain_english_summary":"This Statement of Principles from the Repatriation Medical Authority sets the medical rules for deciding whether a veteran’s epilepsy was caused or worsened by Australian Defence service, affecting veterans and DVA decision-makers and determining access to compensation and treatment. It lists 40 medical factors; if at least one applies and is linked to relevant service on the balance of probabilities, epilepsy can be accepted as service-related. It updates and replaces the 2013 version."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-epilepsy-balance-of-probabilities-no-85-of-2022","history":"/api/acts/statement-of-principles-concerning-epilepsy-balance-of-probabilities-no-85-of-2022/history","analysis":"/api/acts/statement-of-principles-concerning-epilepsy-balance-of-probabilities-no-85-of-2022/analysis","conflicts":"/api/acts/statement-of-principles-concerning-epilepsy-balance-of-probabilities-no-85-of-2022/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-epilepsy-balance-of-probabilities-no-85-of-2022/important-cases","documents":"/api/acts/statement-of-principles-concerning-epilepsy-balance-of-probabilities-no-85-of-2022/documents"}}