{"id":"F2022L01132","name":"Statement of Principles concerning epilepsy (Reasonable Hypothesis) (No. 84 of 2022)","slug":"statement-of-principles-concerning-epilepsy-reasonable-hypothesis-no-84-of-2022","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441500,"registerId":"F2022L01132-fast-fetch-1775956783097","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning epilepsy (Reasonable Hypothesis) (No. 84 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 (Reasonable Hypothesis)\n\n(No. 84 of 2022)\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 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 (Reasonable Hypothesis) (No. 84 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning epilepsy No. 75 of 2013 (Federal Register of Legislation No. F2013L01894) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that epilepsy and death from epilepsy 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 epilepsy or death from epilepsy 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 2 months 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 20 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 10 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 or type 2 diabetes mellitus at the time of the clinical onset of epilepsy;\n\nNote: type 1 diabetes mellitus and type 2 diabetes mellitus are defined in the Schedule 1– Dictionary.\n\n(18) having clinically significant depressive disorder at least 1 year before the clinical onset of epilepsy;\n\nNote: clinically significant is defined in the Schedule 1 – Dictionary.\n\n(19) having eclampsia within the 4 weeks before the clinical onset of epilepsy;\n\nNote: eclampsia is defined in the Schedule 1 – Dictionary.\n\n(20) consuming at least 75 kilograms of alcohol within the 5 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(21) 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(22) having a moderate to severe traumatic brain injury before the clinical worsening of epilepsy;\n\n(23) having concussion within the 20 years before the clinical worsening of epilepsy;\n\n(24) 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(25) having a surgical procedure which involves a craniotomy or cranioplasty before the clinical worsening of epilepsy;\n\n(26) having brain radiotherapy to treat primary or secondary brain neoplasia or to treat brain arteriovenous malformation before the clinical worsening of epilepsy;\n\n(27) having an hypoxic cerebral insult within the 2 months before the clinical worsening of epilepsy;\n\nNote: hypoxic cerebral insult is defined in the Schedule 1 – Dictionary.\n\n(28) having a central nervous system vascular lesion from the specified list of central nervous system vascular lesions within the 20 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(29) 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(30) having an infection of the brain or meninges within the 10 years before the clinical worsening of epilepsy;\n\n(31) having infection with human immunodeficiency virus at the time of the clinical worsening of epilepsy;\n\n(32) having septicaemia at the time of the clinical worsening of epilepsy;\n\n(33) 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(34) 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(35) 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(36) having obstructive sleep apnoea at the time of the clinical worsening of epilepsy;\n\n(37) having tetramine poisoning before the clinical worsening of epilepsy;\n\n(38) having type 1 diabetes mellitus or type 2 diabetes mellitus at the time of the clinical worsening of epilepsy;\n\nNote: type 1 diabetes mellitus and type 2 diabetes mellitus are defined in the Schedule 1– Dictionary.\n\n(39) having clinically significant depressive disorder at least 1 year before the clinical worsening of epilepsy;\n\nNote: clinically significant is defined in the Schedule 1 – Dictionary.\n\n(40) 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(41) consuming at least 75 kilograms of alcohol within the 5 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(42) inability to use continuous positive airway pressure (CPAP) ventilation for diagnosed sleep apnoea, at the time of the clinical worsening of epilepsy;\n\n(43) 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(22) to 9(43) 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(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 autoimmune encephalitis means a diffuse brain injury due to autoimmune inflammation of the brain.\n\n clinically significant means sufficient to warrant ongoing management which may involve regular visits (for example, at least monthly) to a psychiatrist, counsellor or general practitioner.\n\nNote: To warrant ongoing management does not require that any actual management was received or given for the condition.\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 eclampsia means a condition occurring in pregnant or puerperal women, characterised by hypertension, coma, convulsions, oedema or proteinuria.\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) 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 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 type 2 diabetes mellitus means a form of diabetes mellitus caused by variable degrees of insulin resistance and impaired insulin secretion.\n\n VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n\n \n","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier Statement of Principles concerning epilepsy No. 75 of 2013 (see s4) and replaces it with an updated list of qualifying factors, expanded definitions and explicit temporal limits (see s9 and Schedule 1). It retains the same statutory basis under subsection 196B(2) of the VEA (see s3) and applies to claims under section 120A VEA or section 338 MRCA (see s5), thereby changing the operative medical criteria while keeping the instrument’s application to those statutory claim streams."},"complexity_factors":["Medical/clinical complexity: many technical conditions, syndromes and exclusions are defined (see s7(2), Schedule 1).","Temporal qualifiers: different look‑back periods and time windows apply to onset versus clinical worsening (see ss9(2)–9(21) and ss9(22)–9(43)).","Multiple causal pathways: factors include trauma, infection, intoxication, metabolic and autoimmune causes, neurosurgery, radiotherapy and specific reflex triggers (see s9).","Quantitative threshold: a specific alcohol consumption metric (≥75 kg over 5 years) is prescribed, requiring conversion to standard drinks (see ss9(20), 9(41) and notes).","Cross‑references to other instruments: if a listed factor is covered by another Statement of Principles, that other Statement applies (see s11).","Administrative scope and applicability: applies only to claims under specified VEA/MRCA sections and repeals the 2013 Statement (see ss5, 4).","Decision‑making clarity vs discretion: the instrument prescribes which factors must exist to raise a reasonable hypothesis but requires relation to relevant service, creating an evidentiary link that decision‑makers must assess (see s10).","Defined terms and exclusions increase interpretive burden: numerous defined medical terms and explicit exclusions (Schedule 1; e.g. exclusion of psychogenic seizures, ECT).","Interaction of onset vs aggravation rules: separate lists apply where epilepsy pre‑existed service and the question is material contribution or aggravation (see s10(2)).","Evidence and compliance burden: claimants and clinicians must establish existence and timing of listed factors and their relation to service to meet the instrument’s threshold (see s9 and s10)."],"plain_english_summary":"This instrument, made by the Repatriation Medical Authority, sets the medical criteria used to decide when epilepsy (including death from epilepsy) can be linked on a “reasonable hypothesis” to a person’s service under the Veterans’ Entitlements Act or the Military Rehabilitation and Compensation Act. It applies to claims under section 120A of the VEA or section 338 of the MRCA. At least one listed medical factor, exposure or event within specified time limits must be present before a reasonable hypothesis of service‑connection is raised."},"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":6,"scope_assessment":{"changed":false,"description":"The legislation maintains its original purpose as a medical-legal instrument for determining service connection for epilepsy claims. The 2022 update appears to be a routine replacement of the 2013 version (No. 75 of 2013) with updated medical evidence, rather than an expansion into new areas. The scope remains tightly focused on the specific condition (epilepsy) and the statutory framework for veterans' compensation."},"complexity_factors":["43 distinct factors with varying time-based conditions (e.g., 'within 20 years', 'within 2 months', 'at least 1 year before')","18 defined terms in Schedule 1, many with nested sub-definitions (e.g., 'moderate to severe alcohol use disorder' has 10 diagnostic criteria)","Dual structure: factors apply to both 'clinical onset' and 'clinical worsening' with slightly different rules (factors 1-21 vs 22-43)","Cross-referencing mechanism in section 11: factors can trigger other Statements of Principles, creating interdependent legal pathways","Specific exclusions within definitions (e.g., electrical injury excludes transcranial magnetic stimulation)","Technical medical terminology requiring specialist knowledge (encephalitis, craniotomy, arteriovenous malformation, etc.)","Conditional logic in section 10(2) restricting worsening factors to pre-existing conditions not arising from service"],"plain_english_summary":"This Statement of Principles from the Repatriation Medical Authority sets out 43 medical factors that, if present, create a \"reasonable hypothesis\" that a person's epilepsy was caused or worsened by military service. It’s the legal test used to decide compensation claims, affecting veterans, current and former defence members, and peacekeepers under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004.\n\nBy lowering the test to plausibility and updating medical criteria (replacing the 2013 version), it determines access to benefits."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-epilepsy-reasonable-hypothesis-no-84-of-2022","history":"/api/acts/statement-of-principles-concerning-epilepsy-reasonable-hypothesis-no-84-of-2022/history","analysis":"/api/acts/statement-of-principles-concerning-epilepsy-reasonable-hypothesis-no-84-of-2022/analysis","conflicts":"/api/acts/statement-of-principles-concerning-epilepsy-reasonable-hypothesis-no-84-of-2022/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-epilepsy-reasonable-hypothesis-no-84-of-2022/important-cases","documents":"/api/acts/statement-of-principles-concerning-epilepsy-reasonable-hypothesis-no-84-of-2022/documents"}}