{"id":"F2025L01284","name":"Statement of Principles concerning fibromuscular dysplasia (Balance of Probabilities) (No. 82 of 2025)","slug":"statement-of-principles-concerning-fibromuscular-dysplasia-balance-of-probabilities-no-82-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443004,"registerId":"F2025L01284-fast-fetch-1775957922274","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning fibromuscular dysplasia (Balance of Probabilities) (No. 82 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\nFIBROMUSCULAR DYSPLASIA  (Balance of Probabilities)\n\n(No. 82 of 2025)\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 24 October 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\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 fibromuscular dysplasia (Balance of Probabilities) (No. 82 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 24 November 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning fibromuscular dysplasia (Balance of Probabilities) (No. 80 of 2016) (Federal Register of Legislation No. F2016L01683) made under subsection 196B(3) of the VEA is repealed.\n\n1.                Application\n\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\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 fibromuscular dysplasia and death from fibromuscular dysplasia.\n\n\nMeaning of fibromuscular dysplasia\n\n1.           For the purposes of this Statement of Principles, fibromuscular dysplasia means a non-atherosclerotic and non-inflammatory segmental disease of the musculature of arterial walls, leading to stenosis of small and medium-sized arteries and either:\n  1.           warrants medical treatment; or\n  1.           results in at least one of the following clinical manifestations involving a small or medium sized artery (most commonly renal or carotid):\n    1.             partial or complete occlusion;\n    2.          aneurysm;\n    3.        dissection; or\n    4.         ischaemia to an organ; and\n  2.           excludes carotid web.\n\n\nNote: Clinical features of fibromuscular dysplasia vary widely, depending on what artery is affected, for example moderate to severe or poorly controlled hypertension when a renal artery is affected or headache and pulsatile tinnitus when a carotid artery is affected.\n\n1.           While fibromuscular dysplasia attracts ICD‑10‑AM code I77.3, in applying this Statement of Principles the meaning of fibromuscular dysplasia 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 fibromuscular dysplasia\n\n1.           For the purposes of this Statement of Principles, fibromuscular dysplasia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's fibromuscular dysplasia.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that fibromuscular dysplasia and death from fibromuscular dysplasia 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\n1.                Factors that must exist\n\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, fibromuscular dysplasia or death from fibromuscular dysplasia is connected with the circumstances of a person's relevant service:\n\n1.           having smoked at least 10 pack-years before clinical onset or clinical worsening;\n\n\nNote: one pack-year is defined in the Schedule 1 – Dictionary\n\n1.           inability to obtain appropriate clinical management for fibromuscular dysplasia before clinical worsening.\n\n\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 clinical worsening aspect of factors set out in section 9 apply only to material contribution to, or aggravation of, fibromuscular dysplasia where the person's fibromuscular dysplasia 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(3) 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                               fibromuscular dysplasia—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                               one pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.\n\nNote 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.\n\nNote 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.\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":"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 is a standard replacement instrument that maintains the same narrow scope as the original 2016 version. It continues to address only fibromuscular dysplasia in the context of veterans' compensation, with no expansion into new areas of law or policy. The update appears to be a routine republication or minor amendment rather than a scope expansion."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 2 substantive factors in section 9 (smoking history and clinical management)","7 defined terms in Schedule 1 Dictionary","Clear hierarchical structure with numbered sections","Single medical condition scope (fibromuscular dysplasia only)","Minimal cross-referencing (only to other Statements of Principles in section 11)","Straightforward conditional logic (\"at least one of the following factors\")","Standard template structure common to all Repatriation Medical Authority Statements of Principles"],"plain_english_summary":"This rulebook (updating a 2016 version) sets the medical test for when Australian veterans can get compensation for fibromuscular dysplasia (FMD), a non-atherosclerotic arterial disease (excluding carotid web). It applies to veterans under the VEA and current/former defence members under the MRCA.\n\nIt says service connection is accepted on the balance of probabilities if factors like heavy prior smoking (≥10 pack‑years) or lack of timely care caused or worsened FMD, and counts death from FMD complications."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2016 Statement of Principles (s4) and replaces it with a new Statement that defines the condition, includes death from the condition, and sets a limited set of qualifying factors (s7–s9). That repeal-and-replace structure changes the operative instrument governing eligibility for claims under the VEA and MRCA (s5), and therefore alters the practical scope of what evidence can establish a service connection."},"complexity_factors":["Specialised medical definition of fibromuscular dysplasia with clinical manifestations (stenosis, aneurysm, dissection, ischaemia) requiring medical interpretation (s7(2)).","Evidentiary standard is 'balance of probabilities' but relies on medical‑scientific judgment by the Repatriation Medical Authority (s8).","Narrow list of qualifying factors (smoking 10 pack‑years; inability to obtain appropriate clinical management) with potential evidential and temporal issues (s9, Schedule – pack‑year definition).","Requirement that any listed factor be related to the person's relevant service introduces factual linking and causation assessment (s10).","Interplay with other Statements of Principles when a factor refers to another injury/disease creates cross‑instrument dependency (s11).","Some terms and exclusions (eg, exclusion of carotid web; definition of terminal event) are technical and affect scope (s7(2), Schedule).","Calculation rules for pack‑years and equivalencies for different tobacco types require numeric assessment of exposure (Schedule).","Vague standard 'inability to obtain appropriate clinical management' will require case‑by‑case administrative and evidentiary assessment, increasing discretionary decision‑making (s9)."],"plain_english_summary":"This instrument replaces the Repatriation Medical Authority's earlier Statement of Principles for fibromuscular dysplasia. It defines the condition (and death from it), sets the decision standard as ‘balance of probabilities’, and identifies two qualifying factors—smoking of at least 10 pack‑years before clinical onset/worsening, or inability to obtain appropriate clinical management—that can connect the condition to eligible service under the VEA or MRCA. It affects veterans and service members making entitlement claims and guides decision‑makers about what evidence counts."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-fibromuscular-dysplasia-balance-of-probabilities-no-82-of-2025","history":"/api/acts/statement-of-principles-concerning-fibromuscular-dysplasia-balance-of-probabilities-no-82-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-fibromuscular-dysplasia-balance-of-probabilities-no-82-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-fibromuscular-dysplasia-balance-of-probabilities-no-82-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-fibromuscular-dysplasia-balance-of-probabilities-no-82-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-fibromuscular-dysplasia-balance-of-probabilities-no-82-of-2025/documents"}}