{"id":"F2021L00010","name":"Statement of Principles concerning giant cell arteritis (Balance of Probabilities) (No. 12 of 2021)","slug":"statement-of-principles-concerning-giant-cell-arteritis-balance-of-probabilities-no-12-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":130957,"registerId":"commonwealth-F2021L00010-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning giant cell arteritis (Balance of Probabilities) (No. 12 of 2021)","content":"![Commonwealth Coat of Arms](image.001.png)  \n\nStatement of Principles concerning giant cell arteritis (Balance of Probabilities) (No. 12 of 2021)\n\nmade under subsection 196B(3) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 19 September 2022\n\nIncludes amendments up to: Veterans' Entitlements (Statements of Principles—definition of \"one pack-year\") Amendment Determination 2022 (No. 94 of 2022) (F2022L01128)\n\nThe day of commencement of this Amendment Determination is 19 September 2022.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning giant cell arteritis (Balance of Probabilities) (No. 12 of 2021) that shows the text of the law as amended and in force on 19 September 2022.\n\nThe notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.\n\nUncommenced amendments\n\nThe effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.\n\nApplication, saving and transitional provisions for provisions and amendments\n\nIf the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.\n\nModifications\n\nIf the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.\n\nSelf‑repealing provisions\n\nIf a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.\n\nContents\n\n1 Name\n\n3 Authority\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\nEndnotes\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\n  \n\n1 Name\n\nThis is the Statement of Principles concerning giant cell arteritis (Balance of Probabilities) (No. 12 of 2021).\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\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 giant cell arteritis and death from giant cell arteritis.\n\nMeaning of giant cell arteritis\n\n(2) For the purposes of this Statement of Principles, giant cell arteritis means a systemic autoimmune vasculitis that involves large and medium-sized arteries and principally affects the cranial branches of the carotid arteries.\n\n> Note 1: Examples of affected arteries include the temporal, occipital, ophthalmic, vertebral, distal subclavian and axillary arteries, and the thoracic aorta. Typical clinical symptoms associated with the involvement of the cranial arteries include headache, visual loss and jaw claudication.\n\n> Note 2: This condition is also known as temporal arteritis and cranial arteritis.\n\n(3) While giant cell arteritis attracts ICD‑10‑AM code M31.5 or M31.6, in applying this Statement of Principles the meaning of giant cell arteritis 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 giant cell arteritis\n\n(5) For the purposes of this Statement of Principles, giant cell arteritis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's giant cell arteritis.\n\n> Note: 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 giant cell arteritis and death from giant cell arteritis can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\n> Note: 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, giant cell arteritis or death from giant cell arteritis is connected with the circumstances of a person's relevant service:\n\n(1) having smoked at least 10 pack-years of tobacco products before the clinical onset of giant cell arteritis, and where smoking has ceased, the clinical onset of giant cell arteritis has occurred within 20 years of cessation;\n\n> Note: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(2) having smoked at least 10 pack-years of tobacco products before the clinical worsening of giant cell arteritis, and where smoking has ceased, the clinical worsening of giant cell arteritis has occurred within 20 years of cessation;\n\n> Note: one pack-year is defined in the Schedule 1 - Dictionary\n\n(3) inability to obtain appropriate clinical management for giant cell arteritis.\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(2) to 9(3) apply only to material contribution to, or aggravation of, giant cell arteritis where the person's giant cell arteritis 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\ngiant cell arteritis—see subsection 7(2).\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\none 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\n> Note 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\n> Note 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\nrelevant 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\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\nterminal 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\nVEA means the Veterans' Entitlements Act 1986.\n\n> Note: Endnotes\n\n> Note: Endnote 1—About the endnotes\n\nThe endnotes provide information about this compilation and the compiled law.\n\nThe following endnotes are included in every compilation:\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\nAbbreviation key—Endnote 2\n\nThe abbreviation key sets out abbreviations that may be used in the endnotes.\n\nLegislation history and amendment history—Endnotes 3 and 4\n\nAmending laws are annotated in the legislation history and amendment history.\n\nThe legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.\n\nThe amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.\n\nMisdescribed amendments\n\nA misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.\n\nIf a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.\n\n> Note: Endnote 2—Abbreviation key\n\n|                                                | o = order(s)                        |\n| ---------------------------------------------- | ----------------------------------- |\n| ad = added or inserted                         | Ord = Ordinance                     |\n| am = amended                                   | orig = original                     |\n| amdt = amendment                               | par = paragraph(s)/subparagraph(s)  |\n| c = clause(s)                                  | /sub‑subparagraph(s)                |\n| C[x] = Compilation No. x                       | pres = present                      |\n| Ch = Chapter(s)                                | prev = previous                     |\n| def = definition(s)                            | (prev…) = previously                |\n| Dict = Dictionary                              | Pt = Part(s)                        |\n| disallowed = disallowed by Parliament          | r = regulation(s)/rule(s)           |\n| Div = Division(s)                              |                                     |\n| exp = expires/expired or ceases/ceased to have | reloc = relocated                   |\n| effect                                         | renum = renumbered                  |\n| F = Federal Register of Legislation            | rep = repealed                      |\n| gaz = gazette                                  | rs = repealed and substituted       |\n| LA = Legislation Act 2003                      | s = section(s)/subsection(s)        |\n| LIA = Legislative Instruments Act 2003         | Sch = Schedule(s)                   |\n| (md) = misdescribed amendment can be given     | Sdiv = Subdivision(s)               |\n| effect                                         | SLI = Select Legislative Instrument |\n| (md not incorp) = misdescribed amendment       | SR = Statutory Rules                |\n| cannot be given effect                         | Sub‑Ch = Sub‑Chapter(s)             |\n| mod = modified/modification                    | SubPt = Subpart(s)                  |\n| No. = Number(s)                                | underlining = whole or part not     |\n|                                                | commenced or to be commenced        |\n\n> Note: Endnote 3—Legislation history\n\n| Name                                                                                                                          | Registration              | Commencement      | Application, saving and transitional provisions |\n| ----------------------------------------------------------------------------------------------------------------------------- | ------------------------- | ----------------- | ----------------------------------------------- |\n| Statement of Principles concerning giant cell arteritis (Balance of Probabilities) (No. 12 of 2021)                           | 4 January 2021F2021L00010 | 25 January 2021   |                                                 |\n| Veterans' Entitlements (Statements of Principles—definition of \"one pack-year\") Amendment Determination 2022 (No. 94 of 2022) | 26 August 2022F2022L01128 | 19 September 2022 |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected                             | How affected      |\n| ---------------------------------------------- | ----------------- |\n| Section 2……………….                               | rep LA s 48D      |\n| Section 4……………….                               | rep LA s 48C      |\n| Subsection 9(1) note….                         | rs No. 94 of 2022 |\n| Subsection 9(2) note....                       | rs No. 94 of 2022 |\n| Schedule 1 – Dictionary – one pack-year...…….. | rs No. 94 of 2022 |","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":"The legislation remains tightly focused on its original purpose: establishing the causal factors for giant cell arteritis in veterans' compensation claims. The only amendment (No. 94 of 2022) refined the definition of 'one pack-year' for consistency across all Statements of Principles without expanding the scope beyond the specific disease and service connection framework."},"complexity_factors":["Short, focused instrument (approximately 12 substantive sections)","Only 3 operative factors in section 9 (smoking onset, smoking worsening, clinical management)","Single cross-reference to other Statements of Principles (section 11)","Minimal conditional logic — straightforward 'at least one factor must exist' structure","8 defined terms in Schedule 1 Dictionary","No nested exceptions or complex temporal calculations beyond the 20-year smoking cessation window","Clear hierarchical structure with dedicated definition section"],"plain_english_summary":"This Statement of Principles sets the medical test for linking giant cell arteritis to Australian Defence Force service, affecting current and former ADF members and veterans claiming under the VEA or MRCA. It applies the \"balance of probabilities\" standard to connection with service.\n\nA claim succeeds only where evidence shows a service‑related contribution—primarily significant smoking exposure (10+ pack‑years, with timing rules) or lack of appropriate clinical care—thereby determining entitlement to disability pensions and other compensation."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"Amendments noted in the instrument (Endnote 4) clarify the definition of 'one pack‑year' and update notes to subsections 9(1) and 9(2), but do not add new kinds of linking factors or alter the classes of service or claims to which the Statement applies (see sections 5, 7, 9 and Schedule 1). The instrument therefore retains its original coverage of giant cell arteritis and related death for relevant service claims."},"complexity_factors":["Specialised medical definition of giant cell arteritis (section 7(2)) requiring clinical understanding","Quantitative smoking exposure metric (one pack‑year) and its calculation details in the Dictionary","Temporal limitation on smoking cessation (20 years) affecting causal timing","Interaction with other Statements of Principles (section 11) requiring cross-referencing","Application to two statutory claim routes (VEA s120B and MRCA s339) (section 5)","Evidentiary standard is balance of probabilities but the Repatriation Medical Authority’s medical‑scientific view underpins the linkage (section 8)"],"plain_english_summary":"This Statement of Principles sets the medical criteria used to decide whether giant cell arteritis (including death from it) is connected to a veteran’s or service member’s relevant service on the balance of probabilities. It applies to claims under the VEA (s120B) or the MRCA (s339). The instrument pinpoints three linking factors — a quantified smoking history, a smoking-related worsening rule, or inability to obtain appropriate clinical management — and defines key terms (eg. pack‑years, relevant service) used to assess claims."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-giant-cell-arteritis-balance-of-probabilities-no-12-of-2021","history":"/api/acts/statement-of-principles-concerning-giant-cell-arteritis-balance-of-probabilities-no-12-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-giant-cell-arteritis-balance-of-probabilities-no-12-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-giant-cell-arteritis-balance-of-probabilities-no-12-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-giant-cell-arteritis-balance-of-probabilities-no-12-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-giant-cell-arteritis-balance-of-probabilities-no-12-of-2021/documents"}}