{"id":"F2021L00621","name":"Statement of Principles concerning IgA nephropathy (Balance of Probabilities) (No. 64 of 2021)","slug":"statement-of-principles-concerning-iga-nephropathy-balance-of-probabilities-no-64-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440861,"registerId":"F2021L00621-fast-fetch-1775956337808","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning IgA nephropathy (Balance of Probabilities) (No. 64 of 2021)","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\nIgA NEPHROPATHY (Balance of Probabilities)\n\n(No. 64 of 2021)\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 21 May 2021\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:
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Professor Nicholas Saunders AO
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 IgA nephropathy (Balance of Probabilities) (No. 64 of 2021).\n\n2 Commencement\n\n This instrument commences on 21 June 2021.\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 mesangial IgA glomerulonephritis No. 53 of 2012 (Federal Register of Legislation No. F2012L01794) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 IgA nephropathy and death from IgA nephropathy.\n\nMeaning of IgA nephropathy\n\n(2) For the purposes of this Statement of Principles, IgA nephropathy means:\n\n(a) a disease of the kidneys characterised by deposition of immunoglobulin A in the renal mesangium demonstrated by renal biopsy and which results in haematuria or proteinuria or renal dysfunction; and\n\n(b) excludes IgA vasculitis (Henoch-Schönlein purpura).\n\nNote: IgA nephropathy is also known as mesangial IgA glomerulonephritis or IgA glomerulonephritis.\n\n(3) While IgA nephropathy attracts ICD‑10‑AM code N02.1, N02.2, N02.2.1, N02.3, N02.5 or N02.8, in applying this Statement of Principles the meaning of IgA nephropathy 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 IgA nephropathy\n\n(5) For the purposes of this Statement of Principles, IgA nephropathy, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's IgA nephropathy.\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 IgA nephropathy and death from IgA nephropathy 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, IgA nephropathy or death from IgA nephropathy is connected with the circumstances of a person's relevant service:\n\n(1) having cirrhosis of the liver or chronic liver disease at the time of the clinical onset of IgA nephropathy;\n\nNote: chronic liver disease is defined in the Schedule 1 - Dictionary. \n\n(2) having an autoimmune disease from the specified list of autoimmune diseases at the time of the clinical onset of IgA nephropathy;\n\nNote: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.\n\n(3) having a malignant neoplasm at the time of the clinical onset of IgA nephropathy;\n\n(4) taking a drug which is associated in the individual with the clinical onset of IgA nephropathy during drug therapy and either:\n\n(a) the improvement of IgA nephropathy within 3 months of discontinuing or tapering drug therapy; or\n\n(b) the redevelopment of IgA nephropathy on rechallenge with the same drug; and\n\nwhere taking the drug continued for at least the 7 days before the clinical onset of IgA nephropathy;\n\n(5) taking a biologic agent for the treatment of cancer or autoimmune disease for at least the 7 days before the clinical onset of IgA nephropathy;\n\nNote: biologic agent is defined in the Schedule 1 - Dictionary.\n\n(6) undergoing kidney transplantation before the clinical onset of IgA nephropathy;\n\n(7) having cirrhosis of the liver or chronic liver disease at the time of the clinical worsening of IgA nephropathy;\n\nNote: chronic liver disease is defined in the Schedule 1 - Dictionary. \n\n(8) having an autoimmune disease from the specified list of autoimmune diseases at the time of the clinical worsening of IgA nephropathy;\n\nNote: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.\n\n(9) having a malignant neoplasm at the time of the clinical worsening of IgA nephropathy;\n\n(10) taking a drug which is associated in the individual with the clinical worsening of IgA nephropathy during drug therapy and either:\n\n(a) the improvement of IgA nephropathy within 3 months of discontinuing or tapering drug therapy; or\n\n(b) the worsening of IgA nephropathy on rechallenge with the same drug; and\n\nwhere taking the drug continued for at least the 7 days before the clinical worsening of IgA nephropathy;\n\n(11) taking a biologic agent for the treatment of cancer or autoimmune disease for at least the 7 days before the clinical worsening of IgA nephropathy;\n\nNote: biologic agent is defined in the Schedule 1 - Dictionary.\n\n(12) undergoing kidney transplantation before the clinical worsening of IgA nephropathy;\n\n(13) being overweight or obese for at least the 5 years before the clinical worsening of IgA nephropathy;\n\nNote: being overweight or obese is defined in the Schedule 1 - Dictionary.\n\n(14) having smoked at least 5 pack-years of tobacco products in the 10 years before the clinical worsening of IgA nephropathy;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(15) inhaling, ingesting or having cutaneous contact with an organic solvent in an unventilated and confined space:\n\n(a) for an average of at least 2 hours per week; and\n\n(b) for at least 1 year within the 5 years before the clinical worsening of IgA nephropathy;\n\nNote: organic solvent is defined in the Schedule 1 - Dictionary.\n\n(16) inability to obtain appropriate clinical management for IgA nephropathy.\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(7) to 9(16) apply only to material contribution to, or aggravation of, IgA nephropathy where the person's IgA nephropathy 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\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n being overweight or obese means having a Body Mass Index (BMI) of 25 or greater.\n\nNote: BMI is also defined in the Schedule 1 - Dictionary.\n\n biologic agent means a therapeutic product which is derived from living organisms or which contains components of living organisms.\n\nNote: Examples of biologic agents used for the treatment of cancer or autoimmune disease include interferons, monoclonal antibodies, tumour necrosis factor-α inhibitors, tyrosine kinase inhibitors and vascular endothelial growth factor antagonists.\n\n BMI means W/H2 where:\n\n(a) W is the person's weight in kilograms; and\n\n(b) H is the person's height in metres.\n\n chronic liver disease means progressive destruction of the liver parenchyma resulting in abnormal liver function which has been present for at least 6 months.\n\n IgA nephropathy—see subsection 7(2).\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\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 organic solvent means:\n\n(a) aliphatic hydrocarbon solvent; \n\n(b) aromatic hydrocarbon solvent; \n\n(c) chlorinated organic solvent; or\n\n(d) oxygenated organic solvent.\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 specified list of autoimmune diseases means:\n\n(a) coeliac disease; or\n\n(b) inflammatory bowel disease.\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":7,"scope_assessment":{"changed":true,"description":"Compared to the 2012 Statement of Principles it replaces (No. 53 of 2012 concerning mesangial IgA glomerulonephritis), this version adds several new factors that can link the disease to service, including being overweight or obese, smoking at least 5 pack‑years, and inhaling organic solvents in confined spaces. These additions broaden the circumstances under which IgA nephropathy may be accepted as service‑related, expanding the potential eligibility for compensation."},"complexity_factors":["16 separate factors, each with specific conditions (e.g., timing, duration, type of drug)","Two sets of factors: 6 for clinical onset and 9 for clinical worsening, with some overlap","Multiple defined terms in the dictionary (13 definitions, including 'biologic agent', 'chronic liver disease', 'organic solvent')","Conditional logic within factors (e.g., factor 4 requires both taking a drug and either improvement on discontinuation or redevelopment on rechallenge)","Cross‑references to other Statements of Principles (Section 11) for factors that refer to other diseases","Notes throughout explaining terms and calculations (e.g., pack‑years, BMI)","References to ICD‑10‑AM codes and specific editions of medical classification systems","Distinction between factors for 'clinical onset' and 'clinical worsening', with different relationship to service provisions (Section 10)"],"plain_english_summary":"This document is a set of rules (called a Statement of Principles) made by the Repatriation Medical Authority. It deals with a kidney disease called IgA nephropathy (also known as mesangial IgA glomerulonephritis). The rules say when a veteran’s IgA nephropathy can be legally linked to their military service for the purposes of getting compensation or benefits under the Veterans' Entitlements Act or the Military Rehabilitation and Compensation Act.\n\nThe disease is defined as a kidney problem shown by a biopsy to have deposits of immunoglobulin A in the kidney, causing blood or protein in the urine or reduced kidney function. It does not include a related condition called IgA vasculitis.\n\nTo connect the disease to service, at least one of 16 listed factors must exist. These factors include: having certain liver diseases, autoimmune diseases (like coeliac disease or inflammatory bowel disease), cancer, taking specific drugs that cause or worsen the disease, having a kidney transplant, being overweight or obese, smoking at least 5 pack‑years in the 10 years before the disease got worse, or being exposed to organic solvents in a confined space for at least 2 hours a week over a year in the 5 years before worsening.\n\nSome factors apply to the start (clinical onset) of the disease, and some to its worsening. The rules also say that these factors must be related to the person's service, and if a factor refers to another disease covered by a different Statement of Principles, that other Statement's rules apply.\n\nImportantly, this document does not grant benefits by itself. It just sets the medical guidelines that decision‑makers must follow when deciding if a veteran’s IgA nephropathy is service‑related.\"\n\nThis instrument replaces an earlier one from 2012. It expands the list of factors (e.g., adding smoking, obesity, and organic solvent exposure) that can link the disease to service, which broadens the potential scope for claims."},"kimi_summary":{"content_quality":"ok","complexity_score":5,"scope_assessment":{"changed":false,"description":"This is a standard replacement Statement of Principles under the Veterans' Entitlements Act framework. It updates the 2012 version (No. 53 of 2012) with current medical evidence and ICD-10-AM coding. The scope remains tightly focused on establishing the causal connection between IgA nephropathy and military service for compensation purposes. The addition of factors 13-16 (obesity, smoking, solvent exposure, and clinical management) reflects expanded medical knowledge rather than scope creep."},"complexity_factors":["16 distinct factors with specific temporal requirements (e.g., 'at least 7 days before', 'at least 5 years before', 'within the 10 years before')","Dual application structure: factors 1-6 for clinical onset, factors 7-16 for clinical worsening, with factor 16 applying to both","Nested definitions requiring cross-reference (e.g., 'being overweight or obese' refers to BMI, which has its own mathematical formula; 'specified list of autoimmune diseases' is a closed list of two conditions)","Cross-referencing mechanism in section 11 allowing incorporation of other Statements of Principles by reference","Specific exclusion: IgA vasculitis (Henoch-Schönlein purpura) is explicitly excluded from the definition despite similar pathology","Technical medical terminology throughout (immunoglobulin A, renal mesangium, biologic agents, organic solvents with four sub-categories)","Calculation-heavy definitions: pack-years of smoking requires mathematical conversion; BMI requires weight/height calculation","Conditional logic in factor 4 and 10 requiring both association with drug therapy AND improvement/discontinuation OR rechallenge response"],"plain_english_summary":"This legislation sets the medical rules for deciding whether veterans and defence force members can get compensation for **IgA nephropathy** — a kidney disease where a type of antibody (IgA) builds up in the kidneys, causing blood in the urine, protein in the urine, or kidney problems.\n\n**Who it affects:**\n- Veterans and current/former defence members claiming under the *Veterans' Entitlements Act 1986* or the *Military Rehabilitation and Compensation Act 2004*\n\n**What it does:**\n- Replaces an older 2012 Statement of Principles on the same condition\n- Lists **16 specific medical factors** that must be present to prove, \"on the balance of probabilities\" (more likely than not), that the kidney disease is connected to military service\n- These factors include things like having liver cirrhosis, certain autoimmune diseases, cancer, taking specific medications or biologic agents, kidney transplants, obesity, smoking history, or exposure to organic solvents\n- Some factors apply to the **onset** of the disease; others apply to **worsening** of an existing condition\n- The last factor (inability to get proper medical care) is a catch-all for cases where service prevented appropriate treatment\n\n**Why it matters:**\nThis is the legal gateway for compensation claims. If a veteran's doctor can show at least one of these 16 factors exists AND it's related to their service, they can qualify for benefits. Without meeting these criteria, compensation is denied."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-iga-nephropathy-balance-of-probabilities-no-64-of-2021","history":"/api/acts/statement-of-principles-concerning-iga-nephropathy-balance-of-probabilities-no-64-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-iga-nephropathy-balance-of-probabilities-no-64-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-iga-nephropathy-balance-of-probabilities-no-64-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-iga-nephropathy-balance-of-probabilities-no-64-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-iga-nephropathy-balance-of-probabilities-no-64-of-2021/documents"}}