{"id":"F2018L00883","name":"Statement of Principles concerning localised sclerosis (Reasonable Hypothesis) (No. 61 of 2018)","slug":"statement-of-principles-concerning-localised-sclerosis-reasonable-hypothesis-no-61-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":97557,"registerId":"commonwealth-F2018L00883-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning localised sclerosis (Reasonable Hypothesis) (No. 61 of 2018)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning localised sclerosis (Reasonable Hypothesis) (No. 61 of 2018)\n\nmade under subsection 196B(2) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 23 July 2018\n\nIncludes amendments up to: Amendment Statement of Principles concerning localised sclerosis (Reasonable Hypothesis) (No. 15 of 2019) (F2019L00005)\n\nThe day of commencement of this Amendment Statement of Principles concerning localised sclerosis is 23 July 2018.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning localised sclerosis (Reasonable Hypothesis) (No. 61 of 2018) that shows the text of the law as amended and in force on 23 July 2018.\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\n![RMA-Red](image.002.jpeg)\n\nStatement of Principles\n\nconcerning\n\nLOCALISED SCLEROSIS  \n(Reasonable Hypothesis)\n\n(No. 61 of 2018)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\nDated 22 June 2018\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\n1 Name\n\nThis is the Statement of Principles concerning localised sclerosis (Reasonable Hypothesis) (No. 61 of 2018).\n\n2 Commencement\n\nThis instrument commences on 23 July 2018.\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 localised sclerosis No. 66 of 2009 (Federal Register of Legislation No. F2009L03229) 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 localised sclerosis and death from localised sclerosis.\n\nMeaning of localised sclerosis\n\n(2) For the purposes of this Statement of Principles, localised sclerosis (also known as localised scleroderma or morphea):\n\n(a) means an autoimmune, fibrosing connective tissue disorder characterised by localised skin thickening with increased quantities of collagen; and\n\n(b) excludes systemic sclerosis, graft versus host disease with dermal fibrosis, and scleroderma-like conditions (for example, lipodermatosclerosis, scleromyxoedema, eosinophilic fasciitis and chronic radiation dermatitis).\n\n> Note 1: Localised sclerosis is limited to the skin, subcutaneous tissue and underlying bone.\n\n> Note 2: Localised sclerosis typically presents with an absence of sclerodactyly, Raynaud phenomenon and nailfold capillary changes, and is not associated with major vascular symptoms or with visceral disease.\n\n> Note 3: The diagnosis of localised sclerosis is based on clinical findings, although histopathologic confirmation is sometimes needed to rule out other diseases. Serological markers for localised sclerosis include elevated levels of antinuclear antibody, anti-ssDNA antibody, anti-topoisomerase II alpha antibody and rheumatoid factor.\n\n(3) While localised sclerosis attracts ICD‑10‑AM code L94.0 or L94.1, in applying this Statement of Principles the meaning of localised sclerosis 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 localised sclerosis\n\n(5) For the purposes of this Statement of Principles, localised sclerosis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's localised sclerosis.\n\n> Note: 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 localised sclerosis and death from localised sclerosis 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\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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting localised sclerosis or death from localised sclerosis with the circumstances of a person's relevant service:\n\n(1) inhaling respirable crystalline silica dust, at the time material containing crystalline silica was being:\n\n(a) produced;\n\n(b) excavated;\n\n(c) drilled, cut or ground; or\n\n(d) used in construction, manufacturing, cleaning or blasting,\n\nfor a cumulative period of at least 2 500 hours before the clinical onset of localised sclerosis;\n\n(2) being treated with a drug or a drug from a class of drugs from the specified list of drugs at the time of the clinical onset of localised sclerosis;\n\n> Note: specified list of drugs is defined in the Schedule 1 - Dictionary.\n\n(3) undergoing a course of therapeutic radiation for cancer, where the affected site was in the field of radiation, before the clinical onset of localised sclerosis;\n\n(4) having an injury to the skin at the affected site within the six months before the clinical onset of localised sclerosis;\n\n> Note: injury to the skin is defined in the Schedule 1 - Dictionary.\n\n(5) being treated with a drug or a drug from a class of drugs from the specified list of drugs at the time of the clinical worsening of localised sclerosis;\n\n> Note: specified list of drugs is defined in the Schedule 1 - Dictionary.\n\n(6) undergoing a course of therapeutic radiation for cancer, where the affected site was in the field of radiation, before the clinical worsening of localised sclerosis;\n\n(7) inability to obtain appropriate clinical management for localised sclerosis.\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(5) to 9(7) apply only to material contribution to, or aggravation of, localised sclerosis where the person's localised sclerosis 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\ninjury to the skin means any injury which is capable of causing inflammation of the skin, and includes cuts, abrasions, burns, pressure, surgery, injections and infectious lesions.\n\nlocalised sclerosis—see subsection 7(2).\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\nrelevant 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\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\nspecified list of drugs means:\n\n(a) balicatib;\n\n(b) bleomycin;\n\n(c) enfuvirtide;\n\n(d) pemetrexed;\n\n(e) taxanes; or\n\n(f) tumour necrosis factor-α inhibitors.\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 localised sclerosis (Reasonable Hypothesis) (No. 61 of 2018)           | 26 June 2018F2018L00883   | 23 July 2018 |                                                 |\n| Amendment Statement of Principles concerning localised sclerosis (Reasonable Hypothesis) (No. 15 of 2019) | 2 January 2019F2019L00005 | 23 July 2018 |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected   | How affected       |\n| -------------------- | ------------------ |\n| Subsection 9(2)……….. | am. No. 15 of 2019 |\n| Subsection 9(5)……….. | am. No. 15 of 2019 |","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":4,"scope_assessment":{"changed":false,"description":"This is a standard Statement of Principles instrument that remains tightly focused on its original purpose: establishing the medical connection between localised sclerosis and military service for compensation purposes. It replaces an earlier 2009 version (No. 66 of 2009) but maintains the same fundamental scope. The 2019 amendment (incorporated in this compilation) made minor technical amendments to subsections 9(2) and 9(5) regarding drug treatments, but did not expand the scope beyond the original intent of defining service-related causation factors for this specific condition."},"complexity_factors":["Moderate cross-referencing: References to the Veterans' Entitlements Act 1986, Military Rehabilitation and Compensation Act 2004, and ICD-10-AM medical classification system","Medical terminology: Uses specific clinical terms (sclerodactyly, Raynaud phenomenon, antinuclear antibody, etc.) though these are explained in notes","Conditional logic: Section 9 presents 7 alternative factors with 'at least one must exist' structure, plus subsection 10(2) creates a limitation on when factors 5-7 apply","Defined terms: 8 defined terms in Schedule 1 Dictionary, including nested definitions (MRCA and VEA defined, then referenced within 'relevant service' definition)","Temporal requirements: Specific timeframes (2,500 hours cumulative exposure, 6 months for skin injury, 'before clinical onset/worsening')","Exclusions in definition: Section 7(2)(b) excludes several related conditions with parenthetical examples","Self-referential structure: Section 11 creates a meta-rule about how other Statements of Principles interact with this one"],"plain_english_summary":"This Statement of Principles guides decisions on whether veterans or defence members with localised sclerosis can get benefits under the VEA or MRCA. It sets a “reasonable hypothesis” test: if the disease and at least one listed service-related factor (e.g., prolonged silica exposure, certain medications, radiation to the affected area, recent skin injury, or lack of care) are linked to service, causation should be accepted. Without such a connection, claims are unlikely to succeed."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2009 Statement of Principles (s4) and, as amended, modifies the factors that raise a reasonable hypothesis in s9 (amendments to subsections 9(2) and 9(5) per Amendment No.15 of 2019). The result is a changed scope of qualifying exposures/treatments that can link localised sclerosis to relevant service under the VEA/MRCA."},"complexity_factors":["Medical‑scientific interpretation required: clinicians and decision‑makers must apply diagnostic criteria and biomarkers (see s7(2) and notes).","Quantified exposure threshold: a cumulative exposure requirement for respirable crystalline silica creates evidentiary complexity (s9(1)).","Multiple causal pathways and timing rules: factors include drugs, therapeutic radiation, skin injury and lack of appropriate management, with differing temporal conditions for onset versus aggravation (s9; s10(2)).","Cross‑references to other instruments and definitions: relies on VEA/MRCA concepts and other Statements of Principles (ss3,5,11; Schedule 1), increasing interaction complexity.","Defined exclusions and diagnostic boundaries: distinction between localised and systemic forms affects scope of claims (s7(2)–(4)).","Administrative discretion and burden of proof: determination that a 'reasonable hypothesis' is raised depends on applying these factors to service history and medical records (ss8–9,10).","Evidence sourcing and coding: references to ICD‑10‑AM coding and histopathologic confirmation impose clinical documentation requirements (s7(3)–(4) and notes).","Amendment and repeal history: replacement of the 2009 Statement and later amendments to subsection 9 provisions mean practitioners must track changes (s4; Endnotes; amendment history)."],"plain_english_summary":"This instrument sets the medical criteria the Repatriation Medical Authority uses to decide whether localised sclerosis (a skin‑limited autoimmune fibrosing condition) — and death from it — can be reasonably linked to a veteran’s service. It prescribes defined exposure, treatment, injury and management‑access factors that claimants must show are related to their 'relevant service', and so determines whether the Commonwealth may be liable under the VEA or MRCA. The rules change what clinical and documentary evidence veterans and clinicians must supply."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-localised-sclerosis-reasonable-hypothesis-no-61-of-2018","history":"/api/acts/statement-of-principles-concerning-localised-sclerosis-reasonable-hypothesis-no-61-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-localised-sclerosis-reasonable-hypothesis-no-61-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-localised-sclerosis-reasonable-hypothesis-no-61-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-localised-sclerosis-reasonable-hypothesis-no-61-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-localised-sclerosis-reasonable-hypothesis-no-61-of-2018/documents"}}