{"id":"F2023L00481","name":"Statement of Principles concerning Marfan syndrome (Balance of Probabilities) (No. 52 of 2023)","slug":"statement-of-principles-concerning-marfan-syndrome-balance-of-probabilities-no-52-of-2023","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441828,"registerId":"F2023L00481-fast-fetch-1775957023140","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning Marfan syndrome (Balance of Probabilities) (No. 52 of 2023)","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\nMARFAN SYNDROME (Balance of Probabilities)\n\n(No. 52 of 2023)\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 April 2023.\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 Marfan syndrome (Balance of Probabilities) (No. 52 of 2023).\n\n2 Commencement\n\n This instrument commences on 23 May 2023.\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 Marfan syndrome No. 26 of 2015 (Federal Register of Legislation No. F2014L01838) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 Marfan syndrome and death from Marfan syndrome.\n\nMeaning of Marfan syndrome\n\n(2) For the purposes of this Statement of Principles, Marfan syndrome means a genetic disorder of connective tissue that typically involves abnormalities of the eyes, bones, heart and blood vessels.\n\n(3) While Marfan syndrome attracts ICD‑10‑AM code Q87.4, in applying this Statement of Principles the meaning of Marfan syndrome 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 Marfan syndrome\n\n(5) For the purposes of this Statement of Principles, Marfan syndrome, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's Marfan syndrome.\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 Marfan syndrome and death from Marfan syndrome 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, Marfan syndrome or death from Marfan syndrome is connected with the circumstances of a person's relevant service:\n\n(1) being pregnant before the clinical worsening of Marfan syndrome;\n\n(2) inability to obtain appropriate clinical management for Marfan syndrome.\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(1) and 9(2) apply only to material contribution to, or aggravation of, Marfan syndrome where the person's Marfan syndrome 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 Marfan syndrome—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 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"},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument repeals the 2015 Statement (s4) and restates coverage for Marfan syndrome and death from Marfan syndrome, applying to claims under the VEA and MRCA (s5, s7). The text of this instrument does not, by itself, indicate an expansion or narrowing of scope beyond replacing the prior instrument."},"complexity_factors":["Narrow medical definition with an ICD-10-AM code reference (s7(2)–(4)) increases reliance on clinical classification and records.","Causation limited to two broad factors—pregnancy timing and access to appropriate clinical management—creating evidentiary issues about timing and standard of care (s9).","Temporal restriction: factors apply only where Marfan syndrome was suffered or contracted before or during (but did not arise out of) service (s10(2)), requiring chronological proof.","Standard of proof set to balance of probabilities underpinned by a scientific-evidence statement (s8), affecting adjudicators’ evaluation of medical evidence.","Cross‑references to other Statements of Principles mean claim outcomes may depend on interpreting and applying other instruments (s11).","Administrative scope and claim applicability are tied to specific statutory claim pathways (VEA s120B; MRCA s339) (s5).","Repeal of the 2015 Statement (s4) requires administrators to ensure transition to the new instrument and confirm any differences in application."],"plain_english_summary":"This Statement of Principles, made by the Repatriation Medical Authority, defines Marfan syndrome and death from it for veterans’ claims and sets when, on the balance of probabilities, the condition can be connected to relevant service. It applies to claims under the VEA and MRCA and identifies two qualifying factors that can link Marfan syndrome to service: pregnancy before clinical worsening and inability to obtain appropriate clinical management."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the same narrow scope as its 2015 predecessor. It addresses only Marfan syndrome and does not expand into related connective tissue disorders or broader genetic conditions. The two aggravating factors (pregnancy and inability to obtain clinical management) are standard limitations for genetic conditions under the veterans' compensation framework."},"complexity_factors":["Short, single-purpose instrument (approximately 1,500 words)","Only 6 defined terms in the Dictionary (Schedule 1)","Simple conditional structure: two alternative factors in section 9, with a single limitation in section 10(2)","Minimal cross-referencing — only refers to parent Acts (VEA and MRCA) and one repealed instrument","No nested exceptions or complex definitional chains","Straightforward logical flow: definition → factors → relationship to service → dictionary"],"plain_english_summary":"This Statement of Principles sets the medical test for when Australian Defence Force members and veterans can get compensation for Marfan syndrome. It applies a \"balance of probabilities\" link to service, recognising Marfan is genetic and not caused by service but may be aggravated by service circumstances—notably pregnancy or inadequate access to appropriate medical treatment—where the condition pre‑existed. It replaces a 2015 version and narrows when genetic conditions qualify for compensation."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-marfan-syndrome-balance-of-probabilities-no-52-of-2023","history":"/api/acts/statement-of-principles-concerning-marfan-syndrome-balance-of-probabilities-no-52-of-2023/history","analysis":"/api/acts/statement-of-principles-concerning-marfan-syndrome-balance-of-probabilities-no-52-of-2023/analysis","conflicts":"/api/acts/statement-of-principles-concerning-marfan-syndrome-balance-of-probabilities-no-52-of-2023/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-marfan-syndrome-balance-of-probabilities-no-52-of-2023/important-cases","documents":"/api/acts/statement-of-principles-concerning-marfan-syndrome-balance-of-probabilities-no-52-of-2023/documents"}}