{"id":"F2023L00480","name":"Statement of Principles concerning Marfan syndrome (Reasonable Hypothesis) (No. 51 of 2023)","slug":"statement-of-principles-concerning-marfan-syndrome-reasonable-hypothesis-no-51-of-2023","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441823,"registerId":"F2023L00480-fast-fetch-1775957020995","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning Marfan syndrome (Reasonable Hypothesis) (No. 51 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 (Reasonable Hypothesis)\n\n(No. 51 of 2023)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) 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:
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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 (Reasonable Hypothesis) (No. 51 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning Marfan syndrome No. 25 of 2015 (Federal Register of Legislation No. F2014L01835) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that Marfan syndrome and death from Marfan syndrome 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\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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting Marfan syndrome or death from Marfan syndrome 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(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\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) 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\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":"The instrument repeals the 2015 Statement (cl.4) and restates the condition, definitions, qualifying factors and application to VEA/MRCA claims (cls.5–11, Schedule). The text itself does not indicate an explicit expansion or contraction of the classes of persons or conditions covered compared with the repealed instrument; any substantive scope change is not identified within this instrument."},"complexity_factors":["Cross‑reference to statutory claims framework (applies to claims under s.120A of the VEA and s.338 of the MRCA) (cl.5)","Medical definition and coding reference for Marfan syndrome, tying legal coverage to clinical description and ICD‑10‑AM code (cl.7(2)–(4))","Limited set of qualifying factors (two discrete triggers) that raise a 'reasonable hypothesis'—pregnancy before clinical worsening; inability to obtain appropriate clinical management (cl.9)","Causation constraint that factors must relate to 'relevant service' and apply only where Marfan syndrome pre‑existed or was suffered before/during (but did not arise out of) service (cl.10)","Inclusion of death from Marfan syndrome via defined 'terminal event' list, which expands covered outcomes beyond diagnosis (cl.7(5), Schedule)","Dependency on other Statements where a factor refers to another injury or disease (cl.11), requiring cross‑instrument interpretation","Repeal of an earlier Statement (cl.4) which raises implementation questions for ongoing claims and transitional handling","Legal standard of proof is the statutory 'reasonable hypothesis' (subsection 196B(2) authority referenced in cl.3), which is lower than balance‑of‑probabilities but requires evidentiary linkage"],"plain_english_summary":"Replaces an earlier Statement and sets the criteria for when Marfan syndrome (a genetic connective‑tissue disorder) can be reasonably connected to veterans’ or defence members’ service for claims under the VEA or MRCA. It names two primary triggers that raise a reasonable hypothesis — pregnancy before clinical worsening, and inability to obtain appropriate clinical management — and includes death from Marfan syndrome (with specified terminal events). Those triggers determine who can proceed with a service‑connection claim and the evidentiary threshold decision‑makers will apply."},"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 the specific medical condition (Marfan syndrome) and the limited circumstances under which service can aggravate this pre-existing genetic condition. The scope has not expanded beyond the original purpose of determining service-related aggravation for this specific disorder."},"complexity_factors":["Short document (approximately 1,500 words)","Only 6 defined terms in the Dictionary","Simple binary structure: two alternative factors in section 9","Limited cross-referencing (only refers to other Statements of Principles in section 11, and standard definitions)","Clear conditional logic in section 10 limiting application to aggravation of pre-existing condition only","No nested exceptions or complex procedural requirements"],"plain_english_summary":"This Statement of Principles sets the medical test for when Marfan syndrome—an inherited connective‑tissue disorder—can be treated as materially worsened by Australian military service, replacing the 2015 version. It applies to veterans and current/former defence members claiming under the VEA or MRCA.\n\nCompensation requires pre‑existing Marfan and a service‑connected worsening (for example, pregnancy before deterioration or inability to obtain appropriate treatment)."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-marfan-syndrome-reasonable-hypothesis-no-51-of-2023","history":"/api/acts/statement-of-principles-concerning-marfan-syndrome-reasonable-hypothesis-no-51-of-2023/history","analysis":"/api/acts/statement-of-principles-concerning-marfan-syndrome-reasonable-hypothesis-no-51-of-2023/analysis","conflicts":"/api/acts/statement-of-principles-concerning-marfan-syndrome-reasonable-hypothesis-no-51-of-2023/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-marfan-syndrome-reasonable-hypothesis-no-51-of-2023/important-cases","documents":"/api/acts/statement-of-principles-concerning-marfan-syndrome-reasonable-hypothesis-no-51-of-2023/documents"}}