{"id":"F2019L01358","name":"Statement of Principles concerning microscopic polyangiitis (Balance of Probabilities) (No. 91 of 2019)","slug":"statement-of-principles-concerning-microscopic-polyangiitis-balance-of-probabilities-no-91-of-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440274,"registerId":"F2019L01358-fast-fetch-1775955962684","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning microscopic polyangiitis (Balance of Probabilities) (No. 91 of 2019)","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\nMICROSCOPIC POLYANGIITIS (Balance of Probabilities)\n\n(No. 91 of 2019)\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 18 October 2019\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 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 microscopic polyangiitis (Balance of Probabilities) (No. 91 of 2019).\n\n2 Commencement\n\n This instrument commences on 18 November 2019.\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 microscopic polyangiitis No. 14 of 2011 (Federal Register of Legislation No. F2010L03262) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 microscopic polyangiitis and death from microscopic polyangiitis.\n\nMeaning of microscopic polyangiitis\n\n(2) For the purposes of this Statement of Principles, microscopic polyangiitis:\n\n(a) means a necrotising non-granulomatous vasculitis with few or no immune deposits predominantly affecting small vessels (capillaries, venules or arterioles); and\n\n(b) excludes polyarteritis nodosa, granulomatosis with polyangiitis (Wegener granulomatosis) and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).\n\nNote: Microscopic polyangiitis commonly manifests in the kidney as rapidly progressive crescentic glomerulonephritis, or in the lungs as pulmonary capillaritis. Antineutrophil cytoplasmic antibodies (ANCA) are usually present.\n\n(3) While microscopic polyangiitis attracts ICD‑10‑AM code M31.7, in applying this Statement of Principles the meaning of microscopic polyangiitis 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 microscopic polyangiitis\n\n(5) For the purposes of this Statement of Principles, microscopic polyangiitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's microscopic polyangiitis.\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 microscopic polyangiitis and death from microscopic polyangiitis 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, microscopic polyangiitis or death from microscopic polyangiitis is connected 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 5 000 hours before the clinical onset of microscopic polyangiitis;\n\n(2) having silicosis at the time of the clinical onset of microscopic polyangiitis;\n\n(3) being treated with a drug from the specified list of drugs at the time of the clinical onset of microscopic polyangiitis;\n\nNote: specified list of drugs is defined in the Schedule 1 - Dictionary. \n\n(4) 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 5 000 hours before the clinical worsening of microscopic polyangiitis;\n\n(5) having silicosis at the time of the clinical worsening of microscopic polyangiitis;\n\n(6) being treated with a drug from the specified list of drugs at the time of the clinical worsening of microscopic polyangiitis;\n\nNote: specified list of drugs is defined in the Schedule 1 - Dictionary. \n\n(7) inability to obtain appropriate clinical management for microscopic polyangiitis.\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 subsection 9(4) to 9(7) apply only to material contribution to, or aggravation of, microscopic polyangiitis where the person's microscopic polyangiitis 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 microscopic polyangiitis—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 specified list of drugs means:\n\n(a) benzylthiouracil;\n\n(b) carbimazole;\n\n(c) hydralazine;\n\n(d) methimazole; or\n\n(e) propylthiouracil.\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":5,"scope_assessment":{"changed":true,"description":"The instrument repeals the earlier Statement of Principles No. 14 of 2011 (s4) and replaces it with updated criteria. It continues to apply to claims under section 120B of the VEA and section 339 of the MRCA (s5) but alters the substantive factors and definitions used to link MPA to service — for example by specifying a 5,000‑hour silica exposure threshold and listing specific drugs (s9; Schedule 1)."},"complexity_factors":["Legal cross‑references to two compensation frameworks (VEA and MRCA) and reliance on statutory claim rules (application: s5)","Technical medical definition of MPA and exclusion of related vasculitides (s7(2)–(3))","Quantitative exposure threshold (cumulative 5,000 hours of respirable crystalline silica) with specific activity contexts (s9(1),(4))","Temporal distinctions between clinical onset and clinical worsening and differing application of factors (s9, s10(2))","Interaction with other Statements of Principles where factors reference other diseases (s11)","Specified drug list that creates a discrete pharmacological causation pathway (Schedule 1 – specified list of drugs)","Inclusion of death via terminal events and definition of 'terminal event' (s7(5); Schedule 1)","Repeal and replacement of an earlier Statement of Principles, requiring attention to transitional and comparative scope (s4)"],"plain_english_summary":"This Statement of Principles sets the medical criteria used to decide whether microscopic polyangiitis (MPA) — and death from MPA — can be connected to a person’s military or veteran service for claims under the VEA and MRCA. It lists specific causal factors (notably cumulative respirable crystalline silica exposure of 5,000 hours, silicosis, certain listed drugs, and inability to obtain appropriate clinical management) and requires those factors be related to the person’s relevant service."},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the standard scope of Repatriation Medical Authority Statements of Principles. It provides a focused, disease-specific determination for microscopic polyangiitis without expanding beyond the statutory framework established by section 196B(3) of the Veterans' Entitlements Act 1986. The instrument replaces a 2011 version but does not appear to have expanded the scope beyond the original legislative intent of establishing medical criteria for service-related compensation claims."},"complexity_factors":["Multiple cross-references to other legislation (Veterans' Entitlements Act 1986, Military Rehabilitation and Compensation Act 2004)","Conditional logic distinguishing between 'clinical onset' and 'clinical worsening' with different rules applying to each","Nested definitions requiring reference to Schedule 1 (Dictionary) for key terms like 'relevant service', 'terminal event', and 'specified list of drugs'","Specific quantitative threshold (5,000 hours of silica exposure) requiring cumulative calculation","Exclusion clauses in the disease definition (excluding similar conditions like granulomatosis with polyangiitis)","Reference to external medical classification system (ICD-10-AM Tenth Edition) with specific edition and ISBN","Complex temporal relationships — section 10(2) creates a limited application for factors 9(4)-9(7) only where disease pre-existed service"],"plain_english_summary":"This instrument sets the medical and legal test for linking microscopic polyangiitis to Australian Defence service so veterans and current/former ADF members can claim compensation under the Veterans' Entitlements Act and the MRCA. It replaces the 2011 rules.\n\nA claim succeeds on the balance of probabilities if service-related silica exposure, silicosis, specified medications, or inability to obtain treatment contributed — but those factors only cover worsening of a pre‑existing disease, not new onset caused by service."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-balance-of-probabilities-no-91-of-2019","history":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-balance-of-probabilities-no-91-of-2019/history","analysis":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-balance-of-probabilities-no-91-of-2019/analysis","conflicts":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-balance-of-probabilities-no-91-of-2019/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-balance-of-probabilities-no-91-of-2019/important-cases","documents":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-balance-of-probabilities-no-91-of-2019/documents"}}