{"id":"F2019L01353","name":"Statement of Principles concerning microscopic polyangiitis (Reasonable Hypothesis) (No. 90 of 2019)","slug":"statement-of-principles-concerning-microscopic-polyangiitis-reasonable-hypothesis-no-90-of-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440276,"registerId":"F2019L01353-fast-fetch-1775955962704","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning microscopic polyangiitis (Reasonable Hypothesis) (No. 90 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 (Reasonable Hypothesis)\n\n(No. 90 of 2019)\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 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 (Reasonable Hypothesis) (No. 90 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning microscopic polyangiitis No. 13 of 2011 (Federal Register of Legislation No. 2010L03260) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that microscopic polyangiitis and death from microscopic polyangiitis 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 microscopic polyangiitis or death from microscopic polyangiitis 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 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 2 500 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 subsections 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(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 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) 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 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":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard replacement Statement of Principles under the Veterans' Entitlements Act framework. It repeals and replaces the 2011 version (No. 13 of 2011) but maintains the same fundamental scope: establishing medical criteria for linking microscopic polyangiitis to service. The structure and purpose align with the original legislative intent of the Repatriation Medical Authority's determinations under section 196B(2)."},"complexity_factors":["Medical terminology requiring specialist knowledge (e.g., 'necrotising non-granulomatous vasculitis', 'crescentic glomerulonephritis', 'ANCA')","Cross-references to two separate Acts (VEA and MRCA) with six different service types defined","Conditional logic distinguishing between 'clinical onset' and 'clinical worsening' with partially overlapping but distinct factor sets","Nested definitions requiring navigation between main text and Schedule 1 Dictionary","Specific quantitative threshold (2,500 hours cumulative exposure) requiring evidentiary calculation","Exclusion clauses that require distinguishing this disease from similar conditions (polyarteritis nodosa, granulomatosis with polyangiitis, Churg-Strauss syndrome)","Reference to external classification system (ICD-10-AM Tenth Edition) with specific edition and ISBN citation"],"plain_english_summary":"This Statement of Principles sets the medical test for linking microscopic polyangiitis—a rare autoimmune small‑vessel disease—to Australian military service under the lower \"reasonable hypothesis\" standard. It identifies specific service‑related exposures and conditions (for example, heavy silica dust exposure, silicosis, certain medications, or lack of proper treatment) that, if shown, allow a claim to proceed.\n\nIt affects current and former ADF members and veterans seeking entitlements, creating a rebuttable presumption that eases the burden of proving the disease is service‑related."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier Statement (section 4) and replaces it with updated criteria. It specifies a quantitative silica exposure threshold (2,500 cumulative hours) (sections 9(1), 9(4)), lists particular drugs in the Dictionary (Schedule 1) and explicitly includes 'inability to obtain appropriate clinical management' as a factor (section 9(7)). It therefore alters the operational criteria claimants and decision‑makers must apply compared with the prior instrument."},"complexity_factors":["Technical medical definition of microscopic polyangiitis and excluded conditions — requires clinical interpretation (see section 7(2)–(3)).","Quantitative exposure threshold: cumulative 2,500 hours of respirable crystalline silica exposure as a presumptive factor — requires occupational exposure assessment (sections 9(1) and 9(4)).","Listing of discrete clinical triggers (silicosis, specified drugs, inability to obtain appropriate management) that each operate at disease onset or clinical worsening — timing and medical records matter (sections 9(2)–9(7)).","Specified list of drugs is enumerated in the Dictionary and must be checked against prescription/medication history (Schedule 1: specified list of drugs).","Interaction with other Statements of Principles where a factor refers to another injury/disease — cross‑referencing required (section 11).","Legal threshold is 'reasonable hypothesis' tied to VEA/MRCA claims — requires administrative/medical judgement rather than proof on balance (sections 5 and 8).","Application limited to claims under particular statutory provisions (section 5 refers to section 120A of the VEA and section 338 of the MRCA) so administrators must apply statutory gatekeeping rules.","Repeal of prior Statement increases administrative transition work and may require updating case files (section 4).","Use of ICD‑10‑AM code as a cross-reference but reliance on the instrument’s textual definition may create interpretive steps (section 7(3)–(4))."],"plain_english_summary":"This instrument sets the medical criteria used to decide whether microscopic polyangiitis (MPA) or death from MPA can be linked to a veteran’s or service‑member’s military service for VEA/MRCA compensation claims. It defines MPA, lists specific causal factors (for example prolonged respirable crystalline silica exposure, silicosis, use of certain drugs, and inability to obtain appropriate clinical management) and identifies how those factors must connect to relevant service. It matters because those criteria determine whether a ‘reasonable hypothesis’ exists for entitlement, and so shape evidentiary and clinical requirements for claimants and decision makers."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-reasonable-hypothesis-no-90-of-2019","history":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-reasonable-hypothesis-no-90-of-2019/history","analysis":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-reasonable-hypothesis-no-90-of-2019/analysis","conflicts":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-reasonable-hypothesis-no-90-of-2019/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-reasonable-hypothesis-no-90-of-2019/important-cases","documents":"/api/acts/statement-of-principles-concerning-microscopic-polyangiitis-reasonable-hypothesis-no-90-of-2019/documents"}}