{"id":"F2018L01488","name":"Statement of Principles concerning moderate to severe traumatic brain injury (Balance of Probabilities) (No. 95 of 2018)","slug":"statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-balance-of-probabilitie","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439813,"registerId":"F2018L01488-fast-fetch-1775955691103","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning moderate to severe traumatic brain injury (Balance of Probabilities) (No. 95 of 2018)","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\nMODERATE TO SEVERE TRAUMATIC BRAIN INJURY (Balance of Probabilities)\n\n(No. 95 of 2018)\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 26 October 2018\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 moderate to severe traumatic brain injury (Balance of Probabilities) (No. 95 of 2018).\n\n2 Commencement\n\n This instrument commences on 26 November 2018.\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 moderate to severe traumatic brain injury No. 63 of 2012 (Federal Register of Legislation No. F2012L01805) 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 moderate to severe traumatic brain injury and death from moderate to severe traumatic brain injury.\n\nMeaning of moderate to severe traumatic brain injury\n\n(2) For the purposes of this Statement of Principles, moderate to severe traumatic brain injury:\n\n(a) means damage to the brain resulting from the transfer of kinetic energy to the brain from external physical forces, as manifested by at least one of the following:\n\n(i) loss of consciousness for more than 30 minutes;\n\n(ii) anterograde amnesia for more than 24 hours;\n\n(iii) an intracranial lesion, including an abnormality attributable to the injury seen on structural imaging (conventional magnetic resonance imaging or computed tomography scanning);\n\n(iv) penetration of the dura mater; or\n\n(v) a Glasgow Coma Scale score of less than 13; and\n\n(b) excludes injury from radiation, electricity, heat and surgery.\n\nNote: This Statement of Principles applies to moderate to severe traumatic brain injury only. Trauma to the brain can cause other diseases or injuries, and these are covered by a range of other Statements of Principles in which trauma to the brain (variously worded) is listed as a risk factor. The relevant Statements of Principles include but are not limited to: accommodation disorder, Alzheimer disease, anosmia, arachnoid cyst, bruxism, cerebrovascular accident, deep vein thrombosis, dementia pugilistica, epilepsy, epileptic seizure, female sexual dysfunction, hypopituitarism, Meniere's disease, narcolepsy, optochiasmatic arachnoiditis, Parkinson's disease and parkinsonism, periodic limb movement disorder, pulmonary thromboembolism, schizophrenia, subarachnoid haemorrhage, subdural haematoma, suicide and attempted suicide, and trigeminal neuropathy.\n\nDeath from moderate to severe traumatic brain injury\n\n(3) For the purposes of this Statement of Principles, moderate to severe traumatic brain injury, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's moderate to severe traumatic brain injury.\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 moderate to severe traumatic brain injury and death from moderate to severe traumatic brain injury 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, moderate to severe traumatic brain injury or death from moderate to severe traumatic brain injury is connected with the circumstances of a person's relevant service:\n\n(1) experiencing a specified event at the time of the clinical onset of moderate to severe traumatic brain injury;\n\nNote: specified event is defined in the Schedule 1 - Dictionary. \n\n(2) inability to obtain appropriate clinical management for moderate to severe traumatic brain injury.\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 factor set out in subsection 9(2) applies only to material contribution to, or aggravation of, moderate to severe traumatic brain injury where the person's moderate to severe traumatic brain injury 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 moderate to severe traumatic brain injury—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 event means:\n\n(a) the head being struck by an object;\n\n(b) the head striking an object;\n\n(c) the brain undergoing an acceleration or deceleration movement without direct external trauma to the head;\n\n(d) a foreign body penetrating the brain; or\n\n(e) an explosion or explosive blast.\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":3,"scope_assessment":{"changed":false,"description":"The instrument maintains its original narrow scope. It replaces a 2012 version (No. 63 of 2012) with substantively identical purpose: establishing the causal link between service and moderate to severe TBI. The definition has been refined (adding imaging criteria and Glasgow Coma Scale) but the fundamental scope — determining service connection for this specific injury type — remains unchanged."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 6 defined terms in the Dictionary (Schedule 1)","Clear, non-nested structure: definitions → application → two simple factors in section 9","Minimal cross-referencing — only refers to other Statements of Principles in section 11 for related conditions","Single conditional limitation in section 10(2) regarding pre-existing injuries","Medical criteria in section 7(2) use plain language alternatives (Glasgow Coma Scale, anterograde amnesia) but are clearly enumerated"],"plain_english_summary":"This instrument sets the medical test for when Australian veterans and current/former defence members can get compensation for moderate to severe traumatic brain injury from service. It defines the medical thresholds (e.g. prolonged loss of consciousness, extended memory loss, imaging or skull penetration, low coma scores), the kinds of head events or blast exposure that must be linked to service, and covers death or worsened injury from denied treatment.\n\nIt matters because these criteria are the gateway to benefits under VEA/MRCA; related conditions (epilepsy, dementia, mental illness) are decided under separate rules."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument replaces (repeals) the 2012 Statement (s4) and re-states criteria for moderate to severe traumatic brain injury and death contributed to by it, applying to claims under section 120B of the VEA and section 339 of the MRCA (s5). The text provided does not identify a substantive expansion or narrowing of claimant scope compared with the prior instrument; it mainly consolidates definitional and connection rules within the new instrument (see s7–s11 and Schedule 1)."},"complexity_factors":["Detailed clinical thresholds and exclusions (loss of consciousness >30 minutes; anterograde amnesia >24 hours; intracranial lesion on imaging; penetration of dura mater; Glasgow Coma Scale <13; excludes radiation/electricity/heat/surgery) (s7(2)(a)-(b))","Balance of probabilities legal standard invoked for causation (s8)","Two alternative causal pathways required for service connection: specified event at time of clinical onset OR inability to obtain appropriate clinical management (s9(1)-(2))","Requirement that any factor be related to the person's defined relevant service (s10(1))","Special limitation on the clinical-management factor: it applies only to material contribution/aggravation where the injury pre‑existed or was suffered before/during but did not arise out of service (s10(2))","Cross‑reference to other Statements of Principles when a factor refers to an injury/disease covered elsewhere (s11)","Comprehensive definitions in Schedule 1 for key terms that materially affect application (specified event; relevant service; terminal event) (Schedule 1)","Instrumental administrative elements: made by the Repatriation Medical Authority (s3/header), repeals the 2012 Statement (s4), and applies to claims under specific statutory sections (s5)","Inclusion of death from a terminal event contributed to by the TBI, with examples of terminal events listed (s7(3); Schedule 1)"],"plain_english_summary":"**What this instrument does:** It sets medical criteria for moderate to severe traumatic brain injury and for death contributed to by that injury, and establishes when those conditions can be treated as connected to military or veteran service for claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. \n\n**Who it affects and why it matters:** Veterans, current members and decision-makers use these clinical thresholds and service‑connection rules when deciding entitlement on the balance of probabilities."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-balance-of-probabilitie","history":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-balance-of-probabilitie/history","analysis":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-balance-of-probabilitie/analysis","conflicts":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-balance-of-probabilitie/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-balance-of-probabilitie/important-cases","documents":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-balance-of-probabilitie/documents"}}