{"id":"F2018L01487","name":"Statement of Principles concerning moderate to severe traumatic brain injury (Reasonable Hypothesis) (No. 94 of 2018)","slug":"statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-reasonable-hypothesis-n","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439807,"registerId":"F2018L01487-fast-fetch-1775955688852","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 (Reasonable Hypothesis) (No. 94 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![RMA-Red](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nMODERATE TO SEVERE TRAUMATIC BRAIN INJURY  (Reasonable Hypothesis)\n\n(No. 94 of 2018)\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   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:<br> |\n| --- |\n| ![](image.002.png)<br> <br>Professor Nicholas Saunders AO<br>Chairperson<br> |\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 (Reasonable Hypothesis) (No. 94 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(2) of the Veterans' Entitlements Act 1986.\n\n4               Repeal\n\nThe Statement of Principles concerning moderate to severe traumatic brain injury No. 62 of 2012 (Federal Register of Legislation No. F2012L01804) 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 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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates 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, 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 moderate to severe traumatic brain injury or death from moderate to severe traumatic brain injury 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(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                             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)          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 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":{"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"},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument maintains its original narrow scope. It addresses only the specific medical criteria for establishing a connection between moderate to severe traumatic brain injury and eligible military service. The 2018 revision appears to be a routine reissue updating the 2012 version without expansion into new substantive areas."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 7 defined terms in the Dictionary (Schedule 1)","Clear, linear structure with numbered sections following a logical sequence","Limited cross-referencing — primarily internal references to the Dictionary and explicit references to only two principal Acts (VEA and MRCA)","Simple conditional logic: 'at least one of the following factors must exist' (section 9) with only two alternative pathways","Single nested condition in section 10(2) regarding timing of injury relative to service","No exceptions to exceptions or deeply nested subsections"],"plain_english_summary":"This instrument sets the medical criteria for claiming compensation for moderate to severe traumatic brain injury arising from service, defining the level of injury by clinical signs (e.g., prolonged unconsciousness, lasting amnesia, imaging or skull penetration, low consciousness scores). It requires a plausible link to service—either a traumatic event or inadequate treatment—and covers deaths from TBI complications. It affects veterans, current/former defence members and peacekeepers and replaces the 2012 instrument."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2012 Statement of Principles (section 4) and replaces it with the current definitions and trigger criteria. The current scope is limited to moderate to severe traumatic brain injury as defined (subsection 7(2)), excludes certain non‑kinetic causes (7(2)(b)), explicitly includes death contributed to by TBI (7(3)), and applies to claims under section 120A of the VEA or section 338 of the MRCA (section 5). The repeal indicates a change from the prior instrument, with the present instrument prescribing the specific medical and service‑linking conditions above."},"complexity_factors":["Medical-technical thresholds for TBI (loss of consciousness >30 min; anterograde amnesia >24 hrs; intracranial lesion on imaging; dura penetration; Glasgow Coma Scale <13) — subsection 7(2)(a)(i)-(v)","Narrow scope and exclusions (excludes injury from radiation, electricity, heat and surgery) — subsection 7(2)(b)","Legal linkage to service via defined categories of ‘relevant service’ (VEA/MRCA definitions in Schedule 1) and application to specified claim provisions — section 5 and Schedule 1","Two alternative triggering factors for a ‘reasonable hypothesis’ (specified event at clinical onset; inability to obtain appropriate clinical management) and the limited application of the latter — sections 9 and 10(2)","Cross‑reference to and interaction with other Statements of Principles where factors refer to other injuries/diseases — section 11","Inclusion of death from a terminal event contributed to by the TBI (affects proximate/ultimate cause analysis) — subsection 7(3)","Repeal of a prior Statement (No. 62 of 2012) which may alter substantive coverage or thresholds — section 4"],"plain_english_summary":"This instrument sets the medical criteria the Repatriation Medical Authority uses to decide whether moderate to severe traumatic brain injury (and death contributed to by it) can be reasonably linked to a veteran’s service for VEA or MRCA claims. It defines what counts as “moderate to severe” TBI, lists the minimum events or care‑failures that must be present to raise a reasonable hypothesis, and repeals the earlier 2012 Statement of Principles. It affects veterans and other eligible service members seeking entitlements by clarifying when injury is treated as service‑related."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-reasonable-hypothesis-n","history":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-reasonable-hypothesis-n/history","analysis":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-reasonable-hypothesis-n/analysis","conflicts":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-reasonable-hypothesis-n/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-reasonable-hypothesis-n/important-cases","documents":"/api/acts/statement-of-principles-concerning-moderate-to-severe-traumatic-brain-injury-reasonable-hypothesis-n/documents"}}