{"id":"F2021L01630","name":"Statement of Principles concerning motor neurone disease (Balance of Probabilities) (No. 112 of 2021)","slug":"statement-of-principles-concerning-motor-neurone-disease-balance-of-probabilities-no-112-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441079,"registerId":"F2021L01630-fast-fetch-1775956490543","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning motor neurone disease (Balance of Probabilities) (No. 112 of 2021)","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\nMOTOR NEURONE DISEASE (Balance of Probabilities)\n\n(No. 112 of 2021)\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 November 2021\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 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 motor neurone disease (Balance of Probabilities) (No. 112 of 2021).\n\n2 Commencement\n\n This instrument commences on 20 December 2021.\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 motor neurone disease No. 68 of 2013 (Federal Register of Legislation No. F2013L01656) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 motor neurone disease and death from motor neurone disease.\n\nMeaning of motor neurone disease\n\n(2) For the purposes of this Statement of Principles, motor neurone disease:\n\n(a) means a progressive neurodegenerative disease with either:\n\n(i) the presence of upper and lower motor neurone dysfunction in at least one body region; or\n\n(ii) the presence of lower motor neurone dysfunction in at least two body regions; and\n\n(b) the absence of other disease processes that explain the motor neurone dysfunction.\n\n(3) While motor neurone disease attracts ICD‑10‑AM code G12.2, in applying this Statement of Principles the meaning of motor neurone disease 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 motor neurone disease\n\n(5) For the purposes of this Statement of Principles, motor neurone disease, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's motor neurone disease.\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 motor neurone disease and death from motor neurone disease 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, motor neurone disease or death from motor neurone disease is connected with the circumstances of a person's relevant service:\n\n(1) having smoked tobacco products in an amount of at least 20 pack-years before the clinical onset of motor neurone disease;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(2) having smoked tobacco products in an amount of at least 20 pack-years before the clinical worsening of motor neurone disease;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(3) inability to obtain appropriate clinical management for motor neurone disease.\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(2) and 9(3) apply only to material contribution to, or aggravation of, motor neurone disease where the person's motor neurone disease 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 motor neurone disease—see subsection 7(2).\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n one pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.\n\nNote 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.\n\nNote 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.\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 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":"The legislation maintains its original purpose as a medical determination instrument for veterans' compensation claims. It replaces a 2013 version but does not expand beyond the established framework of determining service connection for MND under the VEA and MRCA."},"complexity_factors":["Multiple defined terms in Schedule 1 (motor neurone disease, one pack-year, relevant service, terminal event, MRCA, VEA)","Nested conditional logic in section 9 requiring 'at least one' factor from a closed list","Section 10 creates a bifurcated application: subsection 9(1) applies generally, while subsections 9(2) and 9(3) are restricted to aggravation of pre-existing disease only","Cross-reference to external classification system (ICD-10-AM Tenth Edition) with specific ISBN and effective date","Incorporation by reference to other Statements of Principles in section 11","Mathematical calculation required for 'pack-years' with conversion rules for non-cigarette tobacco","Dual statutory framework application (VEA and MRCA with different service definitions)"],"plain_english_summary":"This Statement of Principles sets the medical tests the Department of Veterans’ Affairs uses to decide if motor neurone disease (MND) or death from MND is linked to military service for claims under the VEA and MRCA. It defines MND clinically and says, to connect service, claimants must show either heavy prior smoking (≥20 pack‑years) or that service prevented access to proper MND treatment — and those factors only apply where MND existed before or during service. It tightens proof compared with 2013."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier Statement of Principles No. 68 of 2013 (s4) and replaces it with updated definitions and qualifying factors (including a 20 pack‑year smoking threshold, a clinical management factor, and a specified clinical definition of MND) and applies to claims under the VEA and the MRCA (s5, s7, s9). From the text alone the net broadening or narrowing of claimant coverage versus the 2013 instrument cannot be determined; the instrument plainly updates the criteria decision‑makers must apply."},"complexity_factors":["Statutory context and application to multiple Acts: applies to claims under VEA s120B and MRCA s339 (s5).","Medical diagnostic detail: specific clinical definition of MND requiring upper/lower motor neurone dysfunction and exclusion of other causes (s7(2)).","Evidential standard: 'more probable than not' basis for linking MND to service (s8) increases fact-finding burden.","Binary qualifying factors with quantification: 20 pack‑year tobacco threshold for onset or worsening (s9(1)‑(2); Schedule 1 definition of one pack‑year), requiring historical exposure reconstruction.","Service‑relationship requirement: qualifying factors must be related to the person's relevant service; subsectional distinctions for aggravation/material contribution where disease pre‑existed service (s10(1)‑(2)).","Clinical management factor: inability to obtain appropriate clinical management is a non‑quantitative, potentially discretionary factor (s9(3)).","Interaction with other Statements of Principles: cross‑references where a factor involves another condition covered elsewhere (s11).","Death linkage and terminal events: death from MND includes death from terminal events contributed to by MND, with a defined list (s7(5); Schedule 1 terminal event).","Use of ICD‑10‑AM coding alongside a bespoke clinical definition (s7(3)‑(4)) requiring translators between medical coding and instrument criteria.","Repeal and update of prior instrument: replaces Statement No. 68 of 2013 (s4), so decision‑makers must apply the new text to claims from commencement."],"plain_english_summary":"This instrument sets the legal rules for when motor neurone disease (MND) or death from MND can be treated as connected to a person’s military \"relevant service\" for veterans’ compensation claims. It repeals the 2013 Statement and commenced on 20 December 2021.\n\nIt defines MND clinically and makes entitlement turn on specified qualifying factors — principally a heavy smoking history (20 pack‑years) or inability to obtain appropriate clinical management — that must be related to the person’s service. It applies to claims under the VEA and the MRCA."},"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-motor-neurone-disease-balance-of-probabilities-no-112-of-2021","history":"/api/acts/statement-of-principles-concerning-motor-neurone-disease-balance-of-probabilities-no-112-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-motor-neurone-disease-balance-of-probabilities-no-112-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-motor-neurone-disease-balance-of-probabilities-no-112-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-motor-neurone-disease-balance-of-probabilities-no-112-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-motor-neurone-disease-balance-of-probabilities-no-112-of-2021/documents"}}