{"id":"F2018L00009","name":"Statement of Principles concerning non-freezing cold injury (Balance of Probabilities) (No. 6 of 2018)","slug":"statement-of-principles-concerning-non-freezing-cold-injury-balance-of-probabilities-no-6-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439446,"registerId":"F2018L00009-fast-fetch-1775955469765","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning non-freezing cold injury (Balance of Probabilities) (No. 6 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\nNON-FREEZING COLD INJURY (Balance of Probabilities)\n\n(No. 6 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 22 December 2017\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 Revocation\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 non-freezing cold injury (Balance of Probabilities) (No. 6 of 2018).\n\n2 Commencement\n\n This instrument commences on 29 January 2018.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Revocation\n\nThe Statement of Principles concerning immersion foot No. 26 of 2009, made under subsection 196B(3) of the VEA is revoked.\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 non-freezing cold injury and death from non-freezing cold injury.\n\nMeaning of non-freezing cold injury\n\n(2) For the purposes of this Statement of Principles, non-freezing cold injury:\n\n(a) means a disease of the sympathetic nerves and blood vessels affecting the tissues of a limb or limbs, most commonly the foot, due to prolonged exposure of the affected part to wet and non-freezing cold conditions; and\n\n(b) excludes tropical immersion foot, chilblains, frostnip and frostbite.\n\nNote 1: Non-freezing cold injury is also known as trench foot or immersion foot.\n\nNote 2: Non-freezing cold injury typically is accompanied by coldness and numbness in feet and hands exposed to wet and cold conditions, followed by pain and redness of the affected part on rewarming. Non-freezing cold injury causes ongoing cold sensitivity, altered sensation and less frequently, neuropathic pain of the affected part.\n\n(3) While non-freezing cold injury attracts ICD‑10‑AM code T69.0, in applying this Statement of Principles the meaning of non-freezing cold injury 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 non-freezing cold injury\n\n(5) For the purposes of this Statement of Principles, non-freezing cold injury, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's non-freezing cold 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 non-freezing cold injury and death from non-freezing cold 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, non-freezing cold injury or death from non-freezing cold injury is connected with the circumstances of a person's relevant service:\n\n(1) exposing the affected limb to moisture and non-freezing temperatures below 21 degrees Celsius, for a period of at least ten hours within the 24 hours before the clinical onset of non-freezing cold injury;\n\nNote 1: Non-freezing cold injury is most commonly associated with temperatures just above freezing.\n\nNote 2: Exposure to moisture and non-freezing temperatures may occur during military training or exercises in the outdoors, but are also likely to occur in other circumstances, examples of which include the homeless, those who are intoxicated with alcohol, and those who have poorly controlled psychiatric illness.\n\n(2) inability to obtain appropriate clinical management for non-freezing cold 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, non-freezing cold injury where the person's non-freezing cold 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 MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n non-freezing cold injury—see subsection 7(2).\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":{"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":"This instrument revokes the previous 'immersion foot No. 26 of 2009' (section 4) and replaces it with a Statement that defines 'non‑freezing cold injury', excludes related conditions (subsection 7(2)), and restates factors and linkage to 'relevant service' for VEA/MRCA claims (sections 5, 7–10)."},"complexity_factors":["Technical medical definition of 'non‑freezing cold injury' with exclusions (subsection 7(2)).","Specific exposure threshold requirement: moisture and non‑freezing temperatures below 21°C for at least 10 hours within 24 hours before clinical onset (section 9(1)) increases evidentiary precision and burden.","Alternative pathway based on 'inability to obtain appropriate clinical management' (section 9(2)) and its limited application where injury pre‑dated or occurred before/during but did not arise out of service (section 10(2)).","Requirement that the factor(s) be related to 'relevant service' (section 10(1)) ties medical facts to legal categories of service (Schedule 1 definitions).","Inclusion of death from a terminal event contributed to by the injury (section 7(5)) requires causal linkage through terminal causes.","Interplay with other Statements of Principles when factors refer to injuries covered elsewhere (section 11) creates cross‑instrument dependency.","Reference to ICD‑10‑AM code but reliance on the instrument's own definition (subsections 7(3)–(4)) introduces a terminological anchor to clinical coding.","Evidentiary standard expressed as 'more probable than not' based on RMA's view of sound medical‑scientific evidence (section 8) sets the standard of proof.","Revocation of the prior immersion foot Statement (section 4) means practitioners and decision‑makers must apply the new wording from commencement (section 2), creating an implementation task."],"plain_english_summary":"**What this does:** This instrument is the Repatriation Medical Authority's Statement of Principles that sets the medical criteria used to decide whether non‑freezing cold injury (and death from it) is connected to a person's service for VEA/MRCA claims, and it revokes the prior immersion‑foot Statement. \n\n**Who it affects and why it matters:** It affects veterans and service members claiming entitlement: claimants must meet the Statement's medical factors (commonly prolonged wet, non‑freezing exposure or inability to obtain appropriate clinical care) and link those factors to their relevant service to succeed."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the same scope as its predecessor (Statement of Principles concerning immersion foot No. 26 of 2009), which it explicitly revokes. It updates the medical terminology and diagnostic criteria but does not expand beyond the original purpose of determining compensation eligibility for cold-related limb injuries in veterans. The scope remains tightly focused on non-freezing cold injury as a specific medical condition with defined causal factors."},"complexity_factors":["Short document: approximately 1,500 words across 11 sections plus a brief dictionary","Only 5 defined terms in Schedule 1 (MRCA, non-freezing cold injury, relevant service, terminal event, VEA)","Simple binary structure: two alternative factors in section 9, with one conditional limitation in section 10(2)","Minimal cross-referencing: only internal references to the Dictionary and one reference to ICD-10-AM coding system","Clear exclusionary definitions in section 7(2)(b) that remove ambiguity by listing what is NOT covered","Single legislative hook: made under one subsection of the Veterans' Entitlements Act 1986 (subsection 196B(3))"],"plain_english_summary":"This rulebook sets when Australian veterans and current/former defence members can get compensation for non-freezing cold injury (trench/immersion foot)—a nerve and blood-vessel injury from prolonged wet, cold exposure. It requires a “more likely than not” service connection and outlines two pathways to establish that link: direct cold exposure during service or service-related lack of treatment worsening a pre-existing condition.\n\nIt clarifies exclusions (e.g., frostbite) and replaces the 2009 immersion-foot guidance."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-non-freezing-cold-injury-balance-of-probabilities-no-6-of-2018","history":"/api/acts/statement-of-principles-concerning-non-freezing-cold-injury-balance-of-probabilities-no-6-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-non-freezing-cold-injury-balance-of-probabilities-no-6-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-non-freezing-cold-injury-balance-of-probabilities-no-6-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-non-freezing-cold-injury-balance-of-probabilities-no-6-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-non-freezing-cold-injury-balance-of-probabilities-no-6-of-2018/documents"}}