{"id":"F2018L00208","name":"Statement of Principles concerning personality disorder (Balance of Probabilities) (No. 18 of 2018)","slug":"statement-of-principles-concerning-personality-disorder-balance-of-probabilities-no-18-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":96832,"registerId":"commonwealth-F2018L00208-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning personality disorder (Balance of Probabilities) (No. 18 of 2018)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning personality disorder (Balance of Probabilities) (No. 18 of 2018)\n\nmade under subsection 196B(3) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 24 September 2018\n\nIncludes amendments up to: Veterans' Entitlements (Statements of Principles—Category 1B Stressor) Amendment Determination 2018 (No. 87 of 2018) (F2018L01188)\n\nThe day of commencement of this Amendment Determination is 24 September 2018.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning personality disorder (Balance of Probabilities) (No. 18 of 2018) that shows the text of the law as amended and in force on 24 September 2018.\n\nThe notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.\n\nUncommenced amendments\n\nThe effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.\n\nApplication, saving and transitional provisions for provisions and amendments\n\nIf the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.\n\nModifications\n\nIf the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.\n\nSelf‑repealing provisions\n\nIf a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.\n\n![RMA-Red](image.002.jpeg)\n\nStatement of Principles\n\nconcerning\n\nPERSONALITY DISORDER  \n(Balance of Probabilities)\n\n(No. 18 of 2018)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\nDated 2 March 2018\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\n1 Name\n\nThis is the Statement of Principles concerning personality disorder (Balance of Probabilities) (No. 18 of 2018).\n\n2 Commencement\n\nThis instrument commences on 2 April 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 personality disorder No. 71 of 2008, as amended, made under subsections 196B(3) and (8) 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 personality disorder and death from personality disorder.\n\nMeaning of personality disorder\n\n(2) For the purposes of this Statement of Principles, personality disorder means a disorder of mental health that meets the following diagnostic criteria (derived from DSM-5):\n\n    An enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:\n\n(i) cognition (that is, ways of perceiving and interpreting self, other people and events);\n\n(ii) affectivity (that is, the range, intensity, lability and appropriateness of emotional response);\n\n(iii) interpersonal functioning; or\n\n(iv) impulse control.\n\n    B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.\n    C. The enduring pattern leads to clinically significant distress or impairment in social, occupational or other important areas of functioning.\n    D. The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood.\n    E. The enduring pattern is not better explained as a manifestation or consequence of another mental disorder.\n    F. The enduring pattern is not attributable to the physiological effects of a substance (for example, a drug of abuse, a medication) or another medical condition (for example, head trauma).\n\n> Note 1: The definition of personality disorder includes paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, antisocial personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder, other specified personality disorder and unspecified personality disorder.\n\n> Note 2: The definition of personality disorder excludes personality change due to another medical condition.\n\n> Note 3: DSM-5 and personality change due to another medical condition are defined in the Schedule 1 - Dictionary.\n\n(3) While personality disorder attracts ICD‑10‑AM code:\n\n(a) F60.0 (paranoid personality disorder);\n\n(b) F60.1 (schizoid personality disorder);\n\n(c) F21 (schizotypal personality disorder);\n\n(d) F60.2 (antisocial personality disorder);\n\n(e) F60.31 (borderline personality disorder);\n\n(f) F60.4 (histrionic personality disorder);\n\n(g) F60.8 (narcissistic personality disorder);\n\n(h) F60.6 (avoidant personality disorder);\n\n(i) F60.7 (dependent personality disorder);\n\n(j) F60.5 (obsessive-compulsive personality disorder); or\n\n(k) F60.9 (other specified personality disorder and unspecified personality disorder);\n\nin applying this Statement of Principles the meaning of personality disorder 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 personality disorder\n\n(5) For the purposes of this Statement of Principles, personality disorder, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's personality disorder.\n\n> Note: 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 personality disorder and death from personality disorder can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\n> Note: 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, personality disorder or death from personality disorder is connected with the circumstances of a person's relevant service:\n\n(1) experiencing a category 1A stressor within the one year before the clinical onset of personality disorder;\n\n> Note: category 1A stressor is defined in the Schedule 1 - Dictionary.\n\n(2) experiencing a category 1B stressor within the six months before the clinical onset of personality disorder;\n\n> Note: category 1B stressor is defined in the Schedule 1 - Dictionary.\n\n(3) experiencing severe childhood abuse before the clinical onset of personality disorder;\n\n> Note: severe childhood abuse is defined in the Schedule 1 - Dictionary.\n\n(4) having a clinically significant disorder of mental health as specified, within the five years before the clinical onset of personality disorder;\n\n> Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 \\- Dictionary.\n\n(5) experiencing a category 1A stressor within the one year before the clinical worsening of personality disorder;\n\n> Note: category 1A stressor is defined in the Schedule 1 - Dictionary.\n\n(6) experiencing a category 1B stressor within the six months before the clinical worsening of personality disorder;\n\n> Note: category 1B stressor is defined in the Schedule 1 - Dictionary.\n\n(7) experiencing severe childhood abuse before the clinical worsening of personality disorder;\n\n> Note: severe childhood abuse is defined in the Schedule 1 - Dictionary.\n\n(8) having a clinically significant disorder of mental health as specified, within the five years before the clinical worsening of personality disorder;\n\n> Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 \\- Dictionary.\n\n(9) inability to obtain appropriate clinical management for personality disorder.\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(5) to 9(9) apply only to material contribution to, or aggravation of, personality disorder where the person's personality disorder 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\ncategory 1A stressor means one of the following severe traumatic events:\n\n(a) experiencing a life-threatening event;\n\n(b) being subject to a serious physical attack or assault including rape and sexual molestation; or\n\n(c) being threatened with a weapon, being held captive, being kidnapped or being tortured.\n\ncategory 1B stressor means one of the following severe traumatic events:\n\n(a) killing or maiming a person;\n\n(b) being an eyewitness to a person being killed or critically injured;\n\n(c) being an eyewitness to atrocities inflicted on another person;\n\n(d) participating in the clearance of a corpse or a critically injured casualty; or\n\n(e) viewing a corpse or a critically injured casualty as an eyewitness.\n\n> Note: corpse and eyewitness are also defined in the Schedule 1 - Dictionary.\n\nclinically significant disorder of mental health as specified means one of the following conditions, which is of sufficient severity to warrant ongoing management:\n\n(a) acute stress disorder;\n\n(b) agoraphobia;\n\n(c) alcohol use disorder;\n\n(d) anxiety disorder;\n\n(e) attention-deficit/hyperactivity disorder (including other specified attention-deficit/hyperactivity disorder and unspecified attention-deficit/hyperactivity disorder);\n\n(f) bipolar disorder;\n\n(g) conduct disorder (including other specified disruptive, impulse-control, and conduct disorder and unspecified disruptive, impulse-control, and conduct disorder);\n\n(h) depressive disorder;\n\n(i) eating disorder;\n\n(j) gambling disorder;\n\n(k) gender dysphoria;\n\n(l) obsessive-compulsive disorder;\n\n(m) oppositional defiant disorder;\n\n(n) panic disorder;\n\n(o) posttraumatic stress disorder;\n\n(p) schizophrenia;\n\n(q) social anxiety disorder;\n\n(r) somatic symptom disorder;\n\n(s) specific phobia; or\n\n(t) substance use disorder.\n\nNote 1: Management\" of the condition may involve regular visits (for example, at least monthly) to a psychiatrist, counsellor or general practitioner.\n\nNote 2: To \"warrant ongoing management\" does not require that any actual management was received or given for the condition.\n\ncorpse means the human remains or body parts of one or more persons who have met a violent or horrific death.\n\nNote: Examples of a violent or horrific death may include death due to suicide, gunshot, improvised explosive devices, natural and technological disasters, terrorist attacks or motor vehicle accidents. Seeing a closed body bag or viewing a body in an open-casket coffin are excluded from this definition.\n\nDSM-5 means the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.\n\neyewitness means a person who experiences an incident first hand and can give direct evidence of it. This excludes persons exposed only to public broadcasting or mass media coverage of the incident.\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\npersonality change due to another medical condition means a disorder of mental health (derived from DSM-5) which is characterised by a persistent personality disturbance that is due to the direct physiological effects of a medical condition (for example, frontal lobe lesion, ischaemic stroke or cerebral trauma).\n\nNote: DSM-5 is also defined in the Schedule 1 - Dictionary.\n\npersonality disorder—see subsection 7(2).\n\nrelevant 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\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\nsevere childhood abuse means:\n\n(a) serious physical, emotional, psychological or sexual harm whilst a child aged under 16 years; or\n\n(b) neglect involving a serious failure to provide the necessities for health, physical and emotional development, or wellbeing whilst a child aged under 16 years;\n\nwhere such serious harm or neglect has been perpetrated by a parent, a care provider, an adult who works with or around that child, or any other adult in contact with that child.\n\nterminal 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\nVEA means the Veterans' Entitlements Act 1986.\n\n> Note: Endnotes\n\n> Note: Endnote 1—About the endnotes\n\nThe endnotes provide information about this compilation and the compiled law.\n\nThe following endnotes are included in every compilation:\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\nAbbreviation key—Endnote 2\n\nThe abbreviation key sets out abbreviations that may be used in the endnotes.\n\nLegislation history and amendment history—Endnotes 3 and 4\n\nAmending laws are annotated in the legislation history and amendment history.\n\nThe legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.\n\nThe amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.\n\nMisdescribed amendments\n\nA misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.\n\nIf a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.\n\n> Note: Endnote 2—Abbreviation key\n\n|                                                | o = order(s)                        |\n| ---------------------------------------------- | ----------------------------------- |\n| ad = added or inserted                         | Ord = Ordinance                     |\n| am = amended                                   | orig = original                     |\n| amdt = amendment                               | par = paragraph(s)/subparagraph(s)  |\n| c = clause(s)                                  | /sub‑subparagraph(s)                |\n| C[x] = Compilation No. x                       | pres = present                      |\n| Ch = Chapter(s)                                | prev = previous                     |\n| def = definition(s)                            | (prev…) = previously                |\n| Dict = Dictionary                              | Pt = Part(s)                        |\n| disallowed = disallowed by Parliament          | r = regulation(s)/rule(s)           |\n| Div = Division(s)                              |                                     |\n| exp = expires/expired or ceases/ceased to have | reloc = relocated                   |\n| effect                                         | renum = renumbered                  |\n| F = Federal Register of Legislation            | rep = repealed                      |\n| gaz = gazette                                  | rs = repealed and substituted       |\n| LA = Legislation Act 2003                      | s = section(s)/subsection(s)        |\n| LIA = Legislative Instruments Act 2003         | Sch = Schedule(s)                   |\n| (md) = misdescribed amendment can be given     | Sdiv = Subdivision(s)               |\n| effect                                         | SLI = Select Legislative Instrument |\n| (md not incorp) = misdescribed amendment       | SR = Statutory Rules                |\n| cannot be given effect                         | Sub‑Ch = Sub‑Chapter(s)             |\n| mod = modified/modification                    | SubPt = Subpart(s)                  |\n| No. = Number(s)                                | underlining = whole or part not     |\n|                                                | commenced or to be commenced        |\n\n> Note: Endnote 3—Legislation history\n\n| Name                                                                                                                 | Registration              | Commencement      | Application, saving and transitional provisions |\n| -------------------------------------------------------------------------------------------------------------------- | ------------------------- | ----------------- | ----------------------------------------------- |\n| Statement of Principles concerning personality disorder (Balance of Probabilities) (No. 18 of 2018)                  | 6 March 2018F2018L00208   | 2 April 2018      |                                                 |\n| Veterans' Entitlements (Statements of Principles—Category 1B Stressor) Amendment Determination 2018 (No. 87 of 2018) | 28 August 2018F2018L01188 | 24 September 2018 |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected                               | How affected       |\n| ------------------------------------------------ | ------------------ |\n| Schedule 1 – Dictionary – category 1B stressor.. | rs. No. 87 of 2018 |\n| Schedule 1 – Dictionary – corpse………….……..        | ad. No. 87 of 2018 |","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument appears consistent with its original purpose under the Veterans' Entitlements Act 1986 and Military Rehabilitation and Compensation Act 2004. It updates the 2008 Statement of Principles to reflect current DSM-5 diagnostic criteria and refines the stressor categories (particularly Category 1B) based on medical-scientific evidence. The scope remains focused on establishing medical criteria for service connection of personality disorders in the veteran and Defence community. The 2018 amendment specifically updated definitions for Category 1B stressors and added the definition of 'corpse' to clarify evidentiary requirements, but did not expand the instrument beyond its original compensatory determination purpose."},"complexity_factors":["Moderate length (approximately 11 substantive sections plus a dictionary schedule)","15 defined terms in Schedule 1 Dictionary, including nested definitions (e.g., 'corpse' and 'eyewitness' are defined separately and referenced within 'category 1B stressor')","Cross-references to external classification systems: DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) and ICD-10-AM (International Classification of Diseases, Australian Modification)","Conditional logic in section 9 requiring 'at least one' of nine alternative factors to exist, with temporal limitations (1 year, 6 months, 5 years) varying by factor type","Dual application structure: factors apply to both 'clinical onset' (new condition) and 'clinical worsening' (aggravation of pre-existing condition) with slightly different timeframes","Section 10 creates a service-connection requirement that operates differently for pre-existing conditions versus new conditions","Incorporation by reference of other Statements of Principles through section 11, creating potential circularity if other instruments are amended","Specific exclusion of 'personality change due to another medical condition' requiring careful differential diagnosis"],"plain_english_summary":"This instrument replaces the 2008 rule and sets the medical-legal test for whether a personality disorder is connected to Australian military service. It applies to veterans and current/former Defence members seeking entitlements under the VEA and MRCA, requires proof on the balance of probabilities, and identifies specific stressors, traumatic experiences, childhood abuse, comorbid mental disorders, and treatment gaps as relevant factors. It matters because it determines access to compensation, medical care, and rehabilitation for service-related personality disorders."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument updates and replaces the previous Statement of Principles on personality disorder (revoking No. 71 of 2008, section 4) by aligning the diagnostic language to DSM‑5, listing precise stressor categories and time windows, and clarifying application to death and to clinical worsening. Those are refinements and clarifications to the SOP's mechanics rather than a substantial expansion beyond the original purpose of setting medical criteria for linking personality disorder to service. The instrument therefore narrows ambiguity and adjusts evidentiary contours but does not substantially broaden the policy's scope of who may claim under the VEA/MRCA."},"complexity_factors":["Relatively short instrument (11 sections plus a dictionary) focused on one condition","Multiple defined terms in Schedule 1 (e.g. category 1A stressor, category 1B stressor, clinically significant disorder, severe childhood abuse, corpse, DSM-5) — creating dependence on definitions","Several time-windowed and conditional factors in section 9 (9 separate factor subparagraphs and cross-applicability to onset vs worsening)","Cross-references to external diagnostic standards (DSM-5 and ICD-10-AM) and to other Statements of Principles (section 11)","Requirement that listed factors be 'related to' relevant service (section 10) introduces judgment-based determinations","Notes and exclusions (e.g. personality change due to another medical condition) add limited conditional complexity","Administrative interaction with two different statutes/systems (VEA and MRCA) for application (section 5)"],"plain_english_summary":"**What this instrument does (mechanically)\n\n- This is a Statement of Principles (SOP) made under the Veterans' Entitlements Act 1986 and used when deciding certain veterans' or Defence members' claims for entitlements or compensation (see sections 3 and 5).  The SOP sets out when, on the balance of probabilities (more likely than not), a diagnosis of \"personality disorder\" or death contributed to by personality disorder can be said to be connected with a person's \"relevant service\" (see sections 7, 8 and 9).\n\n- The SOP defines what is meant by \"personality disorder\" (using DSM‑5 diagnostic language) and lists the ICD‑10‑AM codes that map to that meaning for administrative use (section 7(2)–(4)).  It also expressly includes \"death from personality disorder\" where the disorder contributed to the terminal event (section 7(5)).\n\n- It lists the factual, medical or exposure-related events that must exist for the causal link to be accepted. At least one of those factors in section 9 must be present for a positive connection on the balance of probabilities. The factors include: recent exposure to specified severe traumatic events (\"category 1A\" or \"category 1B\" stressors within defined time windows), severe childhood abuse, having a clinically significant mental disorder within five years before clinical onset, clinical worsening tied to recent stressors, and inability to obtain appropriate clinical management (section 9).\n\n- The SOP requires that any of those factors be related to the person's relevant service (section 10). It also says that if a listed factor refers to an injury/disease already covered by another SOP, the rules in that other SOP apply (section 11).\n\nWho this affects\n\n- Primary affected persons: veterans and former or current members of the ADF or Forces who lodge claims under the Veterans' Entitlements Act (VEA) or the Military Rehabilitation and Compensation Act (MRCA) where personality disorder or death from personality disorder is alleged (section 5).\n\n- Decision-makers and administrators: officials who determine entitlement/compensation claims will use this SOP as the medical/legal benchmark when assessing whether personality disorder is connected with service (sections 3, 8, 9, 10, 11).\n\n- Clinicians and medical assessors: psychiatrists, GPs and other treating or independent medical examiners will need to provide evidence about diagnosis, clinical onset/worsening, timing and presence of the listed factors (sections 7 and 9).\n\nWhy it matters (purpose claim and implications)\n\n- The SOP's stated medical-scientific view is that personality disorder (and death contributed to by it) can, more likely than not, be related to relevant service (section 8). That is the instrument's purpose-claim: to provide a principled, evidence-based list of factors for linking personality disorder to service.\n\n- Practical effect: if a claimant can establish one of the section 9 factors and link it to relevant service (section 10), their claim is more likely to be accepted for VEA/MRCA entitlements. The SOP thus directly shapes which service-connected mental health conditions qualify for benefits.\n\nCosts, incentives and trade-offs (concrete mechanisms)\n\n- Who pays: payments or entitlements that flow from an accepted connection are provided under the VEA or MRCA. The SOP itself does not create payments; it defines the medical connection that triggers those statutory payments (sections 3, 5, 8).\n\n- Evidence and compliance burden: claimants must provide or obtain clinical evidence of diagnosis, timing (onset/worsening), and the presence of specified stressors or prior mental disorders (section 9). This increases demand for clinical assessments, records retrieval, and medico-legal reports.\n\n- Administrative discretion: decision-makers will exercise judgment about whether the evidence meets the \"balance of probabilities\" standard and whether a factor is \"related to\" relevant service (sections 8 and 10). Cross-references to other SOPs (section 11) create additional interpretive choices.\n\n- Risk of substitution and strategic behaviour: because the SOP lists particular stressors, claimants and medical advisers may emphasise diagnoses, timelines or exposure narratives that fit the listed factors. Conversely, conditions excluded from the definition (for example, \"personality change due to another medical condition\") will not be accepted under this SOP (section 7(2), Schedule definitions).\n\n- Effects on private providers and markets: the instrument does not regulate private providers' prices, ownership or competition. It does increase demand for psychiatric and medico-legal services (documented evidence of onset and management), which may shift workload and billing patterns for private clinicians.\n\nImplementation risks and administrative costs\n\n- Medical uncertainty: personality disorder diagnoses and retrospective timing of \"clinical onset\" or \"worsening\" can be clinically contested. This raises the risk of disagreement between treating clinicians, independent medical examiners, and decision-makers (sections 7 and 9).\n\n- Proof thresholds and record availability: some factors require evidence of traumatic exposures (category 1A/1B) or severe childhood abuse; such evidence can be hard to obtain and may rely on claimant testimony and corroborating records.\n\nConcentrated benefits vs diffuse costs\n\n- Concentrated benefits: the SOP provides a clear path for certain claimants (those with the listed stressors or prior disorders) to have personality disorder accepted as service-related (section 9). That benefit is concentrated among those claimants.\n\n- Diffuse public cost: any increase in accepted claims translates into program expenditure under VEA/MRCA; the instrument does not itself set expenditure but affects entitlement outcomes (sections 3 and 5).\n\nKey reference points in the SOP\n\n- Definition of personality disorder and diagnostic standard: section 7(2) (DSM‑5 language) and section 7(3)–(4) (ICD‑10‑AM codes).\n- Core causal factors the claimant must show: section 9.\n- Requirement that listed factors be related to \"relevant service\": section 10.\n- Use of other SOPs when a factor refers to another injury/disease: section 11.\n\nSummary sentence\n\nThis SOP updates the medical-legal test for when personality disorder (or death contributed to by it) will be treated as connected with a veteran's or member's service for the purposes of VEA/MRCA claims by (1) defining the diagnosis to be used, (2) listing discrete factors and time windows that must be present for a positive link, and (3) directing decision-makers to treat related factors under other relevant SOPs where applicable (sections 7–11)."},"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-personality-disorder-balance-of-probabilities-no-18-of-2018","history":"/api/acts/statement-of-principles-concerning-personality-disorder-balance-of-probabilities-no-18-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-personality-disorder-balance-of-probabilities-no-18-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-personality-disorder-balance-of-probabilities-no-18-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-personality-disorder-balance-of-probabilities-no-18-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-personality-disorder-balance-of-probabilities-no-18-of-2018/documents"}}