{"id":"F2020L00501","name":"Statement of Principles concerning polyarteritis nodosa (Balance of Probabilities) (No. 34 of 2020)","slug":"statement-of-principles-concerning-polyarteritis-nodosa-balance-of-probabilities-no-34-of-2020","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440471,"registerId":"F2020L00501-fast-fetch-1775956077484","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning polyarteritis nodosa (Balance of Probabilities) (No. 34 of 2020)","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\nPOLYARTERITIS NODOSA (Balance of Probabilities)\n\n(No. 34 of 2020)\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 24 April 2020\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 polyarteritis nodosa (Balance of Probabilities) (No. 34 of 2020).\n\n2 Commencement\n\n This instrument commences on 25 May 2020.\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 polyarteritis nodosa No. 12 of 2011 (Federal Register of Legislation No. F2010L03259) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 polyarteritis nodosa and death from polyarteritis nodosa.\n\nMeaning of polyarteritis nodosa\n\n(2) For the purposes of this Statement of Principles, polyarteritis nodosa:\n\n(a) means a non-granulomatous necrotising arteritis predominantly affecting medium or small arteries; and\n\n(b) includes cutaneous polyarteritis nodosa and single organ polyarteritis nodosa; and\n\n(c) excludes:\n\n(i) glomerulonephritis;\n\n(ii) Kawasaki disease;\n\n(iii) microscopic polyangiitis; and\n\n(iv) polyangiitis overlap syndrome.\n\nNote: Polyarteritis nodosa is usually associated with an absence of antineutrophil cytoplasmic antibodies.\n\n(3) While polyarteritis nodosa attracts ICD‑10‑AM code M30.0, in applying this Statement of Principles the meaning of polyarteritis nodosa 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 polyarteritis nodosa\n\n(5) For the purposes of this Statement of Principles, polyarteritis nodosa, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's polyarteritis nodosa.\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 polyarteritis nodosa and death from polyarteritis nodosa 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, polyarteritis nodosa or death from polyarteritis nodosa is connected with the circumstances of a person's relevant service:\n\n(1) having infection with hepatitis B virus at the time of the clinical onset of polyarteritis nodosa;\n\n(2) having infection with human immunodeficiency virus at the time of the clinical onset of polyarteritis nodosa;\n\n(3) having infection with hepatitis B virus at the time of the clinical worsening of polyarteritis nodosa;\n\n(4) having infection with human immunodeficiency virus at the time of the clinical worsening of polyarteritis nodosa;\n\n(5) inability to obtain appropriate clinical management for polyarteritis nodosa.\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(3) to 9(5) apply only to material contribution to, or aggravation of, polyarteritis nodosa where the person's polyarteritis nodosa 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 polyarteritis nodosa—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"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the same scope as its predecessor (No. 12 of 2011). It is a specific, single-disease Statement of Principles with a tightly defined purpose: establishing the causal factors for polyarteritis nodosa in veterans' compensation claims. The 2020 version updates the medical definitions and ICD-10-AM reference but does not expand beyond the original intent of determining service connection for this specific condition."},"complexity_factors":["Multiple cross-references to other legislation (VEA, MRCA) and other Statements of Principles","Conditional logic distinguishing between clinical onset vs clinical worsening (subsections 9(1)-9(2) vs 9(3)-9(5))","Nested exclusions in the disease definition (subsection 7(2)(c) excludes 4 specific conditions)","Technical medical terminology requiring definition (non-granulomatous necrotising arteritis, antineutrophil cytoplasmic antibodies)","Specific limitation in section 10(2) restricting certain factors to aggravation cases only","Reference to external classification system (ICD-10-AM Tenth Edition) with specific ISBN and effective date"],"plain_english_summary":"This Statement of Principles sets the medical standard for deciding whether polyarteritis nodosa (PAN) or death from PAN is service-related for veterans and current/former Australian Defence Force members claiming under veterans’ compensation laws. \n\nA claim succeeds only if PAN is more likely than not linked to service — commonly via hepatitis B or HIV at onset/worsening, or by inability to obtain appropriate medical treatment — and replaces the 2011 version to ensure consistent decisions."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the prior 2011 Statement and substitutes new, specified criteria. It reiterates definitions and sets a closed list of qualifying factors (hepatitis B, HIV, inability to obtain appropriate clinical management) and clarifies application to VEA/MRCA claims (sections 4–5, 7–9)."},"complexity_factors":["Technical medical definitions and explicit exclusions for related vasculitides (subsection 7(2)).","Legal causation standard combined with a closed list of factual factors that must be proved on the balance of probabilities (sections 8–9).","Timing requirements for infections: presence at clinical onset or at clinical worsening (sections 9(1)–9(4)).","Requirement that any qualifying factor be related to the person's relevant service, including different rules for aggravation or material contribution (section 10).","Cross‑references to other Statements of Principles where factors overlap, creating dependency on other instruments (section 11).","Necessity of clinical and documentary evidence (e.g. serology, medical management records) and use of ICD‑10‑AM coding to identify the condition (sections 7(3)–7(4), 9).","Administrative transition from the repealed 2011 Statement, requiring claim handlers to apply the new instrument from its commencement (section 4).","Limited statutory scope: applies only to claims under the VEA or MRCA, so procedural fit with those schemes is required (section 5)."],"plain_english_summary":"This instrument replaces the earlier Statement of Principles for polyarteritis nodosa and sets the medical and legal criteria used to decide veterans’ compensation claims under the VEA and MRCA. It defines what polyarteritis nodosa and death from it mean, and cites the relevant ICD-10‑AM code.\n\nIt provides that, on the balance of probabilities, the disease or death is connected to relevant service only if at least one listed factor applies—principally infection with hepatitis B or HIV at clinical onset or worsening, or inability to obtain appropriate clinical management—and that the factor must be related to the person’s relevant service."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-balance-of-probabilities-no-34-of-2020","history":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-balance-of-probabilities-no-34-of-2020/history","analysis":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-balance-of-probabilities-no-34-of-2020/analysis","conflicts":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-balance-of-probabilities-no-34-of-2020/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-balance-of-probabilities-no-34-of-2020/important-cases","documents":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-balance-of-probabilities-no-34-of-2020/documents"}}