{"id":"F2020L00500","name":"Statement of Principles concerning polyarteritis nodosa (Reasonable Hypothesis) (No. 33 of 2020)","slug":"statement-of-principles-concerning-polyarteritis-nodosa-reasonable-hypothesis-no-33-of-2020","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440472,"registerId":"F2020L00500-fast-fetch-1775956078359","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning polyarteritis nodosa (Reasonable Hypothesis) (No. 33 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 (Reasonable Hypothesis)\n\n(No. 33 of 2020)\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 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 (Reasonable Hypothesis) (No. 33 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning polyarteritis nodosa No. 11 of 2011 (Federal Register of Legislation No. F2010L03258) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that polyarteritis nodosa and death from polyarteritis nodosa 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 polyarteritis nodosa or death from polyarteritis nodosa 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 hepatitis C virus at the time of the clinical onset of polyarteritis nodosa;\n\n(3) having infection with human immunodeficiency virus at the time of the clinical onset of polyarteritis nodosa;\n\n(4) being treated with minocycline for at least the 12 months before the clinical onset of polyarteritis nodosa;\n\nNote: Antineutrophil cytoplasmic antibodies may be associated with minocycline-induced polyarteritis nodosa.\n\n(5) having hairy cell leukaemia before the clinical onset of polyarteritis nodosa;\n\n(6) having had a hepatitis B vaccination within the three months before the clinical onset of polyarteritis nodosa;\n\n(7) having infection with hepatitis B virus at the time of the clinical worsening of polyarteritis nodosa;\n\n(8) having infection with hepatitis C virus at the time of the clinical worsening of polyarteritis nodosa;\n\n(9) having infection with human immunodeficiency virus at the time of the clinical worsening of polyarteritis nodosa;\n\n(10) being treated with minocycline for at least the 12 months before the clinical worsening of polyarteritis nodosa;\n\nNote: Antineutrophil cytoplasmic antibodies may be associated with minocycline-induced polyarteritis nodosa.\n\n(11) 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(7) to 9(11) 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(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 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) 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 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":4,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2011 Statement of Principles (s4) and sets out the current definitional scope, listed factors and exclusions for linking PAN to relevant service (notably inclusion of cutaneous and single‑organ PAN and explicit exclusions) (s7(2)). Because this instrument replaces the earlier instrument, the legal instrument in force has changed; a textual comparison would be required to determine whether the substantive scope has been broadened or narrowed. The new instrument also clarifies timing rules for contribution or aggravation (s9, s10)."},"complexity_factors":["Medical specificity and terminology (definition of PAN, inclusions/exclusions) — see s7(2)","Multiple temporal distinctions (clinical onset vs clinical worsening; pre/during service considerations) — see s9 and s10","Evidentiary standard framed as a ‘reasonable hypothesis’ requiring at least one listed factor — see s9","Cross‑references to other legislation and coding systems (VEA, MRCA, ICD‑10‑AM) and claim provisions — see s3, s5, s7(3)-(4), Schedule 1","Interaction with other Statements of Principles where a listed factor relates to another instrument — see s11","Ambiguous or open‑ended factor wording increasing adjudicator discretion (for example, “inability to obtain appropriate clinical management”) — see s9(11)","Inclusion of death via contribution to a terminal event introduces causation via proximate/ultimate causes — see s7(5) and Schedule 1","Repeal and replacement of prior instrument changes the statutory instrument in force (administrative transition risk) — see s4","RMA’s evaluative role stated as a view based on medical‑scientific evidence, which leaves scope for expert interpretation — see s8"],"plain_english_summary":"This Statement of Principles sets the medical criteria the Repatriation Medical Authority uses to decide whether polyarteritis nodosa (PAN) or death from PAN can be linked to a veteran's relevant service. It lists specific factors that raise a “reasonable hypothesis” (e.g. hepatitis B/C/HIV infection, prolonged minocycline use, hairy cell leukaemia, recent hepatitis B vaccination, or inability to obtain appropriate clinical management) (s9), applies to VEA/MRCA claims (s5) and repeals the 2011 Statement (s4)."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the same scope as its predecessor and the standard template for Repatriation Medical Authority Statements of Principles. It addresses a single medical condition (polyarteritis nodosa) with the standard structure: definition, causal factors for onset and worsening, and service connection rules. There is no evidence of scope creep beyond the original purpose of determining medical eligibility for veterans' compensation claims."},"complexity_factors":["Short, focused instrument (approximately 6 pages of substantive content)","Only 5 defined terms in the Dictionary (MRCA, polyarteritis nodosa, relevant service, terminal event, VEA)","Simple structure: definitions, disease description, 11 enumerated factors, relationship to service rules","Limited cross-referencing—only internal references to the Dictionary and other Statements of Principles in section 11","Clear conditional logic with straightforward temporal requirements ('at the time of', 'within the three months before', 'for at least the 12 months before')","Single medical condition focus rather than multiple diseases or complex interaction effects","No nested exceptions or deeply conditional subsections—section 10(2) contains the only limitation and it is clearly expressed"],"plain_english_summary":"This instrument sets the medical rules for when Australian veterans and ADF members can claim compensation for polyarteritis nodosa (PAN). \n\nIt identifies specific medical factors—such as relevant infections, prolonged medication use, certain malignancies, recent vaccination, or inadequate treatment—that establish a reasonable hypothesis linking PAN to service, allowing affected personnel to access benefits without proving definitive causation."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-reasonable-hypothesis-no-33-of-2020","history":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-reasonable-hypothesis-no-33-of-2020/history","analysis":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-reasonable-hypothesis-no-33-of-2020/analysis","conflicts":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-reasonable-hypothesis-no-33-of-2020/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-reasonable-hypothesis-no-33-of-2020/important-cases","documents":"/api/acts/statement-of-principles-concerning-polyarteritis-nodosa-reasonable-hypothesis-no-33-of-2020/documents"}}