{"id":"F2021L00021","name":"Statement of Principles concerning psoriatic arthritis (Balance of Probabilities) (No. 16 of 2021)","slug":"statement-of-principles-concerning-psoriatic-arthritis-balance-of-probabilities-no-16-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440739,"registerId":"F2021L00021-fast-fetch-1775956270841","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning psoriatic arthritis (Balance of Probabilities) (No. 16 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\nPSORIATIC ARTHRITIS (Balance of Probabilities)\n\n(No. 16 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 24 December 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:
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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 psoriatic arthritis (Balance of Probabilities) (No. 16 of 2021).\n\n2 Commencement\n\n This instrument commences on 25 January 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 psoriatic arthropathy No. 6 of 2012 (Federal Register of Legislation No. F2012L00010) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 psoriatic arthritis and death from psoriatic arthritis.\n\nMeaning of psoriatic arthritis\n\n(2) For the purposes of this Statement of Principles, psoriatic arthritis means a seronegative chronic inflammatory arthritis, occurring in association with skin or nail psoriasis.\n\nNote: Psoriatic arthritis is characterised by synovitis, enthesitis and dactylitis.\n\n(3) While psoriatic arthritis attracts ICD‑10‑AM code M07.0 to M07.3, in applying this Statement of Principles the meaning of psoriatic arthritis 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 psoriatic arthritis\n\n(5) For the purposes of this Statement of Principles, psoriatic arthritis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's psoriatic arthritis.\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 psoriatic arthritis and death from psoriatic arthritis 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, psoriatic arthritis or death from psoriatic arthritis is connected with the circumstances of a person's relevant service:\n\n(1) having psoriasis at the time of the clinical onset of psoriatic arthritis;\n\n(2) having trauma to the affected joint in the 30 days before the clinical onset of psoriatic arthritis;\n\nNote: trauma to the affected joint is defined in the Schedule 1 - Dictionary.\n\n(3) taking a biologic agent for the treatment of cancer and autoimmune disease for at least the seven days before the clinical onset of psoriatic arthritis;\n\nNote: biologic agent is defined in the Schedule 1 - Dictionary.\n\n(4) taking a biologic agent for the treatment of cancer and autoimmune disease for at least the seven days before the clinical worsening of psoriatic arthritis;\n\nNote: biologic agent is defined in the Schedule 1 - Dictionary.\n\n(5) inability to obtain appropriate clinical management for psoriatic arthritis.\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(4) to 9(5) apply only to material contribution to, or aggravation of, psoriatic arthritis where the person's psoriatic arthritis 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 biologic agent means a therapeutic product which is derived from living organisms or which contains components of living organisms.\n\nNote: Examples of biologic agents used for the treatment of cancer and autoimmune disease include interferons, monoclonal antibodies, tumour necrosis factor-α inhibitors, tyrosine kinase inhibitors and vascular endothelial growth factor antagonists.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n psoriatic arthritis—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 trauma to the affected joint means a discrete event involving the application of significant physical force to or through the affected joint, that causes:\n\n(a) damage to the affected joint; and\n\n(b) the development, within 24 hours of the event occurring, of symptoms and signs of pain, tenderness and altered range of movement of the affected joint. In the case of sustained unconsciousness or the masking of pain by analgesic medication, these symptoms and signs must appear on return to consciousness or the withdrawal of the analgesic medication; and\n\n(c) the persistence of these symptoms and signs for a period of at least seven days following their onset, save for where medical intervention for the trauma to that joint has occurred and that medical intervention involves one of the following:\n\n(i) immobilisation of the affected joint by splinting or similar external agent;\n\n(ii) injection of a corticosteroid or local anaesthetic into that joint; or\n\n(iii) surgery to that joint.\n\n VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier Statement of Principles concerning psoriatic arthropathy No. 6 of 2012 (s4) and replaces it with a new Statement of Principles that applies to claims under section 120B of the VEA or section 339 of the MRCA (s5). It restates the clinical meaning of psoriatic arthritis (s7), specifies the factors that must exist for a positive service connection finding (s9) and requires those factors to be related to the person’s relevant service (s10). It also provides for interaction with other Statements of Principles (s11)."},"complexity_factors":["Medical and technical definitions are central: a clinical definition of psoriatic arthritis plus an ICD‑10‑AM code reference (s7(2)–(4)).","Evidentiary standard is ‘balance of probabilities’ tied to medical‑scientific view (s8) rather than a prescriptive diagnostic algorithm.","Several temporally specific windows that affect causal inference: 30 days for trauma before onset, 7 days for biologic agent exposure before onset/worsening (s9(2)–(4)).","Legal linkage requirement: any listed factor must be related to the person’s relevant service (s10(1)); factors for aggravation apply only if condition pre‑existed or was suffered before/during service (s10(2)).","One criterion — 'inability to obtain appropriate clinical management' — is open to factual interpretation and may generate evidentiary disputes (s9(5)).","Cross‑references and interaction with other Statements of Principles can shift which rules apply (s11), increasing administrative complexity.","Repeal and replacement of a prior Statement of Principles requires administrators to map old claims to new terms (s4).","Implementation requires documentary proof of clinical onset, treatment history and service connection (s7, s9, s10), imposing evidentiary burden on claimants."],"plain_english_summary":"This instrument is a Statement of Principles from the Repatriation Medical Authority that sets the medical criteria for linking psoriatic arthritis (and death from it) to a veteran’s or defence member’s service for VEA/MRCA claims. It defines psoriatic arthritis, lists specific causative or aggravating factors (for example pre‑existing psoriasis, recent joint trauma, recent biologic drug exposure, and inability to obtain appropriate clinical management) and requires those factors to be related to the person’s relevant service."},"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":"The instrument maintains its original scope as a specific disease-determination under the Veterans' Entitlements Act framework. It replaces a 2012 predecessor on the same condition (psoriatic arthropathy) without expanding into new benefit categories or claimant populations. The structure and purpose remain consistent with the statutory scheme for military compensation medical determinations."},"complexity_factors":["Multiple nested conditions in definitions (e.g., 'trauma to the affected joint' requires 3 cumulative elements with an exception sub-clause containing 3 alternative medical interventions)","Cross-referencing between instruments — section 11 creates dynamic incorporation of other Statements of Principles by reference","Dual legislative framework application (VEA and MRCA with different service categories)","Temporal precision requirements (30 days, 7 days, 24 hours, 'at least' qualifiers)","Bifurcated application — factors 9(1)-(3) apply to onset, while 9(4)-(5) are restricted to aggravation of pre-existing conditions per section 10(2)","Medical terminology requiring specialist knowledge (seronegative, synovitis, enthesitis, dactylitis, ICD-10-AM codes)"],"plain_english_summary":"This instrument replaces the 2012 policy and sets the legal test for linking psoriatic arthritis to Australian defence service, using the \"balance of probabilities\" standard. It affects veterans and current/former defence members claiming under the VEA and MRCA. Claims succeed where specified service‑connected factors (e.g., pre‑existing psoriasis, recent joint trauma, biologic drug exposure, or lack of treatment) can be shown to connect the condition to service — determining who receives taxpayer-funded compensation."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-balance-of-probabilities-no-16-of-2021","history":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-balance-of-probabilities-no-16-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-balance-of-probabilities-no-16-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-balance-of-probabilities-no-16-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-balance-of-probabilities-no-16-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-balance-of-probabilities-no-16-of-2021/documents"}}