{"id":"F2021L00019","name":"Statement of Principles concerning psoriatic arthritis (Reasonable Hypothesis) (No. 15 of 2021)","slug":"statement-of-principles-concerning-psoriatic-arthritis-reasonable-hypothesis-no-15-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440738,"registerId":"F2021L00019-fast-fetch-1775956270840","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning psoriatic arthritis (Reasonable Hypothesis) (No. 15 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 (Reasonable Hypothesis)\n\n(No. 15 of 2021)\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 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 (Reasonable Hypothesis) (No. 15 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning psoriatic arthropathy No. 5 of 2012 (Federal Register of Legislation No. F2012L00009) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that psoriatic arthritis and death from psoriatic arthritis 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 psoriatic arthritis or death from psoriatic arthritis 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(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 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) 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 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_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","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 (Statement of Principles concerning psoriatic arthropathy No. 5 of 2012). It is a routine reissue updating the disease name from 'psoriatic arthropathy' to 'psoriatic arthritis' and refreshing the ICD-10-AM code reference to the 2017 edition. The factor structure and service connection tests remain consistent with the original intent of providing medical determination rules for this specific condition under veterans' compensation schemes."},"complexity_factors":["Multiple nested definitions with cross-references (e.g., 'trauma to the affected joint' has a 3-part definition with a 3-part exception)","Conditional application rules in section 10(2) limiting factors 9(4)-9(5) to aggravation cases only","Reference to external classification system (ICD-10-AM Tenth Edition) with specific ISBN and effective date","Incorporation by reference of other Statements of Principles in section 11","Dual statutory framework requiring definitions for both VEA and MRCA schemes","Technical medical terminology requiring explanation (seronegative, synovitis, enthesitis, dactylitis, biologic agents)"],"plain_english_summary":"This Statement of Principles provides the medical-scientific test for whether psoriatic arthritis is service-related for veterans and current/former defence members claiming under the Veterans' Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004, replacing the 2012 terms. It identifies the kinds of clinical links (including worsening of pre-existing disease and death) that, if connected to service, support entitlement to compensation."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"The instrument expressly repeals the 2012 Statement (s4) and substitutes a new Statement (s1–11). It restates and narrows the operative medical definition of 'psoriatic arthritis' (s7), sets specific qualifying factors and timeframes (s9 and Schedule), and limits when factors count as material contribution or aggravation to pre-existing or service-not-origin conditions (s10(2)). It explicitly applies to claims under section 120A of the VEA and section 338 of the MRCA (s5)."},"complexity_factors":["Legal-technical structure: short, formal instrument with defined sections (name, commencement, authority, repeal, application, definitions, factors, relationship to service).","Medical definitions and coding: introduces a clinical definition of psoriatic arthritis and references ICD-10-AM (s7(2)–(4)).","Temporal and factual thresholds: specific time windows and durations for qualifying factors (30 days for trauma; seven days for biologic exposure; symptom persistence and onset criteria in trauma definition) (s9(2)–(4); Schedule definition of trauma).","Detailed trauma definition: multi-part test requiring discrete force, onset within 24 hours, persistence for seven days or specified medical interventions (Schedule: trauma to the affected joint).","Interplay with other Statements: cross-reference rule that defers to other Statements of Principles when factors relate to other injuries/diseases (s11).","Scope and application constraints: distinction between causation and material contribution/aggravation, and limitation of some factors to pre‑existing or service-not-origin conditions (s10(2)).","Administrative effect: repeal of prior instrument and direct application to claims under specified statutory sections (s4, s5)."],"plain_english_summary":"This Statement of Principles replaces the 2012 psoriatic arthropathy statement and sets the medical criteria the Repatriation Medical Authority uses to decide if psoriatic arthritis (and death from it) can be reasonably linked to a person's military service. It lists minimum qualifying factors (for example, existing psoriasis, recent joint trauma, recent biologic therapy, or inability to obtain appropriate clinical management), defines key terms, and applies to claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-reasonable-hypothesis-no-15-of-2021","history":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-reasonable-hypothesis-no-15-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-reasonable-hypothesis-no-15-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-reasonable-hypothesis-no-15-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-reasonable-hypothesis-no-15-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-psoriatic-arthritis-reasonable-hypothesis-no-15-of-2021/documents"}}