{"id":"F2018L01165","name":"Statement of Principles concerning reactive arthritis (Balance of Probabilities) (No. 76 of 2018)","slug":"statement-of-principles-concerning-reactive-arthritis-balance-of-probabilities-no-76-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439729,"registerId":"F2018L01165-fast-fetch-1775955639846","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning reactive arthritis (Balance of Probabilities) (No. 76 of 2018)","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\nREACTIVE ARTHRITIS (Balance of Probabilities)\n\n(No. 76 of 2018)\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 August 2018\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 reactive arthritis (Balance of Probabilities) (No. 76 of 2018).\n\n2 Commencement\n\n This instrument commences on 24 September 2018.\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 reactive arthritis No. 27 of 2010 (Federal Register of Legislation No. F2010L01043) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 reactive arthritis and death from reactive arthritis.\n\nMeaning of reactive arthritis\n\n(2) For the purposes of this Statement of Principles, reactive arthritis:\n\n(a) means an immune-mediated arthritis of more than four weeks' duration; and\n\n(b) is usually associated with evidence of a preceding extra-articular infection; and\n\n(c) excludes:\n\n(i) acute rheumatic fever;\n\n(ii) arthritis associated with viruses which are known to cause arthritis as part of the usual spectrum of clinical manifestations (for example, Ross River virus infection, Barmah Forest virus, rubella virus, parvovirus B19);\n\n(iii) leptospirosis;\n\n(iv) Lyme disease;\n\n(v) post-streptococcal reactive arthritis; and\n\n(vi) septic arthritis.\n\nNote: Typical clinical manifestations include a predominantly lower limb, asymmetric oligoarthritis and may include extra-articular manifestations, such as urethritis, cervicitis, conjunctivitis, skin lesions, sacroiliitis, spondylitis and enthesitis.\n\n(3) While reactive arthritis attracts ICD‑10‑AM code M02, in applying this Statement of Principles the meaning of reactive 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 reactive arthritis\n\n(5) For the purposes of this Statement of Principles, reactive arthritis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's reactive 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 reactive arthritis and death from reactive 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, reactive arthritis or death from reactive arthritis is connected with the circumstances of a person's relevant service:\n\n(1) having an infection as specified within the three months before the clinical onset of reactive arthritis;\n\nNote: infection as specified is defined in the Schedule 1 - Dictionary. \n\n(2) having infection with human immunodeficiency virus at the time of the clinical onset of reactive arthritis;\n\n(3) being vaccinated with hepatitis B vaccine within the 30 days before the clinical onset of reactive arthritis;\n\n(4) having intravesical BCG therapy for malignant neoplasm of the bladder or intradermal BCG therapy for a malignant neoplasm within the 30 days before the clinical onset of reactive arthritis;\n\nNote: BCG therapy is defined in the Schedule 1 - Dictionary.\n\n(5) having active mycobacterial disease within the 30 days before the clinical onset of reactive arthritis;\n\nNote: active mycobacterial disease is defined in the Schedule 1 - Dictionary.\n\n(6) having intestinal bypass surgery within the one year before the clinical onset of reactive arthritis;\n\n(7) inability to obtain appropriate clinical management for reactive 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 factor set out in subsection 9(7) applies only to material contribution to, or aggravation of, reactive arthritis where the person's reactive 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 active mycobacterial disease means an illness in which tuberculosis bacteria or atypical mycobacteria are multiplying and inducing an inflammatory response.\n\n BCG therapy means treatment with the Bacille Calmette-Guerin vaccine.\n\n infection as specified means:\n\n(a) clinical or laboratory evidence of a bowel infection; or\n\n(b) clinical or laboratory evidence of a sexually acquired urogenital infection (including proctitis and excluding genital warts and herpes simplex); or\n\n(c) clinical or laboratory evidence of an infection with Staphylococcus aureus, Chlamydia pneumoniae, Chlamydia psittaci or Chlamydia trachomatis.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n reactive 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 VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the standard scope of Repatriation Medical Authority Statements of Principles. It replaces the 2010 version (No. 27 of 2010) with updated medical evidence but does not expand beyond the traditional purpose of establishing service connection criteria for a specific medical condition. The structure follows the standard template: definition, factors, relationship to service, and dictionary."},"complexity_factors":["Moderate cross-referencing: 8 defined terms in Schedule 1, with multiple terms (MRCA, VEA, reactive arthritis, terminal event) requiring lookup in the Dictionary","Nested definitions: 'infection as specified' contains 3 sub-categories (bowel, sexually acquired urogenital, specific bacterial infections)","Conditional logic in section 9: 7 alternative factors with varying timeframes (30 days, 3 months, 1 year) creating a decision tree structure","Exclusion clauses in section 7(2)(c): 6 specific exclusions from the definition of reactive arthritis","Dual application framework: applies to two different Acts (VEA and MRCA) with different service categories defined in 'relevant service'","Section 10(2) contains a limitation clause restricting factor 9(7) to aggravation cases only, adding a conditional exception","Section 11 incorporates by reference other Statements of Principles, creating external dependencies"],"plain_english_summary":"This Statement of Principles sets the medical test for when reactive arthritis — an immune-mediated arthritis lasting more than four weeks, typically after infection — is accepted for compensation. It requires at least one of seven specified service‑related factors and a connection to service to meet the “balance of probabilities” standard. It applies to veterans and current/former ADF members claiming under the VEA or MRCA and replaces the 2010 instrument."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument repeals the earlier Statement (s.4) and restates medical criteria, exclusions and triggering timeframes for linking reactive arthritis to relevant service (s.7, s.9). On its face it does not expand or narrow the class of persons covered beyond application to VEA and MRCA claims (s.5); no express broadening of scope appears within the text."},"complexity_factors":["Medical-definition precision and exclusions for reactive arthritis (including ICD-10-AM reference) (s.7(2)–(4)).","Discrete temporal evidentiary windows for triggering events (3 months, 30 days, 1 year) that must be established (s.9(1)–(6)).","Interaction with other Statements of Principles when a listed factor refers to another condition (cross-application risk and dependency) (s.11).","Legal causation standard—‘balance of probabilities’ and requirement that a factor be related to relevant service (s.8; s.10(1)).","Special rule limiting factor 9(7) (inability to obtain appropriate care) to aggravation or material contribution for pre-existing conditions (s.10(2)).","Inclusion of death from reactive arthritis via contribution to a terminal event, which raises proximate-cause considerations (s.7(5); Schedule definition of terminal event).","Repeal of the prior Statement and continuity considerations for claims previously assessed under the old instrument (s.4)."],"plain_english_summary":"This instrument tells the Repatriation Medical Authority what medical facts are sufficient to treat reactive arthritis (and death from it) as connected with a veteran’s or service member’s relevant service for claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act (see s.3, s.5).\n\nIt lists specific triggering factors and time limits (for example, specified infections within three months, certain vaccines or BCG/mycobacterial events within 30 days, intestinal bypass within one year) and excludes other diagnoses; meeting at least one listed factor is required to establish service connection on the balance of probabilities (s.9, s.8)."},"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-reactive-arthritis-balance-of-probabilities-no-76-of-2018","history":"/api/acts/statement-of-principles-concerning-reactive-arthritis-balance-of-probabilities-no-76-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-reactive-arthritis-balance-of-probabilities-no-76-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-reactive-arthritis-balance-of-probabilities-no-76-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-reactive-arthritis-balance-of-probabilities-no-76-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-reactive-arthritis-balance-of-probabilities-no-76-of-2018/documents"}}