{"id":"F2022L01399","name":"Statement of Principles concerning restless legs syndrome (Balance of Probabilities) (No. 114 of 2022)","slug":"statement-of-principles-concerning-restless-legs-syndrome-balance-of-probabilities-no-114-of-2022","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":102799,"registerId":"commonwealth-F2022L01399-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning restless legs syndrome (Balance of Probabilities) (No. 114 of 2022)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning restless legs syndrome (Balance of Probabilities) (No. 114 of 2022)\n\nmade under subsection 196B(3) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 30 May 2023\n\nIncludes amendments up to: Amendment Statement of Principles concerning restless legs syndrome (Balance of Probabilities) (No. 61 of 2023) (F2023L00558)\n\nThe day of commencement of this Amendment Statement of Principles concerning restless legs syndrome is 30 May 2023.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning restless legs syndrome (Balance of Probabilities) (No. 114 of year) that shows the text of the law as amended and in force on 30 May 2023.\n\nThe notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.\n\nUncommenced amendments\n\nThe effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.\n\nApplication, saving and transitional provisions for provisions and amendments\n\nIf the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.\n\nModifications\n\nIf the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.\n\nSelf‑repealing provisions\n\nIf a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.\n\nContents\n\n1 Name\n\n3 Authority\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\nEndnotes\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\n  \n\n1 Name\n\nThis is the Statement of Principles concerning restless legs syndrome (Balance of Probabilities) (No. 114 of 2022).\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\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 restless legs syndrome and death from restless legs syndrome.\n\nMeaning of restless legs syndrome\n\n(2) For the purposes of this Statement of Principles, restless legs syndrome:\n\n(a) means a sensorimotor neurological disorder, in which there is:\n\n(i) a strong urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs; and\n\n(ii) the urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting; and\n\n(iii) the urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching; and\n\n(iv) the urge to move or unpleasant sensations are worse in the evening or night than during the day, or only occur in the evening or night; and\n\n(b) these clinical features:\n\n(i) occur at least 3 times per week, and have persisted for at least 3 consecutive months; and\n\n(ii) cause significant distress, or impairment in behavioural, social, physical or occupational functioning; and\n\n(iii) are not solely accounted for by another medical or behavioural condition.\n\n> Note: Examples of other medical or behavioural conditions with clinical features that mimic restless legs syndrome include myalgia, venous stasis, leg oedema, arthritis, leg cramps and habitual foot tapping.\n\n(3) While restless legs syndrome attracts ICD‑10‑AM code G25.81, in applying this Statement of Principles the meaning of restless legs syndrome 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 restless legs syndrome\n\n(5) For the purposes of this Statement of Principles, restless legs syndrome, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's restless legs syndrome.\n\n> Note: 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 restless legs syndrome and death from restless legs syndrome can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\n> Note: 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, restless legs syndrome or death from restless legs syndrome is connected with the circumstances of a person's relevant service:\n\n(1) having diabetes mellitus at the time of the clinical onset of restless legs syndrome;\n\n(2) having iron deficiency at the time of the clinical onset of restless legs syndrome;\n\nNote: iron deficiency is defined in the Schedule 1 – Dictionary.\n\n(3) having chronic renal failure at the time of the clinical onset of restless legs syndrome;\n\nNote: chronic renal failure is defined in the Schedule 1 - Dictionary.\n\n(4) having a neurological disorder from the specified list of neurological disorders, involving the lower limbs, at the time of the clinical onset of restless legs syndrome;\n\nNote: specified list of neurological disorders is defined in the Schedule 1 – Dictionary.\n\n(5) taking a drug from the specified list of drugs:\n\n(a) as prescribed for ongoing use; and\n\n(b) for at least the 30 days before the clinical onset of restless legs syndrome;\n\nNote: specified list of drugs is defined in the Schedule 1 - Dictionary.\n\n(6) having multiple sclerosis at the time of the clinical onset of restless legs syndrome;\n\n(7) having smoked tobacco products in an amount of at least 10 pack-years before the clinical onset of restless legs syndrome, and if smoking has ceased before the clinical onset of restless legs syndrome, then that onset occurred within 5 years of cessation;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(8) being obese for at least the 5 years before the clinical onset of restless legs syndrome;\n\nNote: being obese is defined in the Schedule 1 – Dictionary.\n\n(9) being pregnant at the time of the clinical onset of restless legs syndrome;\n\n(10) having diabetes mellitus at the time of the clinical worsening of restless legs syndrome;\n\n(11) having iron deficiency at the time of the clinical worsening of restless legs syndrome;\n\nNote: iron deficiency is defined in the Schedule 1 – Dictionary.\n\n(12) having chronic renal failure at the time of the clinical worsening of restless legs syndrome;\n\nNote: chronic renal failure is defined in the Schedule 1 - Dictionary.\n\n(13) having a neurological disorder from the specified list of neurological disorders, involving the lower limbs, at the time of the clinical worsening of restless legs syndrome;\n\n> Note: specified list of neurological disorders is defined in the Schedule 1 – Dictionary.\n\n(14) taking a drug from the specified list of drugs:\n\n(a) as prescribed for ongoing use; and\n\n(b) for at least the 30 days before the clinical worsening of restless legs syndrome;\n\nNote: specified list of drugs is defined in the Schedule 1 – Dictionary.\n\n(15) having multiple sclerosis at the time of the clinical worsening of restless legs syndrome;\n\n(16) having smoked tobacco products in an amount of at least 10 pack-years before the clinical worsening of restless legs syndrome, and if smoking has ceased before the clinical worsening of restless legs syndrome, then that worsening occurred within 5 years of cessation;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(17) being obese for at least the 5 years before the clinical worsening of restless legs syndrome;\n\nNote: being obese is defined in the Schedule 1 – Dictionary.\n\n(18) being pregnant at the time of the clinical worsening of restless legs syndrome;\n\n(19) having chronic obstructive pulmonary disease at the time of the clinical worsening of restless legs syndrome;\n\n(20) having obstructive sleep apnoea at the time of the clinical worsening of restless legs syndrome;\n\n(21) for restless legs syndrome augmentation only, taking a dopaminergic agent including levodopa and pramipexole, or tramadol, for a continuous period of at least the 3 months before the clinical worsening of restless legs syndrome;\n\nNote: restless legs syndrome augmentation is defined in the Schedule 1 – Dictionary.\n\n(22) inability to obtain appropriate clinical management for restless legs syndrome.\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(10) to 9(22) apply only to material contribution to, or aggravation of, restless legs syndrome where the person's restless legs syndrome 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\nbeing obese means having a Body Mass Index (BMI) of 30 or greater.\n\n> Note: BMI is also defined in the Schedule 1 - Dictionary.\n\nBMI means W/H2 where:\n\n(a) W is the person's weight in kilograms; and\n\n(b) H is the person's height in metres.\n\nchronic renal failure means:\n\n(a) having a glomerular filtration rate of less than 15 mL/min/1.73 m2 for a period of at least 3 months; or\n\n(b) a need for renal replacement therapy (dialysis or transplantation) for treatment of complications of decreased glomerular filtration rate which would otherwise increase the risk of morbidity and mortality; or\n\n(c) undergoing chronic dialysis.\n\niron deficiency means having a serum ferritin level of less than 30 micrograms per litre.\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\none pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.\n\n> Note 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.\n\n> Note 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.\n\nradiculopathy means a disease of the nerve roots resulting in symptoms of weakness, pain or loss of sensation.\n\nrelevant 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\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\nrestless legs syndrome—see subsection 7(2).\n\nrestless legs syndrome augmentation means a worsening of restless legs symptoms caused by long-term high dose drug therapy for that disease.\n\n> Note: > Note: Augmentation is characterised by more severe symptoms and earlier onset of symptoms during the day. It often involves the spread of symptoms to the arms or other regions of the body\n> \n> .\n\nspecified list of drugs means:\n\n(a) antipsychotics including olanzapine and quetiapine;\n\n(b) histamine H2-receptor antagonists including chlorpheniramine and hydroxyzine;\n\n(c) selective serotonin re-uptake inhibitors including citalopram, escitalopram, fluoxetine and sertraline;\n\n(d) serotonin-norepinephrine reuptake inhibitors including venlafaxine;\n\n(e) tetracyclic antidepressants including mianserin and mirtazapine;\n\n(f) topiramate;\n\n(g) tricyclic antidepressants including amitriptyline; or\n\n(h) zonisamide.\n\nspecified list of neurological disorders means:\n\n(a) a spinal cord lesion;\n\n(b) peripheral neuropathy; or\n\n(c) radiculopathy.\n\n> Note 1: Examples of causes of spinal cord lesions include transverse myelitis, neoplasm, trauma, syringomyelia and compression of the spine.\n\n> Note 2: radiculopathy is also defined in the Schedule 1 – Dictionary.\n\nterminal 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\nVEA means the Veterans' Entitlements Act 1986.\n\n> Note: Endnotes\n\n> Note: Endnote 1—About the endnotes\n\nThe endnotes provide information about this compilation and the compiled law.\n\nThe following endnotes are included in every compilation:\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\nAbbreviation key—Endnote 2\n\nThe abbreviation key sets out abbreviations that may be used in the endnotes.\n\nLegislation history and amendment history—Endnotes 3 and 4\n\nAmending laws are annotated in the legislation history and amendment history.\n\nThe legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.\n\nThe amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.\n\nMisdescribed amendments\n\nA misdescribed amendment is an amendment that does not accurately describe how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.\n\nIf a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and “(md not incorp)” is added to the amendment history.\n\n> Note: Endnote 2—Abbreviation key\n\n| ad = added or inserted                         | orig = original                     |\n| ---------------------------------------------- | ----------------------------------- |\n| am = amended                                   | par = paragraph(s)/subparagraph(s)  |\n| amdt = amendment                               | /sub‑subparagraph(s)                |\n| c = clause(s)                                  | pres = present                      |\n| C[x] = Compilation No. x                       | prev = previous                     |\n| Ch = Chapter(s)                                | (prev…) = previously                |\n| def = definition(s)                            | Pt = Part(s)                        |\n| Dict = Dictionary                              | r = regulation(s)/rule(s)           |\n| disallowed = disallowed by Parliament          | reloc = relocated                   |\n| Div = Division(s)                              | renum = renumbered                  |\n| exp = expires/expired or ceases/ceased to have | rep = repealed                      |\n| effect                                         | rs = repealed and substituted       |\n| F = Federal Register of Legislation            | s = section(s)/subsection(s)        |\n| gaz = gazette                                  | Sch = Schedule(s)                   |\n| LA = Legislation Act 2003                      | Sdiv = Subdivision(s)               |\n| LIA = Legislative Instruments Act 2003         | SLI = Select Legislative Instrument |\n| (md not incorp) = misdescribed amendment       | SR = Statutory Rules                |\n| cannot be given effect                         | Sub‑Ch = Sub‑Chapter(s)             |\n| mod = modified/modification                    | SubPt = Subpart(s)                  |\n| No. = Number(s)                                | underlining = whole or part not     |\n| o = order(s)                                   | commenced or to be commenced        |\n| Ord = Ordinance                                |                                     |\n|                                                |                                     |\n|                                                |                                     |\n\n> Note: Endnote 3—Legislation history\n\n| Name                                                                                                            | Registration               | Commencement     | Application, saving and transitional provisions |\n| --------------------------------------------------------------------------------------------------------------- | -------------------------- | ---------------- | ----------------------------------------------- |\n| Statement of Principles concerning restless legs syndrome (Balance of Probabilities) (No. 114 of 2022)          | 25 October 2022F2022L01399 | 21 November 2022 |                                                 |\n| Amendment Statement of Principles concerning restless legs syndrome (Balance of Probabilities) (No. 61 of 2023) | 18 May 2023F2023L00558     | 30 May 2023      |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected                            | How affected      |\n| --------------------------------------------- | ----------------- |\n| Section 2……………….                              | rep LA s 48D      |\n| Section 4……………….                              | rep LA s 48C      |\n| Schedule 1 – Dictionary – relevant service……. | am No. 61 of 2023 |","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":"The legislation remains focused on its original purpose: establishing criteria for determining service connection of restless legs syndrome in veterans. The 2023 amendment was minor (updating the definition of 'relevant service'), and the instrument maintains its narrow, technical scope as a medical-determination tool under the Veterans' Entitlements Act."},"complexity_factors":["22 distinct factors with specific temporal requirements (e.g., 'at least 30 days before', 'at least 5 years before', 'within 5 years of cessation')","8 defined terms in Schedule 1 Dictionary including nested definitions (e.g., 'being obese' defined via BMI formula, 'one pack-year' with mathematical calculation)","Cross-references to other Statements of Principles for conditions mentioned as factors (section 11)","Dual structure covering both 'clinical onset' (factors 1-9) and 'clinical worsening' (factors 10-22)","Specific medical thresholds requiring measurement (serum ferritin <30 μg/L, GFR <15 mL/min/1.73 m², BMI ≥30)","Conditional logic in smoking factor requiring calculation of pack-years and cessation timing","Specific drug lists and neurological condition lists that must be consulted","Note references providing examples and clarifications throughout"],"plain_english_summary":"This Statement of Principles sets the medical test for restless legs syndrome (RLS) in compensation claims, defining its clinical features and the risk factors that can link RLS to military service (examples include certain medical conditions, specific medications, smoking, obesity and pregnancy). It applies to veterans and current/former defence members under the VEA and MRCA, uses the balance‑of‑probabilities standard, and distinguishes causation from clinical worsening."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"The instrument’s scope was amended: the definition of \"relevant service\" in Schedule 1 – Dictionary was amended by Amendment No. 61 of 2023 (see Endnote 4). That change alters which types of service fall within the Statement’s application and therefore who may rely on these factors for entitlement under the VEA/MRCA."},"complexity_factors":["Detailed medical diagnostic criteria and frequency/duration thresholds for restless legs syndrome (subsection 7(2))","Numerical clinical thresholds in the Dictionary (serum ferritin <30 μg/L; GFR <15 mL/min/1.73 m2; BMI ≥30) (Schedule 1)","Multiple distinct risk/exposure factors with temporal conditions (section 9: factors 1–22) including onset vs worsening distinctions","Specified drug and neurological disorder lists that must be checked against treatment history (Schedule 1: specified list of drugs; specified neurological disorders)","Requirement that any factor be related to the person’s relevant service (section 10) — introduces evidentiary and causal-link tasks","Cross‑reference rule to other Statements of Principles where factors overlap (section 11) — requires checking other instruments","Inclusion of death from a terminal event contributed to by RLS (subsection 7(5)) — expands evidentiary scope","Calculation rules for smoking (pack‑years) and related limits and cessation timing (section 9(7),(16); Schedule 1)","Administrative detail: applies to VEA and MRCA claims and is made under subsection 196B(3) of the VEA (section 3)","Amendment and compilation history that may affect interpretation (endnotes)"],"plain_english_summary":"This Statement of Principles sets a legal definition of restless legs syndrome and lists medical conditions, exposures and treatments that — if present and linked to a person’s relevant service — make it more probable than not the condition (or death from it) is related to service. It applies to claims under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. The clinical criteria, numeric thresholds and timing rules determine entitlement decisions and the evidence veterans must produce."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-restless-legs-syndrome-balance-of-probabilities-no-114-of-2022","history":"/api/acts/statement-of-principles-concerning-restless-legs-syndrome-balance-of-probabilities-no-114-of-2022/history","analysis":"/api/acts/statement-of-principles-concerning-restless-legs-syndrome-balance-of-probabilities-no-114-of-2022/analysis","conflicts":"/api/acts/statement-of-principles-concerning-restless-legs-syndrome-balance-of-probabilities-no-114-of-2022/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-restless-legs-syndrome-balance-of-probabilities-no-114-of-2022/important-cases","documents":"/api/acts/statement-of-principles-concerning-restless-legs-syndrome-balance-of-probabilities-no-114-of-2022/documents"}}