{"id":"F2025L00501","name":"Statement of Principles concerning Scheuermann’s disease (kyphosis) (Balance of Probabilities) (No. 46 of 2025)","slug":"statement-of-principles-concerning-scheuermann-s-disease-kyphosis-balance-of-probabilities-no-46-of-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442818,"registerId":"F2025L00501-fast-fetch-1775957747938","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning Scheuermann’s disease (kyphosis) (Balance of Probabilities) (No. 46 of 2025)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nSCHEUERMANN’S DISEASE (KYPHOSIS)  (Balance of Probabilities)\n\n(No. 46 of 2025)\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 15 April 2025\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\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\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning Scheuermann’s disease (kyphosis) (Balance of Probabilities) (No. 46 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 19 May 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning Scheuermann’s disease No. 76 of 2016 (Federal Register of Legislation No. F2016L01343) made under subsection 196B(3) of the VEA is repealed.\n\n1.                Application\n\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\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about Scheuermann’s disease (kyphosis) and death from Scheuermann’s disease (kyphosis).\n\n\nMeaning of Scheuermann’s disease (kyphosis)\n\n1.           For the purposes of this Statement of Principles, Scheuermann’s disease (kyphosis) (also known as juvenile osteochondrosis of the spine):\n  1.           means a disease of children and adolescents involving necrosis and regeneration in the growth centres of the thoracic or thoracolumbar vertebrae. It is characterised by a rigid hyperkyphosis due to anterior wedging of at least 5° in one or more consecutive vertebrae; and\n  2.           clinical manifestations of postural deformity and/or subacute thoracic pain; and\n  3.           excludes postural kyphosis.\n\n\n \n\n1.           While Scheuermann’s disease (kyphosis) attracts ICD‑10‑AM code M42.0, in applying this Statement of Principles the meaning of Scheuermann’s disease (kyphosis) is that given in subsection (2).\n2.           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\n\nDeath from Scheuermann’s disease (kyphosis)\n\n1.           For the purposes of this Statement of Principles, Scheuermann’s disease (kyphosis), in relation to a person, includes death from a terminal event or condition that was contributed to by the person's Scheuermann’s disease (kyphosis).\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that Scheuermann’s disease (kyphosis) and death from Scheuermann’s disease (kyphosis) 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\n1.                Factors that must exist\n\n\nThe following factor must exist before it can be said that, on the balance of probabilities, Scheuermann’s disease (kyphosis) or death from Scheuermann’s disease (kyphosis) is connected with the circumstances of a person's relevant service:\n\n1.           inability to obtain appropriate clinical management for Scheuermann’s disease (kyphosis) before clinical worsening.\n\n\nNote: clinical worsening is defined in the Schedule 1 – Dictionary.\n\n1.            Relationship to service\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  2.           The factor set out in subsection 9(1) applies only to material contribution to, or aggravation of, Scheuermann’s disease (kyphosis) where the person's Scheuermann’s disease (kyphosis) was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 9 applies in relation to a person; and\n2.           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\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                               clinical worsening means the point backwards in time from the date of presentation to a registered medical practitioner first confirming the signs and/or symptoms of preexisting Scheuermann’s disease to the date at which the signs and/or symptoms of Scheuermann’s disease were permanently present, as assessed by a registered medical practitioner.\n\n                             MRCA means the Military Rehabilitation and Compensation Act 2004.\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                               scheuermann’s disease (kyphosis)—see subsection 7(2).\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":3,"scope_assessment":{"changed":false,"description":"This is a straightforward reissue of a 2016 Statement of Principles with updated references and formatting. The scope remains tightly limited to determining compensation eligibility for pre-existing Scheuermann's disease based on access to clinical management. No expansion of coverage or substantive change to the causal pathway."},"complexity_factors":["Short document (approximately 1,500 words)","Only 7 defined terms in the Dictionary","Single causal factor in section 9 with no sub-factors or alternatives","Minimal cross-referencing — only refers to the parent Acts (VEA and MRCA) and one repealed instrument","Straightforward conditional logic: one 'if-then' pathway for claims","No nested exceptions or complex temporal calculations beyond the 'clinical worsening' definition"],"plain_english_summary":"This instrument updates the compensation rules for Scheuermann’s disease, narrowly defining the condition and setting a single test for service connection: the claimant must show service prevented proper treatment before the disorder became permanently worse.  \n\nIt affects veterans and present/former defence members with a pre‑existing condition and matters because it creates a high bar—compensation is only possible when lack of access to care during service can be proven."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument replaces the 2016 Statement of Principles for the same disease but does not materially broaden the kinds of claims it covers. It updates and clarifies the medical definition, confirms inclusion of death caused or contributed to by the disease, and sets a single, narrowly framed mandatory factor (inability to obtain appropriate clinical management before clinical worsening) for establishing service connection. Those are technical refinements and a replacement of the earlier instrument rather than a substantive expansion beyond the original subject-matter (Scheuermann’s disease and death from it)."},"complexity_factors":["Short instrument (single-page Statement of Principles)","Fewer than 10 defined terms in Schedule 1","Single mandatory factor to establish connection (Factors section)","Medical definitions requiring retrospective clinical judgment (\"clinical worsening\")","Cross-reference to other Statements of Principles (Factors referring to another Statement)","Reference to external ICD code but statutory definition controls (cross-reference to ICD-10-AM)"],"plain_english_summary":"**What this instrument does (mechanics)**\n\n- This is a Statement of Principles about Scheuermann’s disease (kyphosis). It replaces the previous Statement of Principles from 2016 (Repeal section) and starts to operate on 19 May 2025 (Commencement section).\n- It is made by the Repatriation Medical Authority under the Veterans' Entitlements Act 1986 (Authority section) and applies to claims processed under the VEA or the Military Rehabilitation and Compensation Act (Application section).\n- The document defines what counts as Scheuermann’s disease for the purpose of veterans’ entitlements (Definitions / Kind of injury). That medical definition requires rigid hyperkyphosis with anterior wedging of at least 5° in one or more consecutive vertebrae, clinical signs (postural deformity and/or subacute thoracic pain), and it expressly excludes simple postural kyphosis (Kind of injury, subsection (2)). The ICD‑10‑AM code is noted but the statutory meaning is the textual definition in the instrument (Kind of injury, subsections (2) and (3)).\n- The Statement expressly includes death caused or materially contributed to by Scheuermann’s disease (Death from Scheuermann’s disease section and Schedule — terminal event definition).\n- For a compensable link to service (on the balance of probabilities), the claimant must show the single mandatory factor set out in the instrument: an inability to obtain appropriate clinical management for Scheuermann’s disease before clinical worsening (Factors that must exist section). \"Clinical worsening\" is defined in the Schedule as a retrospective medical assessment of when signs/symptoms became permanently present.\n- The mandatory factor must be related to the person's \"relevant service\" (Relationship to service section); and it only supports claims of material contribution or aggravation where the disease existed before or during (but did not arise out of) the relevant service.\n- If the mandatory factor refers to another injury/disease that is already covered by a separate Statement of Principles, the other Statement’s factors also apply (cross-application section).\n\n**Who this affects**\n\n- Primary beneficiaries: veterans and current or former members of the Defence Forces making claims under the VEA or MRCA for Scheuermann’s disease or death resulting from it (Application section).\n- Decision-makers: officials who apply Statements of Principles to decide service connection under the VEA/MRCA, and medical practitioners asked to provide retrospective clinical assessments.\n- Indirectly affected: taxpayers (who fund any additional entitlements) and private clinicians who may be asked to provide records or expert opinions.\n\n**Why it matters (practical effect)**\n\n- This Statement sets the legal-medical test that must be met for a finding that Scheuermann’s disease (or death from it) is connected to relevant service. Practically, a claimant must show that they could not obtain appropriate clinical treatment before their condition permanently worsened (Factors that must exist; Schedule definition of clinical worsening).\n- That single factor determines whether pre-existing disease was materially contributed to or aggravated by service (Relationship to service). If it is satisfied and tied to relevant service, decision-makers can accept service connection on the balance of probabilities (Basis for determining the factors).\n\n**Official rationale and a practical test against costs, incentives and risks**\n\n- Official claim: the Repatriation Medical Authority states that, on the available medical-scientific evidence, it is more probable than not that Scheuermann’s disease can be related to relevant service (Basis section).\n\nPractical implications and trade-offs:\n- Who pays: any additional entitlements resulting from acceptance of claims are public expenditure (the VEA/MRCA compensation systems). The instrument itself does not change funding arrangements but can increase or channel claims that lead to payments.\n- Who decides: the RMA sets the Statement (Authority section); claims are decided by the authorised decision-makers under the VEA/MRCA applying this Statement.\n- Evidence and compliance burden: claimants must establish inability to obtain appropriate clinical management and demonstrate timing of clinical worsening. That requires retrospective medical evidence and may increase demand for specialist assessments and medical records (Factors that must exist; Schedule definition). This raises administrative and evidentiary burdens on claimants and on the Department processing claims.\n- Measurement and implementation risk: the key concepts — \"inability to obtain appropriate clinical management\" and the retrospective point of \"clinical worsening\" — require judgments by clinicians about past events. Those judgments can be subjective, produce variability between experts, and increase scope for dispute and expert reports.\n- Concentrated benefits, diffuse costs: the benefits of any accepted claims are concentrated on individual claimants (and potentially their dependants in death cases), while costs are borne by the public fund. The Statement does not create an entitlement by itself but sets the test used to establish one.\n- Potential for substitution or strategic behaviour: because the test focuses on access to appropriate clinical care prior to worsening, claimants may prioritise documenting attempts to obtain care (appointments, referrals, waiting lists). Providers may be asked to document refusals/limits of treatment availability.\n- Cross-application complexity: where the mandatory factor refers to another injury/disease covered by a different Statement of Principles, that other Statement applies as well, which can complicate claim assessment and require cross-referencing multiple Statements (Factors referring to another Statement section).\n\n**What changes behaviour in practice**\n\n- Claimants and medical practitioners will need to assemble contemporaneous clinical records and possibly expert retrospective opinions that address when clinical worsening occurred and what treatment was (or was not) reasonably available before that point.\n- Decision-makers will evaluate claims against this narrow, medically framed trigger (inability to obtain appropriate clinical management before clinical worsening) rather than a broader range of service-related risk factors.\n\n**Relevant sections cited**\n\n- Authority: instrument made under subsection 196B(3) of the VEA (Authority section).\n- Application: applies to claims under section 120B VEA or section 339 MRCA (Application section).\n- Kind of injury, meaning and exclusion of postural kyphosis: Kind of injury (subsections (2)–(3)).\n- Inclusion of death from Scheuermann’s disease and definition of \"terminal event\": Death from Scheuermann’s disease section and Schedule (terminal event definition).\n- Mandatory factor: \"inability to obtain appropriate clinical management before clinical worsening\" (Factors that must exist section; Schedule definition of clinical worsening).\n- Relationship rules limiting when the factor applies: Relationship to service section.\n- Repeal of prior 2016 Statement: Repeal section."},"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-scheuermann-s-disease-kyphosis-balance-of-probabilities-no-46-of-","history":"/api/acts/statement-of-principles-concerning-scheuermann-s-disease-kyphosis-balance-of-probabilities-no-46-of-/history","analysis":"/api/acts/statement-of-principles-concerning-scheuermann-s-disease-kyphosis-balance-of-probabilities-no-46-of-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-scheuermann-s-disease-kyphosis-balance-of-probabilities-no-46-of-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-scheuermann-s-disease-kyphosis-balance-of-probabilities-no-46-of-/important-cases","documents":"/api/acts/statement-of-principles-concerning-scheuermann-s-disease-kyphosis-balance-of-probabilities-no-46-of-/documents"}}