{"id":"F2025L00500","name":"Statement of Principles concerning Scheuermann’s disease (kyphosis) (Reasonable Hypothesis) (No. 45 of 2025)","slug":"statement-of-principles-concerning-scheuermann-s-disease-kyphosis-reasonable-hypothesis-no-45-of-202","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442821,"registerId":"F2025L00500-fast-fetch-1775957747972","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) (Reasonable Hypothesis) (No. 45 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)  (Reasonable Hypothesis)\n\n(No. 45 of 2025)\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    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   \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) (Reasonable Hypothesis) (No. 45 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(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning Scheuermann’s disease No. 75 of 2016 (Federal Register of Legislation No. F2016L01344) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\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\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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that Scheuermann’s disease (kyphosis) and death from Scheuermann’s disease (kyphosis) 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\n1.                Factors that must exist\n\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 Scheuermann’s disease (kyphosis) or death from Scheuermann’s disease (kyphosis) with the circumstances of a person's relevant service:\n\n1.           engaging in strenuous physical activity for the 5 years before clinical worsening;\n\n\nNote: This includes any sustained, repetitive strenuous activity that applies large forces or heavy loading to the spine. Examples include sports such as weightlifting, skiing, rugby or manual work such as bricklaying or construction.\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\n \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 worsening factors set out in subsections 9 apply 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(2) 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)          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 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":{"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument repeals Statement No. 75 of 2016 (section 4) and reissues a Statement that narrows the operational causal tests to two explicit factors (section 9) and clarifies temporal assessment via a defined 'clinical worsening' (Schedule 1). It continues to apply to claims under section 120A of the VEA and section 338 of the MRCA (section 5) and adds explicit treatment of death-by-terminal-event (Schedule 1). These changes alter the practical scope and evidentiary framing claimants and decision-makers must use."},"complexity_factors":["Technical medical definition and diagnostic threshold for Scheuermann’s disease (rigid hyperkyphosis with anterior wedging ≥5°) (subsection 7(2)).","Inclusion of death from the disease through contribution to listed terminal events (Schedule 1 definition of terminal event).","Two discrete causal/worsening factors that must be met to raise a reasonable hypothesis: (a) strenuous physical activity in the 5 years before clinical worsening; (b) inability to obtain appropriate clinical management (section 9).","Temporal concept of 'clinical worsening' requiring retrospective clinical assessment from first presentation to date at which signs were permanently present (Schedule 1 definition).","Requirement that any listed factor be related to the person's relevant service as defined (section 10; Schedule 1 relevant service list).","Legal standard used — 'reasonable hypothesis' — and the RMA's stated view of sound medical‑scientific evidence as the basis (section 8 and instrument title).","Cross-reference mechanism to other Statements of Principles when a factor refers to an injury/disease covered elsewhere (section 11).","Instrument-level changes: repeal of the 2016 Statement and commencement formalities which may affect transitional claim handling (section 4 and commencement).","Reference to ICD‑10‑AM coding while relying on the instrument's own definitional text (subsection 7(3))."],"plain_english_summary":"This Repatriation Medical Authority Statement of Principles defines Scheuermann’s disease (kyphosis) for veterans’ and defence members’ claims under the VEA and MRCA and replaces the 2016 statement. It sets the medical definition, includes death caused by related terminal events, and lists the specific factors that must exist to raise a reasonable hypothesis linking the condition to relevant service (notably recent strenuous spinal loading or inability to obtain appropriate care). It matters because those factors determine entitlement eligibility for affected claimants."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the same narrow scope as its 2016 predecessor and the standard template for Repatriation Medical Authority Statements of Principles. It addresses only the specific medical condition (Scheuermann's disease) and the reasonable hypothesis standard for service connection. There is no expansion into related conditions, comorbidities, or broader eligibility categories."},"complexity_factors":["Short, single-purpose instrument (approximately 1,500 words)","Only 7 defined terms in the Dictionary (Schedule 1)","Simple binary structure: two alternative factors in section 9, either of which satisfies the test","Minimal cross-referencing — only refers to parent Acts (VEA and MRCA) for service definitions","No nested exceptions or conditional logic beyond the basic 'at least one factor must exist' requirement","Straightforward repeal and replacement of a single previous instrument (No. 75 of 2016)"],"plain_english_summary":"This instrument replaces the 2016 rules and narrows what counts as Scheuermann’s disease for compensation, applying to ADF members, peacekeepers and claimants under the VEA/MRCA. It allows a “reasonable hypothesis” link to service if the condition worsened after five years of strenuous physical activity or because the veteran couldn’t obtain appropriate treatment, provided those factors are connected to their military service. That shifts the burden, making it easier for eligible veterans to obtain benefits."},"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-reasonable-hypothesis-no-45-of-202","history":"/api/acts/statement-of-principles-concerning-scheuermann-s-disease-kyphosis-reasonable-hypothesis-no-45-of-202/history","analysis":"/api/acts/statement-of-principles-concerning-scheuermann-s-disease-kyphosis-reasonable-hypothesis-no-45-of-202/analysis","conflicts":"/api/acts/statement-of-principles-concerning-scheuermann-s-disease-kyphosis-reasonable-hypothesis-no-45-of-202/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-scheuermann-s-disease-kyphosis-reasonable-hypothesis-no-45-of-202/important-cases","documents":"/api/acts/statement-of-principles-concerning-scheuermann-s-disease-kyphosis-reasonable-hypothesis-no-45-of-202/documents"}}