{"id":"F2026L00153","name":"Statement of Principles concerning schizophrenia (Balance of Probabilities) (No. 28 of 2026)","slug":"statement-of-principles-concerning-schizophrenia-balance-of-probabilities-no-28-of-2026","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443162,"registerId":"F2026L00153-fast-fetch-1775958070416","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning schizophrenia (Balance of Probabilities) (No. 28 of 2026)","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\nSCHIZOPHRENIA  (Balance of Probabilities)\n\n(No. 28 of 2026)\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                                                 20 February 2026\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\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 schizophrenia (Balance of Probabilities) (No. 28 of 2026).\n\n1.                Commencement\n\n\n              This instrument commences on 23 March 2026.\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 schizophrenia No. 84 of 2016 (Federal Register of Legislation No. F2016L01685) made under subsection 196B(3) of the VEA is repealed.\n\n1.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 schizophrenia and death from schizophrenia.\n\n\nMeaning of schizophrenia\n\n1.           For the purposes of this Statement of Principles, schizophrenia means a disorder of mental health meeting the following diagnostic criteria (derived from DSM-5-TR):\n\n\n1.     Two (or more) of the following, each present for a significant portion of time during a one-month period (or less if successfully treated), at least one being (i), (ii) or (iii):\n  1.              delusions;\n  2.          hallucinations;\n  3.        disorganised speech (for example, frequent derailment or incoherence);\n  4.          grossly disorganised or catatonic behaviour; or\n  5.           negative symptoms (that is, diminished emotional expression or avolition).\n2.      For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas of life, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic or occupational functioning).\n3.      Continuous signs of the disturbance persist for at least six months.  This six-month period must include at least one month of symptoms (or less if successfully treated) that meet Criterion A and may include periods of prodromal or residual symptoms.  During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (for example, odd beliefs, unusual perceptual experiences).\n4.     Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either:\n  1.         no major depressive or manic episodes have occurred concurrently with the active-phase symptoms; or\n  2.      if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.\n5.      The disturbance is not attributable to the physiological effects of a substance (for example, a drug of abuse, a medication) or another medical condition.\n6.       If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least one month (or less if successfully treated).\n\n\nNote: DSM-5-TR is defined in the Schedule 1 – Dictionary.\n\n1.           While schizophrenia attracts ICD‑10‑AM code F20.0-F20.3, F20.5 or F20.9, in applying this Statement of Principles the meaning of schizophrenia 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 schizophrenia\n\n1.           For the purposes of this Statement of Principles, schizophrenia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's schizophrenia.\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 schizophrenia and death from schizophrenia 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\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, schizophrenia or death from schizophrenia is connected with the circumstances of a person's relevant service:\n\n1.           having experienced as a child (under the age of 18) one of the following;\n  1.           serious physical, emotional, or sexual harm;\n  2.           neglect involving a serious failure to provide the necessities for health, physical and emotional development, or wellbeing by adults with obligations to provide such necessities;\n\n\nbefore clinical onset;\n\n1.           having onset of infection with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in the 1 month before clinical onset;\n\n\nNote: SARS-CoV-2 is the virus which causes coronavirus disease 2019 (COVID-19).\n\n1.           experiencing a category 1A stressor in the 3 months before clinical onset or clinical worsening;\n\n\nNote: category 1A stressor is defined in the Schedule 1 - Dictionary.\n\n1.           experiencing a category 1B stressor within the 3 months before clinical onset or clinical worsening;\n\n\nNote: category 1B stressor is defined in the Schedule 1 - Dictionary.\n\n1.           experiencing the death of a related child within the 2 years before clinical onset or clinical worsening;\n\n\nNote: related child is defined in the Schedule 1 – Dictionary.\n\n1.           experiencing the death of a parent within the 10 years before clinical onset or clinical worsening, where the person was under the age of 18 at the time of the parent's death;\n2.           having cannabis use disorder within the 20 years before clinical onset or clinical worsening;\n3.           having used cannabis at least twice a week for a continuous period of at least 2 years before the age of 18 years, within the 20 years before clinical onset or clinical worsening;\n\n\nNote: This factor includes the use of prescribed cannabis.\n\n1.           having alcohol use disorder or substance use disorder involving a drug or a drug from a class of drugs from Specified List 1 of drugs, within the 5 years before clinical onset or clinical worsening;\n\n\nNote: Specified List 1 of drugs is defined in the Schedule 1 – Dictionary.\n\n1.       having one of the following clinically significant disorders of mental health at the time of clinical worsening:\n  1.           acute stress disorder;\n  2.           alcohol use disorder;\n  3.           anxiety disorder;\n  4.           depressive disorder;\n  5.           eating disorder;\n  6.            obsessive-compulsive disorder;\n  7.           panic disorder;\n  8.           posttraumatic stress disorder;\n  9.             sleep-wake disorder;\n  10.             social anxiety disorder; or\n  11.           substance use disorder;\n\n\nNote: clinically significant disorder of mental health is defined in the Schedule 1 dictionary.\n\n1.       taking a medication which results in the re-development or worsening of signs or symptoms of schizophrenia, where the treatment with the medication continued for at least the 2 days before clinical worsening;\n2.       taking a drug or a drug from a class of drugs from Specified List 2 of drugs in the 30 days before clinical worsening;\n\n\nNote: Specified List 2 of drugs is defined in the Schedule 1 – Dictionary.\n\n1.       having ceased, reduced or changed antipsychotic drug therapy, in the 7 days before clinical worsening;\n2.       inability to obtain appropriate clinical management for schizophrenia before clinical worsening.\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 clinical worsening aspect of factors set out in section 9 apply only to material contribution to, or aggravation of, schizophrenia where the person's schizophrenia 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  category 1A stressor means one of the following severe traumatic events:\n\n(a)          experiencing a life-threatening event;\n\n(b)          being subject to a serious physical attack, or assault including rape or sexual molestation;\n\n(c)          being threatened with a weapon, being held captive, being kidnapped, or being tortured.\n\n category 1B stressor means one of the following severe traumatic events:\n\n(a)          killing or maiming a person;\n\n(b)          being a witness to a person being killed or critically injured;\n\n(c)          being a witness to atrocities inflicted on another person;\n\n(d)          witnessing human remains or a critically injured casualty, excluding seeing a closed body bag or viewing a body in an open-casket.\n\nNote: witness is defined in the Schedule 1 – Dictionary.\n\n clinically significant disorder of mental health means a disorder of mental health which is of sufficient severity to warrant ongoing management.\n\nNote: To warrant ongoing management does not require that any actual management was received or given for the condition.\n\n DSM-5-TR means the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Text Revision Washington, DC, American Psychiatric Association, 2022.\n\n inhalants means breathable chemicals that produce psychoactive vapours or fumes and include organic solvents, aerosols and anaesthetics.\n\nNote: organic solvents is also defined in the Schedule 1 – Dictionary.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n organic solvents means:\n\n(a)          aliphatic hydrocarbon solvents; or\n\n(b)          aromatic hydrocarbon solvents; or\n\n(c)          chlorinated organic solvents; or\n\n(d)          oxygenated organic solvents.\n\n related child means your biological, adopted, step- or foster child.\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 schizophrenia—see subsection 7(2).\n\n Specified List 1 of drugs means:\n\n(a)          amphetamines and amphetamine-type substances, including methamphetamine and 3,4-methylenedioxymethamphetamine (ecstasy);\n\n(b)          cocaine; or\n\n(c)          opioids.\n\n Specified List 2 of drugs means:\n\n(a)          aciclovir\n\n(b)          aldesleukin;\n\n(c)          amphetamines and amphetamine-type substances, including methamphetamine and 3,4-methylenedioxymethamphetamine (ecstasy);\n\n(d)          bupropion;\n\n(e)          cannabis;\n\n(f)           cocaine;\n\n(g)          ephedrine;\n\n(h)          fenfluramine;\n\n(i)            hallucinogens;\n\n(j)            inhalants;\n\n(k)          mefloquine;\n\n(l)            opioids;\n\n(m)        phencyclidine;\n\n(n)          phentermine;\n\n(o)          phenylpropanolamine;\n\n(p)          pseudoephedrine; or\n\n(q)          varenicline.\n\nNote: inhalants is 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 witness means a person who experiences an incident at the time it occurs and can give direct evidence of it. This excludes persons exposed only to public broadcasting or mass media coverage of the incident.\n\n                                \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Repatriation Medical Authority Statements of Principles. It replaces the 2016 version (No. 84 of 2016) with updated medical criteria (DSM-5-TR instead of DSM-5 or earlier versions) and incorporates newer factors such as COVID-19 infection. The structure remains consistent with the standard RMA template: definition of the condition, factors for onset/worsening, relationship to service requirements, and dictionary. While the specific medical factors have been updated to reflect current evidence (particularly around cannabis use and COVID-19), the legislative mechanism and scope — determining service-relatedness for veterans' compensation purposes — remains unchanged from the original intent of section 196B(3) of the Veterans' Entitlements Act 1986."},"complexity_factors":["Multiple nested definitions requiring cross-referencing (e.g., 'category 1A stressor' and 'category 1B stressor' defined in Schedule 1, then referenced in section 9)","Precise temporal requirements with varying windows (1 month for COVID-19, 3 months for stressors, 2 years for child death, 10 years for parent death, 20 years for cannabis, 5 years for alcohol/drugs, 30 days for Specified List 2 drugs, 7 days for medication changes)","Dual application structure — distinguishes between 'clinical onset' (first getting sick) and 'clinical worsening' (getting sicker), with different rules for each","Extensive defined terms in Schedule 1 (approximately 15+ defined terms including nested definitions like 'inhalants' referencing 'organic solvents' which has its own sub-definitions)","Incorporation of external medical standards by reference (DSM-5-TR diagnostic criteria with 6 specific criteria and sub-criteria for schizophrenia definition)","Conditional logic requiring connection to 'relevant service' — the factors alone aren't enough; they must be service-related","Cross-referencing mechanism in section 11 allowing other Statements of Principles to 'import' their factors dynamically","Specific drug lists (Specified List 1 and Specified List 2) with 3 and 17 entries respectively, requiring precise identification","Exception handling for pre-existing conditions (section 10(2) limits worsening claims to 'material contribution' or 'aggravation' where condition existed before service)"],"plain_english_summary":"This instrument gives the Repatriation Medical Authority the medical criteria for deciding whether a veteran's schizophrenia was caused or worsened by their Australian Defence Force service, using DSM-5-TR definitions and applying to claims under the VEA and MRCA. \n\nIt affects current and former ADF members making claims, decision-makers and treating clinicians. Outcomes determine access to pensions, treatment and rehabilitation, so proving a service link within the specified timeframes and circumstances is decisive to compensation."},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2016 Statement (s4) and reissues criteria that add and specify new factors and temporal windows (notably inclusion of SARS‑CoV‑2 as a proximate factor, listed drug classes and drug lists, and detailed childhood and stressor categories in s9 and Schedule 1). Those additions alter the range of qualifying circumstances and so change the Statement's scope compared with the prior instrument."},"complexity_factors":["Detailed clinical diagnostic standard tied to DSM‑5‑TR (schizophrenia definition) requiring clinical judgements about symptom clusters and duration (s7(2)).","Multiple temporal proximity rules for different factors (e.g. 1 month for SARS‑CoV‑2, 3 months for category 1A/1B stressors, up to 20 years for cannabis) increase evidentiary complexity (s9).","Enumerated contributory exposures and clinical states (childhood harm, specified stressors, substance‑use disorders, clinically significant mental disorders, medication/drug lists) require cross‑disciplinary medical and social-history assessments (s9; Schedule 1).","Two specified drug lists (Specified List 1 and Specified List 2 in Schedule 1) and definitions of categories like inhalants/organic solvents add technical pharmacological detail (Schedule 1; s9).","Requirement that an identified factor be related to 'relevant service' imposes a causal or nexus assessment between service events and the factor (s10(1)).","Interaction with other Statements of Principles: where a factor refers to another disease/injury with its own Statement, those rules apply and must be reconciled (s11).","Administrative steps: repeal of the 2016 Statement and commencement notice create transitional and implementation tasks for decision-makers (s2, s4).","Definitions and exclusions (e.g. witness definition, terminal event, clinically significant disorder) narrow or broaden application in ways that require careful interpretation (Schedule 1)."],"plain_english_summary":"This instrument replaces the 2016 Statement and sets updated medical criteria and a list of service‑related factors that decision‑makers must use to connect schizophrenia (and death from it) to a veteran's relevant service under the VEA and MRCA. \n\nIt affects veterans and current or former Defence members claiming entitlements by defining a DSM‑5‑TR based diagnosis, specific exposure and timing windows (for example: childhood harm, traumatic stressors, certain infections, drug use, medication changes) and requiring that identified factors be related to the person’s relevant service."},"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-schizophrenia-balance-of-probabilities-no-28-of-2026","history":"/api/acts/statement-of-principles-concerning-schizophrenia-balance-of-probabilities-no-28-of-2026/history","analysis":"/api/acts/statement-of-principles-concerning-schizophrenia-balance-of-probabilities-no-28-of-2026/analysis","conflicts":"/api/acts/statement-of-principles-concerning-schizophrenia-balance-of-probabilities-no-28-of-2026/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-schizophrenia-balance-of-probabilities-no-28-of-2026/important-cases","documents":"/api/acts/statement-of-principles-concerning-schizophrenia-balance-of-probabilities-no-28-of-2026/documents"}}