{"id":"F2021L00353","name":"Statement of Principles concerning seborrhoeic dermatitis (Balance of Probabilities) (No. 44 of 2021)","slug":"statement-of-principles-concerning-seborrhoeic-dermatitis-balance-of-probabilities-no-44-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440806,"registerId":"F2021L00353-fast-fetch-1775956307634","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning seborrhoeic dermatitis (Balance of Probabilities) (No. 44 of 2021)","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\nSEBORRHOEIC DERMATITIS (Balance of Probabilities)\n\n(No. 44 of 2021)\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 26 March 2021\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 seborrhoeic dermatitis (Balance of Probabilities) (No. 44 of 2021).\n\n2 Commencement\n\n This instrument commences on 27 April 2021.\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 seborrhoeic dermatitis No. 14 of 2013 (Federal Register of Legislation No. F2013L00407) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 seborrhoeic dermatitis and death from seborrhoeic dermatitis.\n\nMeaning of seborrhoeic dermatitis\n\n(2) For the purposes of this Statement of Principles, seborrhoeic dermatitis means an exfoliative, chronic dermatitis involving areas of increased sebaceous gland activity.\n\nNote: Seborrhoeic dermatitis characteristically affects the scalp, face, ears and the flexural creases of the body.\n\n(3) While seborrhoeic dermatitis attracts ICD‑10‑AM code L21.0, L21.8 or L21.9, in applying this Statement of Principles the meaning of seborrhoeic dermatitis 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 seborrhoeic dermatitis\n\n(5) For the purposes of this Statement of Principles, seborrhoeic dermatitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's seborrhoeic dermatitis.\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 seborrhoeic dermatitis and death from seborrhoeic dermatitis 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, seborrhoeic dermatitis or death from seborrhoeic dermatitis is connected with the circumstances of a person's relevant service:\n\n(1) having infection with human immunodeficiency virus before the clinical onset of seborrhoeic dermatitis;\n\n(2) having Parkinson's disease or secondary parkinsonism at the time of the clinical onset of seborrhoeic dermatitis;\n\n(3) having a physical disability or psychiatric disease which significantly limits the person's ability to maintain personal hygiene of the affected area at the time of the clinical onset of seborrhoeic dermatitis;\n\nNote: Examples of conditions which can significantly limit a person's ability to maintain personal hygiene include severe injuries, paralysis, immobility, alcohol use disorder and major depressive disorder.\n\n(4) being immobile for at least the four weeks before the clinical onset of seborrhoeic dermatitis;\n\nNote: Examples of being immobile include being in intensive care, having a spinal cord injury and, for facial seborrhoeic dermatitis, having facial paralysis.\n\n(5) taking a drug from the specified list of drugs for the treatment of cancer or autoimmune disease for at least the seven days before the clinical onset of seborrhoeic dermatitis;\n\nNote: specified list of drugs is defined in the Schedule 1 - Dictionary.\n\n(6) taking a drug which is associated in the individual with the clinical onset of seborrhoeic dermatitis during drug therapy and either:\n\n(a) the improvement of seborrhoeic dermatitis within three months of discontinuing or tapering drug therapy; or\n\n(b) the redevelopment of seborrhoeic dermatitis on rechallenge with the same drug; and\n\nwhere taking the drug continued for at least the seven days before the clinical onset of seborrhoeic dermatitis;\n\n(7) having infection with human immunodeficiency virus before the clinical worsening of seborrhoeic dermatitis;\n\n(8) having Parkinson's disease or secondary parkinsonism at the time of the clinical worsening of seborrhoeic dermatitis;\n\n(9) having a physical disability or psychiatric disease which significantly limits the person's ability to maintain personal hygiene of the affected area at the time of the clinical worsening of seborrhoeic dermatitis;\n\nNote: Examples of conditions which can significantly limit a person's ability to maintain personal hygiene include severe injuries, paralysis, immobility, alcohol use disorder and major depressive disorder.\n\n(10) being immobile for at least the four weeks before the clinical worsening of seborrhoeic dermatitis;\n\nNote: Examples of being immobile include being in intensive care, having a spinal cord injury and, for facial seborrhoeic dermatitis, having facial paralysis.\n\n(11) taking a drug from the specified list of drugs for the treatment of cancer or autoimmune disease for at least the seven days before the clinical worsening of seborrhoeic dermatitis;\n\nNote: specified list of drugs is defined in the Schedule 1 - Dictionary.\n\n(12) taking a drug which is associated in the individual with the clinical worsening of seborrhoeic dermatitis during drug therapy and either:\n\n(a) the improvement of seborrhoeic dermatitis within three months of discontinuing or tapering drug therapy; or\n\n(b) the worsening of seborrhoeic dermatitis on rechallenge with the same drug; and\n\nwhere taking the drug continued for at least the seven days before the clinical worsening of seborrhoeic dermatitis;\n\n(13) wearing a surgical mask or face covering intended to provide protection from human-to-human respiratory virus transmission, for a cumulative period of at least 20 hours in the seven days before the clinical worsening of seborrhoeic dermatitis;\n\n(14) inability to obtain appropriate clinical management for seborrhoeic dermatitis.\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(7) to 9(14) apply only to material contribution to, or aggravation of, seborrhoeic dermatitis where the person's seborrhoeic dermatitis 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 biologic agent means a therapeutic product which is derived from living organisms or which contains components of living organisms.\n\nNote: Examples of biologic agents used for the treatment of cancer or autoimmune disease include interferons, monoclonal antibodies, B-Raf inhibitors, epidermal growth factor receptor inhibitors, interleukins, MEK-inhibitors and tyrosine kinase inhibitors.\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 seborrhoeic dermatitis—see subsection 7(2).\n\n specified list of drugs means:\n\n(a) a biologic agent;\n\n(b) capecitabine; or\n\n(c) fluorouracil.\n\nNote 1: Fluorouracil is also known as 5-fluorouracil or 5-FU, and capecitabine is a pro-drug for fluorouracil. Both fluorouracil and capecitabine are available systemically while fluorouracil is also available topically.\n\nNote 2: biologic agent 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 \n\n \n","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"},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2013 Statement of Principles (s4) and replaces it with updated factors (s9) while keeping the same application to VEA/MRCA claims (s5). New or clarified inclusions include a specified drug list (Schedule 1: biologic agents, capecitabine, fluorouracil) and measurable exposure criteria such as surgical mask/face covering use (s9(13)), plus temporal and evidentiary tests for drug association (s9(6), s9(12)) and immobility timeframes (s9(4)). Relationship-to-service limitations are restated (s10(1)–(2))."},"complexity_factors":["Medical specificity and clinical thresholds (e.g. definition of seborrhoeic dermatitis in s7(2); ICD code referenced but definition in s7(3))","Enumerated causation factors with temporal conditions (multiple items in s9 requiring presence before clinical onset or worsening and time-limits like 4 weeks immobility in s9(4) and 7 days drug exposure in s9(5)/(6)/(11)/(12))","Drug‑related evidentiary rules including specified list and biologic agents (Schedule 1 definitions; specified list in Schedule 1) and requirements for improvement within 3 months or positive rechallenge (s9(6), s9(12))","New behavioural/usage criterion with measurable exposure (mask wearing: cumulative 20 hours in 7 days before worsening in s9(13))","Cross‑reference to other Statements of Principles where factors refer to other injuries/diseases (s11) creating potential interdependence of instruments","Legal standard of proof (balance of probabilities) stated in s8, requiring adjudicative assessment rather than fixed presumptions","Definitions and terms dispersed between main text and Schedule 1 (s6 and Schedule 1), requiring synthesis for application","Relationship-to-service constraints and distinctions between material contribution/aggravation versus arising out of service (s10(1)–(2))","Repeal and replacement of prior instrument (s4) so historical claims may need re-assessment under changed criteria"],"plain_english_summary":"This instrument repeals the earlier Statement of Principles and sets the medical criteria the Repatriation Medical Authority will use to decide, on the balance of probabilities, whether seborrhoeic dermatitis (or death from it) is connected to a veteran's or member's service for VEA/MRCA claims.\n\nIt lists specific factors — HIV infection, Parkinsonism, immobility or hygiene‑limiting conditions, certain cancer/autoimmune drugs (biologics, capecitabine, fluorouracil), mask use, and inability to obtain appropriate clinical care — that, when present and linked to relevant service, can establish entitlement; it applies to veterans and members lodging claims."},"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 2013 version with updated medical evidence and adds a contemporary factor (mask-wearing) reflecting changed service conditions, but does not expand beyond the established purpose of determining service connection for specific medical conditions."},"complexity_factors":["14 distinct factors with multiple sub-clauses and alternative pathways (e.g., factors 6 and 12 have nested (a)/(b) conditions)","Cross-references to other Statements of Principles for related conditions (section 11)","Defined terms in Schedule 1 including technical medical terms (biologic agents, pro-drugs) and legislative cross-references (VEA, MRCA)","Temporal requirements specified with precision (e.g., 'at least 20 hours in the seven days', 'at least four weeks', 'at least seven days')","Dual structure covering both clinical onset AND clinical worsening (factors 1-6 for onset, 7-14 for worsening)","Conditional limitation in section 10(2) restricting factors 7-14 to aggravation cases only","Medical-scientific evidentiary basis requirement in section 8"],"plain_english_summary":"This Statement of Principles sets the medical test for whether seborrhoeic dermatitis (or death from it) is service-related for veterans and current/former defence members claiming under the VEA or MRCA. Using the balance-of-probabilities, it lists 14 medical risk/trigger factors (including prolonged surgical mask use) that can link onset or aggravation to service. It replaces the 2013 version and guides what evidence is needed for compensation."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-seborrhoeic-dermatitis-balance-of-probabilities-no-44-of-2021","history":"/api/acts/statement-of-principles-concerning-seborrhoeic-dermatitis-balance-of-probabilities-no-44-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-seborrhoeic-dermatitis-balance-of-probabilities-no-44-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-seborrhoeic-dermatitis-balance-of-probabilities-no-44-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-seborrhoeic-dermatitis-balance-of-probabilities-no-44-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-seborrhoeic-dermatitis-balance-of-probabilities-no-44-of-2021/documents"}}