{"id":"F2025L00503","name":"Statement of Principles concerning systemic lupus erythematosus (Balance of Probabilities) (No. 48 of 2025)","slug":"statement-of-principles-concerning-systemic-lupus-erythematosus-balance-of-probabilities-no-48-of-20","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":106296,"registerId":"commonwealth-F2025L00503-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning systemic lupus erythematosus (Balance of Probabilities) (No. 48 of 2025)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning systemic lupus erythematosus (Balance of Probabilities) (No. 48 of 2025)\n\nmade under subsection 196B(3) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 19 May 2025\n\nIncludes amendments: Amendment Statement of Principles concerning systemic lupus erythematosus (Balance of Probabilities) (No. 55 of 2025) (F2025L00560)\n\nThe day of commencement of this Amendment Statement of Principles concerning systemic lupus erythematosus is 19 May 2025.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning systemic lupus erythematosus (Balance of Probabilities) (No. 48 of 2025) that shows the text of the law as amended and in force on 19 May 2025.\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 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 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 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\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\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 systemic lupus erythematosus (Balance of Probabilities) (No. 48 of 2025).\n\n1.  Commencement\n\nThis instrument commences on 19 May 2025.\n\n1.  Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.  Repeal\n\nThe Statement of Principles concerning systemic lupus erythematosus (Balance of Probabilities) (No. 22 of 2016) (Federal Register of Legislation No. F2016L00274) made under subsection 196B(3) of the VEA is repealed.\n\n1.  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\n1.  Definitions\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 systemic lupus erythematosus and death from systemic lupus erythematosus.\n\nMeaning of systemic lupus erythematosus\n\n1.  For the purposes of this Statement of Principles, systemic lupus erythematosus:\n    1.  means a chronic inflammatory autoimmune disease characterised by the presence of antibodies directed against cell nuclei; and\n    2.  includes:\n        1.  drug induced systemic lupus erythematosus;\n        2.  lupus nephritis; and\n        3.  lupus pneumonitis; and\n    3.  excludes:\n        1.  subacute cutaneous lupus erythematosus;\n        2.  discoid lupus erythematosus; and\n        3.  mixed connective tissue disease.\n\n> Note: Common clinical manifestations of systemic lupus erythematosus include polyarthritis and arthralgia, photosensitivity, rash, serositis, and renal, haematological and neurological disorders.\n\n1.  While systemic lupus erythematosus attracts ICD‑10‑AM code M32, in applying this Statement of Principles the meaning of systemic lupus erythematosus 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\nDeath from systemic lupus erythematosus\n\n1.  For the purposes of this Statement of Principles, systemic lupus erythematosus, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's systemic lupus erythematosus.\n\n> Note: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.  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 systemic lupus erythematosus and death from systemic lupus erythematosus 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\n1.  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, systemic lupus erythematosus or death from systemic lupus erythematosus is connected with the circumstances of a person's relevant service:\n\n1.  being exposed to sunlight or ultraviolet light at a level sufficient to induce erythema (sunburn) at least 24 hours, but not more than 30 days, before clinical worsening of systemic lupus erythematosus skin rash;\n2.  inhaling respirable crystalline silica dust for a cumulative period of at least 2,000 hours before clinical onset or clinical worsening;\n\n> Note: Examples of when exposure to respirable crystalline silica dust can occur include when material containing crystalline silica is being produced, excavated, drilled, cut or ground, or used in construction, manufacturing, cleaning or blasting.\n\n1.  inhaling respirable crystalline silica dust in an amount greater than 100 micrograms/m3\\-years of cumulative exposure before clinical onset or clinical worsening;\n\n> Note 1: Examples of when exposure to respirable crystalline silica dust can occur include when material containing crystalline silica is being produced, excavated, drilled, cut or ground, or used in construction, manufacturing, cleaning or blasting.\n\n> Note 2: micrograms/m3-years is defined in the Schedule 1 – Dictionary.\n\n1.  where smoking has not ceased before clinical onset, smoking at least 20 pack-years before clinical onset or clinical worsening;\n\n> Note: one pack-year is defined in the Schedule 1 – Dictionary.\n\n1.  taking one of the following medications (which cannot be ceased or substituted) at the time of clinical onset or clinical worsening;\n    1.  chlorpromazine;\n    2.  hydralazine;\n    3.  isoniazid;\n    4.  minocycline;\n    5.  tumour necrosis factor-alpha inhibitors;\n    6.  terbinafine;\n    7.  flutamide;\n    8.  interferon gamma;\n    9.  ethosuximide;\n    10.  oxcarbazepine;\n    11.  carbamazepine;\n    12.  phenytoin.\n2.  taking sulfadiazine or trimethoprim-sulfamethoxazole (which cannot be ceased or substituted) at the time of clinical worsening;\n3.  taking a medication which is associated with:\n    1.  the development of systemic lupus erythematosus including laboratory markers during medication therapy; and\n    2.  the cessation of systemic lupus erythematosus including laboratory markers within 3 months of discontinuing medication therapy; and\n\nwhere treatment with the drug continued for at least the 3 days before clinical onset or clinical worsening;\n\n1.  having a clinically symptomatic bacterial, viral or fungal infection at the time of clinical worsening;\n2.  being pregnant within the 6 weeks before clinical worsening;\n3.  inability to obtain appropriate clinical management for systemic lupus erythematosus before clinical worsening.\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 aspects of factors in section 9 apply only to material contribution to, or aggravation of, systemic lupus erythematosus where the person's systemic lupus erythematosus 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\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\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\nmicrograms/m3\\-years means micrograms/m3 multiplied by years of exposure.\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\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\nsystemic lupus erythematosus—see subsection 7(2).\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> Note: Endnote 3—Legislation history\n\n| Name                                                                                                                  | Registration             | Commencement | Application, saving and transitional provisions |\n| --------------------------------------------------------------------------------------------------------------------- | ------------------------ | ------------ | ----------------------------------------------- |\n| Statement of Principles concerning systemic lupus erythematosus (Balance of Probabilities) (No. 48 of 2025)           | 16 April 2025F2025L00503 | 19 May 2025  |                                                 |\n| Amendment Statement of Principles concerning systemic lupus erythematosus (Balance of Probabilities) (No. 55 of 2025) | 9 May 2025F2025L00560    | 19 May 2025  |                                                 |\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| Section 9……………….   | am No. 55 of 2025 |","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2016 Statement (s4) and replaces it with updated criteria that specify quantified exposure thresholds, a defined smoking metric and an enumerated drug list (see s9 and Schedule). Section 9 was amended (Endnote 4) so the qualifying factors that link SLE to service have been changed. The application remains limited to claims under section 120B of the VEA or section 339 of the MRCA (s5), but claimants now must meet the newly articulated factors and evidentiary formats to establish service connection."},"complexity_factors":["Technical medical definitions and exclusions for SLE (definition and inclusions/exclusions) (s7(2)).","Quantitative exposure metrics: cumulative 2,000 hours and >100 micrograms/m3‑years for respirable crystalline silica (s9(1)(b)–(c); Schedule: micrograms/m3‑years).","Smoking threshold of 20 pack‑years and detailed pack‑year calculation/equivalents (s9(1)(d); Schedule: one pack‑year and examples).","Enumerated medication list and drug‑related causal test (named drugs and criteria for drug‑induced SLE) (s9(1)(e)–(g)).","Temporal linking requirements: exposures must precede clinical onset or clinical worsening and clinical worsening rules apply only to pre‑existing SLE (s9; s10(2)).","Requirement that any listed factor be related to the person's relevant service (s10(1)) and application limited to claims under specified VEA/MRCA sections (s5).","Cross‑references to other Statements of Principles if a factor invokes another instrument (s11), creating dependency on other instruments' terms.","Administrative/scientific standard: RMA’s view based on 'sound medical‑scientific evidence' and application of the balance of probabilities (s8), which requires interpretation and expert assessment.","Repeal of the prior 2016 Statement and contemporaneous amendment history (s4; Endnote 3–4), meaning practitioners must use the new criteria and track amendments.","Implementation and evidentiary burden on claimants to document specific exposures, drug use, timing and clinical worsening — implementation complexity arises from measuring and proving the quantitative thresholds (s9; Schedule notes)."],"plain_english_summary":"Sets the medical criteria the Repatriation Medical Authority uses to decide, on the balance of probabilities, whether systemic lupus erythematosus (SLE) or death from SLE is connected to a person's relevant service. It lists specific exposures, quantitative thresholds (for silica and smoking), a named list of medications and clinical triggers, and excludes some lupus variants. It affects veterans and claimants seeking entitlements under the VEA or MRCA by defining what evidence will support a service connection."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard replacement of an existing Statement of Principles under the Veterans' Entitlements Act. It maintains the same scope as its 2016 predecessor — determining compensation eligibility for SLE in veterans — with updated medical evidence and minor technical amendments. No scope creep detected."},"complexity_factors":["Moderate cross-referencing between the main instrument and Schedule 1 (Dictionary) for defined terms","Technical medical terminology requiring specialist knowledge (ICD-10-AM codes, specific drug names, clinical thresholds)","Mathematical calculations required for exposure measurements (pack-years, micrograms/m3-years, cumulative hours)","Conditional logic with multiple nested exceptions (section 7 exclusions for certain lupus types, section 10 limitation on clinical worsening claims)","Dual legislative framework application (VEA and MRCA with different service definitions)","Specific temporal requirements (24 hours to 30 days for sun exposure, 6 weeks for pregnancy, 3 months for medication cessation, 3 days minimum medication duration)"],"plain_english_summary":"This Statement of Principles sets the rules for deciding when systemic lupus erythematosus (SLE) in veterans and current/former defence members is connected to service for claims under the VEA and MRCA. It lists factors that can establish that connection—notably recent sun/UV exposure, significant silica dust exposure, heavy smoking, certain medications, and triggers like infection or pregnancy—and applies the balance‑of‑probabilities test.\n\nIt replaces the 2016 version, covers death from SLE, and excludes skin‑only lupus forms."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-systemic-lupus-erythematosus-balance-of-probabilities-no-48-of-20","history":"/api/acts/statement-of-principles-concerning-systemic-lupus-erythematosus-balance-of-probabilities-no-48-of-20/history","analysis":"/api/acts/statement-of-principles-concerning-systemic-lupus-erythematosus-balance-of-probabilities-no-48-of-20/analysis","conflicts":"/api/acts/statement-of-principles-concerning-systemic-lupus-erythematosus-balance-of-probabilities-no-48-of-20/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-systemic-lupus-erythematosus-balance-of-probabilities-no-48-of-20/important-cases","documents":"/api/acts/statement-of-principles-concerning-systemic-lupus-erythematosus-balance-of-probabilities-no-48-of-20/documents"}}