Statement of Principles concerning cervical dystonia (spasmodic torticollis) (Reasonable Hypothesis) (No. 41 of 2025)
1Statement of Principles concerning cervical dystonia (spasmodic torticollis) (Reasonable Hypothesis) (No. 41 of 2025)
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The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.
Dated 15 April 2025
Professor Terence Campbell AM
Chairperson
by and on behalf of
The Repatriation Medical Authority
Contents
1 Name
2 Commencement
3 Authority
4 Repeal
5 Application
6 Definitions
7 Kind of injury, disease or death to which this Statement of Principles relates
8 Basis for determining the factors
9 Factors that must exist
10 Relationship to service
11 Factors referring to an injury or disease covered by another Statement of Principles
Schedule 1 - Dictionary
1 Definitions
Name
This is the Statement of Principles concerning cervical dystonia (spasmodic torticollis) (Reasonable Hypothesis) (No. 41 of 2025).
Commencement
This instrument commences on 19 May 2025.
Authority
This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.
Repeal
The Statement of Principles concerning spasmodic torticollis No. 63 of 2016 (Federal Register of Legislation No. F2016L01136) made under subsection 196B(2) of the VEA is repealed.
Application
This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies.
Definitions
The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.
Kind of injury, disease or death to which this Statement of Principles relates
This Statement of Principles is about cervical dystonia (spasmodic torticollis) and death from cervical dystonia (spasmodic torticollis).
Meaning of cervical dystonia (spasmodic torticollis)
For the purposes of this Statement of Principles, cervical dystonia (spasmodic torticollis):
means a chronic focal dystonia characterised by sustained or intermittent involuntary neck muscle contractions, causing repetitive movements or abnormal movements or postures of the head, neck, and shoulders; and
excludes:
1. drug-induced dystonia;
2. generalised or hemidystonia;
3. paroxysmal dystonia;
4. congenital dystonia;
5. dystonia resulting from a neurological disorder;
6. dystonia resulting from a structural lesion of the brain or cervical cord; and
7. dystonia resulting from a local lesion of the cervical region.
Note: A percentage of patients with cervical dystonia may have other focal or segmental (affecting adjacent body parts) dystonias.
While cervical dystonia (spasmodic torticollis) attracts ICD‑10‑AM code G24.3, in applying this Statement of Principles the meaning of cervical dystonia (spasmodic torticollis) is that given in subsection (2).
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.
Death from cervical dystonia (spasmodic torticollis)
For the purposes of this Statement of Principles, cervical dystonia (spasmodic torticollis), in relation to a person, includes death from a terminal event or condition that was contributed to by the person's cervical dystonia (spasmodic torticollis).
Note: terminal event is defined in the Schedule 1 – Dictionary.
Basis for determining the factors
The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that cervical dystonia (spasmodic torticollis) and death from cervical dystonia (spasmodic torticollis) 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.
Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.
Factors that must exist
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting cervical dystonia (spasmodic torticollis) or death from cervical dystonia (spasmodic torticollis) with the circumstances of a person's relevant service:
having trauma to the neck, head, or shoulders which results in local symptoms lasting for at least 2 weeks, within the 1 year before clinical onset;
Note: Mechanisms of trauma include motor vehicle accidents, whiplash, assault, falls, and heavy lifting.
inability to obtain appropriate clinical management for cervical dystonia (spasmodic torticollis) before clinical worsening.
Relationship to service
The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.
The factor set out in subsection 9(2) applies only to material contribution to, or aggravation of, cervical dystonia (spasmodic torticollis) where the person's cervical dystonia (spasmodic torticollis) was suffered or contracted before or during (but did not arise out of) the person's relevant service.
Factors referring to an injury or disease covered by another Statement of Principles
In this Statement of Principles:
if a factor referred to in section 9 applies in relation to a person; and
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;
then 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.