Statement of Principles concerning eating disorder (Reasonable Hypothesis) (No. 15 of 2025)

The document is structured around a small set of interlocking legal‑medical concepts that will determine how claims are assessed. These concepts are expressed in the statutory provisions and the Schedule 1 dictionary; the main ones are set out below with their source references.

• Eating disorder: Defined purposively and exhaustively for this SoP (s7(2)). The definition is clinical and functional: a persistent disturbance of eating or eating‑related behaviour resulting in altered consumption/absorption of food, significantly impairing physical health or psychosocial functioning, with an express list of included DSM‑5‑TR‑derived diagnostic categories and specified exclusions (s7(2)-(3) and Schedule 1 entries for each disorder).

• Diagnostic criteria derived from DSM‑5‑TR: For each named disorder the SoP reproduces DSM‑5‑TR diagnostic criteria (for example anorexia nervosa, bulimia nervosa, binge‑eating disorder, pica, rumination disorder, avoidant/restrictive food intake disorder, atypical anorexia nervosa, purging disorder, night eating syndrome, unspecified feeding or eating disorder). The instrument identifies DSM‑5‑TR as the source (Schedule 1: DSM‑5‑TR).

• Reasonable hypothesis threshold: The SoP does not decide entitlement; it specifies the factual and medical factors that must exist before a decision maker can properly conclude a reasonable hypothesis of service connection is raised. It requires that at least one factor in s9 exist, and many factors are constrained by timing to the 2‑year window before clinical onset or clinical worsening of specific disorders (s9).

• Specified factors and timing: Section 9 lists the factors that can raise a reasonable hypothesis. These include exposure to defined stressors (category 1A, 1B, category 2), being the subject of bullying, bereavement (for binge‑eating disorder), pre‑existing clinically significant mental disorders within 2 years, childhood harm or neglect (under 18), childhood sexual abuse (for other specified feeding or eating disorder), food insecurity (for binge‑eating disorder), type 1 diabetes mellitus of at least 3 months duration (for certain disorders), and inability to obtain appropriate clinical management (s9 and Schedule 1 definitions).

• Relation to service: The SoP requires that any factor relied on must be related to the person’s relevant service (s10(1)(a)). It also sets a rule about clinical worsening: the clinical worsening elements apply only when the eating disorder existed before or during relevant service (but did not arise out of service) and the service materially contributed to or aggravated the condition (s10(1)(b)).

• Cross‑reference to other SoPs: Where a factor in s9 refers to an injury or disease covered by another SoP, the factors from that other SoP apply (s11). This makes the SoP a node in an interconnected set of RMA determinations.

• Death from eating disorder: The SoP covers death where a terminal event (as defined in the dictionary , e.g., pneumonia, respiratory failure, cardiac arrest, circulatory failure, cessation of brain function) was contributed to by the person’s eating disorder (s7(6); Schedule 1).

• Exclusions and code references: While the instrument notes the ICD‑10‑AM codes that correspond to eating disorder (s7(4)-(5)), it expressly states that in applying the SoP the meaning of eating disorder is that given in subsection 7(2), not merely the ICD codes (s7(4)).

Collectively, these concepts create a medical‑fact framework for claim assessment: the RMA supplies clinical definitions and a closed list of causal/associative factors (with timing and relational requirements) which decision makers must consider when assessing whether the statutory threshold of a reasonable hypothesis connecting the condition to relevant service is met.

This SoP affects three principal groups through its operation as an evidentiary and medico‑legal standard in the VEA/MRCA claims processes.

1. Claimants and potential claimants: Veterans, members of Peacekeeping Forces, and members of Forces covered by the VEA, and persons covered by the MRCA, who are seeking an entitlement where an eating disorder or death from an eating disorder is alleged to be connected to relevant service. The instrument expressly applies to claims to which s120A of the VEA or s338 of the MRCA applies (s5). Claimants whose cases involve the listed eating disorder diagnoses, or death from an eating disorder, will be assessed against the factors in s9 and the diagnostic descriptions in s7.

2. Decision‑makers and administrators: The primary operational users are the decision makers within the Department of Veterans’ Affairs or other bodies assessing claims under the VEA or MRCA. The RMA’s SoP provides the RMA’s view of the medical‑scientific evidence (s8) and therefore supplies the criterion for raising a reasonable hypothesis. Administrative medical advisers, adjudicators, and review tribunals will treat the SoP as authoritative medical guidance for claim assessment under the statutory framework (Authority, s3; Application, s5).

3. Medical experts and treating clinicians: Clinicians preparing reports for claims will need to apply the DSM‑5‑TR‑derived criteria reproduced in the SoP and address the specific factors the SoP lists (for example, whether a category 1A, 1B, or category 2 stressor occurred in the 2 years before clinical onset/worsening) (s7(2), s9). The SoP’s practical effect is to shape the content and focus of medical expert evidence.

There are also secondary effects on other stakeholders:

• Representatives and advisers: Lawyers, advocates, and welfare organisations preparing claims will need to marshal evidence mapped to the SoP’s factors and temporal windows (s9, s10).

• Records holders: Military units, health services, police, coroners, and other bodies that might hold contemporaneous records of stressor exposure, bullying, child harm, or medical management will be sources of evidence necessary to satisfy the SoP’s factors.

The instrument does not itself change who is eligible for benefits or the statutory tests for entitlement under the VEA or MRCA. Rather, it supplies the RMA’s medico‑factual yardstick used in making the preliminary finding of whether a reasonable hypothesis exists such that a claim should proceed to substantive consideration under the relevant Acts (s3, s5). The SoP’s definitions and the 2‑year timing constraints in s9 therefore influence which claimant circumstances will satisfy the reasonable hypothesis threshold.

This instrument is framed as an evidentiary specification rather than a statute imposing duties or creating private rights. Nonetheless, it creates binding obligations for decision makers who apply RMA SoPs and shapes the rights of claimants in the claims process.

• Duty of the RMA: The instrument is made by the RMA under subsection 196B(2) VEA (Authority, s3). That statutory power obliges the RMA to determine SoPs; the instrument records the RMA’s view about the medical‑scientific basis for linking eating disorder and death from eating disorder with relevant service (s8). The RMA’s determinations are used by the decision maker when assessing whether a reasonable hypothesis exists.

• Duty of decision makers applying SoPs: While the instrument does not itself restate the duties of decision makers under the VEA or MRCA, its application clause (s5) makes clear it is intended to be applied in claims under s120A VEA or s338 MRCA. In the statutory claim process a decision maker is required to apply RMA SoPs when determining whether a reasonable hypothesis has been raised; therefore decision makers have a duty to consider the SoP’s factors and definitions in their inquiries and determinations.

• Rights of claimants: The SoP affects claimants’ procedural position. If a claimant can demonstrate the existence of at least one of the factors specified in s9, within the timing requirements, and related to relevant service as required by s10, a reasonable hypothesis will have been raised, advancing the claim within the statutory process. The SoP therefore gives claimants a clear list of evidence‑relevant matters that can found a reasonable hypothesis; it does not guarantee entitlement, but it affects the right to have the claim proceed to full consideration.

• Medical reporting and evidential expectations: The SoP implies duties on clinicians and experts who prepare reports for the claims process: the diagnostic criteria (DSM‑5‑TR‑derived) and the specified factors are the evidential framework to be addressed. The Schedule’s definition of “clinically significant disorder of mental health” notes that warranting ongoing management is sufficient even where no actual management was received (Schedule 1). This affects how clinicians should report history and functional impact.

• Interrelation with other SoPs: Section 11 imposes a rule where a s9 factor refers to an injury/disease covered by another SoP; the other SoP’s factors then apply. This creates a procedural duty to consult and apply the terms of the other SoP in such cases.

• No criminal penalties or fines in this instrument: The SoP contains no provisions that create criminal offences or civil sanctioning powers. Its operational purpose is evidentiary; enforcement is administrative through the claims process (the instrument itself does not set administrative enforcement mechanisms).

Rights and duties therefore arise in practice from the SoP’s role as the RMA’s authoritative medical guidance: decision makers must apply it; claimants and clinicians must frame evidence around it; and cross‑references to other SoPs must be respected (s11). The Schedule provisions , for instance, the definition that “warranting ongoing management does not require that any actual management was received” , adjust evidentiary burdens by permitting un‑treated but severe conditions to be counted (Schedule 1).

The Statement of Principles is an administrative medical standard and does not create criminal offences, civil penalties, or express enforcement mechanisms. The instrument contains no penalty provisions, monetary fines, or sanctions. Its function is to specify medical factors that raise a reasonable hypothesis connecting an eating disorder or death from an eating disorder to relevant service for the purposes of claims under the VEA and MRCA (Authority, s3; Application, s5; Basis, s8).

Enforcement in practice occurs within the administrative and adjudicative processes established by the VEA and MRCA. The SoP supplies a medico‑factual threshold that decision makers use to determine whether the reasonable hypothesis test is met; if the threshold is met the claim proceeds to substantive assessment under the statutory scheme (s5). The SoP thereby affects the procedural outcome of claims: failing to satisfy the factors in s9 will leave a claimant without the reasonable hypothesis required to proceed. However, the instrument itself does not prescribe how the decision maker is to proceed operationally, the evidential standard required to prove the factors beyond the reasonable hypothesis, nor the nature or amount of any benefit payable under the VEA or MRCA.

Compliance and contestation of decisions that rely on SoPs are handled through the administrative appeal and review mechanisms provided by the VEA/MRCA and related tribunals, as those Acts provide. The instrument does not set alternative dispute resolution or review routes; it simply supplies the medical standard to be assessed in claims. Where a decision maker misapplies the SoP or fails to consider the relevant factors, that would be contested under the statutory review and merits‑review processes available under the VEA/MRCA and related review bodies , this instrument does not itself create or modify those review rights.

Finally, the SoP’s cross‑reference rule (s11) can constrain how decision makers apply medical factors when a factor points to another disease/injury covered by a different SoP, which could affect procedural correctness and therefore become a ground of review if not followed. The instrument therefore has procedural enforcement relevance even though it contains no stand‑alone enforcement or penalty sections.

The SoP operates within the legal architecture of veterans’ entitlements and compensation. Its legal interactions are explicit in the instrument and in the Schedule.

• Statutory basis: The instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986 (Authority, s3). That statutory power is the receptor for RMA SoPs; the SoP itself is not a stand‑alone Act but an instrument within the VEA regulatory framework.

• Application to VEA and MRCA claims: The SoP explicitly applies to claims to which s120A of the VEA or s338 of the MRCA applies (Application, s5). Those sections set out, in their respective Acts, the reasonable hypothesis test and the claims framework; this SoP is the RMA’s technical input into those statutory provisions.

• Cross‑SoP interaction: Section 11 provides a tie‑in for factors that refer to injuries or diseases which are the subject of other SoPs. Where a s9 factor refers to a condition covered by another SoP determined under subsection 196B(2), the factors in that other SoP apply “in accordance with the terms of that Statement of Principles as in force from time to time.” This makes the RMA’s SoPs mutually referencing; where conditions overlap the other SoP’s criteria will govern those particular factors.

• Diagnostic classifications and reference works: The instrument references and adopts DSM‑5‑TR diagnostic criteria (Schedule 1). It also notes ICD‑10‑AM codes that are ordinarily associated with eating disorders (s7(4)-(5)). The instrument clarifies that, for application of the SoP, the clinical meaning of “eating disorder” is the subsection 7(2) definition, even though ICD‑10‑AM codes are identified. Thus the SoP uses internationally recognised diagnostic systems as clinical anchors while declaring its own definitional primacy for claims.

• Interaction with coronial, medical or employment law: The SoP makes a formal statement about death from an eating disorder where a terminal event (defined in Schedule 1) was contributed to by the eating disorder (s7(6)). While coronial law and other causes of death determinations remain separate legal processes, the SoP’s inclusion of terminal events such as pneumonia, respiratory failure, cardiac arrest, circulatory failure, and cessation of brain function provides an administrative basis for linking a death to underlying eating disorder in the veterans’ claims context. The SoP does not purport to alter coronial findings or criminal law; instead it identifies what terminal events the RMA regards as capable of being contributed to by an eating disorder for claims.

• Interaction with evidentiary rules and administrative law: The SoP operates as an evidential benchmark in administrative decision making under the VEA/MRCA. Administrative law principles about procedural fairness, reasonableness, and correctness of applying statutory standards will therefore govern decisions that rely on the SoP. In addition, the Schedule’s definitional choices , for example the Schedule definition that a “clinically significant disorder of mental health” need not have actually received management to be considered , will affect evidential strategies and administrative findings.

• No override of primary statutes: The SoP does not amend or override substantive entitlement provisions of the VEA or MRCA. It is an instrument for applying the reasonable hypothesis test in those Acts. Where the SoP references other instruments, diagnostic systems, or SoPs, it does so to guide application of statutory tests rather than to displace the text of the VEA or MRCA.

Practitioners should therefore treat the SoP as an authoritative medical/legal standard that interacts principally with the VEA and MRCA claims machinery, with cross‑references to other RMA SoPs and reliance on DSM‑5‑TR and ICD‑10‑AM coding as clinical supports. The SoP’s definitions and timing windows will determine what evidence is necessary to satisfy the statutory reasonable hypothesis tests in the primary statutes.

This instrument records a limited amendment history as part of its own operation. The relevant points that the text states are:

• Repeal of earlier SoP: Section 4 expressly repeals the Statement of Principles concerning eating disorder (Reasonable Hypothesis) (No. 13 of 2016) (Federal Register of Legislation No. F2016L00261), which was made under subsections 196B(2) and (8) of the VEA. That prior instrument is therefore no longer in force as of the commencement of this instrument (s4). The current instrument replaces the 2016 SoP.

• Dates and commencement: The instrument is dated 17 December 2024 and the stated commencement date is 28 January 2025 (Name, Commencement). Those dates establish the point from which the revised definitions and factors are to be applied in claims.

• No other amendments recorded in the text: The SoP contains no internal amendment schedule, transitional provisions, savings clauses, or multi‑stage commencement for different parts. It does not itself list prior modifications to the 2016 SoP beyond its repeal. Any future amendments would be effected by subsequent RMA determinations under subsection 196B(2) and would be promulgated as new instruments.

• Cross‑SoP dynamism: Section 11 contemplates that other SoPs will apply “as in force from time to time.” This creates an operationally dynamic interaction: when a s9 factor refers to an injury/disease that is later the subject of a different SoP change, that later SoP will apply. While not an “amendment history” of this instrument, it means practitioners must track changes to related SoPs because the cross‑derivative application will follow the current terms of those other SoPs.

• External classification updates: The instrument references external classification resources , DSM‑5‑TR (2022) and ICD‑10‑AM Tenth Edition (effective 1 July 2017). Changes to those external works would not automatically alter the SoP; the SoP specifies that diagnostic criteria are “derived from DSM‑5‑TR” and that references to ICD‑10‑AM codes are to a specified edition (s7(4)-(5)). If new editions are adopted in future RMA determinations, that would be recorded in later SoPs.

In short, the instrument replaces the 2016 SoP in full as of its commencement date. It contains no internal amendment mechanism; any subsequent amendments will appear as new RMA instruments. Because the SoP cross‑references other SoPs “as in force from time to time” (s11), users must monitor the RMA’s ongoing determinations for changes affecting intersecting conditions.

The instrument itself does not record any litigation history. It contains no references to court or tribunal decisions, nor does it name or rely upon judicial authorities. The text comprises only the RMA’s determinations of medical facts, definitions, and the factors that will raise a reasonable hypothesis for eating disorder and death from eating disorder (Authority, s3; Basis, s8). As such, there are no cases cited or litigation outcomes recorded within the SoP.

Practical implications for litigation practitioners and litigants include:

• Administrative review and merits review avenues under the VEA/MRCA: Although the SoP does not list litigation, decisions applying or failing to apply this SoP will be reviewable under the VEA/MRCA statutory schemes and any applicable merits review tribunals and judicial review channels in administrative law. Challenges could allege that a decision maker misapplied RMA SoPs, failed to consider a relevant factor, or erred in fact or law in assessing whether a reasonable hypothesis was raised. The SoP’s text is therefore centrally relevant evidence in such proceedings, even though no litigation history is recorded in the instrument itself.

• No precedent statements within the instrument: Because the SoP makes no reference to caselaw, practitioners must rely on the VEA/MRCA, administrative law, tribunal decisions, and any judicial authorities outside the instrument to develop litigation arguments about the application of the SoP. That means that litigation history relevant to application of this SoP will be found in decisions that post‑date its commencement, not within the instrument.

• Importance of the SoP as administrative guidance: In litigation or review contexts, tribunals and courts typically treat RMA SoPs as authoritative medical opinions for the purposes of the reasonable hypothesis threshold, subject to review on correctness and reasonableness grounds. The absence of litigation references in the instrument does not reduce its centrality in disputes about entitlement; it simply means the instrument is a primary administrative source that will be debated and interpreted in subsequent litigation.

Practitioners preparing to litigate or review decisions involving this SoP should therefore search tribunal and court decisions arising after the SoP’s commencement date for interpretations and applications of the definitions and the s9 factors. The instrument itself contains no litigation history to cite.

Several features of the SoP may surprise users or create traps for claimants, advisers, and decision makers. These are factual or procedural risks grounded in the instrument’s text and its structure.

1. At least one specified factor is mandatory: The SoP requires that “at least one” factor in section 9 must exist before a reasonable hypothesis can be raised (s9). This is a binary gate: failure to establish any of the s9 factors , with their timing constraints , will mean the SoP does not support a reasonable hypothesis, irrespective of alternative theories not listed. Practitioners must therefore align evidence to the s9 items precisely.

2. Tight and disorder‑specific timing windows: Many s9 factors require occurrence “during the 2 years before clinical onset or clinical worsening” of particular disorders (s9). The SoP repeatedly uses the phrase “clinical onset or clinical worsening” but does not define those terms in the Schedule 1. The absence of a statutory definition of “clinical onset” or “clinical worsening” in the instrument itself may create evidential and interpretative disputes about the relevant window. Parties will need to establish when onset or worsening occurred on clinical grounds (s7, s9, s10).

3. “Clinical worsening” limited to material contribution/aggravation: Section 10(1)(b) specifies that the clinical worsening aspects of s9 apply only to material contribution or aggravation where the eating disorder existed before or during but “did not arise out of” relevant service. In other words, for a pre‑existing disorder to be implicated via worsening, the service must materially contribute to the worsening. That requires causation evidence focused on aggravation rather than first causation.

4. Cross‑SoP dependency: If a s9 factor refers to an injury/disease covered by another SoP, that other SoP’s factors apply (s11). This can complicate claims where a factor names conditions (for example, PTSD or other mental disorders) that are the subject of separate SoPs; claimants must then satisfy the other SoP’s terms as well as demonstrating the linkage to eating disorder.

5. Exclusions that look like near synonyms: The SoP includes anorexia nervosa but excludes “anorexia” (s7(2)-(3)). That textual choice may create confusion where medical records use non‑specific language. Practitioners must ensure diagnostic labels in records match the SoP’s defined terms and criteria.

6. Reliance on DSM‑5‑TR and ICD‑10‑AM: The SoP explicitly derives diagnostic criteria from DSM‑5‑TR (Schedule 1) and identifies ICD‑10‑AM codes (s7(4)-(5)). However, s7(4) states that in applying the SoP the meaning of eating disorder is that given in subsection 7(2). Therefore, ICD coding alone is not decisive; the clinical criteria in the SoP govern. Where clinicians use other diagnostic conventions or earlier DSM/ICD editions, clarifying reports linking to the SoP’s DSM‑5‑TR criteria will be necessary.

7. Broad and partly subjective definitions: Several key terms (for example, “bullying” and category 2 stressor items such as “being socially isolated” or “having concerns in the work environment”) are formulated in general language and include subjective elements (Schedule 1 definitions). Proving these matters will commonly require contemporaneous records, witness statements, or clinical corroboration, and may be contentious.

8. “Clinically significant disorder of mental health” permissive test: The Schedule defines this to mean a disorder “of sufficient severity to warrant ongoing management” and explicitly notes that actual management is not required. This is favourable to claimants who were not treated but had significant symptoms, but it also imposes an evidentiary need to show severity consistent with “warranting ongoing management” even where no treatment occurred (Schedule 1).

9. Age‑limited childhood matters: The childhood harm and neglect items apply only to experiences “as a child (under the age of 18)” (s9). Practitioners must be precise in establishing timing of the harmful events relative to the claimant’s age.

10. Death causation framing: Death from eating disorder is included only if a terminal event (as defined in Schedule 1) was contributed to by the eating disorder (s7(6)). The list of terminal events is finite and specified (for example pneumonia, respiratory failure, cardiac arrest). Where death certificates or coroners’ reports use other terminal descriptors, linkages to the Schedule list will need explicit medical analysis.

11. Other specific factual triggers: Some s9 factors are narrow and disorder‑specific. For example, the bereavement factor applies only to binge‑eating disorder (s9(5)); regular food insecurity for a continuous 3 months applies to binge‑eating disorder (s9(10)); and type 1 diabetes mellitus of at least 3 months’ duration applies for anorexia nervosa, bulimia nervosa, and avoidant/restrictive food intake disorder (s9(12)). Matching factual evidence to those narrow triggers is essential.

12. “Witness” exclusion of media exposure: Schedule 1 defines witness as a person who experienced an incident in real time and excludes persons exposed only to public broadcasting or mass media. For category 1B stressors that depend on witnessing atrocities or corpses, claimants relying on media exposure will not meet the SoP’s witness definition unless they were present.

These “gotchas” emphasise that the SoP is detailed and inflexible in structure. Practitioners must cross‑check diagnoses, timing, and the exact wording of factors against available evidence; absent or imprecise records are likely to be decisive in claim outcomes.

This SoP does not prescribe statutory compliance steps but it creates a clear evidentiary checklist that claimants, clinicians, and advisers must follow to satisfy the reasonable hypothesis threshold. Below are practical, source‑grounded steps and documentary strategies mapped to the instrument’s provisions.

1. Identify the precise diagnosis under the SoP: Confirm whether the claimant’s condition falls within the SoP’s definition of “eating disorder” as set out in s7(2) (for example anorexia nervosa, bulimia nervosa, binge‑eating disorder, avoidant/restrictive food intake disorder, etc.). Ensure medical records and expert reports explicitly map the claimant’s presentation to the DSM‑5‑TR‑derived diagnostic criteria reproduced in the SoP (Schedule 1 and s7(2)). Where records use non‑specific terms such as “anorexia”, obtain clarification because “anorexia” is excluded (s7(3)(a)).

2. Establish timing of clinical onset or worsening: Many s9 factors require occurrence in the two years before “clinical onset or clinical worsening.” Because the SoP does not define those phrases, obtain a clinical expert report that states, on clinical grounds, when onset or a meaningful clinical worsening occurred, and why that date is clinically justified. Link the timing of the factor (for example a category 1A stressor) to that clinical date (s9, s10).

3. Map evidence to at least one s9 factor: The SoP requires at least one s9 factor to exist for a reasonable hypothesis. Use the checklist below and assemble documentary support:

   • Category 1A stressor (s9(1)): evidence of life‑threatening events, serious physical attack or rape, being threatened with a weapon, captivity, torture. Sources: incident reports, service records, police reports, medical records, witness statements (Schedule 1: category 1A stressor).

   • Category 1B stressor (s9(2)): evidence of killing or maiming others, witnessing killings or critical injuries, viewing corpses, participating in casualty clearance. Obtain service reports, unit logs, contemporaneous statements. Remember the Schedule excludes media exposure for “witness” (Schedule 1).

   • Category 2 stressor (s9(3)): chronic negative life events (social isolation, relationship breakdown, work environment issues, legal detention, severe financial hardship, prejudice/discrimination). Obtain employment records, counselling records, financial statements, court records, or contemporaneous notes showing ongoing distress.

   • Bullying (s9(4)): corroborate repeated unwanted aggressive behaviour and imbalance of power , personnel files, complaints, witness affidavits (Schedule 1).

   • Death of an important person (s9(5)): for binge‑eating disorder only; obtain death certificates, relationship evidence, clinical records linking bereavement to onset.

   • Clinically significant mental disorders (s9(6)): document diagnosis or clinical notes for alcohol use disorder, anxiety disorder, depressive disorder, PTSD, ADHD, personality disorder, gender dysphoria, OCD, panic disorder, social anxiety disorder, substance use disorder within two years before onset/worsening. The Schedule defines “clinically significant disorder” as warranting ongoing management and notes that actual management is not required , the expert report should address severity (Schedule 1).

   • Childhood harm/neglect or sexual abuse (s9(7)-(9)): for events under 18, gather child protection records, police reports, medical notes, school records, or specialist assessments.

   • Food insecurity (s9(10)): for binge‑eating disorder a continuous 3‑month period of food insecurity must be shown: obtain social services, welfare records, landlord or employment evidence, or family statements (Schedule 1 definition of food insecurity).

   • Type 1 diabetes mellitus (s9(12)): show diagnosis and duration of at least 3 months prior to onset or worsening , specialist diabetes clinic records or GP notes.

   • Inability to obtain appropriate clinical management (s9(13)): document attempts to obtain care, waitlists, refusals, distance or other barriers, and contemporaneous clinical deterioration.

4. For death claims: If the claim concerns death from an eating disorder, obtain the medical cause of death, coroner’s findings if any, and an expert affidavit linking the eating disorder to the terminal event listed in Schedule 1 (for example pneumonia, respiratory failure, cardiac arrest) to show contribution (s7(6); Schedule 1 terminal event).

5. Where s9 factors point to conditions covered by other SoPs: If a s9 factor refers to an injury/disease that is already the subject of another SoP, identify that SoP and assemble evidence that satisfies the other SoP’s factors, because s11 makes that other SoP’s factors applicable (s11).

6. Evidence quality and witness requirements: For category 1B witnessing elements, the Schedule defines “witness” narrowly and excludes exposure via media (Schedule 1). Collect contemporaneous accounts, unit records, and affidavits from persons who personally experienced the incident. For bullying and category 2 chronic stressors, contemporaneous complaints, workplace investigations, or health records will strengthen the claim.

7. Expert reports: Commission reports that explicitly reference the SoP: map clinical features to DSM‑5‑TR criteria reproduced in the SoP, state dates of clinical onset/worsening, explain how the s9 factor is causally related to onset or worsening (or materially contributed to worsening), and address alternatives. Where treatment was not received, the expert should deal with the Schedule note that “warranting ongoing management” suffices and explain severity accordingly (Schedule 1).

8. Documentation checklist: Service records, incident reports, medical and psychiatric records, coroners’ reports, police records, child protection files, workplace investigation files, welfare or social services files for food insecurity, diabetes specialist reports, and any contemporaneous notes or witness statements that establish timing and factual elements of s9 factors.

9. Address gaps proactively: Where records are sparse, obtain supporting affidavits from peers, family, or colleagues that are consistent with documentary material. For matters such as “social isolation” or “workplace disharmony,” provide multiple sources linking the symptoms to service period and clinical onset/worsening.

10. Procedural use of the SoP: In submissions to decision makers under s120A VEA or s338 MRCA, explicitly rely on the SoP’s sections and schedule definitions, pointing to which s9 factor is said to apply, the dates of clinical onset/worsening as supported by evidence, and the causal link between the factor and the condition. If a s9 factor involves another SoP under s11, identify that SoP and show compliance with its factors.

11. Monitor related SoPs and classification standards: Because s11 imports other SoPs “as in force from time to time”, keep track of any RMA updates to related SoPs. Also note that the SoP uses DSM‑5‑TR criteria and cites ICD‑10‑AM codes (s7(4)-(5), Schedule 1); clinical reports should reference DSM‑5‑TR criteria to align with the SoP.

12. Consider strategic sequencing for pre‑existing disorders: If the claimant had an eating disorder before service and alleges service materially worsened it, prepare a focussed causation report addressing aggravation and material contribution, consistent with s10(1)(b).

Following these steps aligns evidence and submissions with the SoP’s precise language and timing. Because the SoP is the RMA’s authoritative medical input for the reasonable hypothesis test, failure to address its specific criteria and Schedule definitions is a common cause of unsuccessful claims; precise, DSM‑5‑TR‑referenced medical reporting and contemporaneous documentation mapped to s9 remain the most direct route to satisfying the instrument’s threshold.