Statement of Principles concerning Lyme disease/Lyme borreliosis (Balance of Probabilities) (No. 18 of 2025)

This instrument organises the law around a handful of precise medico‑legal concepts. The primary concepts and their operational mechanics as set out in the text are:

• Lyme disease/Lyme borreliosis: Defined in subsection 7(2). It is an infection with Borrelia burgdorferi sensu lato spirochetes transmitted by an Ixodes tick in an endemic location; it expressly includes chronic untreated Lyme disease and expressly excludes Lyme‑like illness (s 7(2)(a)-(c)). The instrument further supplements the definition with four notes listing the species of Borrelia within the sensu lato complex, Ixodes tick species known to transmit Borrelia to humans, example endemic geographic locations, and example clinical manifestations (Notes 1-4 to s 7).
• Clinical onset and the 33‑day window: The factors in s 9 require exposure, tick bite, or presence in an endemic location to have occurred within 33 days before clinical onset. The instrument hinges causal connection on that 33‑day temporal window (s 9(1)-(3)).
• Exposure to an infected vector versus location exposure: The instrument recognises both vector‑level evidence (being bitten by an infected Ixodes tick, s 9(2)) and location‑level evidence (being in a geographic location where Lyme disease is endemic, s 9(3)) as alternative routes to establish causal connection on the balance of probabilities.
• Inability to obtain appropriate clinical management: The instrument provides a separate ground that can connect a claimant’s Lyme disease to relevant service where the person was unable to obtain appropriate clinical management before clinical worsening (s 9(4)). Subsection 10(2) limits this factor to material contribution or aggravation where the disease was suffered or contracted before, or during (but did not arise out of), the person’s relevant service.
• Relationship to relevant service: Any factor relied upon must be related to the relevant service rendered by the person (s 10(1)). The Schedule defines relevant service for the purpose of this instrument (Schedule 1).
• Death linked to Lyme disease: The instrument treats death as included where it is from a terminal event or condition that was contributed to by the person’s Lyme disease (s 7(5)). The Schedule defines terminal event to include proximate/ultimate causes such as pneumonia, respiratory failure, cardiac arrest, circulatory failure, and cessation of brain function (Schedule 1).
• Interaction with other Statements of Principles: Section 11 sets a mechanism for overlap. If a factor in this instrument refers to an injury or disease covered by another Statement of Principles determined under subsection 196B(3) of the VEA, then the factors in that other Statement apply in accordance with its terms (s 11).

Ancillary technical references include the instrument’s note that while Lyme disease has ICD‑10‑AM code A69.2, for the purposes of this instrument the meaning is that given in subsection 7(2), and that ICD‑10‑AM references are to the Tenth Edition effective 1 July 2017 (s 7(4)-(5)). The Schedule furnishes definitions of MRCA, VEA and relevant service (Schedule 1).

These concepts structure the evidentiary inquiry decision‑makers must undertake: establish the disease as defined; show one of the specified factors within the 33‑day window (or show inability to obtain appropriate clinical management, within the limits in s 10(2)); and link that factor to relevant service as defined in the Schedule (s 7, s 9, s 10, Schedule 1).

The instrument affects three categories of legal actors and decision contexts, as well as practical stakeholders:

• Claimants (veterans and members of the Forces): The instrument applies to claims to which section 120B of the Veterans’ Entitlements Act 1986 or section 339 of the Military Rehabilitation and Compensation Act 2004 applies (s 5). Although the instrument does not itself create entitlements, it sets the medical criteria RMA determined for proving connection on the balance of probabilities; claimants who advance Lyme disease‑related claims under those statutory claim routes will be affected because the instrument will be the operative Statement of Principles used in adjudication.
• Decision‑makers and assessing bodies: Administrative decision‑makers who adjudicate claims under the VEA and the MRCA will use this Statement to assess whether Lyme disease or death from Lyme disease is connected to relevant service. The instrument was made under the RMA’s statutory power (s 3) and is intended to guide determinations under the cited statutory provisions (s 5). The instrument does not itself name which agency performs the final compensation decision, but it establishes the RMA’s medical criteria which the statutory decision framework must apply.
• Medical and forensic experts: Medical experts instructed in support of claims will need to engage with the instrument’s precise medical definition (s 7(2) and accompanying notes), the 33‑day temporal window for onset (s 9), and the narrow grounds in s 9(4) regarding inability to obtain appropriate clinical management, including the limitation in s 10(2). Entomologists, infectiologists and pathologists may be relevant to proving exposure to infected Ixodes ticks or presence in endemic locations as listed in the notes to s 7.
• Families and estates: Where death is claimed to be contributed to by Lyme disease, the instrument treats death from a terminal event contributed to by Lyme disease as within scope (s 7(5)); that affects dependants and estates pursuing death benefits under the relevant statutory mechanisms.

Geographic and clinical reach: The instrument lists specific geographic locations where Lyme disease is endemic (Note 3 to s 7). By doing so, it affects claimants who were in those locations during service. The Schedule’s definition of relevant service limits the operational reach to service types enumerated there (eligible war service, defence service (excluding hazardous and British nuclear test defence service), and peacetime service under the MRCA) (Schedule 1). Therefore, people who were not in those categories of service are not within the instrument’s intended application.

Evidentiary burden and practical effects on claimants: The instrument’s factors are factual: proof of exposure to Borrelia spirochetes (s 9(1)), proof of a bite by an infected Ixodes tick (s 9(2)), proof of presence in an endemic area (s 9(3)), or proof that appropriate clinical management could not be obtained prior to clinical worsening (s 9(4)). The instrument does not itself specify admissibility rules or evidentiary thresholds beyond the balance of probabilities standard, but it does circumscribe the factual elements that must be shown, and so affects the sort of evidence claimants must generate.

Relevance to medical confirmation and codes: The instrument notes that while Lyme disease corresponds to ICD‑10‑AM code A69.2, the definitional content for the Statement is that in subsection 7(2) (s 7(4)). It also notes usual laboratory methods for confirming infection (Note 5), which affects medical evidence relied upon, although the instrument does not make laboratory confirmation a mandatory criterion.

This Statement of Principles does not impose criminal or regulatory duties directly on individuals. Instead, it establishes medico‑legal criteria that govern administrative rights to have a condition accepted as connected with relevant service for the purposes of claims under the VEA and MRCA. The key duties and rights, as derived from the text, are:

• Right to have a condition assessed against the RMA’s medical criteria: A person making a claim to which section 120B of the VEA or section 339 of the MRCA applies is entitled to have their Lyme disease or death from Lyme disease assessed against the factors set out in this instrument (s 5). The Statement is the RMA’s determination of the medical factors that need to be present on the balance of probabilities (s 8).
• Duty on claimants to establish connection on the balance of probabilities: The instrument frames the causal test as balance of probabilities; it requires that at least one of the section 9 factors exist before a finding that the disease or death is connected with relevant service can be made (s 9). It does not itself allocate evidentiary burdens beyond that general civil standard, but by enumerating specific factors it channels what claimants must prove.
• Duty to link the factor to relevant service: Even where a factor in s 9 is established, subsection 10(1) mandates the factor must be related to the relevant service rendered by the person. The instrument therefore requires claimants to link the proven factor causally to their service period as defined in the Schedule (s 10(1), Schedule 1).
• Limitation on the inability‑to‑obtain‑management factor: Subsection 10(2) narrows the operation of s 9(4). That factor only applies to material contribution to, or aggravation of, Lyme disease where the disease was suffered or contracted before or during (but did not arise out of) the person’s relevant service. Practically, this limits the circumstances in which failure to obtain appropriate treatment will operate as the causal link.
• Right to rely on other Statements of Principles where relevant: Section 11 provides that if a factor in s 9 refers to an injury or disease already covered by another Statement of Principles determined under subsection 196B(3) of the VEA, then the factors in that other Statement apply as in force from time to time. This creates a right to rely on the medical criteria from a separate, applicable Statement where there is overlap (s 11).
• Administrative rights and processes not detailed: The instrument is a medical determination; it does not itself stipulate procedural rights such as review avenues, timelines for decision‑making, or the form of evidence to be filed. Those procedural rights will remain governed by the VEA and MRCA and the decision‑making frameworks that implement them (s 3, s 5).

Practically, these provisions require claimants and their advisers to gather and present evidence that aligns with the instrument’s concrete factors and with the statutory definition of relevant service in the Schedule. The instrument imposes no duties on health professionals but makes their contemporaneous records and laboratory results material to administrative determinations.

The instrument itself contains no penal provisions and imposes no civil fines or criminal penalties. Its enforcement mechanism is administrative rather than penal:

• No statutory penalties in the Statement: The text sets out medical factors for causal connection but does not create offences, fines, or sanctions within the instrument. It operates as a medico‑legal rule used in administrative decision‑making (see s 3, s 5).
• Administrative enforcement through claims determination: The practical effect is enforcement in the context of claims for entitlements under the VEA and MRCA. That is, the Statement provides the RMA’s clinical criteria which decision‑makers must apply in assessing whether Lyme disease or death from Lyme disease is connected with relevant service for the purposes of entitlements under the cited statutory provisions (s 5, s 8). Acceptance or rejection of a claim under those statutes is the mechanism by which the instrument’s criteria are enforced.
• Interaction with other administrative mechanisms: Section 11 contemplates application of other Statements of Principles where a factor refers to an injury or disease covered by another Statement. Enforcement then also depends on the interaction of multiple medical determinations, each of which is applied administratively by the relevant decision‑making agencies (s 11).
• Evidentiary consequences and decision risk: Because the Statement prescribes the factual elements required, decision‑makers will deny claims that do not satisfy at least one of the section 9 factors as related to relevant service. The instrument does not prescribe the evidentiary standard beyond balance of probabilities; it leaves the mechanics of proof and evidentiary admissibility to the existing claim processes under the VEA and MRCA (s 8, s 9).
• No policing or investigatory regime set out: The Statement does not create investigatory powers or compliance audits; it is a medical standard to be applied in individual claims. Any enforcement action relating to false statements, fraud, or administrative misconduct would arise from separate statutory or administrative powers not contained in this instrument.

For practitioners and compliance officers, the relevant enforcement risk is therefore administrative: failing to meet the factual factors (s 9) will result in claim denial under the statutory claim mechanisms referenced in s 5. The Statement itself does not provide for penalties, but adverse findings in claims can have material financial and entitlement consequences for claimants.

The instrument is an RMA Statement of Principles made under subsection 196B(3) of the Veterans’ Entitlements Act 1986 and is expressly linked to two statutory claim routes: section 120B of the VEA and section 339 of the MRCA (s 3, s 5). Its operation therefore sits within the statutory frameworks of the VEA and the MRCA, but the instrument itself is limited to setting medical factors. Key interaction points with other laws and instruments, as set out in the text, are:

• Authority and statutory integration: The RMA made the instrument under the authority granted by subsection 196B(3) of the VEA (s 3). The Statement is designed to be applied when adjudicating claims under the VEA and MRCA as specified in s 5. It therefore functions as medical guidance within the statutory adjudicative systems, rather than as freestanding law creating entitlements.
• Repeal of prior Statement: The instrument expressly repeals the earlier Statement of Principles concerning Lyme disease (Balance of Probabilities) (No. 26 of 2016). Practitioners must therefore apply this new Statement to relevant claims once it commences (s 4). The instrument does not include transitional provisions; therefore, established claims in progress may be affected by the repeal once the new instrument is in force (s 2, s 4).
• Reference to other Statements of Principles: Section 11 creates an explicit mechanism for cross‑reference with other Statements of Principles determined under subsection 196B(3) of the VEA. If a factor in this Statement refers to an injury or disease covered by another Statement, then the factors in that other Statement apply in accordance with its terms as in force from time to time (s 11). This is the prescribed route for handling overlap between medical conditions or shared causal mechanisms.
• Medical classification systems: The instrument notes that Lyme disease attracts ICD‑10‑AM code A69.2 but states that for the purposes of the Statement the meaning is that given in subsection 7(2) (s 7(4)). It also specifies the edition and effective date of the ICD‑10‑AM referenced (Tenth Edition, effective 1 July 2017) (s 7(5)). Practitioners should therefore treat the instrument’s definitional text as determinative rather than relying solely on ICD coding.
• Definitions that tie into other legislation: The Schedule defines MRCA and VEA and sets out what constitutes relevant service for the Statement (Schedule 1). These definitions determine which categories of service are within the Statement’s reach. The instrument therefore operates in conjunction with the statutory definitions and processes established in the VEA and MRCA.
• No express displacement of other statutory tests: The instrument does not purport to alter the primary legislative tests for entitlement that the VEA or MRCA may set out. Instead it supplies medical factors used in the statutory determination process. Where the VEA or MRCA impose procedural rules, appeal rights, or other substantive requirements for claims, those remain operative and the Statement interfaces with them by defining the medical content of causation.
• Laboratory and clinical practice interaction: The Statement notes usual laboratory methods for confirmation of infection (Note 5 to s 7), which will interact with clinical practice and the type of medical evidence decision‑makers may request. However, it does not mandate any particular diagnostic protocol as definitive for entitlement.

In short, the instrument is an RMA medical determination designed to be applied within the existing VEA and MRCA claim processes, it replaces the 2016 Statement, it cross‑references other Statements of Principles where overlap occurs (s 4, s 5, s 11), and it defines medical and definitional parameters that must be applied in adjudicating connection to service.

The instrument contains a concise amendment history within its text. Relevant points from the document are:

• Date of the instrument and authorising signature: The Statement is dated 17 December 2024 and is signed by the Chairperson of the Repatriation Medical Authority (front matter). It is numbered as No. 18 of 2025 (cover and s 1).
• Commencement: The instrument commences on 28 January 2025 (s 2). That date is the operative commencement date for the repeal of the previous Statement and for the application of the new factors.
• Repeal of prior instrument: The Statement expressly repeals the Statement of Principles concerning Lyme disease (Balance of Probabilities) (No. 26 of 2016) (Federal Register of Legislation No. F2016L00255) that was previously made under subsection 196B(3) of the VEA (s 4). The text does not include transitional provisions or savings clauses in relation to the repeal; the repeal is stated plainly.
• Authority under current statute: The Statement is made under subsection 196B(3) of the VEA (s 3). The instrument does not itself amend the VEA or MRCA; it is an RMA determination under the existing statutory power.
• No other amendments recorded in the instrument: The text does not record prior amendments to the 2016 Statement beyond its repeal, nor does it record subsequent amending instruments. The Schedule and notes are part of this instrument as issued; no schedules of change or versions are provided beyond this enactment.
• Edition of ICD‑10‑AM referenced: The instrument specifies the ICD‑10‑AM Tenth Edition effective 1 July 2017 as the edition referenced when an ICD code is mentioned (s 7(5)). This is an explicit specification which may be treated as a fixed external reference point for classification purposes unless later amended by a further Statement.

Practical consequence: Where claims straddle the changeover date, practitioners will need to verify which Statement was in force at the relevant time for the claim, and note that the 2016 Statement is repealed and replaced with the new criteria from 28 January 2025 (s 2, s 4). The instrument does not set out transitional arrangements, so decision‑makers and advisers must apply the new Statement from its commencement date.

The instrument itself contains no mention of litigation or judicial history. The document does not record any cases, appeals, or judicial reviews concerning this particular Statement of Principles. It stands as an RMA determination under subsection 196B(3) of the VEA (s 3), but the text contains no narrative of challenges or litigation.

Consequently, within the four corners of this instrument:

• There are no reported or noted judicial decisions cited in the instrument that interpret or apply this Statement.
• There are no references to prior litigation about the repealed 2016 Statement or about the RMA’s determinations generally.
• The instrument does not provide a history of disputes, appeals to merits review bodies, or judicial review matters.

Practitioners should therefore not expect case law interpreting the precise provisions of this new Statement to be available from the instrument itself. Any body of litigation that might develop would have to be sourced from external records,appeal decisions under the VEA or MRCA, Administrative Appeals Tribunal or Federal Court decisions,which are not contained or cited in the instrument.

Because the instrument engages factual standards (for example the 33‑day window in s 9 and the limitation in s 10(2)) and overlaps with other Statements of Principles under s 11, litigation or merits review could, in practice, arise over issues such as interpretation of “clinical onset”, the sufficiency of evidence of exposure or infected tick bites, what constitutes “appropriate clinical management” and its unavailability, and the application of the instrument’s definitions. None of that litigation history, if it exists, is recorded in this Statement.

This Statement contains several technical features and drafting choices that can be significant in practice. The following are concrete points of risk, traps or frequently overlooked implications that advisers, claimants and decision‑makers should note, with section pointers to the instrument:

• The 33‑day temporal requirement (s 9(1)-(3)). Each of the first three factors requires the relevant exposure, bite or presence in an endemic location to have occurred within 33 days before clinical onset. That is an unusually specific and narrow temporal window. Practitioners should not assume longer incubation or latency is captured. Where clinical onset occurs more than 33 days after a claimed exposure or travel to an endemic area, those three factors will not, on their face, be satisfied.
• The instrument does not require laboratory confirmation as a precondition for the s 9 factors (s 7(2), Note 5). Note 5 describes usual laboratory methods for confirmation (IgM/IgG serology with Western blot; culture is gold standard but difficult), but the operative factors focus on exposure, tick bite, location, or lack of management. Therefore, absence of a positive laboratory test does not automatically preclude a favourable finding if one of the specified factors is otherwise established on the balance of probabilities.
• Definition restricts vectors and locations (s 7(2), Notes 1-3). The disease is defined specifically as transmission by ticks of the genus Ixodes and in geographic locations where Lyme disease is endemic (Notes 1-3). Exposures involving non‑Ixodes ticks, alternative transmission routes, or travel to locations not listed as endemic in Note 3 will face a definitional hurdle unless the relevant species or locations are shown to fall within the Notes' enumerations.
• Exclusion of “Lyme‑like illness” (s 7(2)(c)). The instrument explicitly excludes “Lyme‑like illness”. The term is not defined within the instrument. Practitioners will need to be precise in pleading and medical evidence to distinguish cases of proven Borrelia infection from syndromes described clinically as Lyme‑like.
• The inability‑to‑obtain‑management factor is narrow and subordinated (s 9(4), s 10(2)). That factor operates only in specific circumstances and is constrained by subsection 10(2). It applies only to material contribution or aggravation when the disease existed before or during, but did not arise out of, the relevant service. It does not operate as a free‑standing causal pathway to connection where the disease arose out of service. Practitioners relying on lack of access to treatment must therefore establish the pre‑existence or timing that fits s 10(2).
• Requirement that factors be related to relevant service (s 10(1); Schedule 1). Even if a s 9 factor is established, the instrument requires a relationship to relevant service as defined in the Schedule. The Schedule limits relevant service to eligible war service (other than operational service), defence service (other than hazardous service and British nuclear test defence service), and peacetime service under the MRCA. Service outside these categories will not be within the instrument’s remit.
• Death linkage mechanics (s 7(5); Schedule 1 terminal event). Death from Lyme disease is included only where the terminal event or condition was contributed to by the person’s Lyme disease. The Schedule’s definition of terminal event lists proximate causes such as pneumonia and cardiac arrest. Proving contribution to a terminal event will require causation evidence linking Lyme disease to that terminal event.
• Interaction with other Statements of Principles (s 11). If a s 9 factor refers to an injury or disease covered by another Statement, the factors in that other Statement apply. This can complicate cases where multi‑morbidity exists and claimants must map which Statement supplies the operative factors.
• No transitional provisions noted (s 4). The repeal of the 2016 Statement is stated without transitional saving provisions. Claims in progress spanning the repeal date may require careful handling to determine which instrument applies; the Statement itself gives no procedural direction in that respect.
• ICD code is not determinative (s 7(4)-(5)). Although Lyme disease is associated with ICD‑10‑AM code A69.2, the instrument emphasises that for the purposes of this Statement the statutory definition in s 7(2) governs. Relying solely on coding without mapping to the detailed definition (spirochete species, tick genus, endemic location) is insufficient.

These features can materially affect evidence strategy and claim outcomes. The 33‑day window and the narrowly framed inability‑to‑obtain‑management factor are particularly likely to shape admissible proof and medical expert instructions. Where claimants rely on travel history or tick‑bite history, contemporaneous service records, travel logs, medical notes, entomological or laboratory evidence and clear linkage to relevant service categories will be critical.

For claimants, advisers and decision‑makers, compliance means assembling the factual and medical evidence that corresponds to the precise factors and definitions in the Statement. The following practical checklist maps the instrument’s requirements to concrete evidence and steps. Citations to relevant sections are provided.

1. Establish the disease as defined (s 7(2); Notes 1-5)

   • Obtain medical records which document the diagnosis and clinical manifestations identified in Note 4 (for example erythema migrans, neurological symptoms, cardiac involvement).
   • Secure laboratory results if available: IgM/IgG serology results, Western blot, culture attempts (Note 5). Although not mandatory, laboratory evidence is material and will assist in proving infection with Borrelia burgdorferi sensu lato.
   • If the claimant asserts “chronic untreated Lyme disease”, obtain longitudinal medical records showing chronicity and lack of appropriate therapy (s 7(2)(b)).
   • Avoid relying on the ICD‑10‑AM code alone. Map the diagnosis to the definitional elements set out in s 7(2) (s 7(4)).

2. Prove at least one relevant factor within 33 days before clinical onset (s 9(1)-(3))

   • If alleging exposure to Borrelia spirochetes (s 9(1)): obtain evidence of known exposure events, contemporaneous medical notes referring to a tick bite, photographic or witness evidence of ticks, or entomological confirmation where possible. Where possible, link the exposure to the listed Borrelia species (Note 1) or Ixodes species (Note 2).
   • If alleging a bite by an infected Ixodes tick (s 9(2)): secure any available evidence that the tick was removed and tested (if testing occurred), surgical notes, or contemporaneous documentation of a tick attachment and subsequent clinical signs. Practitioner statements about tick bites may be admissible but will be weighed against the 33‑day temporal requirement.
   • If relying on presence in an endemic geographic location (s 9(3)): compile service records, travel records, orders, mission logs, duty rosters, or other official documentation proving presence in one of the locations listed in Note 3 (for example USA, southern Canada, Europe, UK, Russia, Japan, north‑eastern China) within 33 days prior to clinical onset.
   • Precisely document the date of clinical onset, as the 33‑day window pivots on that date. Clinical onset must be evident in the medical record; if an onset date is disputed, obtain expert opinion on when clinical onset likely occurred.

3. If relying on inability to obtain appropriate clinical management (s 9(4); s 10(2))

   • Demonstrate the disease was suffered or contracted before or during the relevant service but did not arise out of that service (s 10(2)).
   • Produce contemporaneous requests for treatment, referrals, records of service‑based medical facilities declining or failing to provide treatment, or evidence of lack of access to appropriate antibiotics or specialist care prior to clinical worsening.
   • Prove material contribution or aggravation as a result of the lack of appropriate management. That will typically require expert medical opinion establishing how lack of management materially contributed to deterioration.

4. Link the factor to relevant service (s 10(1); Schedule 1)

   • Ensure that the asserted factor is causally connected to the person’s relevant service as defined in the Schedule (eligible war service (other than operational), defence service (other than hazardous and British nuclear test defence service), or peacetime service under MRCA). Gather service records, deployment orders, postings and duty rosters to establish the required nexus.
   • If the evidentiary foundation for presence in an endemic location is non‑military travel during service, document authorisations or duty statuses that qualify as relevant service under the Schedule.

5. Where overlap with other Statements exists (s 11)

   • Identify any other Statements of Principles that might be engaged by the facts (for example, if a factor references a separate disease). If engaged, extract the operative factors from that other Statement and ensure evidence addresses those factors as in force at the relevant time.

6. Death claims (s 7(5); Schedule 1)

   • For death claims, obtain the death certificate, terminal event documentation, hospital notes, and expert medico‑legal opinions connecting Lyme disease to the terminal event (for example establishing contribution to pneumonia or cardiac arrest as defined in the Schedule).
   • Be precise about contribution versus sole causation; the instrument requires that the terminal event was contributed to by the person’s Lyme disease.

7. Expert evidence and opinions

   • Instruct clinicians to address the precise statutory wording: whether the infection is by Borrelia burgdorferi sensu lato transmitted by Ixodes in an endemic location, whether the 33‑day window is met, and whether the inability to obtain treatment criterion (where relied upon) fits the narrow s 10(2) limitations.
   • Entomological or microbiological evidence may be required to identify tick species or Borrelia species in some cases, and to establish that a tick was infected.

8. Procedural and strategic steps

   • For claims submitted around the commencement date, confirm whether the new Statement or the repealed 2016 Statement should apply. The instrument provides the commencement date and indicates repeal of the 2016 Statement (s 2, s 4), but contains no transitional provisions; obtain guidance from the decision‑maker about which Statement governs claims spanning the repeal.
   • Keep contemporaneous documentation of onset, symptoms, and medical contacts. Given the 33‑day timing requirement, contemporaneous records are likely to be determinative.

9. Record keeping for decision‑makers

   • Administrative decision‑makers should request evidence that explicitly addresses the statutory elements: disease definition (s 7(2)), the existence of at least one s 9 factor within 33 days before onset, and the relation of that factor to relevant service (s 10(1)). Where s 9(4) is invoked, decision‑makers should ensure the limitation in s 10(2) is satisfied.

This instrument defines narrow, factual gates to entitlement. Compliance therefore relies on robust contemporaneous service and medical documentation, targeted expert opinion addressing the statutory language, and an evidence strategy designed to meet one of the s 9 factors and to show the necessary service nexus under s 10 and the Schedule.