Statement of Principles concerning panic disorder (Balance of Probabilities) (No. 56 of 2018)

The SoP's core legal concept is a statutory, prospectively determined causation framework for panic disorder and death from panic disorder, expressed as a list of medical and situational factors which, when established on the balance of probabilities and related to relevant service, permit a finding of service connection for compensation and rehabilitation entitlements. The SoP adopts DSM‑5 diagnostic criteria as the legal definition of panic disorder (section 7(2)). The DSM‑5 criteria adopted include threshold symptom counts (at least four of a list of 13 symptoms during a panic attack), requirement of recurrent unexpected panic attacks, subsequent persistent concern or maladaptive change in behaviour for at least one month, and exclusions for substance or other medical causes and better explanations by other mental disorders (section 7(2)(A)-(D)).

Causation under the SoP is not open‑ended. Section 9 lists specific factors that must be present for a positive connection finding. The factors split into two contexts: those referring to clinical onset of panic disorder (numbers 1-11) and those referring to clinical worsening or material contribution/aggravation where panic disorder pre‑existed service (numbers 12-23). Common timing windows are two years before clinical onset/worsening (for example category 1A/1B stressors, severe medical illness or life‑threatening injury, severe chronic medical condition) and five years before clinical onset/worsening (for example death of a significant other, clinically significant disorders from specified lists, concussion or moderate to severe TBI) (section 9). There is a discrete factor (9(23)) for inability to obtain appropriate clinical management for panic disorder.

The SoP employs a graded taxonomy of stressors. The Schedule defines category 1A stressors as life‑threatening events, serious physical attack including rape, or being threatened with a weapon/held captive/kidnapped/tortured (Schedule 1). Category 1B includes killing or maiming a person, witnessing killing or critical injury, witnessing atrocities, participating in clearance of corpses or critically injured casualties, or viewing corpses as an eyewitness. Category 2 covers chronic negative life events that cause ongoing distress such as social isolation, long‑term relationship problems, workplace or school disharmony including bullying, legal problems including detention or court processes, severe financial hardship, family member’s major health deterioration, or being a full‑time caregiver (Schedule 1).

Two discrete lists of pre‑existing clinically significant mental health disorders are set out in the Schedule (Specified List 1 and Specified List 2). Both lists are extensive and largely overlapping; an important difference is that Specified List 1 expressly includes personality disorder while Specified List 2 does not (Schedule 1). The Schedule defines "clinically significant" as conditions of sufficient severity to warrant ongoing management, and states that to "warrant ongoing management" does not require that actual management occurred (Schedule 1 notes). Thus the threshold is severity rather than proven treatment.

The SoP also incorporates medical comorbidity and non‑psychiatric illness factors. Sleep apnoea, epilepsy, concussion or moderate to severe traumatic brain injury, severe chronic medical condition and life‑threatening medical illnesses or injuries that cause serious physical or cognitive disability are specifically listed (section 9). The Schedule defines severe chronic medical condition as illnesses that substantially impact functioning and require ongoing daily or almost daily management supervised by a registered health practitioner (Schedule 1).

Finally, the SoP recognises death from panic disorder as a compensable outcome when a terminal event or condition was contributed to by the person’s panic disorder (section 7(5)). The Schedule sets out examples of terminal events such as pneumonia, respiratory failure, cardiac arrest, circulatory failure and cessation of brain function (Schedule 1).

The instrument affects claimants, decision makers, medical practitioners, lawyers and advocates involved in veterans’ and members’ claims under the VEA and MRCA regime. The SoP applies to a claim to which section 120B of the VEA or section 339 of the MRCA applies (section 5). That means the SoP is operationally relevant to veterans and serving members seeking entitlements where those statutory provisions govern connection and entitlements. The Schedule defines "relevant service" to mean eligible war service (other than operational service) under the VEA, defence service (other than hazardous service and British nuclear test defence service) under the VEA, or peacetime service under the MRCA (Schedule 1). In practice, this restricts the class of service to which the SoP can be applied; persons whose service falls into excluded categories will not be within the SoP’s application unless the statutory definition of relevant service covers them.

Who pays and who decides are implicit in the statutory framework the SoP invokes. The SoP provides the evidence and factor grid that administrative decision makers, such as the Repatriation Commission and review tribunals considering claims under the VEA and MRCA, must apply when deciding whether panic disorder or death from panic disorder is connected with relevant service (see sections 5 and 8). The Repatriation Medical Authority (RMA) made the SoP; it does not itself grant entitlements. Medical practitioners who prepare expert opinions are directly affected because the SoP specifies DSM‑5 diagnostic criteria and lists factors and timing windows that experts should address when providing causation and onset/worsening opinions (section 7(2); section 9). Claimant representatives and counsel must structure evidence collection to match the SoP’s prescribed factors and look‑back windows. For example, to rely on factor 9(1) or 9(12) (a category 1A stressor within two years before clinical onset or worsening), the claimant will need primary evidence that the specified stressor occurred and that it occurred within the two‑year window relative to clinical onset or worsening.

Families and estates are affected where death from panic disorder is claimed, because section 7(5) makes death from panic disorder compensable if the terminal event or condition was contributed to by the panic disorder. For those claims, medical causation must be established between the panic disorder and the terminal event listed in the Schedule (Schedule 1).

Administrative gatekeepers such as records custodians, health services, defence records units and coronial offices are indirectly affected because claimants will frequently need access to service records, hospital and psychiatric notes, diagnostic test results (for example to establish sleep apnoea, epilepsy, concussion or TBI), police or incident reports for stressor evidence, child protection records for allegations of severe childhood abuse, and death certificates and terminal event medical records for fatality claims. The SoP’s definitions impose evidentiary contours on these actors’ outputs.

The Statement of Principles itself does not create new duties in the criminal or civil sense; rather, it prescribes the medical‑causation framework that must be applied within existing statutory claims processes under the VEA and MRCA. The primary operative duties and rights arise through those connected statutes and administrative processes, but the SoP defines what decision makers must treat as persuasive evidence of service connection for panic disorder.

Decision makers have the duty to apply this SoP when deciding relevant claims falling under section 120B of the VEA or section 339 of the MRCA, because the SoP is made under subsection 196B(3) of the VEA and section 5 states it applies to such claims. That legal duty is to use the SoP factors and definitions when determining whether the balance of probabilities supports a finding that panic disorder or death from panic disorder is connected to relevant service. The SoP’s adoption of DSM‑5 criteria means that decision makers must require that a diagnosis of panic disorder meet those criteria (section 7(2)). For example, the requirement to exclude panic attacks attributable to substance use or another medical condition (section 7(2)(C)) is a component of the SoP’s diagnostic threshold.

Claimants have the right to have their claim assessed against the SoP’s factors. Practically, that means claimants can rely on any of the enumerated section 9 factors, provided they demonstrate the factor’s existence on the balance of probabilities and link it to relevant service (section 9 and section 10(1)). Where the claimant’s panic disorder pre‑existed service, the claimant has the right to rely on subsections 9(12)-9(23) but only to establish material contribution to, or aggravation of, the pre‑existing disorder, and the claimant bears establishing that legal standard (section 10(2)).

Medical and treating practitioners have a duty, when providing clinical or expert opinion evidence, to address the DSM‑5 criteria, to consider and comment on exclusionary causes noted in section 7(2)(C)-(D), and to respond to the specific factors and timing windows in section 9. The SoP's Schedule clarifies what is meant by "clinically significant" and "warrant ongoing management", which affects how practitioners frame history and severity evidence (Schedule 1 notes). When Specified List conditions are put forward as pre‑existing disorders, expert evidence must address whether the condition "warranted ongoing management" during the relevant look‑back period; actual treatment is not a prerequisite as the Schedule explicitly states that ongoing management need not have been received (Schedule 1 note 2).

Administrative bodies and records holders have practical obligations to locate and provide records requested in support of claims, since the SoP sets narrow and sometimes documentary thresholds (for example evidence of witnessing killings or clearance of corpses, police custody records, child protection records, or medical records diagnosing sleep apnoea, epilepsy, concussion or TBI) that will often be central to decisions under the SoP’s factors.

The SoP imposes no enforcement sanctions on individuals; its operative function is to shape decisions under the VEA and MRCA. The rights created are therefore procedural and statutory: claimants may have a right to entitlements if they meet the SoP’s criteria and the related statutory tests; decision makers have a duty to apply the SoP when determining those claims.

The instrument contains no penal provisions, fines, or direct enforcement mechanisms within its text. It is not a criminal statute and does not prescribe sanctions against individuals for non‑compliance. Instead, the SoP operates as a medical‑causation instrument that is applied within the administrative and compensation processes of the VEA and MRCA. Enforcement and consequences therefore occur through the determination of entitlements under those statutes rather than through penalties imposed by the SoP itself.

Practical enforcement consequences flow from administrative decision making. If a claimant fails to establish the existence of an enumerated factor within the specified time window, or fails to link that factor to relevant service as required by section 10(1), decision makers are likely to find there is no service connection for panic disorder or death from panic disorder. That outcome may deny the claimant access to rehabilitation, medical treatment benefits, or other entitlements under the VEA or MRCA. Conversely, a successful application of the SoP may result in an award of entitlements under those statutes. The SoP therefore functions as an evidentiary and causation gate: it changes the required proof for administrative outcomes rather than imposing penalties.

Enforcement also implicates procedural review channels under the VEA and MRCA. Although the SoP does not itself set review mechanisms, decisions that apply or decline to apply the SoP’s factors can be subject to internal review, merits review, or judicial review under the statutory regimes that implement the VEA and MRCA. The SoP makes explicit in section 11 that if a factor in section 9 refers to an injury or disease covered by another Statement of Principles determined under subsection 196B(3) of the VEA, then the other SoP's factors apply in accordance with the terms of that SoP as in force from time to time. This cross‑reference can lead to disputes over which SoP is authoritative for a particular co‑morbid condition, and those disputes will be resolved within the statutory review processes of the VEA and MRCA.

Because evidence about timing and causation is central, enforcement outcomes are highly contingent on availability and quality of contemporaneous medical records, service records, police or incident reports, child protection files and expert medical opinion. The SoP’s definitions and timing windows create points of contention, and the absence of documentary evidence can be decisive. The instrument places no obligation on third parties to produce documents beyond existing obligations under the VEA and MRCA and general administrative law. The SoP does not create new statutory powers to compel evidence.

This Statement of Principles is made under subsection 196B(3) of the Veterans' Entitlements Act 1986 and is intended to be used in decisions under the VEA and the MRCA. Section 5 expressly states the instrument applies to claims to which section 120B of the VEA or section 339 of the MRCA applies. The SoP therefore plugs into the statutory causation and entitlement frameworks of those Acts rather than forming an independent liability regime. The SoP’s binding operation, and how it is used by decision makers, is conditioned by the relevant provisions of the VEA and MRCA; the instrument itself does not elaborate those statutory tests.

Section 11 provides a specific interaction rule with other SoPs made under subsection 196B(3) of the VEA. If a factor listed in section 9 refers to an injury or disease that is the subject of another SoP, then the factors in that other SoP apply in accordance with its own terms as in force from time to time (section 11). This creates a hierarchical or interlocking application where co‑morbid conditions or causal chains involving other SoPs must be adjudicated using the other SoP’s criteria. Practically, this means an opinion or finding alleging that, for example, a traumatic brain injury or post‑traumatic stress disorder contributed to panic disorder will require decision makers to consult any current SoP that covers TBI or PTSD and apply that SoP’s factors and definitions when assessing the connection.

The SoP references external clinical classification systems: DSM‑5 is adopted for the legal definition of panic disorder (section 7(2)), and ICD‑10‑AM codes are noted for cross‑reference though the SoP insists that the meaning of panic disorder is the DSM‑5 definition not the ICD‑10‑AM code (sections 7(3)-(4)). This means that where other statutory or clinical instruments rely on ICD codes, decision makers must prioritise the DSM‑5 criteria in the context of this SoP.

Because the SoP defines "relevant service" in the Schedule (Schedule 1), excluding certain categories of service (for example operational service, hazardous service and British nuclear test defence service are excluded in certain clauses), it interacts with broader eligibility provisions in VEA and MRCA concerning the types of service that attract coverage. That interaction determines whether an individual’s service falls within the SoP’s scope. The SoP does not itself amend or supersede those statutory eligibility rules; it presupposes them.

The SoP also interacts with administrative law principles in that decisions applying the SoP are subject to review by tribunals and courts under the VEA and MRCA frameworks. Although the SoP represents the RMA’s view of medical causation on the balance of probabilities (section 8), decision makers must apply the SoP consistently with procedural fairness and statutory obligations. Disputes about the interpretation of the SoP’s definitions, the application of specified look‑back windows, and the assessment of clinical onset or worsening are therefore ultimately resolved within the statutory review and judicial processes.

There is no direct interaction in the text with criminal law, workers’ compensation schemes, or private insurance. However, practitioners should expect evidentiary overlap: medical records, coroner’s findings, and police reports often used under other laws will be central to proving factors under this SoP. The SoP does not displace diagnostic standards used in other regimes but establishes DSM‑5 as the diagnostic touchstone for panic disorder in VEA/MRCA claims.

This instrument replaces the prior Statement of Principles concerning panic disorder No. 69 of 2009, which is expressly repealed by section 4. The instrument itself is dated 22 June 2018 and commenced on 23 July 2018 (sections 1-2). The text contains no subsequent amendment provisions. The Schedule includes cross‑references to DSM‑5 and to ICD‑10‑AM (with the ICD‑10‑AM edition specified as the Tenth Edition effective 1 July 2017) but does not indicate amendment machinery beyond the normal legislative and rule‑making processes by which the Repatriation Medical Authority issues Statements of Principles.

The instrument indicates that where a factor in section 9 refers to an injury or disease covered by another Statement of Principles determined under subsection 196B(3) of the VEA, the factors in that other Statement apply "as in force from time to time" (section 11). That phrasing anticipates updates and amendments to other SoPs and indicates that the interrelationship among SoPs is dynamic: subsequent changes to a different SoP will affect how cross‑referenced factors are applied in relation to panic disorder claims without this instrument itself needing amendment.

Aside from repeal of the 2009 instrument, the SoP does not list historical amendments, transitional provisions, or saving clauses. The instrument is a single consolidated SoP dated 2018. Any later amendments to the VEA, MRCA or other Statements of Principles are not reflected within the text we have and would need to be checked against current registers. The absence of amendment history within the instrument itself means practitioners should check the Federal Register of Legislation or the RMA’s published instruments to confirm whether later SoPs or modifications have been made since the 2018 instrument.

The Schedule’s citation to a particular ICD‑10‑AM edition may carry practical implications when third parties or later instruments adopt different editions; however, section 7(3) is explicit that the legal meaning of panic disorder in this SoP is the DSM‑5 derived description in subsection 7(2), and the ICD code reference in subsection 7(4) is for cross‑reference to the Australian modification edition named. Any future revision to DSM or ICD will not alter this SoP unless and until the RMA issues a new or amended Statement.

The instrument itself contains no record of litigation, case names, or judicial consideration. It does not cite decisions or list precedents. The text is an administrative medical instrument, not a judicial determination, and the Schedule and body of the instrument include clinical definitions and evidentiary factors rather than litigation history. Accordingly, there is no litigation history embedded in the document to report.

That absence should not be taken to mean there will be no litigation or review; decisions applying this SoP in individual cases under the VEA or MRCA can be, and in practice are, subject to internal review, merits review by tribunals and judicial review in courts. Any litigation history relevant to the interpretation or application of this particular SoP would appear in decisions of administrative tribunals or courts that have considered claims where the SoP was applied. Those authorities are not part of the instrument and are not cited here.

Practitioners relying on this SoP should therefore expect that contentious factual or medical issues arising under the SoP (for example: whether a particular event satisfies a category 1A or 1B stressor as defined in the Schedule; whether a pre‑existing condition "warranted ongoing management" within the relevant look‑back period; the timing of clinical onset or clinical worsening) are likely candidates for review and that the authoritative record of how the SoP has been interpreted will be found in administrative and court decisions rather than in this instrument. Because the instrument refers to other SoPs "as in force from time to time" (section 11), litigation may also involve issues about which SoP applies where injuries or diseases are overlapping.

Where precedent or administrative interpretations are material to a practitioner’s approach, those authorities must be researched separately, because the instrument does not provide them.

The instrument contains a number of discrete traps and precise thresholds that frequently decide claims. These are factual and definitional rather than broad policy points, and they materially affect evidentiary strategies.

1. DSM‑5 is decisive for diagnosis, not ICD coding. Section 7(2) makes the DSM‑5 criteria the legal definition of panic disorder. Although subsection 7(3) and 7(4) acknowledge ICD‑10‑AM codes F40.01 or F41.0, the meaning in the SoP is the DSM‑5 description. A clinician’s use of ICD codes alone, without addressing DSM‑5 criteria, may be insufficient.

2. Exclusionary rules in diagnosis. Section 7(2)(C)-(D) requires exclusion of panic attacks attributable to substances or another medical condition and requires that panic attacks are not better explained by another mental disorder. If an expert does not address and exclude these possibilities, a decision maker may find the DSM‑5 threshold unmet.

3. Timing windows differ by factor and by whether the issue is onset or worsening. Many factors require evidence within two years before clinical onset or worsening (for example category 1A/1B stressors, severe medical illness, severe chronic medical condition), while others require evidence within five years (for example certain pre‑existing clinically significant mental disorders, concussion or moderate to severe TBI, death of a significant other). Practitioners should not assume uniform look‑back periods.

4. Onset versus worsening. Subsections 9(12)-9(23) apply only to material contribution to, or aggravation of, panic disorder where the person’s panic disorder was suffered or contracted before or during but did not arise out of, the person's relevant service (section 10(2)). The legal test for material contribution or aggravation is distinct and tends to require a different evidentiary focus. Determining whether panic disorder pre‑existed service is therefore consequential.

5. "Warrant ongoing management" does not require treatment. The Schedule states that a clinically significant condition is one of sufficient severity to warrant ongoing management and that this does not require that any actual management was received (Schedule 1 notes). Claims based on pre‑existing disorders therefore do not fail simply because treatment was not sought, but practitioners must still show the condition met the "warranted ongoing management" threshold.

6. Eyewitness and corpse definitions are narrow. Category 1B includes witnessing a corpse or critically injured casualty "as an eyewitness", and the Schedule defines eyewitness as direct observation excluding exposure only via media. "Corpse" excludes viewing a closed body bag or a body in an open‑casket coffin. Reliance on public broadcasting or indirect exposure will not satisfy those factors.

7. Severe childhood abuse definition requires specific perpetrator relationships. The Schedule defines severe childhood abuse as harm or neglect perpetrated by a parent, care provider, adult who works with or around the child, or any other adult in contact with the child. Self‑reported abuse where the perpetrator does not meet these relational criteria may require further evidence.

8. Relevant service exclusions. The Schedule defines relevant service and excludes certain categories such as operational service in respect of eligible war service and hazardous service and British nuclear test defence service for defence service under VEA. This can be determinative: persons whose service falls into excluded categories may not be able to rely on this SoP.

9. "Inability to obtain appropriate clinical management" is a factor but difficult to prove. Section 9(23) lists inability to obtain appropriate clinical management for panic disorder as a factor. The Schedule provides no standard for what counts as appropriate, so claimants will need contemporaneous records showing attempts to access care and reasons for denial, distance or system failures. This is an evidentiary pitfall.

10. Death claims require nexus to terminal event. Section 7(5) makes death compensable only where the terminal event or condition was contributed to by the panic disorder. The Schedule lists examples of terminal events. Establishing contribution to terminal events such as pneumonia or cardiac arrest requires a forensic medical opinion linking panic disorder to the fatal pathophysiology.

11. Overlap with other SoPs. Section 11 requires application of other SoPs where factors refer to injuries or diseases covered by them. That can produce jurisdictional complexity and requires practitioners to track current versions of multiple SoPs.

12. Clinical onset and clinical worsening are not defined. The SoP uses "clinical onset" and "clinical worsening" as temporal anchors but does not define them. Determination therefore relies on clinical judgment of symptom emergence and deterioration, a frequent locus of dispute.

13. Lists differences. Specified List 1 includes 'personality disorder'; Specified List 2 does not. The difference matters because different subsections of section 9 direct reliance on List 1 or List 2 within different timeframes for onset versus worsening.

These are tangible operational risks. They emphasise the need for chronological, contemporaneous and concrete documentary evidence aligned to the SoP’s precise wording.

Compliance in this context means structuring claim evidence and expert opinion so decision makers can apply the SoP’s criteria without ambiguity. The SoP prescribes both diagnostic standards and a grid of causal factors with look‑back windows. Practitioners must therefore organise factual, medical and service evidence to match that grid.

1. Diagnosis against DSM‑5. Ensure that psychiatric reports explicitly apply and document the DSM‑5 criteria as reproduced in section 7(2): record occurrence of recurrent unexpected panic attacks, document at least four of the listed symptoms for attacks, show at least one month of persistent concern or maladaptive behaviour, and explicitly address exclusion of substance or medical causes and exclusion of other primary mental disorders explaining the panic attacks (section 7(2)(A)-(D)). If diagnosis is made by ICD coding, the clinician must also map the ICD code to DSM‑5 criteria for the record.

2. Establish dates for clinical onset and clinical worsening. Because the SoP’s factors are tied to time windows (two years or five years), clinicians should provide clear contemporaneous or retrospective dating of symptom onset and of any clinically significant worsening. Use medical records, hospital notes, GP records, psychiatric outpatient files, workplace incident reports and contemporaneous diaries to anchor dates. Address in the report how the clinician defines "clinical onset" and "clinical worsening" in the individual case.

3. Match factors to the SoP list. Identify which section 9 factors the claimant seeks to rely on. For each factor, collect evidence tailored to the Schedule’s definitions:

   • For category 1A/1B stressors, produce incident reports, service records, witness statements, police reports, or operational logs showing the described events and dates (section 9 and Schedule 1).
   • For category 2 stressors, document social isolation, relationship breakdown evidence, workplace reports or complaints, financial records, detention/court records, caregiving responsibilities, or medical records of family member deterioration (Schedule 1).
   • For severe childhood abuse, produce child protection records, criminal proceedings, medical records, counselling notes, school reports and evidence of the perpetrator’s relationship to the child (Schedule 1).
   • For death of a significant other, provide death certificate, relationship evidence and timing relative to clinical onset/worsening (section 9(4)/(15); Schedule 1).
   • For pre‑existing clinically significant disorders (Specified Lists), obtain psychiatric summaries documenting severity and that the condition "warranted ongoing management" within the five years prior to onset or worsening; the Schedule clarifies that ongoing management need not actually have been provided (Schedule 1 notes).
   • For sleep apnoea, epilepsy, concussion, TBI, severe chronic medical conditions or life‑threatening injuries, obtain diagnostic test results, hospital discharge summaries, imaging reports and specialist notes establishing diagnosis and timing (section 9).

4. Address exclusionary causes. Experts must consider and rule in or out substance use and other medical conditions as causes of panic symptoms per section 7(2)(C) and explain how differential diagnosis was performed.

5. Document inability to obtain management when relied on. If relying on factor 9(23), collect appointment logs, correspondence showing attempts and refusals, public health waiting list evidence, travel/time barriers and any administrative denials to show inability to obtain appropriate clinical management.

6. Where other SoPs are implicated, gather cross‑referenced evidence. If a section 9 factor refers to an injury/disease covered by another SoP (section 11), identify and obtain the relevant SoP(s) and produce the evidence those SoPs require. Practitioners must track the current version of any other SoP "as in force from time to time".

7. For death claims, obtain cause of death documentation and a forensic or treating medical opinion that addresses whether panic disorder contributed to the terminal event. The Schedule lists terminal events that can be linked to panic disorder for compensability (section 7(5); Schedule 1).

8. Prepare witness statements for eyewitness factors. For category 1B stressor claims that rely on witnessing killing, atrocities or corpses, extract signed witness statements from direct observers; exclude reliance on media exposure as the Schedule specifically disqualifies that (Schedule 1).

9. Address the relevant service definition. Confirm that the claimant’s service qualifies as "relevant service" under the Schedule’s definition. Obtain service records that show the nature of service to ensure it falls within eligible war service (other than operational service), defence service (other than hazardous service and British nuclear test defence service), or peacetime service under the MRCA.

10. Use chronological, indexed bundles and cross‑referencing. Produce a chronological chronology that links each piece of evidence to a specific section 9 factor and to the DSM‑5 diagnostic elements in section 7(2). Decision makers frequently rely on clear linkages between documented events and medical opinion.

11. Anticipate challenges about clinical onset and worsening. Because "clinical onset" and "clinical worsening" are not defined, have clinicians explain their clinical rationale for dates and how symptoms objectively manifested or deteriorated, including functional impacts, treatment changes, or episode frequency.

12. Where concurrent conditions exist, be explicit about causation pathways. If a contributor is a medical illness (for example severe chronic disease or TBI) or a mental disorder from the specified lists, experts should explicitly explain the mechanism by which those conditions contributed to onset or worsening of panic disorder.

13. Keep updated on SoP changes. Although this instrument replaced the 2009 SoP, section 11 makes clear that other SoPs may change over time. Practitioners should check the current Federal Register of Legislation and RMA publications before filing or finalising expert reports to ensure they cite the operative SoPs.

14. Address genuineness and plausibility. Given the balance‑of‑probabilities standard, corroboration strengthens a claim. Seek independent records where possible, particularly for stressor events, medical diagnoses and attempts to access care.

Following these steps aligns evidence production with the SoP’s precise criteria. The SoP shapes what is material in adjudication of VEA and MRCA claims for panic disorder; structured, DSM‑5‑aligned diagnostics, temporally anchored evidence and attention to the Schedule’s narrow definitions materially increase the probability that a decision maker can apply the SoP without remand for further evidence.