Statement of Principles concerning personality disorder (Balance of Probabilities) (No. 18 of 2018)

The instrument centres on a small set of interlocking legal and medical concepts. The primary concept is personality disorder as a mental health disorder, defined by criteria derived from the DSM‑5, set out in section 7(2). The DSM‑5 criteria are quoted in full in the instrument and require an enduring, pervasive, inflexible pattern of inner experience and behaviour manifesting in at least two of the specified areas (cognition, affectivity, interpersonal functioning, impulse control), producing clinically significant distress or impairment, with onset traceable to adolescence or early adulthood, and not better explained by another mental disorder or by substance or medical effects.

Linked to that is the concept of death from personality disorder, which for the instrument’s purposes includes a terminal event or condition contributed to by the person’s personality disorder, section 7(5). Terminal event is defined in the Schedule and includes proximate or ultimate causes such as pneumonia, respiratory failure, cardiac arrest, circulatory failure or cessation of brain function.

Causation for administrative purposes is expressed as a balance of probabilities linkage, conditioned on the existence of at least one of the enumerated factors in section 9. Those factors are temporal and factual triggers. They include exposure to severe traumatic events of category 1A within one year before clinical onset, category 1B events within six months before clinical onset, severe childhood abuse prior to onset, a clinically significant disorder of mental health within five years before onset, and the mirrored set of items linked to clinical worsening instead of initial onset, sections 9(1)-9(8). An additional, separate factor is inability to obtain appropriate clinical management for personality disorder, section 9(9).

The definitions in the Schedule refine these factors. Category 1A stressors are severe traumatic events such as life‑threatening events, serious physical attack or sexual assault including rape, and being threatened with a weapon, held captive, kidnapped or tortured. Category 1B stressors cover a different list of severe events, including killing or maiming another person, witnessing persons killed or critically injured or atrocities, participating in clearance of corpses or critically injured casualties, or viewing such casualties as an eyewitness. The Schedule explicitly defines “corpse” and restricts “eyewitness” to persons who experienced an incident first hand, excluding exposure through public broadcasting or mass media.

The instrument also incorporates the list of clinically significant mental disorders that, within five years before clinical onset or worsening, may be a factor. That list is extensive and includes acute stress disorder, PTSD, bipolar disorder, schizophrenia, substance use disorders and more, in Schedule item “clinically significant disorder of mental health as specified”. The note attached to this definition explains that “management” of such a condition may involve regular visits, for example monthly, to a psychiatrist, counsellor or GP, while also stating explicitly that a condition that “warrants ongoing management” does not require that any management was actually provided or received.

Relevant service for the instrument is defined to include specific categories of VEA and MRCA service: 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. These definitions are important because the factors in section 9 must be related to the person’s relevant service, section 10(1).

Finally, the instrument contains a mechanism for interaction with other SoPs. If a factor in this SoP refers to an injury or disease that is the subject of another SoP, the other SoP’s factors apply in accordance with its terms, section 11. This creates an explicit cross‑reference network among SoPs when multiple conditions or events are implicated.

The instrument affects three sets of actors in a specific administrative and evidentiary way.

1. Veterans, serving members and their dependants who lodge claims under the VEA or MRCA that involve personality disorder or death from personality disorder. Section 5 makes clear the SoP applies to claims to which s120B of the VEA or s339 of the MRCA applies. The Schedule’s definition of relevant service in turn constrains which kinds of service give the SoP effect, by enumerating eligible war service (other than operational), defence service (excluding hazardous and British nuclear test defence service) and peacetime MRCA service. Thus, claimants whose service does not meet those enumerated categories are outside the instrument’s scope.

2. Decision makers and administrators who assess entitlement under the VEA and MRCA. The RMA prepares SoPs to provide medical‑scientific bases for administrative determinations. The instrument states the RMA’s view that, on the balance of probabilities, personality disorder and death from personality disorder can be related to relevant service, section 8. Decision makers will apply the factors in section 9 and the definitions in the Schedule to decide whether a claimant has satisfied the causal nexus required by the statute under which the claim is made. Section 11 requires decision makers to consult other SoPs where a factor refers to another recognised injury or disease.

3. Clinicians, treating practitioners and expert witnesses who prepare reports used in claims. The SoP defines personality disorder by reference to DSM‑5 criteria, section 7(2), and lists ICD‑10‑AM codes that attract to personality disorder, section 7(3) and 7(4). Clinicians will be required to apply the DSM‑5 diagnostic criteria, document the timing of clinical onset and worsening, and identify whether the claimant experienced a category 1A or 1B stressor within the prescribed temporal windows. For clinically significant disorders, the Schedule clarifies that evidence of severity will be assessed against whether the condition warranted ongoing management, with an explanatory note that actual management need not have been received.

Secondary affected parties will include legal practitioners advising claimants on evidence and causation, rehabilitation providers asked to explain clinical management histories or absence of management, and records custodians such as Defence or health services who hold service records or clinical records documenting stressor exposure, psychiatric diagnoses, and treatment timelines.

The costs and behaviour changes that follow from the SoP are concretely directed at these groups. Claimants will need to assemble service records demonstrating that the triggering factor occurred in relation to the enumerated relevant service and within the temporal windows in section 9. Clinicians will be asked to apply DSM‑5 criteria and to provide opinions linking onset or worsening temporally to the listed stressors or disorders. Administrative decision makers will be required to apply the enumerated factors and consult other SoPs where cross‑references arise, section 11. The instrument, being a revocation and replacement of a prior SoP, affects any ongoing claims that must now be assessed against the current instrument rather than the revoked instrument, section 4.

This instrument is not an Act that creates duties and criminal sanctions. Its operative effect is to provide a determinative medical framework to be applied by decision makers in claims covered by specified provisions of the VEA and MRCA, see sections 3 and 5. Nonetheless, it creates binding procedural and evidentiary rules that impose obligations on claimants, clinicians and decision makers in practice.

Duties of the decision maker

• Apply the SoP when assessing claims to which s120B of the VEA or s339 of the MRCA apply, section 5. The SoP prescribes the medical criteria and the listed factors that must be considered in determining whether personality disorder or death from personality disorder is connected with relevant service.
• Require proof that at least one of the factors in section 9 exists and that the factor is related to the person’s relevant service, section 9 and section 10(1).
• When a factor in section 9 refers to an injury or disease for which another SoP exists, apply the factors in that other SoP according to its terms, section 11.

Duties or expectations on clinicians and experts

• Diagnose personality disorder by reference to DSM‑5 derived criteria as specified in section 7(2). The instrument expressly derives the diagnostic criteria from DSM‑5 and states that personality disorder, for the purposes of this instrument, means what is given in subsection 7(2).
• Provide objective evidence on timing of clinical onset and of any clinical worsening relative to alleged stressors, because the temporal windows in section 9 (one year for category 1A before onset, six months for category 1B before onset, five years for clinically significant disorder before onset) are determinative for causation.

Practical rights and evidentiary effects for claimants

• A claimant has the right to have their claim assessed against the SoP’s criteria; that assessment will determine whether the medical causation connection for personality disorder is established on the balance of probabilities, section 8.
• The Schedule’s definition of clinically significant disorder includes the explicit note that “warrant ongoing management” does not require that any actual management was received or given. This functions as a clarifying rule in favour of claimants who can show the severity of a prior mental disorder even if access to care was limited.

Constraints imposed by the instrument

• The definition of relevant service in the Schedule limits the type of service that can ground a causal relationship, which constrains the quantum of claims that qualify under this SoP. The instrument does not expand the statutory definition of relevant service; it works within those categories as defined in the Schedule.
• The instrument requires that at least one of its enumerated factors exist and be related to relevant service before a causal connection can be made, sections 9 and 10(1). This sets an evidentiary threshold and prescribes the kinds of events or prior conditions that are acceptable as causal or aggravating mechanisms.

Procedural interaction rights

• Section 11 creates a procedural obligation on decision makers to consult and apply other SoPs when factors in this SoP reference other injuries or diseases. This gives claimants a right to have the interplay between multiple SoPs resolved according to the terms of those instruments.

The instrument does not create direct private sector regulatory duties or administrative penalties. Its effect is to shape the evidentiary landscape for entitlement decisions under the VEA and MRCA, thereby influencing the rights to entitlements that flow from successful causation findings. The RMA’s stated burden of proof for causation is the balance of probabilities, section 8, which is an evidentiary rule rather than a substantive right or duty imposed by the instrument itself.

The Statement of Principles instrument itself contains no express criminal penalties, pecuniary sanctions or administrative fines. It is an instrument that defines medical and causal standards for adjudicating claims under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, sections 3 and 5. Enforcement is therefore administrative and indirect: the SoP is enforced by its application in decisions about entitlement, rehabilitation and compensation that are made under the VEA and MRCA.

How enforcement operates in practice, per the instrument’s text

• Decision makers administer entitlements under the VEA and MRCA and must apply the SoP’s factors and definitions when deciding whether personality disorder or death from personality disorder is connected with relevant service, sections 5, 7, 9 and 10. The instrument therefore functions as a decisive evidentiary instrument used to grant or deny claims.
• Where a factor in section 9 refers to an injury or disease covered by another SoP, section 11 directs that the other SoP’s factors apply. The administrative consequence is that decision makers must consult the other SoP and apply its criteria in order to make a legally correct assessment.

What is not in the instrument

• There are no provisions in the SoP imposing obligations to report, to cease conduct, or to pay fines or penalties for non‑compliance. It does not give the RMA powers of coercive enforcement against individuals. It operates as an evidentiary standard to be used by administrative decision makers.
• The instrument does not set procedural review or appeal mechanisms itself. Challenges to decisions that apply the SoP would be governed by the procedural and judicial review regimes applicable to decisions under the VEA and MRCA, but those regimes and remedies are not set out in this instrument.

Implication for affected persons

• The “penalty” in practice is the administrative denial of an entitlement when decision makers apply the SoP and find that none of the factors in section 9 are satisfied in connection with relevant service. Conversely, where a factor is established and related to relevant service, the consequence is an administrative finding of material contribution or aggravation supporting entitlement. The instrument therefore has direct and decisive impact on an applicant’s ability to obtain benefits, rehabilitation and death entitlements under the statutes to which it applies.
• Because the SoP specifies temporal windows and precise definitions for stressors and prior disorders, the burden of collecting and presenting the required evidence lies on the claimant. Failure to produce evidence that meets the SoP’s definitions and timings will be reflected in the entitlement decision.

Administrative compliance and appeals

• The instrument requires administrative bodies to reconcile it with other SoPs when relevant, section 11. The correctness of a body’s application of the SoP will be susceptible to procedural challenge under the statutes that govern claims, but details of appeal rights and remedies are not in this instrument and must be sought in the VEA and MRCA.

In short, enforcement is exercised through the application of this SoP in benefit and entitlement adjudications. The instrument itself does not prescribe penalties; its effect is to determine whether entitlement exists, which is the consequential enforcement mechanism.

This SoP is explicitly created under subsection 196B(3) of the Veterans' Entitlements Act 1986, section 3. Its legal role is to supply medical scientific determinations that are applied when deciding claims under the VEA and MRCA. The instrument expressly applies to claims to which section 120B of the VEA or section 339 of the MRCA apply, section 5. Those cross‑references show its direct statutory interaction point: decision makers processing the specified statutory claims must apply the SoP.

Cross‑SoP interaction

• The instrument provides an express mechanism for interaction with other Statements of Principles: section 11 states that if a factor in section 9 refers to an injury or disease covered by another SoP determined under subsection 196B(3) of the VEA, then the factors in that other Statement of Principles apply in accordance with its terms. This creates formal cross‑application and requires decision makers to operate across multiple SoPs where causal chains involve several recognised conditions.

Interaction with diagnostic classifications

• The SoP uses DSM‑5 diagnostic criteria as the operative definition of personality disorder, section 7(2). It lists ICD‑10‑AM codes that “attract” to personality disorder but makes clear that “in applying this Statement of Principles the meaning of personality disorder is that given in subsection (2)”, section 7(3). The ICD codes are therefore present for coding and classification, but the DSM‑5-derived textual definition governs legal application.

Interaction with service‑based statutory definitions

• The Schedule defines “relevant service” in specific terms that mirror statutory categories under the VEA and MRCA; relevant service includes 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. This links the SoP to statutory definitions of service and constrains its application to those categories. Where a claimant’s service falls outside these definitions, the SoP does not apply.

Limits imposed by other medical determinations

• The SoP excludes personality change due to another medical condition, noted in section 7(2) and the Schedule definition of personality change due to another medical condition. Where a personality disturbance is attributable to a direct physiological effect of a medical condition, the SoP’s definition excludes that presentation. Decision makers must therefore determine whether the condition is personality disorder as defined by subsection 7(2) rather than personality change due to another medical condition.

Temporal and evidentiary interplay

• The instrument sets temporal windows for causal triggers: one year for category 1A stressors preceding clinical onset, six months for category 1B, and five years for clinically significant disorders preceding onset, section 9. These windows must be read consistently with statutory temporal rules in the VEA and MRCA that govern causation and liability for service‑related conditions. The SoP’s specified times interact with statutory notions of causation when establishing material contribution or aggravation.

Amendment and legislative hierarchy

• The instrument revoked a prior SoP concerning personality disorder No. 71 of 2008, section 4, and the compilation notes show that an amendment determination (No. 87 of 2018) modified Schedule items. The SoP sits as a legislative instrument subordinate to the VEA and MRCA, and its changes are effected by subsequent RMA determinations in accordance with the statutory power under subsection 196B(3).

In practice, interaction requires decision makers to read the SoP together with the substantive and procedural provisions of the VEA and MRCA, to apply cross‑SoP rules under section 11 where co‑morbid or referenced injuries exist, and to assess diagnostic issues against DSM‑5 criteria while using ICD‑10‑AM codes for classification. The instrument therefore operates as part of a network of statutory and administrative materials that together determine entitlements.

The instrument itself records its own preparatory and amendment history in its compilation and endnotes. Key dates and changes documented in the text and endnotes are as follows.

Original instrument and commencement

• The Repatriation Medical Authority determined this Statement of Principles, dated 2 March 2018, and the instrument commenced on 2 April 2018, sections 3 and 2 respectively. The compilation notes record registration on 6 March 2018 and that commencement occurred 2 April 2018 (Endnote 3).

Revocation of prior SoP

• Section 4 explicitly revokes the Statement of Principles concerning personality disorder No. 71 of 2008, as amended, which had been made under subsections 196B(3) and (8) of the VEA. That revocation replaced the prior instrument with the current SoP.

Subsequent amendment determination recorded in compilation

• The compilation indicates it includes amendments up to Veterans' Entitlements (Statements of Principles,Category 1B Stressor) Amendment Determination 2018 (No. 87 of 2018) (F2018L01188). The endnotes show that Determination No. 87 of 2018 was registered 28 August 2018 and commenced 24 September 2018 (Endnote 3). The compilation date is 24 September 2018, and the endnotes identify that Schedule 1 , Dictionary entries for category 1B stressor were amended and the definition of corpse was added by Determination No. 87 of 2018, as recorded in Endnote 4.

Nature of recorded amendments

• The amendment history table in the endnotes shows that Schedule 1 - Dictionary items for category 1B stressor were revised and the definition of corpse was added or amended by Determination No. 87 of 2018 (Endnote 4). The compilation indicates those changes are incorporated into the text of the instrument.

Notes on compilation and uncommenced amendments

• The compilation contains a cautionary note that uncommenced amendments are not reflected in the text, and the endnotes include standard compilation material regarding endnotes, abbreviation keys and legislative history. Any modification of the compiled law by another law operates as modified but those textual modifications may not be reflected in the compilation, as stated in the compilation preface.

Practical effect of the amendment history

• The revocation of the 2008 SoP and the later amendment by Determination No. 87 suggest that the RMA updated definitions and the content of the Schedule, particularly the set of events that constitute a category 1B stressor and the definition of corpse. Those Schedule changes alter the scope of what events can be relied on as causative factors under section 9. The instrument’s endnotes are the official record of these administrative amendments and their commencement dates.

Where to find official amendment details

• The compilation directs readers to the Legislation Register for any uncommenced amendments and to the series page for more information on modifications. The endnotes specify the registration and commencement details for the instrument and its amendment No. 87 of 2018, Endnote 3.

In short, the SoP replaced an earlier 2008 SoP and was itself amended by Determination No. 87 of 2018, with the compilation reflecting those changes as of 24 September 2018. Any further amendments after that date are not shown in this compilation and must be checked against the Legislation Register.

The instrument as compiled contains no recorded litigation history. It does not cite any judicial decisions or administrative review outcomes. The text is an administrative determination of the Repatriation Medical Authority under subsection 196B(3) of the VEA and the compilation includes standard legislative history and endnotes, but no cases or decisions are named in the instrument itself.

What the instrument records and what it does not

• The SoP provides the medical and causal framework to be applied in statutory claim determinations. It does not, however, record decisions of tribunals, courts or merits review bodies applying this SoP. The compilation’s endnotes list the instrument’s registration and amendment history, but do not list any litigation or appeals decisions arising from its application.

Implication for practitioners researching case law

• There is no litigation material contained in this instrument to indicate how courts or tribunals have interpreted or applied the SoP. For a practitioner seeking interpretative guidance, the absence of a recorded litigation history in the instrument itself means that they must consult external sources , tribunal decisions, Federal Court or Full Federal Court jurisprudence, and administrative review records , to see how the SoP has been applied in contested claims. Those external sources are not part of the instrument and are not provided in this compilation.

Risk of interpretative uncertainty

• Because the instrument supplies definitional and temporal criteria but does not include illustrative adjudicative examples or procedural guidance about evidentiary weight, there is potential for disputes about how strictly to apply its time windows, how to assess “warrants ongoing management” when no treatment was received, and how to link an enumerated stressor to the statutory concept of relevant service. In the absence of internal litigation notes, resolution of those disputes will depend on how courts or tribunals later interpret the instrument in individual cases.

Practitioners should therefore be prepared to seek out up‑to‑date case law beyond the compiled instrument to understand how administrative decision makers and review bodies are construing and applying the SoP’s definitions and temporal criteria in contested matters. The instrument itself does not supply that litigation history.

This instrument contains a number of particular textual features and definitional choices that can create trapdoors or produce counterintuitive evidentiary consequences for claimants, clinicians and decision makers. These are matters of legal technique and administrative operation that are explicit in the instrument, and they are worth highlighting for practitioners.

DSM‑5 is the operative diagnostic source, not ICD codes

• Although section 7(3) lists ICD‑10‑AM codes that attract to personality disorder, subsection 7(3) expressly states that “in applying this Statement of Principles the meaning of personality disorder is that given in subsection (2)”, that is the DSM‑5 derived definition in section 7(2). Do not treat ICD codes as dispositive definitions; they are classification labels. Practitioners must ensure that clinical opinions address the DSM‑5 criteria articulated in section 7(2).

Narrow definitions of “relevant service”

• The Schedule defines relevant service as 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. This is not a catch‑all for all Defence service. Claims grounded in service that falls outside these enumerated categories will not be within the SoP’s scope, section 5 and Schedule. Practitioners must check that the claimant’s service fits these categories before applying the SoP.

Temporal windows are strict and differ by trigger

• The SoP specifies distinct temporal windows: one year before clinical onset for category 1A stressors, six months for category 1B stressors, and five years before clinical onset for a clinically significant disorder of mental health, section 9(1)-9(4). Similar windows apply for clinical worsening rather than initial onset, section 9(5)-9(8). Practitioners must link stressor dates or disorder dates precisely to onset or worsening dates as required. A claimed stressor outside the relevant window will not satisfy the factor.

Category 1A versus 1B stressors are different in kind and timing

• Category 1A are life‑threatening events or serious physical attacks including rape, or being threatened with a weapon, held captive, kidnapped or tortured, Schedule. Category 1B includes killing or maiming another, witnessing killings or critical injuries, participating in corpse clearance, or viewing a corpse or critically injured casualty as an eyewitness. The SoP imposes different temporal windows for these categories, and Determination No. 87 of 2018 amended category 1B and the corpse definition. Be careful to read the exact language in the current Schedule when preparing evidence.

Eyewitness and corpse definitions have exclusions

• Eyewitness is confined to first‑hand experience and excludes exposure through public broadcasting or mass media, Schedule. The Schedule’s “corpse” definition excludes seeing closed body bags or viewing closed casket funerals, and gives examples of violent or horrific death types. Evidence based solely on media coverage, hearsay or viewing a closed casket is excluded from the category 1B events that would satisfy section 9.

Clinically significant disorder: severity rather than treatment history

• The Schedule defines clinically significant disorder of mental health as conditions of sufficient severity to warrant ongoing management, and Note 2 clarifies that warranting ongoing management does not require that any actual management was received or given. That is a substantive evidentiary rule that can assist claimants who lacked access to care. However, Note 1’s example that management may involve regular visits makes clear that some objective markers of severity will be expected. Practitioners should prepare evidence of severity rather than relying solely on absence of records of treatment.

Inability to obtain appropriate clinical management is a separate factor

• Section 9(9) lists inability to obtain appropriate clinical management for personality disorder as an independent factor. The SoP does not define here what constitutes “inability to obtain appropriate clinical management” in detail. Practitioners must therefore evidence the attempts to obtain care and barriers encountered, while noting that Note 2 in the clinically significant disorder definition separates lack of treatment from lack of need for it.

Interaction with other SoPs can expand evidentiary requirements

• Section 11 requires decision makers to apply factors in other SoPs if a factor in this SoP refers to an injury or disease covered by them. A practitioner relying on a factor that references another disease must identify and apply the other SoP’s factors, which can add layers of temporal or definitional tests.

Subsections 9(5)-9(9) are limited in application

• Section 10(2) states that subsections 9(5) to 9(9) apply only to material contribution to, or aggravation of, personality disorder where the person’s personality disorder was suffered or contracted before or during (but did not arise out of) the person’s relevant service. That creates a potential pitfall: those subsections cannot be used to show material contribution or aggravation where the personality disorder first arose out of service. Practitioners must analyse whether they are in a pre‑existing PD scenario or a PD arising out of service scenario.

Death from PD includes terminal events contributed to by PD

• Section 7(5) includes death from a terminal event or condition that was contributed to by the person’s personality disorder. Terminal events are defined broadly to include common proximate causes such as pneumonia or cardiac arrest. Practitioners must therefore establish a contribution link between PD and the terminal event in death claims, not just assert PD as a background diagnosis.

Revocation of prior instrument may affect ongoing claims

• Section 4 revokes the earlier No. 71 of 2008 SoP. Practitioners should verify which SoP applies to their matter based on applicable transitional rules or the dates of claim lodgement and decision. The compilation notes indicate the revocation, and that Determination No. 87 later amended the Schedule.

No internal guidance on evidentiary weight or how to assess “related to the person’s relevant service”

• The SoP tells users that factors must be related to relevant service, section 10(1), but does not supply detailed criteria for what constitutes sufficient relation. That leaves room for dispute and requires careful drafting of medical opinions to tie the triggering factor causally and temporally to the defined relevant service.

These concrete textual features are the primary “gotchas” that practitioners must navigate when preparing or defending claims that invoke this SoP.

For practitioners assembling claims or advising clients, compliance with this SoP is an evidence management exercise built around four discrete tasks: 1) confirm applicability; 2) assemble clinical diagnosis evidence that maps to DSM‑5 criteria in section 7(2); 3) establish the triggering factor in section 9 and its temporal relation to onset or worsening; and 4) demonstrate that the factor is related to the person’s relevant service per section 10(1). The following is a practical roadmap grounded in the instrument’s text.

1. Confirm applicability

• Check the claim falls under the statutory gateways specified in section 5, that is it is a claim to which section 120B of the VEA or section 339 of the MRCA applies. Also verify the claimant’s service meets the Schedule’s definition of “relevant service” (eligible war service other than operational service, defence service other than hazardous service and British nuclear test defence service, or peacetime MRCA service). If the service does not fit those categories, the SoP will not apply.

2. Establish diagnosis against DSM‑5 criteria (section 7(2))

• Obtain contemporaneous clinical records and, where necessary, a specialist psychiatric assessment that expressly applies the DSM‑5 derived criteria quoted in section 7(2). The assessment should address each required DSM‑5 element: (a) enduring pattern deviating from cultural expectations and manifesting in at least two of cognition, affectivity, interpersonal functioning, or impulse control; (b) pervasiveness and inflexibility across contexts; (c) clinically significant distress or impairment; (d) stability and traceable onset to adolescence or early adulthood; and (e) exclusion of other mental disorders and substance or medical causes. Draft expert opinion that explicitly engages with each of these subsections so decision makers can see how the diagnostic threshold is met.

3. Identify which factor in section 9 is relied upon and collect supporting evidence

• If relying on a stressor: determine whether the event fits category 1A or 1B in the Schedule. For category 1A events, collect service records, incident reports or personal statements showing a life‑threatening event, serious physical attack or sexual assault or being threatened with a weapon, etc., and ensure the event occurred within one year before clinical onset (section 9(1)). For category 1B events, confirm it is one of the listed items such as killing or maiming a person, witnessing killings or atrocities, participating in corpse clearance, or viewing a corpse as an eyewitness, and ensure it occurred within six months before clinical onset (section 9(2)). Remember the Schedule’s definition of eyewitness excludes media exposure. Use contemporaneous service records, witness statements from other personnel, after action reports, police reports, or hospital records to substantiate the event and its date.
• If relying on severe childhood abuse: collect civil, criminal or child protection records, medical records, counselling notes, or credible witness evidence showing serious physical, emotional, psychological or sexual harm or neglect under the age of 16 by the specified perpetrators, section 9(3) and Schedule definition. Establish timing relative to clinical onset.
• If relying on a clinically significant disorder of mental health: obtain records demonstrating the presence of one of the specified disorders within five years before clinical onset, section 9(4) and Schedule’s enumerated list. Evidence should show severity to the degree that ongoing management would be warranted. Note the Schedule’s Note 2: a lack of actual management does not defeat this factor, but an opinion should explain why the condition would have warranted ongoing management, for example by documenting symptoms, functional impairment, or health practitioner contemporaneous notes.
• If relying on inability to obtain appropriate clinical management: document attempts to access care, dates, referrals, service availability issues, geographical or operational constraints, and any formal denial or lack of capacity from services. The SoP treats this as a separate factor, section 9(9), so create a factual timeline of efforts and barriers.

4. Demonstrate relationship to relevant service (section 10(1))

• The SoP requires the existence of the factor to be related to the relevant service. For this, assemble service records showing the claimant was in the relevant role, location or operation at the time of the stressor or in a context that links the stressor to the statutory category of service. Include unit logs, operational orders, deployment records, internal incident reports, chain of command memoranda, and contemporaneous medical records. Expert medical opinion should explain how the service event plausibly and temporally contributed to onset or worsening, tying the causal pathway to the claimant’s service record.

5. If multiple conditions or cross‑references apply, apply other SoPs per section 11

• If any factor refers to another injury or disease with its own SoP, identify that other SoP and ensure the evidence meets that SoP’s factors, as required by section 11. This may necessitate additional specialist opinions or records.

6. Address onset versus worsening and use section 10(2) appropriately

• If asking for material contribution or aggravation where personality disorder pre‑existed but did not arise out of service, rely on subsections 9(5)-9(9). Be aware that section 10(2) limits those subsections to cases where PD was suffered or contracted before or during the person’s relevant service but did not arise out of it. If the PD arises out of service, different elements of section 9 apply.

7. For death claims, demonstrate contribution to the terminal event (section 7(5) and Schedule)

• Where the claim is death from personality disorder, assemble medical records and, if applicable, coronial findings showing the terminal event (as defined in the Schedule) and an opinion that the decedent’s personality disorder contributed to that terminal event. Expert evidence should explain the causal mechanism linking the PD to the terminal event, for example by showing how personality features led to behaviours or health neglect that precipitated the terminal condition.

8. Evidence quality and expert methodology

• Ensure expert reports explicitly reference the SoP criteria. Experts should state the clinical onset and the basis for dating it, explain how the DSM‑5 criteria are met, and provide a reasoned causal opinion linking the factor to onset or worsening within the prescribed timeframe. When relying on lack of treatment, experts should address Note 2 in the Schedule and explain why care would have been warranted.

9. Procedural housekeeping

• Keep clear timelines that align stressor dates, disorder history, treatment attempts and service records. Label evidence to show which subsection of section 9 is being satisfied. If relying on the corpse or eyewitness definitions, ensure the evidence fits the Schedule’s exclusions regarding media coverage and closed casket observations.

10. Anticipate cross‑examination and appeals

• Because the SoP sets the balance of probabilities standard as the RMA’s view that it is more probable than not that PD can be related to service, section 8, decision makers will weigh competing evidence. Prepare to address gaps, such as absence of contemporaneous records, by obtaining corroborative statements and providing reasoned expert explanation for any uncertainties.

Following these steps will align claim preparation with the instrument’s textual requirements. The SoP’s clarity on DSM‑5 criteria, stressor categories, time windows and the list of clinically significant disorders permits a structured evidence plan. Practitioners should be careful to monitor the Legislation Register for any further amendments to the Schedule definitions, given the instrument’s recent amendment history recorded in the compilation.