1Statement of Principles concerning schizophrenia (Reasonable Hypothesis) (No. 27 of 2026)

---

meta-content-style-type: text/css meta-content-type: application/xhtml+xml; charset=utf-8

?xml version="1.0" encoding="utf-8" standalone="no"?>

                        RMA Australian Government Coat of Arms

 

Statement of Principles

concerning

SCHIZOPHRENIA (Reasonable Hypothesis)

(No. 27 of 2026)

The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

 

Dated                                   20 February 2026

 

 

 

 

 

 

 

 

 

Professor Terence Campbell AM

Chairperson

by and on behalf of

The Repatriation Medical Authority

Contents

1 Name

2 Commencement

3 Authority

4 Repeal

5 Application

6 Definitions

7 Kind of injury, disease or death to which this Statement of Principles relates

8 Basis for determining the factors

9 Factors that must exist

10 Relationship to service

11 Factors referring to an injury or disease covered by another Statement of Principles

Schedule 1 - Dictionary

1 Definitions

 

 

1.                Name

This is the Statement of Principles concerning schizophrenia (Reasonable Hypothesis) (No. 27 of 2026).

1.                Commencement

              This instrument commences on 23 March 2026.

1.                Authority

This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.

1.                Repeal

The Statement of Principles concerning schizophrenia No. 83 of 2016 (Federal Register of Legislation No. F2016L01682) made under subsection 196B(2) of the VEA is repealed.

1.                Application

This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies.

1.                Definitions

The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.

1.                Kind of injury, disease or death to which this Statement of Principles relates
2.           This Statement of Principles is about schizophrenia and death from schizophrenia.

Meaning of schizophrenia

1.           For the purposes of this Statement of Principles, schizophrenia means a disorder of mental health meeting the following diagnostic criteria (derived from DSM-5-TR):

2.     Two (or more) of the following, each present for a significant portion of time during a one-month period (or less if successfully treated), at least one being (i), (ii) or (iii):

3.              delusions;

4.          hallucinations;

5.        disorganised speech (for example, frequent derailment or incoherence);

6.          grossly disorganised or catatonic behaviour; or

7.           negative symptoms (that is, diminished emotional expression or avolition).

8.      For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas of life, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic or occupational functioning).

9.      Continuous signs of the disturbance persist for at least six months.  This six-month period must include at least one month of symptoms (or less if successfully treated) that meet Criterion A and may include periods of prodromal or residual symptoms.  During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (for example, odd beliefs, unusual perceptual experiences).

10.     Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either:

11.         no major depressive or manic episodes have occurred concurrently with the active-phase symptoms; or

12.      if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.

13.      The disturbance is not attributable to the physiological effects of a substance (for example, a drug of abuse, a medication) or another medical condition.

14.       If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least one month (or less if successfully treated).

Note: DSM-5-TR is defined in the Schedule 1 – Dictionary.

1.           While schizophrenia attracts ICD‑10‑AM code F20.0-F20.3, F20.5 or F20.9, in applying this Statement of Principles the meaning of schizophrenia is that given in subsection (2).

2.           For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.

Death from schizophrenia

1.           For the purposes of this Statement of Principles, schizophrenia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's schizophrenia.

Note: terminal event is defined in the Schedule 1 – Dictionary.

1.                Basis for determining the factors

The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that schizophrenia and death from schizophrenia can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA.

Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.

1.                Factors that must exist

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting schizophrenia or death from schizophrenia with the circumstances of a person's relevant service:

1.           having experienced as a child (under the age of 18) one of the following;
2.           serious physical, emotional, or sexual harm;
3.           neglect involving a serious failure to provide the necessities for health, physical and emotional development, or wellbeing by adults with obligations to provide such necessities;

before clinical onset;

1.           having viral meningitis, encephalitis or meningoencephalitis, before the age of 16 years, where the clinical onset of schizophrenia occurs within the 15 years following the infection with that viral meningitis, encephalitis or meningoencephalitis;
2.           having a clinical infection in the 5 years before clinical onset by one of the following organisms:
3.           Chlamydia pneumoniae;
4.           Toxoplasma gondii.
5.           having a moderate to severe traumatic brain injury in the 5 years before clinical onset;
6.           having a concussion in the 6 months before clinical onset;
7.           having onset of infection with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in the 1 month before clinical onset;

Note: SARS-CoV-2 is the virus which causes coronavirus disease 2019 (COVID-19).

1.           taking phenelzine before clinical onset;
2.           experiencing a category 1A stressor in the 6 months before clinical onset or clinical worsening;

Note: category 1A stressor is defined in the Schedule 1 - Dictionary.

1.           experiencing a category 1B stressor within the 6 months before clinical onset or clinical worsening;

Note: category 1B stressor is defined in the Schedule 1 - Dictionary.

1.       experiencing the death of a related child within the 5 years before clinical onset or clinical worsening;

Note: related child is defined in the Schedule 1 – Dictionary.

1.       experiencing the death of a parent within the 10 years before clinical onset or clinical worsening, where the person was under the age of 18 at the time of the parent's death;
2.       having cannabis use disorder within the 20 years before clinical onset or clinical worsening;
3.       having used cannabis at least twice a week for a continuous period of at least 6 months before the age of 18 years, within the 20 years before clinical onset or clinical worsening;

Note: This factor includes the use of prescribed cannabis.

1.       having alcohol use disorder or substance use disorder involving a drug or a drug from a class of drugs from Specified List 1 of drugs, within the 5 years before clinical onset or clinical worsening;

Note: Specified List 1 of drugs is defined in the Schedule 1 – Dictionary.

1.       having one of the following clinically significant disorders of mental health at the time of clinical worsening:
2.           acute stress disorder;
3.           alcohol use disorder;
4.           anxiety disorder;
5.           bipolar disorder;
6.           depressive disorder;
7.            eating disorder;
8.           obsessive-compulsive disorder;
9.           panic disorder;
10.             posttraumatic stress disorder;
11.             sleep-wake disorder;
12.           social anxiety disorder; or
13.             substance use disorder;

Note: clinically significant disorder of mental health is defined in the Schedule 1 dictionary.

1.       taking a medication which results in the re-development or worsening of signs or symptoms of schizophrenia, where the treatment with the medication continued for at least the 2 days before clinical worsening;
2.       taking a drug or a drug from a class of drugs from Specified List 2 of drugs in the 30 days before clinical worsening;

Note: Specified List 2 of drugs is defined in the Schedule 1 – Dictionary.

1.       having ceased, reduced or changed antipsychotic drug therapy, in the 7 days before clinical worsening;

2.       inability to obtain appropriate clinical management for schizophrenia before clinical worsening.

3.            Relationship to service

4.           The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.

5.           The clinical worsening aspect of factors set out in section 9 apply only to material contribution to, or aggravation of, schizophrenia where the person's schizophrenia was suffered or contracted before or during (but did not arise out of) the person's relevant service.

6.            Factors referring to an injury or disease covered by another Statement of Principles

In this Statement of Principles:

1.           if a factor referred to in section 9 applies in relation to a person; and

2.           that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(2) of the VEA;

then the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.

 

 

Schedule 1 - Dictionary  

Note:               See Section 6

1               Definitions

In this instrument:

category 1A stressor means one of the following severe traumatic events:

(a)          experiencing a life-threatening event;

(b)          being subject to a serious physical attack, or assault including rape or sexual molestation;

(c)          being threatened with a weapon, being held captive, being kidnapped, or being tortured.

category 1B stressor means one of the following severe traumatic events:

(a)          killing or maiming a person;

(b)          being a witness to a person being killed or critically injured;

(c)          being a witness to atrocities inflicted on another person;

(d)          witnessing human remains or a critically injured casualty, excluding seeing a closed body bag or viewing a body in an open-casket.

Note: witness is defined in the Schedule 1 – Dictionary.

clinically significant disorder of mental health means a disorder of mental health which is of sufficient severity to warrant ongoing management.

Note: To warrant ongoing management does not require that any actual management was received or given for the condition.

DSM-5-TR means the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Text Revision Washington, DC, American Psychiatric Association, 2022.

inhalants means breathable chemicals that produce psychoactive vapours or fumes and include organic solvents, aerosols and anaesthetics.

Note: organic solvents is also defined in the Schedule 1 – Dictionary.

MRCA means the Military Rehabilitation and Compensation Act 2004.

organic solvents means:

(a)          aliphatic hydrocarbon solvents; or

(b)          aromatic hydrocarbon solvents; or

(c)          chlorinated organic solvents; or

(d)          oxygenated organic solvents.

related child means your biological, adopted, step- or foster child.

relevant service means:

(a)          operational service under the VEA;

(b)          peacekeeping service under the VEA;

(c)          hazardous service under the VEA;

(d)          British nuclear test defence service under the VEA;

(e)          warlike service under the MRCA; or

(f)           non-warlike service under the MRCA.

Note: MRCA and VEA are defined in the Schedule 1 - Dictionary.

schizophrenia—see subsection 7(2).

Specified List 1 of drugs means:

(a)          amphetamines and amphetamine-type substances, including methamphetamine and 3,4-methylenedioxymethamphetamine (ecstasy);

(b)          cocaine; or

(c)          opioids.

Specified List 2 of drugs means:

(a)          aciclovir

(b)          aldesleukin;

(c)          amphetamines and amphetamine-type substances, including methamphetamine and 3,4-methylenedioxymethamphetamine (ecstasy);

(d)          anabolic-androgenic steroids;

(e)          bupropion;

(f)           cannabis;

(g)          cocaine;

(h)          ephedrine;

(i)            fenfluramine;

(j)            hallucinogens;

(k)          inhalants;

(l)            interferons;

(m)        mefloquine;

(n)          opioids;

(o)          phencyclidine;

(p)          phenelzine

(q)          phentermine;

(r)           phenylpropanolamine;

(s)           pseudoephedrine; or

(t)            varenicline.

Note: inhalants is also defined in the Schedule 1 – Dictionary.

terminal event means the proximate or ultimate cause of death and includes the following:

(a)           pneumonia;

(b)           respiratory failure;

(c)           cardiac arrest;

(d)           circulatory failure; or

(e)           cessation of brain function.

VEA means the Veterans' Entitlements Act 1986.

witness means a person who experiences an incident at the time it occurs and can give direct evidence of it. This excludes persons exposed only to public broadcasting or mass media coverage of the incident.