Statement of Principles concerning seizure(Balance of Probabilities) (No. 38 of 2022)

The central conceptual elements are the defined condition, the evidential basis, the enumerated factors that can establish causation on the balance of probabilities, temporal windows, definitions that calibrate the clinical thresholds, and cross‑application to other Statements of Principles.

Definition of seizure. Section 7(2) defines seizure as an acute, nonrecurring episode of paroxysmal brain dysfunction due to sudden, abnormal, excessive neuronal discharge manifesting as seizure. The definition explicitly includes status epilepticus and excludes a number of conditions such as psychogenic seizures, movement disorders (for example restless legs syndrome and chorea), muscle dystonia or spasms associated with tetanus, drugs or chemical poisons, seizures occurring during electroconvulsive therapy and spontaneous movements associated with syncope, vertigo or migraine (s 7(2)(a)-(c)). The instrument therefore confines itself to acute paroxysmal neuronal events and excludes functional or non-epileptic events and certain iatrogenic or secondary movement phenomena.

Death from seizure. Section 7(3) provides that seizure, in relation to a person, includes death from a terminal event or condition that was contributed to by the person’s seizure. The instrument defines terminal event in Schedule 1 and provides examples such as pneumonia, respiratory failure, cardiac arrest and cessation of brain function. This makes clear that fatal outcomes with a seizure contribution fall within the scope of the Statement.

Evidential basis and standard. Section 8 records the Authority’s view, grounded in the medical‑scientific evidence it considered, that seizure and death from seizure can be related to relevant service on the balance of probabilities. This situates the Statement as an evidentiary template used to meet the statutory standard for causation in claims under the VEA and MRCA.

Enumerated factors and temporal limits. Section 9 lists the factors which must be present before it can be said, on the balance of probabilities, that seizure or death from seizure is connected with relevant service. The factors are specific and carry precise temporal windows: for example, moderate to severe traumatic brain injury within 10 years of clinical onset (s 9(1)); concussion within 3 months of onset (s 9(2)); electrical injury (s 9(3)); brain radiotherapy (s 9(6)); infections of brain or meninges within 6 months (s 9(10)); hypoxic cerebral insult within 30 days (s 9(7)); exposure to certain drugs within 24 hours (s 9(31)); reduction of chronically administered sedative drugs within 2 weeks (s 9(34)); and many others. Those temporal thresholds are part of the causal calculus the Authority prescribes.

Precision through definitions. Schedule 1 supplies clinical and operational definitions that matter for the application of section 9. Examples: hypoglycaemia is defined as serum glucose less than 3 mmol/L; hyperglycaemia as greater than 17 mmol/L; sleep deprivation is quantified as not sleeping within 36 hours after the end of the last period of 4 hours or more of uninterrupted sleep or having less than 4 hours sleep for three consecutive 24‑hour periods. Other definitions list specified medical conditions, metals, and the contents of Schedule 2.

Cross‑referencing. Section 11 requires that, where a factor in section 9 refers to an injury or disease covered by another Statement of Principles, the factors in that other Statement apply in accordance with their terms. This creates a hierarchical or networked framework where multiple Statements may interact for a single claim.

Scope and exclusions. Several notes in the instrument limit scope: electrical injury excludes transcranial magnetic stimulation and electroconvulsive therapy (note to s 9(3)); general anaesthetics are mostly included in Schedule 2 but ketamine is excluded from the general anaesthetics exclusion in Schedule 2 (Schedule 2 note). These carve‑outs will be relevant in assessing causation for claims associated with medical or therapeutic exposures.

Primary affected persons. The instrument applies to claimants whose claims fall within s 120B of the Veterans’ Entitlements Act 1986 or s 339 of the Military Rehabilitation and Compensation Act 2004, as stated in section 5. That means veterans and members of the Forces who have relevant service as defined in Schedule 1 , eligible war service, defence service (other than hazardous service and British nuclear test defence service) under the VEA, or peacetime service under the MRCA. Consequently, the main affected cohort comprises persons seeking statutory entitlements under the VEA or MRCA where seizure or death from seizure is alleged to be connected with service.

Clinical practitioners and treating services. The instrument creates detailed evidentiary predicates that clinicians, hospitals and diagnostic services will need to document when treating personnel who later pursue claims. Examples: operative records for craniotomy or cranioplasty (s 9(4)); radiotherapy records (s 9(6)); biochemical or haematological laboratory evidence for metal poisoning (s 9(37) and Schedule 1); serum glucose levels for hypo‑ or hyperglycaemia (Schedule 1); neuroimaging or histopathology demonstrating intracranial space‑occupying lesions (s 9(13) and Schedule 1). The precise definitions in Schedule 1 mean that clinical documentation must align to the thresholds set out in the instrument to be capable of establishing a listed factor.

Decision makers and adjudicators. Administrative decision makers who determine claims under the VEA and MRCA will apply this Statement as the medical template for establishing a disease‑service nexus on the balance of probabilities (s 3, s 5 and s 8). The Repatriation Medical Authority’s statement of the medical‑scientific view in s 8 sets the evidentiary baseline that tribunals and internal reviewers will use in assessing causation.

Dependants and executors in fatal cases. The definition of death from seizure in s 7(3) and the inclusion of terminal events in Schedule 1 mean that beneficiaries pursuing death‑related entitlements (for example, survivors’ benefits where statute allows) must consider the instrument’s criteria and collect evidence of seizure contribution to terminal events such as pneumonia or respiratory failure.

Interacting instruments and health regulators. Where a listed factor is itself covered by a different Statement of Principles (for example, traumatic brain injury or specific infections), section 11 requires the factors in that other Statement to be applied. This places an evidential and procedural interaction between multiple Statements, potentially increasing the complexity of claims that involve multi‑system pathology.

Who does not fall within the scope. Persons whose clinical events are expressly excluded by the instrument’s definitions are affected in a negative sense: psychogenic seizures, seizures during electroconvulsive therapy, movement disorders and spontaneous movements associated with syncope or migraine are excluded by s 7(2)(c). Moreover, the instrument applies only to claims under the specified statutory provisions; seizure cases outside those claims, whether private insurance or other compensation schemes, are not governed by this instrument.

This instrument is primarily an evidentiary tool. It does not impose positive criminal or civil duties, nor does it itself create entitlements. Rather, it prescribes the medical factors that decision makers will treat as sufficient to establish a causal connection between seizure (or death from seizure) and relevant service on the balance of probabilities. The principal operational obligations and entitlements that flow from the instrument are therefore procedural and evidentiary.

Duty to establish at least one listed factor. For a claimant to satisfy the Statement’s threshold, at least one of the factors in section 9 must be present and related to the relevant service rendered by the person (s 9 and s 10(1)). Practically, this places a duty on claimants and their representatives to marshal clinical and documentary evidence that a listed factor existed within the temporal window stated and that the factor is connected to service.

Duty to relate factors to relevant service. Section 10(1) requires the existence in a person of any factor referred to in section 9 to be related to the person’s relevant service. That is a condition precedent: even if a listed factor is present in the person’s medical history, the claimant must demonstrate (via factual evidence and chronology) that the factor is linked to service. The instrument does not specify the quantum of evidence required to prove the relationship; it sets the medical framework for the link while the statutory claims process determines proofs.

Specific limitation on the “inability to obtain appropriate clinical management” factor. Section 9(40) is a listed factor encompassing inability to obtain appropriate clinical management for seizure. Section 10(2) limits the operation of that factor to material contribution to, or aggravation of, seizure where the seizure was suffered or contracted before or during, but did not arise out of, the person’s relevant service. This creates a narrower application for s 9(40) than for other factors, and therefore claimants relying on inadequate medical care must show the temporal and causative relationship described in s 10(2).

Right to rely on other Statements of Principles. Section 11 creates a right for claimants to have factors in other Statements of Principles applied where a section 9 factor is an injury or disease covered by another Statement. In practical terms this allows the cross‑application of complementary medical Statements, but it also means claimants must be alert to the content and terms of other Statements and ensure evidence meets their specific requirements.

Prescriptive operational definitions. Schedule 1 provides clinical thresholds and lists (for example definitions of hypoglycaemia, hyperglycaemia, sleep deprivation, specified metals and specified medical conditions). These definitions operate as standards claimants must meet when presenting laboratory or clinical evidence. For instance, hypoglycaemia is less than 3 mmol/L and hyperglycaemia greater than 17 mmol/L (Schedule 1). Claimants and clinicians should align reporting to these benchmarks if they intend to rely on those triggers.

No penalties or new enforcement powers within the instrument. The Statement does not create sanctions for non‑compliance or new enforcement powers. It functions within the claims adjudication framework of the VEA and MRCA (s 3 and s 5). Any duties to provide information or evidence to the Department of Veterans’ Affairs or other statutory bodies derive from those Acts rather than from this instrument itself.

Evidentiary consequence of Schedule 2 drugs. Section 9(31) makes taking a drug that appears in Schedule 2 within 24 hours before clinical onset of seizure a factor. Section 9(32) gives an alternative drug-related factor where an individual developed a seizure within 24 hours of first taking a drug and had redevelopment of seizure on rechallenge with the same drug. Those provisions confer an evidentiary right: properly documented temporal association or rechallenge evidence may be treated as proof of causation if also related to relevant service under s 10.

The Statement of Principles is not a penal instrument and contains no penalty provisions. It is an evidentiary instrument, created under subsection 196B(3) of the Veterans’ Entitlements Act 1986, to guide the medical causation analysis in claims under section 120B of the VEA and section 339 of the Military Rehabilitation and Compensation Act 2004 (s 3 and s 5). It does not itself confer investigative, sanctioning or enforcement powers.

How enforcement occurs in practice. Enforcement in the sense of ensuring correct application falls to the statutory decision makers and appeals mechanisms established by the VEA and MRCA and their respective administrative review processes. The Statement is a determinative tool for those decision makers when they assess whether a seizure or death from seizure is connected with relevant service on the balance of probabilities (s 8 and s 9). If a decision maker fails to apply the Statement properly, the remedy would lie within the review and appeal channels provided by the primary statutes, not within this instrument.

Documentary and evidentiary obligations. While the Statement does not itself impose duties to produce documents, its content creates practical evidentiary obligations for claimants and clinicians. For example, many factors are time‑limited and defined by laboratory or clinical thresholds (see s 9 and Schedule 1). To prove the existence of a listed factor, claimants will need contemporaneous medical records, surgery notes, imaging, laboratory results, toxicology, medication charts, anaesthetic records, transplant documentation, and other relevant clinical material. Failure to produce evidence meeting the instrument’s definitions will impede the claimant’s ability to satisfy the causation test.

No specified penalties for misstatement. The instrument contains no provision imposing penalties for misrepresentation or false statements. Any legal consequences for false evidence would arise from applicable general laws outside this Statement, such as criminal or civil offences concerning fraudulent claims or false statements under the VEA, MRCA, or general criminal law.

Burden of proof and decision standard. The Statement reflects the medical view that seizure and death from seizure can be connected to service on the balance of probabilities (s 8). The balance of probabilities is the civil standard that applies in claims determinations. The instrument identifies factors that, if established and connected to service, satisfy that standard; it does not alter the standard or provide a different legal test. The decision maker still applies procedural rules in the governing Act when making determinations.

Interaction with other statutory obligations. Because the Statement applies in the context of statutory schemes, enforcement and compliance are shaped by those Acts. For example, the requirement in s 11 that factors covered by another Statement are governed by that Statement means decision makers will enforce the relevant medical criteria across instruments, but again via mechanism provided in the underlying Acts.

Statutory frame. The Statement is made under subsection 196B(3) of the VEA (s 3). Section 5 states it applies to claims to which s 120B of the VEA or s 339 of the MRCA applies. That situates the instrument within the statutory claims regime. The Statement therefore operates as a medical determinative instrument used by tribunals and decision makers acting under the VEA and MRCA and must be interpreted and applied in the context of those statutes and their procedural rules.

Cross‑application to other Statements of Principles. Section 11 provides explicit interaction mechanics: where a section 9 factor refers to an injury or disease that is itself the subject of 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. This creates a network in which multiple Statements can be invoked and where the terms of other Statements may be operative for particular factors. Practitioners must therefore consult not only this Statement but any other relevant Statements that cover the same injury or disease.

Relationship to clinical and administrative law. The instrument sets medical standards and definitions. Administrative decision makers under the VEA and MRCA use those standards to reach statutory determinations. Any challenge to the application of a Statement will proceed through the administrative review, merits review or judicial review routes authorised by the underlying statutes. The Statement itself does not amend or displace those processes.

Interaction with other regulatory regimes. The Statement references medical treatments and exposures that may be regulated under other regimes for safety, licensing and professional conduct. Examples include surgical procedures (craniotomy), radiotherapy and organ transplantation. Those regulatory regimes remain in force; this Statement does not modify clinical standards, but it does translate certain clinical events and therapeutic exposures into causal criteria for statutory claims.

Compatibility with evidentiary standards. The Statement is a device for establishing causation in claims; it prescribes temporal windows and concrete clinical thresholds (Schedule 1). The evidential materials required to meet those thresholds must satisfy the civil standard of proof. Where laboratory values, imaging, medication records or operative notes are required to meet a Schedule definition, those materials will be admitted and evaluated in accordance with the evidentiary rules applicable to the claim process under the VEA and MRCA.

Implications for insurance and private compensation schemes. The Statement is formally limited to the VEA and MRCA claims universe (s 5), and it does not bind private insurers, workers compensation schemes, or other statutory compensation regimes. However, the clinical definitions and temporal windows may be persuasive in other contexts. The instrument contains no provision purporting to apply outside its statutory ambit.

Repeal and supersession. Section 4 repeals the prior Statement of Principles concerning epileptic seizure No. 78 of 2013. That is an explicit interaction with past subordinate instruments. For claims that span the transitional period or where historic medical events are assessed, practitioners must be attentive to which Statement was in force at the time of determination and how the repeal interacts with pending claims procedures under the VEA and MRCA.

Definitions anchoring statutory terms. The instrument defines MRCA, VEA and relevant service in Schedule 1. Those definitions are relevant because the terms “relevant service” and the statutory Acts determine the instrument’s scope (s 5). The Statement therefore interacts with the broader statutory architecture by relying on and reinforcing the statutory language.

This instrument identifies a precise amendment event within itself: it repeals the earlier Statement of Principles concerning epileptic seizure No. 78 of 2013 (Federal Register of Legislation No. F2013L01899) made under subsection 196B(3) of the VEA (s 4). The new instrument is dated 29 April 2022 and commences on 30 May 2022 (sections 1 and 2 and the instrument front matter). No other amendments, schedules or variations are recorded in the text provided.

Because the instrument is itself a delegated subordinate instrument created under the VEA, any future amendments would follow the statutory processes for Statements of Principles set out in the VEA, and the instrument’s note in section 11 anticipates that other Statements may be varied “from time to time”. The instrument does not list earlier amending instruments or an amendment schedule beyond the repeal of the 2013 Statement.

Practitioners should therefore note the following concrete, documentable milestones in the instrument’s lifecycle, as stated in the text:

• Instrument made by the Repatriation Medical Authority and dated 29 April 2022 (front matter).
• Commencement date of 30 May 2022 (s 2).
• Repeal of the Statement of Principles concerning epileptic seizure No. 78 of 2013 (s 4).

There is no additional amendment history recorded in the instrument itself. The instrument’s text anticipates that other Statements of Principles may be “in force from time to time” (s 11), implying that this instrument may operate alongside other Statements which themselves may be amended. Therefore, while the present instrument has a single discrete amendment event (the repeal), the operational amendment environment is dynamic and requires active checking of the Federal Register of Legislation and the Repatriation Medical Authority’s publications for later modifications or substitutions.

For practitioners handling historic claims, be alert to the commencement and repeal dates because the timing of events and determinations may influence which Statement applied to a particular claim or stage of proceedings. The instrument does not contain transitional provisions; where transitional questions arise, the relevant statutory provisions and administrative practice will determine whether the new Statement applies.

The instrument as provided contains no litigation history. It names no cases, records no judicial consideration, and contains no annexed legal opinions. Because the instrument is an administrative medical instrument used in the adjudication of statutory claims, any challenges to its application would ordinarily arise within the administrative review or judicial review processes attendant on determinations under the VEA and MRCA.

Absent any cases cited in the instrument, practitioners should not assume judicial endorsement or disapproval of the Statement’s content. Whether courts or tribunals will treat the Statement as determinative, persuasive, or open to contest on particular factual matrices is a matter for case law which is not contained in this instrument. The Statement does not, in itself, record any precedent or litigation outcomes.

Practical implication. In the absence of litigation references in the text, prospective litigants and advisers should take the Statement as the Repatriation Medical Authority’s statement of medical opinion on causation and treat it as the primary instrument for medical causation in relevant claims. Any argument about the Statement’s legal status, reasonableness, scope or compatibility with the underlying statutes must be developed in external judicial or tribunal proceedings. Those proceedings are not depicted in this document.

Recommended steps for researchers. To establish litigation history, practitioners must consult administrative appeal records, tribunal and court databases, and decisions repositories that record determinations under the VEA and MRCA. The instrument makes clear it interacts with other Statements (s 11) so case law addressing interactions between Statements of Principles may also be relevant, but none is referenced here.

Strict temporal windows and first‑seizure rules. Many factors in section 9 are subject to precise temporal limits. Examples include traumatic brain injury within 10 years of clinical onset (s 9(1)); concussion within 3 months (s 9(2)); hypoxic cerebral insult within 30 days (s 9(7)); infections of the brain or meninges within 6 months (s 9(10)); and a drug appearing in Schedule 2 taken within 24 hours of onset where, if multiple seizures occur, the first seizure must have occurred within 24 hours of taking the drug (s 9(31)). Practitioners and claimants must ensure temporal alignment of the clinical event with the stated windows. Where multiple seizures occur, the instrument repeatedly conditions certain factors on the timing of the first seizure; failing to establish the timing of the first event can defeat reliance on the factor.

Narrow clinical definitions. Schedule 1 contains operational definitions with numeric thresholds. Hypoglycaemia is defined as serum glucose less than 3 mmol/L and hyperglycaemia as greater than 17 mmol/L. Sleep deprivation has a specific definition tied to hours of sleep. These are not descriptive glosses; they are the definitions the Authority uses. Evidence must show those thresholds to invoke the relevant factor.

Exclusions within the core definition. Section 7(2)(c) excludes psychogenic seizures, movement disorders and seizures during electroconvulsive therapy from the instrument’s scope. Where claimants’ events fall within these exclusions, this Statement will not assist in establishing service connection for seizure. For example, seizures occurring during electroconvulsive therapy are excluded despite being paroxysmal events.

Interaction with other Statements. Section 11 provides that if a factor refers to an injury or disease covered by another Statement of Principles, then the factors in that other Statement apply as in force from time to time. That means a factor listed here may import a different or additional evidentiary framework, possibly with different temporal windows or definitions. Missing to consult related Statements can lead to incomplete evidentiary submissions.

Drug‑related subtleties. Schedule 2 is a long, but specific, list of drugs. Section 9(31) requires that a specified drug was taken within 24 hours before clinical onset, and if multiple seizures occur, the first seizure must have occurred within 24 hours of taking the drug. Section 9(32) creates a separate pathway where an individual developed a seizure within 24 hours of first taking a drug and redeveloped seizure on rechallenge. Rechallenge evidence is relatively rare and may be ethically and clinically problematic. Claimants who rely on rechallenge must produce clear documentation; absence of rechallenge evidence will force reliance on s 9(31) timing.

Electroconvulsive therapy and transcranial magnetic stimulation excluded from electrical injury. The note to s 9(3) excludes transcranial magnetic stimulation and electroconvulsive therapy from the definition of electrical injury of the brain. Cases where a seizure follows these procedures cannot be established under s 9(3) as an electrical injury factor.

Factor 9(40) limited in application. The inability to obtain appropriate clinical management is included as a factor (s 9(40)) but section 10(2) confines this factor to cases where the seizure was suffered or contracted before or during, but did not arise out of, relevant service. The limitation means s 9(40) cannot be used to claim that inadequate management during service caused an initial seizure that arose out of service; it is available only for material contribution or aggravation in the specific temporal circumstances described.

Requirement for demonstrative evidence in some factors. For example, s 9(37) requires poisoning with a metal from the specified list as demonstrated by clinical, haematological or biochemical evidence; Schedule 1 lists lead, nickel and tungsten. Mere suspicion of exposure will be insufficient without supportive laboratory or clinical data.

Overlap with underlying statutory tests. The Statement does not alter statutory entitlement tests in the VEA or MRCA. It sets the medical criteria for causation. If a claimant satisfies a listed factor and shows relation to relevant service per s 10, decision makers still apply statutory requirements and procedural rules in the primary Acts. Confusion between the Statement’s medical thresholds and statutory legal requirements is a common pitfall.

Ambiguities around “relevant service” timing. The instrument defines “relevant service” in Schedule 1 but does not itself resolve complex temporal questions about when an exposure or diagnosis can be linked to a period of service. Claimants must map clinical timelines against their service record to ensure the requisite relation to relevant service per s 10(1).

No penalties or enforcement provisions. Users sometimes expect a Statement to impose sanctions for non‑compliance or to create administrative obligations. This instrument does neither; its operational effect arises only through use in claims processes.

Evidence collection aligned to listed factors. To rely on this Statement when making or supporting a claim, assemble objective, contemporaneous clinical documentation that aligns to the specific factor relied upon. Examples include:

• Traumatic brain injury or concussion: hospital records, emergency department notes, imaging reports, Glasgow Coma Scale scores, rehabilitation records, and dated clinical notes that establish both severity and timing relative to seizure onset (s 9(1) and s 9(2)).
• Surgical procedures (craniotomy/cranioplasty): operative reports, anaesthetic records, theatre notes and discharge summaries with dates showing the procedure within 10 years of clinical onset (s 9(4)).
• Radiotherapy: radiotherapy plans, treatment dates and fields confirming brain radiotherapy prior to seizure onset (s 9(6)).
• Infectious or autoimmune causes: microbiology, CSF analysis, serology, neuroimaging and immunological testing to establish infection of brain or meninges within 6 months (s 9(10)), or autoimmune encephalitis at time of onset (s 9(9)).
• Hypoxic cerebral insult: documentation of events causing sustained decreased cerebral flow or oxygen content, with timing within 30 days of seizure onset (s 9(7) and Schedule 1 definition).
• Metabolic and toxic causes: laboratory results demonstrating serum glucose levels, electrolytes, liver and renal function tests to satisfy hyper/hypoglycaemia or electrolyte abnormality definitions (s 9(22)-(25) and Schedule 1 thresholds).
• Drug exposures and rechallenges: medication administration records, pharmacy dispensing records, emergency department drug screens, and documentation of temporal relationship to first seizure and any rechallenge (s 9(31)-(32) and Schedule 2).
• Metals and neurotoxins: haematological and biochemical testing confirming lead, nickel or tungsten levels, or toxicology confirming neurotoxic substances within 24 hours of seizure onset (s 9(37)-(38) and Schedule 1).
• Sleep deprivation and alcohol: contemporaneous nursing notes, driving logbooks, unit rosters, deployment logs or clinical notes to show sleep deprivation definition criteria or documented alcohol intoxication/withdrawal patterns (s 9(16) and Schedule 1 definitions).
• Decompression and hyperbaric exposures: diving records, hyperbaric treatment records, or employment logs confirming exposure to relevant pressures within 24 hours (s 9(35)-(36)).

Map service records to medical timelines. Section 10(1) requires that any factor be related to the person’s relevant service. When preparing a claim, create a chronology that links clinical events with service dates, postings or deployments. Include service medical records, unit diaries, incident reports and contemporaneous notes that confirm the occurrence of relevant exposures or events during service.

Attend to definitions and numerical thresholds. Where Schedule 1 supplies numeric thresholds , for example, hypoglycaemia <3 mmol/L, hyperglycaemia >17 mmol/L, chronic renal failure criteria or sleep deprivation parameters , ensure laboratory reports, clinical measurements and narrative notes explicitly record values and timings that meet those thresholds.

Use other Statements where required. If a factor in s 9 refers to an injury or disease governed by another Statement of Principles, review and comply with that Statement’s requirements as mandated by s 11. That may require additional tests, specific imaging, or different temporal proofs. Check the Repatriation Medical Authority’s database for relevant, current Statements.

Document first seizure timing when multiple seizures occur. Several factors condition applicability on the timing of the first seizure relative to exposure (for example s 9(31) and s 9(33)). If multiple seizures have occurred, ensure records identify the first event and its timing unequivocally.

Corroborate rechallenge evidence with extreme caution. Section 9(32) requires that seizure develops within 24 hours of first taking a drug and redevelops on rechallenge. Because deliberate rechallenge is often clinically inadvisable, practitioners should rely on inadvertent rechallenge documented in records rather than attempting induced rechallenge.

Prepare for cross‑disciplinary evidence. Claims often require combined clinical, laboratory, toxicological, surgical and occupational/service evidence. Coordinate with treating clinicians, pathologists and employers or unit records custodians to assemble a single, referenced bundle.

Address s 9(40) carefully. If relying on inability to obtain appropriate clinical management, ensure that the claimant’s seizure was suffered or contracted before or during (but did not arise out of) relevant service, as required by s 10(2). Produce records showing attempts to obtain care, referrals, local resource limitations and any contemporaneous reports of inadequate access to care.

Quality control and format. Provide certified copies of hospital discharge summaries, laboratory printouts with reference ranges, imaging reports with DICOM headers or date stamps, operative notes with surgeon identification, pharmacy dispensing logs, and service records showing dates and places of exposure. Where possible include the clinician’s commentary linking the factor to seizure onset, and ensure that all material is dated and legible.

Legal and procedural steps. File claims under the VEA or MRCA provisions specified (s 5). Familiarise yourself with the procedural rules and evidence admissibility standards of the relevant statutory adjudicative body. Use the Statement as the medical foundation for causation arguments but ensure that legal submissions address statutory tests, evidential sufficiency and any requirements in the governing Act.

Review for gaps. Before lodging a claim, run the evidence against a checklist derived from section 9 and Schedule 1. Confirm that at least one factor is present, temporally aligned, and related to relevant service per s 10. If no single factor can be established, consider whether the facts might instead engage another Statement of Principles referenced in s 11.

Keep abreast of updates. Although this instrument repealed the 2013 Statement, other Statements may be amended. Review the Federal Register of Legislation and the Repatriation Medical Authority’s publications to ensure the Statement in force at the time of determination is the one relied upon.