Statement of Principles concerning seizure (Reasonable Hypothesis) (No. 37 of 2022)

The instrument rests on a small set of organising concepts: seizure (and death from seizure), reasonable hypothesis, relevant service, listing of contributory factors, temporal proximity rules, cross-references to other SoPs, and statutory authority.

Definition of seizure: The SoP defines seizure as “an acute, nonrecurring episode of paroxysmal brain dysfunction due to sudden, abnormal, excessive neuronal discharge manifesting as seizure” and explicitly includes status epilepticus while excluding certain entities (psychogenic seizures, electroconvulsive therapy seizures, movement disorders, dystonia/spasm from tetanus/drugs/poisons, and spontaneous movements with syncope, vertigo or migraine) (s 7(2)). The Dictionary in Schedule 1 cross‑references “seizure,see subsection 7(2)”. This is a core definitional choice: the instrument addresses an acute, nonrecurring event rather than chronic recurrent epilepsy per se. Death from seizure is included where the seizure contributed to a terminal event or condition; the instrument defines “terminal event” in Schedule 1 (s 7(3), Schedule 1).

Reasonable hypothesis and burden: The SoP is expressly intended to identify the factors which, if present, “must as a minimum exist before it can be said that a reasonable hypothesis has been raised” linking seizure or death from seizure to relevant service (s 9). That phrase indicates the SoP’s role as an evidentiary threshold within VEA/MRCA decision-making: the presence of at least one listed factor with the required temporal or clinical relationship will meet the statutory minimal threshold to raise a reasonable hypothesis that service contributed.

Relevant service and relationship rules: “Relevant service” is defined broadly in Schedule 1 and includes operational, peacekeeping, hazardous and British nuclear test defence service under the VEA and warlike and non‑warlike service under the MRCA. The factors in s 9 must be related to the person’s relevant service (s 10(1)). A specific rule narrows the application of s 9(40) (inability to obtain appropriate clinical management) to circumstances where the seizure was suffered or contracted before or during, but did not arise out of, relevant service (s 10(2)).

Factor list and temporal windows: Section 9 provides a detailed list of 40 distinct factors, each carrying specific timing or clinical requirements. Examples: moderate to severe traumatic brain injury within 20 years before clinical onset (9(1)); concussion within six months (9(2)); electrical injury of the brain (9(3)); craniotomy/cranioplasty within 20 years (9(4)); brain radiotherapy for neoplasia (9(6)); infections of brain or meninges within one year (9(10)); HIV infection at time of onset (9(11)); alcohol intoxication/withdrawal or moderate to severe alcohol use disorder at time of onset (9(16)); specified drugs taken within 24 hours before onset (9(31)); exposure to hyperbaric oxygen above defined partial pressures within 24 hours (9(35)); and inability to obtain appropriate clinical management (9(40)). The instrument supplies further definitional detail in Schedule 1 (for example clinical thresholds for hypoglycaemia and hyperglycaemia), and Schedule 2 enumerates specified drugs referenced in s 9(31).

Cross‑statement interaction: Where a factor refers to an injury or disease that is already the subject of another SoP, the other SoP’s factors apply in accordance with that SoP as in force from time to time (s 11). The instrument therefore operates in a matrix with other SoPs: some listed factors may themselves require application of other Statements rather than direct application of s 9.

Exclusions and notes: The instrument contains explicit exclusions (for example seizures due to ECT and psychogenic seizures in s 7(2)(c)) and notes clarifying scope (for example electrical injury excludes transcranial magnetic stimulation and ECT; radiographic contrast media examples in s 9(33) note). These may bear on evidentiary gathering and dispute about classification.

Primary affected populations: The instrument applies to claimants bringing matters under section 120A of the VEA or section 338 of the MRCA (s 5). That means veterans, members of the Forces, and members of Peacekeeping Forces whose service meets the statutory “relevant service” definitions in Schedule 1 (operational, peacekeeping, hazardous, British nuclear test defence service under the VEA; warlike and non‑warlike service under the MRCA). The SoP is therefore targeted at persons making claims for service connection for seizure or death from seizure within those statutory schemes.

Decision-makers and agencies: The RMA issues the SoP (s 3), but it is utilitised by the departmental decision-makers responsible for assessing VEA/MRCA claims and by review bodies and tribunals that consider appeals. The SoP provides the medical‑scientific catalogue the decision-maker uses to determine whether a reasonable hypothesis has been raised. It changes what evidence and medical findings are likely to be decisive when adjudicators apply the “reasonable hypothesis” test.

Health professionals: Medical practitioners, forensic pathologists and treating clinicians will be affected in practice because the SoP specifies clinical thresholds and definitions,such as the serum glucose cut‑offs for hypo‑ and hyperglycaemia, definitions for sleep deprivation, and the classification of certain vascular lesions and diseases (Schedule 1). Clinicians preparing reports for claimants or for the Department will need to address whether the listed factors are present and within the required temporal windows.

Claims support actors and lawyers: Lawyers, advocates and medical-legal experts advising claimants must align evidence strategies with the SoP’s list and definitions. The need to show a listed factor and a relevant service link means evidence collection plans will focus on military service records, operative notes (for craniotomies), radiotherapy records, medication histories (including exact timing of first dose or rechallenge), toxicology, imaging, and contemporaneous hospital records indicating, for example, hypoxic insults, infections, or metabolic derangement.

Indirectly affected parties: Defence health records custodians, civilian hospitals that treated veterans, and records retrieval services will be routinely engaged. The instrument’s strict temporal windows (eg 24‑hour windows for many exposures, 20‑year windows for some neurosurgical or traumatic brain injuries) mean accurate and retrievable dates and times for exposures and clinical onsets are critical.

Scope limitations on populations: Because the instrument defines seizure as an acute, nonrecurring event (s 7(2)), recurrent epileptic disorders may fall outside the single-event focus of this SoP. The repealed 2013 Statement was entitled “epileptic seizure”; the repeal (s 4) and the present definition may shift how chronic seizure disorders are approached, and claimants with recurrent epilepsy may need to rely on other Statements or evidentiary routes if applicable. The SoP itself does not create new entitlements; it prescribes the elements for raising a reasonable hypothesis within the existing statutory frameworks.

Duties of the Repatriation Medical Authority: The RMA’s duty under the instrument is to declare the Statement of Principles under subsection 196B(2) of the VEA (s 3). The SoP also includes the RMA’s view that there is sound medical‑scientific evidence supporting links between seizure/death from seizure and relevant service (s 8). The RMA’s role is to set the medical criteria which decision-makers must use in applying the “reasonable hypothesis” standard under the VEA and MRCA claims processes.

Duties of decision-makers: The instrument does not itself command conduct by the Department, but it prescribes the medical factors that “must as a minimum exist” before a reasonable hypothesis can be said to be raised (s 9). Administrative decision-makers and tribunals will therefore have the duty to assess whether the claimant’s evidence establishes at least one of the specified factors (with the required temporal relationship) and whether that factor is related to relevant service (s 10(1)). Where a factor refers to an injury or disease subject to another SoP, the decision-maker must apply that other SoP in accordance with its terms (s 11).

Rights of claimants: Claimants have the right to have their claim assessed against the SoP criteria. If the claimant adduces evidence establishing at least one listed factor in the timeframes and showing a relation to relevant service, a reasonable hypothesis will be raised under the statutory test. The SoP thereby identifies the minimum clinical and temporal evidence a claimant needs to produce to get past the reasonable hypothesis threshold, a procedural right within the VEA/MRCA schemes.

Evidentiary duties: Implicitly, claimants bear the duty to produce or authorise production of medical and service records that demonstrate the existence of a listed factor and its time relationship to the clinical onset of seizure. The Dictionary supplies clinical thresholds for certain factors (eg hypoglycaemia <3 mmol/L, hyperglycaemia >17 mmol/L, sleep deprivation defined by specific sleep-loss criteria), and these create concrete evidentiary yardsticks the claimant must meet.

Interaction and referral duties: Where a factor in s 9 refers to a disease already covered by another SoP, the decision-maker must follow the terms of that other SoP (s 11). This creates a duty on decision-makers to identify cross-references and to ensure the correct SoP is applied rather than simply treating the listed factor as freestanding.

No criminal penalties or private civil liabilities in the instrument: The SoP does not create criminal offences or civil penalty regimes. It sets administrative criteria for raising a reasonable hypothesis in claims processes; it does not provide for enforcement against third parties or create private causes of action.

Procedural rights around repeal and commencement: The instrument repeals the earlier epileptic seizure SoP (s 4) and commences on 30 May 2022 (s 2). Claimants and advisers have the procedural right to have claims assessed under the SoP in force at the relevant time of decision; the repeal and commencement dates are therefore material to which instrument applies to a given claim.

The instrument itself contains no penalties, fines, or criminal sanctions. It is not framed as a regulatory instrument imposing conduct obligations subject to administrative penalties; rather, it is a medical‑scientific Statement of Principles made under subsection 196B(2) of the VEA to be used in adjudicating eligibility for entitlements under the VEA and MRCA (s 3, s 5). As such, enforcement is indirect: the SoP informs decision-making about whether a “reasonable hypothesis” connecting seizure or death from seizure to relevant service has been raised. That finding then influences entitlement determinations, which can result in a grant or denial of benefits under the VEA or MRCA frameworks.

Administrative consequence, not criminal sanction: The primary enforcement mechanism is administrative adjudication. If claimants cannot establish any of the factors in s 9 (or cannot show the required relationship to relevant service under s 10), the decision-maker will be entitled to conclude that no reasonable hypothesis has been raised, and the claim could be rejected. Conversely, establishing a listed factor meeting the SoP’s criteria will raise a reasonable hypothesis, requiring the decision-maker to consider whether the statutory causal connection is established for liability under the VEA or MRCA.

Review and appeals: Although the SoP does not itself provide enforcement mechanisms, decisions that apply the SoP will be subject to the usual review and appeal routes under the VEA and MRCA regimes. The instrument’s interplay with administrative decision-making means that disagreements about whether a listed factor exists, whether it meets the dictionary definitions, or whether it is related to relevant service will be litigated or reviewed within the administrative and tribunal systems provided by the VEA/MRCA.

Compliance and evidentiary effect: The SoP’s specified definitions and temporal windows carry practical enforcement implications. Decision-makers will judge compliance with the SoP by reference to documentary and medical evidence (operation reports, radiotherapy records, blood glucose measurements, drug administration records, toxicology, imaging, etc). Failure by claimants to produce this evidence will make it harder to satisfy the SoP’s minimal thresholds, which in practice enforces a requirement to produce clinical documentation.

No direct sanction against third parties: The instrument does not create obligations enforceable against hospitals, clinicians, employers or other third parties beyond those that might already exist under other laws. It does not, for example, impose duties on treating clinicians to provide reports. The practical effect is that claimants will need to marshal cooperation and records from third parties; inability to obtain those records is not penalised by the SoP, but will affect the claimant’s prospects of meeting the minimal criteria.

Relevance of repeal: The repeal of the earlier epileptic seizure SoP (s 4) changes the administrative landscape; claims decided after 30 May 2022 will be assessed against this instrument. There are no transitionary penalty provisions in the instrument concerning claims decided under the prior SoP; the commencement and repeal dates govern which SoP applies.

Statutory framework: The instrument is made under subsection 196B(2) of the VEA (s 3) and applies to claims under section 120A of the VEA or section 338 of the MRCA (s 5). It therefore sits within the statutory architecture of the VEA and the MRCA, where SoPs issued by the RMA are used as medical-scientific guides for raising a reasonable hypothesis linking an injury or disease to relevant service.

Other Statements of Principles: Section 11 creates a direct legal interaction with other SoPs. If a factor in section 9 “refers to an injury or disease in respect of which a Statement of Principles has been determined” under 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.” Practically this means that where s 9 references, for example, a brain infection that is itself the subject of a dedicated SoP, decision-makers must apply the other SoP’s factors rather than treating the s 9 entry as self-contained. The instrument therefore creates a network of cross-references among SoPs which must be navigated in claims adjudication.

Repeal of previous SoP: The instrument expressly repeals the earlier “epileptic seizure” SoP No. 77 of 2013 (s 4). That repeal changes which instrument applies to particular facts and means claimants and decision-makers need to determine which SoP governs a claim depending on dates and subject matter. There is no transitional provision in this instrument text; the commencement date (s 2) governs its operational start.

Definitions and thresholds used to interpret other legislation: Schedule 1 contains clinical thresholds and definitions (for example hypoglycaemia <3 mmol/L, hyperglycaemia >17 mmol/L, sleep deprivation defined by sleep hours) which will be applied by decision-makers when interpreting allegations under the VEA and MRCA. Those definitions are not general law but are operative within the SoP and for the purposes of claims.

No direct displacement of common law: The instrument does not purport to displace common law or statutory rights outside the VEA/MRCA schemes. It is an administrative instrument informing the particular statutory causation test within those statutory schemes. It therefore does not directly change obligations under workplace health and safety law, personal injury law, or criminal law.

Interplay with medical practice standards: The SoP’s medical definitions and timing windows may differ from clinical practice or forensic standards in some respects. That could create tensions where a court or tribunal is asked to reconcile treating clinician opinions with the SoP criteria. The instrument does not itself override clinical standards; it establishes criteria for administrative adjudication.

Record-keeping and evidentiary obligations under other laws: Because the SoP relies on documentary and clinical evidence (operation notes, drug administration timing, blood concentrations), it implicitly interacts with privacy, health records and disclosure laws that govern access to such records. The SoP does not modify those laws, but their operation will affect a claimant’s ability to adduce the evidence the SoP requires.

The instrument itself gives its internal amendment and commencement history. It is dated 29 April 2022 and commences on 30 May 2022 (s 2). It expressly repeals the Statement of Principles concerning epileptic seizure No. 77 of 2013 (Federal Register of Legislation No. F2013L01897) (s 4). No other amendments or prior versions are included within the text provided.

What the repeal means operationally: The 2013 SoP for “epileptic seizure” is replaced by this instrument. That is an express legislative act within the SoP domain: the previously operative criteria and definitions in the 2013 instrument no longer apply from the commencement date. Claimants and decision-makers must therefore use the 2022 instrument’s definitions, temporal windows and factor list for decisions made after commencement (s 2).

No transitional provisions in text: The instrument contains no express transitional wording in the provided text about historical claims or decisions already determined under the 2013 SoP. The instrument’s commencement and repeal provisions are the only temporal markers supplied (s 2-4). In practice, that means the jurisdiction will need to determine for specific claims whether the 2013 or 2022 SoP applies based on statutory interpretation of commencement and application dates, but the instrument itself gives no additional transitional rules.

Schedules and additions: Schedule 1 (Dictionary) and Schedule 2 (Drugs) are integral to the SoP and form part of the operative instrument from commencement. The lists and definitions they contain (for example the specified list of central nervous system vascular lesions, specified medical conditions, and the long Schedule 2 list of drugs) are incorporated by reference in the operative sections (for example s 9(8), s 9(15), s 9(31)). Any future amendment of the instrument by the RMA would therefore likely take the form of an update to these Schedules or the core sections, but no such amendments are recorded in the text provided.

Authority to amend: The RMA makes the SoP under subsection 196B(2) of the VEA (s 3). Any further amendments would in turn be made under that subsection and would likewise be registered as statements under the VEA. The instrument does not itself specify the procedural mechanics for future amendment beyond the statutory power under which it is made.

The instrument contains no recorded litigation history. There are no cases or tribunal decisions cited in the text. The instrument does, however, expressly interact with the statutory decision-making processes under the VEA and MRCA, which are subject to administrative review and judicial review mechanisms provided by those Acts and the general administrative law framework. The text gives no details of past litigation about the 2013 SoP or about seizure claims more broadly.

Implications for litigation: Because the SoP sets the minimal medical factors to raise a reasonable hypothesis, disputes about whether a factor exists (for example whether an exposure occurred within 24 hours; whether a traumatic brain injury meets the moderate-to-severe threshold; whether hypoglycaemia met the <3 mmol/L cut-off) are likely to be litigated in administrative reviews and appeals. The SoP therefore will be a central document in any litigation challenging administrative decisions that apply its criteria, but the instrument itself records no litigation.

No precedential holdings in the instrument: The SoP is not a judicial instrument and does not contain judicial determinations. It is an administrative medical ruling. Any litigation arising will treat the SoP as determinative medical guidance for the reasonable hypothesis test; however, the instrument does not itself resolve disputes about the interpretation of its terms , those will be matters for tribunals and courts in adjudicating particular cases.

What to expect in review: Review bodies will be asked to assess factual findings against the SoP’s definitions and temporal windows. Common areas of dispute likely to be amenable to litigation include interpretation of the clinical definitions in the Dictionary (eg sleep deprivation thresholds, severity thresholds for alcohol use disorder), precise timing of exposures relative to clinical onset of seizure (particularly where multiple seizures occur), and whether a particular factor is properly characterised as an excluded condition (s 7(2)(c)). None of these are described in the instrument’s text; they are foreseeable points of contention given the instrument’s reliance on precise definitions.

Narrow definitional scope of “seizure”: The instrument defines seizure as “an acute, nonrecurring episode” (s 7(2)). That wording is operationally important: recurrent epilepsy (recurrent unprovoked seizures or an established epileptic syndrome) may not be captured by a single-event characterisation. Practitioners and claimants must check whether the claimant’s clinical picture fits the SoP’s acute‑episode framing. The instrument repeals the earlier “epileptic seizure” SoP (s 4), so claimants with chronic epilepsy should not assume automatic continuity of coverage; they must map their facts to the present instrument and to any other SoPs that may apply.

Timing windows are precise and consequential: Many factors require exposure or clinical events to occur within tight windows. Examples include: concussion within six months of clinical onset (s 9(2)); moderate to severe traumatic brain injury within 20 years (s 9(1)); specified drugs taken within 24 hours before clinical onset (s 9(31)); radiographic contrast media exposure within 24 hours (s 9(33)); reducing or withdrawing a chronically administered sedative within two weeks (s 9(34)); hypoxic insult within two months (s 9(7)); infection of brain/meninges within one year (s 9(10)); carbon monoxide poisoning within 30 days (s 9(26)). Evidence must therefore include precise dates and times; vague records will often fail to meet the SoP’s minimal standard.

Multiple seizures and “first seizure” rule: For several factors (notably s 9(31) specified drugs, s 9(33) radiographic contrast, s 9(38) neurotoxic substances, s 9(39) animal envenomation) the instrument requires that “if multiple seizures occur, the first seizure occurred within 24 hours” of exposure. That creates evidentiary complexity in cases of recurrent events: the claimant must document which seizure was first and its timing relative to the exposure. Failure to establish that sequence can be determinative.

Exclusions that may surprise claimants: The instrument excludes psychogenic seizures and seizures during electroconvulsive therapy, and movement disorders or spontaneous movements linked to other causes (s 7(2)(c)). These exclusions require careful clinical characterisation. For claimants whose events are non-epileptic or psychogenic, the SoP will not assist.

Interplay with other SoPs: Section 11 requires application of other SoPs where factors in s 9 refer to diseases already covered by another Statement. Practitioners must search for and compare other SoPs. Failing to do so can lead to incorrect application of the s 9 list as freestanding criteria when a specialised SoP should govern.

Dictionary thresholds matter: The Schedule 1 definitions are not mere background; they contain thresholds that are binding within the instrument’s use. For example, hypoglycaemia is <3 mmol/L; hyperglycaemia is >17 mmol/L; sleep deprivation is defined by specific sleep-duration criteria. If clinical records show glucose levels close to these cut-offs, small measurement variances may be outcome-determinative.

The “inability to obtain appropriate clinical management” factor is narrow: Section 9(40) is available only in limited circumstances and s 10(2) restricts its application to situations where the seizure was suffered or contracted before or during (but did not arise out of) relevant service. That means the factor cannot generally be used to connect a seizure that arose during service to service unless the seizure pre‑existed or was contracted beforehand. Proving inability to obtain appropriate management will require factual evidence of denial, lack of access, or failure to treat,an evidentiary burden not described in detail by the instrument.

Drug list complexity: Schedule 2 enumerates a long list of specified drugs relevant to s 9(31). The list includes widely used therapeutic classes (antidepressants, antipsychotics, antibiotics excluding antimycobacterial agents, opioid analgesics, general anaesthetics excluding ketamine, antineoplastic agents excluding certain agents). Practitioners must scrutinise medication histories to determine whether a particular medication is listed and whether the dose/timing meets the 24‑hour rule. The list also includes illicit substances (cocaine, heroin, amphetamines) and recreational compounds (GHB, synthetic cannabinoids). Omissions from the list (or categorisation as “drug associated in the individual” under s 9(32)) create adjacency issues that require case-by-case proof.

Ambiguities in some medical terms: Terms like “moderate to severe traumatic brain injury” and “electrical injury of the brain” are used but not given numeric thresholds in the Dictionary. That will require clinical interpretation in each case, and different clinicians may vary in their classification. The instrument notes, for example, that electrical injury excludes transcranial magnetic stimulation and ECT (s 9 note), but leaves the clinical boundary for “electrical injury” otherwise open.

Evidence of exposure to neurotoxic substances requires signs of poisoning: For s 9(38) the instrument requires that other signs and symptoms of poisoning are present, as defined in Schedule 1. That is not satisfied by a single exposure claim without corroborating clinical signs.

No penalties but administrative consequence: There are no penalties in the instrument, but failing to meet the SoP’s criteria will have the practical consequence of a negative entitlement decision. That makes evidentiary preparation and records retrieval crucial.

For claimants and advisers: Map the clinical history to the SoP checklist. Step one is to identify the clinical onset of the seizure (date/time) and whether the event is an “acute, nonrecurring episode” consistent with the SoP’s seizure definition (s 7(2)). Next, work systematically through s 9’s 40 factors to identify any factor that could apply and note the specific temporal window or clinical threshold attached to that factor (for example, specified drug within 24 hours s 9(31), concussion within six months s 9(2), craniotomy within 20 years s 9(4)). Where a factor references an injury or disease that has its own SoP, identify and obtain that other SoP (s 11).

Collect contemporaneous clinical records: Obtain emergency department records, inpatient notes, operative reports, radiotherapy records, pathology and toxicology results, blood glucose measurements, imaging reports, and medication administration records. For drug-related factors, obtain pharmacy dispensing records, hospital drug charts, or evidence of first-dose timing and any rechallenge (s 9(32)). For exposures such as radiographic contrast or hyperbaric oxygen, obtain procedural logs and timing. For “inability to obtain appropriate clinical management” (s 9(40)), gather evidence of attempts to obtain treatment, referrals refused, or absence of available medical support during the relevant periods.

Demonstrate temporal relationships: Because the SoP places central importance on timing, assemble documentary evidence establishing when exposure or an injury occurred and when the clinical onset of seizure occurred. Where multiple seizures occurred, document which seizure was first and its timing relative to the exposure (s 9 notes on multiple seizures).

Address Dictionary thresholds explicitly: Where the Dictionary sets numeric or categorical thresholds, obtain proof that meets those thresholds. Examples include: blood glucose <3 mmol/L for hypoglycaemia, >17 mmol/L for hyperglycaemia, sleep deprivation defined by specific sleep-duration criteria (Schedule 1). Medical reports should state measured values, not just subjective impressions. For alcohol-related factors, assemble evidence of alcohol use disorder severity if relevant; the Dictionary sets out clinical criteria for “moderate to severe alcohol use disorder.”

When a factor references another SoP, follow that SoP: If a listed factor in s 9 refers to a disease with its own SoP, gather evidence required under that other SoP. Section 11 requires decision-makers to apply those other SoPs in accordance with their terms, so compliance in practice requires aligning evidence to the applicable Statement.

Prepare for contested interpretation of open terms: Some phrases will require clinical interpretation (for example “moderate to severe traumatic brain injury”). Secure expert clinical reports that explicitly adopt the SoP’s language and explain how the applicant’s clinical findings meet the SoP definitions or thresholds. For example, an expert report should state whether a TBI was moderate to severe and how that diagnosis was reached, referencing Glasgow Coma Scale or other clinical criteria if available.

Document military service link: To satisfy s 10(1), document the relationship between the identified factor and the person’s relevant service. This includes service records, deployment logs, duty rosters and any contemporaneous military medical records. For s 9(40) claims relying on inability to obtain appropriate clinical management, show service-era treatment constraints or failures and tie them to the claimant’s service period (noting the restriction in s 10(2)).

Be precise about exposures to listed drugs and toxins: For claims relying on Schedule 2 drugs or s 9(38) neurotoxic exposures, produce pharmacy dispensing records, forensic toxicology, workplace exposure records or other contemporaneous documentation. The SoP requires the first seizure to occur within 24 hours of certain exposures; sworn statements about timing are less persuasive than medical, pharmacy or procedural logs.

Engage clinicians who can translate clinical records into SoP language: Medical practitioners preparing statements should address the specific SoP provisions and Dictionary definitions. A report that simply states “seizure occurred” without anchored evidence against SoP criteria will not be sufficient for the reasonable hypothesis threshold.

Check for other SoPs and historical applicability: Since the 2013 epileptic seizure SoP has been repealed (s 4), confirm whether the 2022 SoP or another SoP applies to a given claim, especially where clinical histories span the commencement date. Note that the instrument provides no transitional text, so when advising clients on which SoP will govern a claim, confirm dates of service, date of claim, and the relevant statutory decision-making date.

Maintain organised, corroborated timelines: Because many disputes will turn on sequencing and timing, maintain a chronology that integrates service events, medical encounters, exposures, and the precise timing and sequence of seizures. This will help decision-makers apply the instrument’s timing rules (for example the “first seizure” requirement for multiple seizures) and avoid the common pitfall of failing to demonstrate the temporal link.

Anticipate cross-referencing to other SoPs and prepare accordingly: Where a listed factor is itself the subject of another SoP, acquire the documents and expert evidence that the other SoP requires; do not treat s 9’s entry as sufficient on its own.

Plan for appeals: Given the potential for contested interpretation (eg whether a traumatic brain injury qualifies as moderate to severe, or whether a medication was “taken” within 24 hours), prepare for the possibility of administrative review and tribunal proceedings by compiling comprehensive records and medico-legal opinion addressing the SoP language directly.