Statement of Principles concerning substance use disorder (Balance of Probabilities) (No. 60 of 2017)

The document revolves around a few discrete legal‑medical constructs and definitional choices which govern how a claimant’s substance use disorder is assessed and connected to service.

Substance use disorder: The SOP defines this as a DSM‑5‑derived disorder of mental health requiring at least four of a specified set of criteria within a 12‑month period (s7(2)). The enumerated criteria mix behavioural indicators (e.g. unsuccessful attempts to cut down, spending a great deal of time obtaining or recovering from substances, giving up activities) and physiological markers (tolerance and withdrawal, with specific exclusions for medically supervised use). A separate K criterion applies to withdrawal for substances other than hallucinogens or inhalants (s7(2) K). The SOP explicitly excludes alcohol use disorder from the definition of substance use disorder and also excludes acute substance intoxication in the absence of substance use disorder (s7(2), notes). The Schedule 1 list of "substance" includes amphetamine‑type substances, cannabis, cocaine, hallucinogens, inhalants, opioids, sedatives/hypnotics/anxiolytics, and tobacco (Schedule 1).

Death from substance use disorder: The SOP treats death as covered if a terminal event or condition was contributed to by the person’s substance use disorder (s7(3)). "Terminal event" is defined in the Schedule to include proximate or ultimate causes such as pneumonia, respiratory or circulatory failure, cardiac arrest, and cessation of brain function (Schedule 1).

Relevant service and causation standard: The SOP applies to claims linked to specified forms of service under the VEA and MRCA, defined in Schedule 1 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 (Schedule 1: relevant service). The Authority states, on the medical‑scientific evidence available, that it is more probable than not that SUD and death from SUD can be related to relevant service (s8). The SOP is therefore framed to set out the fact patterns that, if established and related to relevant service, will support a positive causation finding on the balance of probabilities.

Factors and timing windows: Section 9 enumerates factors that must exist to make a causal link more probable than not. The factors are split between those assessing association with clinical onset of SUD (ss9(1)-(7)) and those assessing clinical worsening or material contribution/aggravation of pre‑existing SUD (ss9(8)-(14)). The factors reference temporal windows: for example, category 1A and 1B stressors must have occurred within two years before clinical onset or worsening (ss9(2), 9(3), 9(9), 9(10)); death of a significant other within five years (ss9(4), 9(11)); category 2 stressor within six months (ss9(7), 9(13)). Section 10(2) restricts subsections 9(8)-9(14) to material contribution or aggravation where the SUD was suffered or contracted before/during but did not arise out of service.

Cross‑reference to other SOPs: If a factor in section 9 refers to an injury or disease for which an SOP already exists, that other SOP applies according to its own terms as in force (s11).

Definitions and exclusions: Schedule 1 gives precise meanings to categories of stressors (category 1A, 1B, 2), clinically significant mental disorders, "corpse" (defined to exclude closed body bags or viewing a body in an open‑casket coffin), "eyewitness" (excludes exposure by public broadcasting or mass media), "severe childhood abuse", "significant other", and the list of substances covered. These choices materially constrain the range of factual circumstances that will meet the SOP’s factors.

Administrative effect: The SOP operates as a deterministic evidentiary tool for claims assessment. It does not itself create entitlements; rather, it informs the decision‑making under the VEA and MRCA about causation in claims that invoke SUD or death from SUD (s5; ss3 and 8).

The SOP is expressly directed at claims under section 120B of the VEA and section 339 of the MRCA (s5). Practically this brings three primary groups within its immediate scope:

• Veterans and serving members making claims for compensation or rehabilitation where substance use disorder or death from substance use disorder is alleged to be connected with their relevant service. The SOP sets out the medical criteria and the enumerated factors that such claimants must meet and have related to their relevant service for a causation finding (s7; s9; s10).

• Medical and allied health professionals who provide medico‑legal reports, psychiatric assessments or expert evidence to support or rebut causation. The SOP prescribes DSM‑5‑derived diagnostic criteria and temporal relationships that these professionals must address,for example, establishing date of clinical onset or clinical worsening, demonstrating that specified stressors occurred in the relevant time windows, and assessing contribution to terminal events (s7(2); s9).

• Decision‑makers within DVA and MRCA, whose adjudication of claims will use this SOP as the medical‑scientific basis for deciding whether SUD or death from SUD is connected with relevant service. The SOP revokes the prior No. 4 of 2009 (s4), meaning decision‑makers will apply the 2017 text and subsequent amendments (ss2, 4; Endnotes). It also requires cross‑checking with other SOPs where section 9 refers to injuries covered elsewhere (s11).

Secondary affected parties include legal advisers, advocates, and tribunals that review administrative decisions under the VEA and MRCA frameworks. While the SOP does not create procedural rights, it shapes the evidence that will be persuasive at first instance and on review: whether a stressor qualifies as category 1A or 1B, whether an event satisfies the "corpse" definition, whether a claimant’s disorder meets the DSM‑5‑derived threshold, whether a specified time window is met, and whether an alleged contribution to a terminal event is medically supported are all matters that will determine claim outcomes (s7; Schedule 1).

The schedule definitions also affect which substances can ground a SUD finding. The list in Schedule 1 includes amphetamine‑type substances, cannabis, cocaine, hallucinogens, inhalants, opioids, sedatives/hypnotics/anxiolytics and tobacco (Schedule 1: substance). The instrument explicitly excludes alcohol use disorder from the SOP’s definition of substance use disorder (s7(2) note), so claims based purely on alcohol use disorder will not be covered by this SOP. Yet the Schedule’s list of "clinically significant disorder of mental health as specified" does include "alcohol use disorder" as a qualifying antecedent condition (Schedule 1), creating an interaction where alcohol use disorder may be relevant as a pre‑existing mental disorder factor under s9(1) or s9(8) even though alcohol itself is excluded from the SUD definition covered by this instrument.

Finally, the SOP’s definition of "relevant service" (Schedule 1) limits applicability. For example, the definition excludes hazardous service and British nuclear test defence service from the defence service limb; this affects which serving members or veterans can rely on this SOP when making claims (Schedule 1: relevant service).

This instrument does not impose criminal sanctions or civil liabilities. Instead it establishes evidentiary and determinative duties for administrative decision‑makers and sets out rights and thresholds for claimants seeking a causal link between service and substance use disorder. The operative duties and rights flow from the SOP together with the VEA and MRCA frameworks it serves.

Duty of proof standard and the RMA’s view: The SOP states that on the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that SUD and death from SUD can be related to relevant service (s8). The SOP is therefore intended to be applied under the balance of probabilities standard in claims processes (this is a medical‑scientific foundation, not an evidentiary rule imposed by the SOP itself).

Duty for claimants to establish factors: Before a connection can be found, at least one of the factors enumerated in section 9 must be present and related to the person’s relevant service (s9; s10(1)). The claimant therefore has the practical task of adducing probative material to establish:

• that the person meets the DSM‑5‑derived criteria for SUD at the time of clinical onset or worsening (s7(2); s9(1), 9(8));

• that one or more qualifying stressors occurred within the specified temporal windows (e.g. category 1A/1B within two years, category 2 within six months, death of a significant other within five years) (ss9(2)-(7), 9(9)-(13));

• where relevant, that the person had a medical or psychiatric condition for which a substance was medically prescribed at the time of clinical onset and the SUD involves the same pharmacological class (s9(5));

• or that the inability to obtain appropriate clinical management existed (s9(14)).

Duty to relate factors to relevant service: Section 10(1) requires that any factor in section 9 must be related to the person’s relevant service. This places an evidentiary obligation on claimants to show the nexus between the enumerated factor and service. For example, a category 1A stressor must have a causal relation to the person's relevant service, not merely be an isolated non‑service life event (s10(1)).

Restriction where SUD pre‑existed service: Section 10(2) narrows the application of subsections 9(8)-9(14) to cases where the person’s SUD was suffered or contracted before or during, but did not arise out of, their relevant service. In those cases the listed factors only support a finding of material contribution or aggravation of a pre‑existing condition (s10(2)). The practical effect is that for pre‑existing SUD, the SOP requires evidence that service materially contributed to or aggravated that pre‑existing disorder through the specified factors.

Cross‑reference duty: If a factor in section 9 refers to an injury or disease for which another SOP exists, section 11 directs that the factors in that other SOP apply in accordance with its terms. This creates a duty to consult and apply other SOPs when one of the enumerated factors points to a condition already the subject of a different SOP (s11).

Rights implied in administrative processes: While the SOP does not create statutory procedural rights, it defines the contours of what medical and factual evidence will be decisive. A claimant has the right, under the VEA/MRCA processes, to have causation assessed using the SOP applicable at the time (s5), and decision‑makers have the duty to apply the SOP as the medical‑scientific basis for causation findings (s3; s8). The SOP also notes its own revocation of the prior SOP and its amendment history, so claimants and advisers must ensure which SOP text is current when bringing or defending claims (ss4; Endnotes).

Definitions as determinative rights/limits: Schedule 1’s definitions operate as bright‑line tests for certain qualifying facts. For example, the SOP’s narrow definition of a "corpse" and the exclusion of viewing a closed body bag or open‑casket viewing from certain qualifying events will determine whether a claimant’s exposure reasonably counts as a category 1B stressor (Schedule 1). "Eyewitness" excludes exposure solely through media coverage. These definitional choices are therefore rights/limits for claimants: they determine whether particular exposures qualify under the SOP’s factors.

No criminal or civil penalties in the instrument: The SOP itself does not prescribe penalties or enforcement measures. Compliance duties are procedural and evidentiary as they relate to claims assessment under the VEA and MRCA (s3; s5). Any decision‑making consequences, including entitlements or rejections, arise under the VEA and MRCA statutory frameworks rather than from this SOP's text.

The Statement of Principles is an administrative instrument; it contains no criminal sanctions, civil fines or direct enforcement mechanisms within its text. The instrument’s legal effect is procedural and evidentiary: it directs how medical‑scientific causation is to be assessed for claims under the VEA and MRCA (s3; s5; s8). Enforcement in the ordinary sense (penalties or sanctions) is therefore not provided for in this SOP itself.

How "enforcement" operates practically is through the decision‑making apparatus of the VEA and MRCA regimes. Decision‑makers who determine entitlement to benefits and rehabilitation will apply the SOP when assessing whether substance use disorder or death from substance use disorder is connected with relevant service. A claimant whose evidence satisfies the SOP’s conditions will be more likely, on the Authority’s medical‑scientific view, to receive a positive causation finding; a claimant who fails to meet the SOP’s criteria will be at risk of having causation rejected. These administrative consequences flow from application of the SOP but are executed under the VEA/MRCA statutory processes, not by the SOP itself (s5).

Review and administrative challenge routes are not set out in this instrument. Any appeals or reviews of entitlement decisions would be pursued under the appeal and review mechanisms provided for in the VEA or MRCA regimes; the SOP does not itself specify those mechanisms. The SOP does require decision‑makers to consider cross‑references to other SOPs where relevant (s11), and it revokes the prior SOP (s4), so decision‑makers must apply the current SOP text in force (s2; Endnotes).

There are two notable enforcement‑related implications that claimants and advisers must manage in practice, drawn from the SOP’s text:

• Evidentiary burden and medical proof: The SOP sets out DSM‑5‑derived diagnostic thresholds and specific timing windows for stressors and other factors (s7; s9). Decision‑makers will expect medical and documentary evidence calibrated to those thresholds. Failure to adduce that evidence will result in adverse administrative outcomes, though those outcomes are executed via the VEA/MRCA determinations rather than by penalty provisions in the SOP.

• Cross‑SOP consistency and revocation: Because the SOP revokes the earlier 2009 SOP (s4) and because s11 requires reference to other SOPs where factors refer to other injuries or diseases, there is an enforcement pressure on decision‑makers to apply the correct SOP and definitions in force. Misapplication could be challenged administratively or judicially under the VEA/MRCA appeal regimes, but the SOP itself does not set out enforcement steps.

In short, the text prescribes no punishment or enforcement apparatus. Its practical enforcement is via administrative decisions about entitlement which rely on the SOP as the Repatriation Medical Authority’s medical‑scientific determination (s3; s8). Any consequences flow from the application of the SOP in the VEA/MRCA decision‑making process.

This Statement of Principles sits within the statutory architecture of veterans’ compensation and rehabilitation law and interacts with several elements of those regimes.

Statutory basis and applicability: The instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986 (s3). It applies to claims to which section 120B of the VEA or section 339 of the MRCA applies (s5). Therefore the SOP functions as an evidentiary, medical‑scientific determination for causation questions arising under those statutory claims processes. Its application is limited to those statutory claim types; it does not directly govern other legislation.

Revocation and contemporaneity: The SOP expressly revokes the prior Statement of Principles concerning substance use disorder No. 4 of 2009 as amended and made under subsections 196B(3) and (8) of the VEA (s4). Administratively, decision‑makers must apply the 2017 SOP and its amendments as in force at the time of assessment. The endnotes record an amendment determination in 2018 that amended the category 1B stressor and added to the "corpse" definition (Endnotes; Legislation history). This means that the SOP’s text interacts with the statutory amendment process and must be read in its current compiled form when applied.

Cross‑reference to other SOPs: Section 11 provides an explicit mechanism for interaction with other SOPs. If a factor in section 9 refers to an injury or disease for which another SOP has been determined, then the factors in that other SOP apply according to its terms as in force (s11). This creates an inter‑instrument dependency: a causal factor tied to, for example, post‑traumatic stress disorder may require applying the SOP for PTSD in determining whether the referenced factor is satisfied. The practical effect is that claimants and decision‑makers must consult multiple SOPs where cross‑references exist to determine whether the combined tests are met.

Interaction with DSM‑5 and medical classification: The SOP explicitly bases its diagnostic thresholds on DSM‑5 (s7(2); Schedule 1: DSM‑5). This anchors the medical standard to an external professional manual, meaning the SOP interacts with recognised psychiatric diagnostic practice rather than setting an entirely novel medical standard. Experts will be required to frame their medical opinions in DSM‑5 terms to align with the SOP.

VEA and MRCA definitions and exclusions: Schedule 1 defines "relevant service" in a way that limits the SOP’s scope to particular types of service (Schedule 1: relevant service). For example, certain defence service categories are excluded (hazardous service and British nuclear test defence service for the defence service limb). Therefore, the SOP’s application intersects with statutory definitions in the VEA and MRCA, and claim outcomes will turn on whether the claimant’s service falls within those policy boundaries.

No conflict with criminal law or general health regulation: The SOP does not purport to alter criminal law, therapeutic obligations, or health‑regulation frameworks. It moulds the administrative evidentiary standard for causation in claims under the VEA and MRCA only, leaving other legal regimes intact.

Administrative law and review: While the SOP does not set out appeal routes, it will be engaged in judicial review or merits review of decisions under the VEA/MRCA. Judicial or tribunal bodies reviewing decisions will evaluate whether decision‑makers correctly applied the SOP and whether the evidence supports findings under its terms. The SOP’s definitions, timing windows and cross‑references therefore interact with administrative law principles of correct application of governing instruments and reasonableness of findings, although the SOP itself does not prescribe those review mechanisms.

Amendment and temporal application: The endnotes show the SOP has been amended (e.g. No. 87 of 2018). Where the SOP is amended, decision‑makers must apply the version in force at the time of assessment, consistent with applicable transitional provisions under the VEA/MRCA if any. The instrument’s compilation notes caution about uncommenced amendments and modifications (Compilation notes), so practitioners must check the current version on the Legislation Register.

In sum, the SOP operates as a medical‑scientific determinative instrument within the VEA/MRCA administrative framework, interacts with other SOPs by cross‑reference, anchors medical definitions to DSM‑5, and depends on statutory definitions of relevant service for its scope (s3; s5; s11; Schedule 1).

The compiled instrument includes a short amendment history recorded in the endnotes. The original Determination was registered on 6 November 2017 and commenced on 4 December 2017 (Endnote 3: Legislation history). The compilation date for the version you have is 24 September 2018 (front matter).

Key amendment recorded in the compilation:

• Veterans' Entitlements (Statements of Principles,Category 1B Stressor) Amendment Determination 2018 (No. 87 of 2018). Registered 28 August 2018 and commenced on 24 September 2018 (Endnote 3). The amendment amended Schedule 1 - Dictionary entries for category 1B stressor (rs No. 87 of 2018) and added material to the "corpse" definition (ad No. 87 of 2018) (Endnote 4).

The instrument’s compilation notes make procedural observations:

• The compilation shows the text as amended and in force on 24 September 2018 and indicates that uncommenced amendments, if any, are not reflected in the compiled text (Compilation notes).

• The compilation includes endnotes that supply a legislation history table and an amendment history table, identifying the relevant amending instruments and the provisions affected (Endnotes 3 and 4).

The SOP also expressly revokes the prior Statement of Principles concerning substance use disorder No. 4 of 2009, as amended, which had been made under subsections 196B(3) and (8) of the VEA (s4). The revocation is a material statutory step: it removes the prior medical‑scientific determination and replaces it with the 2017 text (and subsequent amendment in 2018).

Practical consequence of the amendment history: decision‑makers, practitioners and claimants must ensure they apply the SOP version current at the date of the claim assessment. Because the SOP is an administrative instrument, amendments alter the medical‑scientific yardstick against which causation is measured. The 2018 amendment specifically changed the category 1B stressor definition and the scope of the "corpse" definition, which will affect claims that rely on eyewitness exposure to corpses or critical casualties. The compilation’s endnotes warn that uncommenced amendments are not shown; therefore practitioners should consult the Legislation Register for any later changes.

There is no legislative history in the compiled text beyond these formal registration and amendment entries. The instrument does not refer to parliamentary debates, explanatory memoranda or regulatory impact analyses within the body of the SOP itself; references to such documents would need to be sought elsewhere if they exist. The Authority’s Dated signature is 3 November 2017, consistent with registration and commencement entries (front matter).

The compiled SOP does not include any judicial decisions or tribunal determinations. The instrument itself names no cases and records no litigation history in the endnotes. The text provides the RMA’s medical‑scientific determinations and operational definitions but does not record any litigation in relation to interpretation or application.

Because this is an administrative instrument used in the VEA and MRCA claims environment, litigation and review challenges arising from its application (for example judicial review or merits review of decisions where the SOP was applied) would be found in external case law, tribunals or court records rather than in the SOP text. The SOP’s compilation notes and endnotes do not attach or summarise such decisions.

Practitioners seeking published decisions that interpret or apply this SOP should therefore review decisions under the VEA and MRCA appeal frameworks in administrative tribunals and courts subsequent to the SOP’s commencement and amendment dates. The SOP itself does not supply a litigation history or list precedent decisions.

The SOP contains several specific definitional choices and structural limits that create sharp practical pitfalls for claimants, medical experts and decision‑makers. These are concrete, textual traps that must be handled with care.

1. Alcohol is excluded from "substance use disorder" but appears as a "clinically significant disorder of mental health as specified". The SOP explicitly excludes alcohol use disorder from the definition of substance use disorder (s7(2), notes). However Schedule 1’s list of clinically significant disorders includes "alcohol use disorder" (Schedule 1: clinically significant disorder of mental health as specified, item (d)). The practical effect is that alcohol use disorder cannot itself be the SUD covered by this SOP but may be relied upon as a pre‑existing clinically significant mental disorder factor under s9(1) or as a clinically significant disorder under s9(8) when assessing aggravation. Parties must not conflate SUD under this SOP with alcohol use disorder; evidence must be geared to the DSM‑5 criteria for the substances listed in Schedule 1 if the claim asserts SUD under this instrument.

2. "Substance" list includes tobacco. The Schedule lists tobacco as a substance (Schedule 1: substance, item (h)). That means nicotine dependence falls within the SOP’s scope as a potential SUD, which may surprise practitioners used to thinking of tobacco separately. Conversely, alcohol is absent. Evidence and expert reports must address these differences.

3. Differences between onset and aggravation factors and timing windows. Section 9 splits factors into those that support a connection at the time of clinical onset (ss9(1)-(7)) and those that support clinical worsening or material contribution/aggravation (ss9(8)-(14)). The temporal windows for qualifying stressors differ: category 1A and 1B stressors must occur within two years before clinical onset or worsening (ss9(2), 9(3), 9(9), 9(10)), category 2 stressors within six months (ss9(7), 9(13)), and death of a significant other within five years (ss9(4), 9(11)). Misstating the relevant index date (clinical onset vs clinical worsening) or the applicable time window will undermine a claim.

4. "Corpse" definition is narrow. Schedule 1 defines "corpse" as human remains or body parts of persons who have met a violent or horrific death and explicitly excludes seeing a closed body bag or viewing a body in an open‑casket coffin (Schedule 1: corpse). This has immediate relevance for category 1B stressors that depend on participating in clearance of a corpse or viewing a corpse as an eyewitness (category 1B, Schedule 1). Claims based on closed body bag exposure or open‑casket viewing will not meet the Schedule definition.

5. "Eyewitness" excludes media exposure. The Schedule’s "eyewitness" requires first‑hand experience and excludes persons exposed only to public broadcasting or mass media coverage. Therefore, exposure through news footage or photos will not qualify as an eyewitness event for category 1B stressor purposes.

6. Clinically significant disorder of mental health does not require documented treatment. Note 2 to that definition clarifies that "to ‘warrant ongoing management’ does not require that any actual management was received or given" and Note 1 uses an example of monthly visits as indicative of "management" (Schedule 1). This means absence of treatment history does not automatically negate the presence of such a disorder; clinical assessment may still find the disorder warrants ongoing management. However, this must be shown on medical evidence.

7. Narrow prescription‑related factor. Subsection 9(5) is limited: it only applies where a medical or psychiatric condition for which a substance was prescribed existed at the time of clinical onset, and the SUD involves one or more agents from the same pharmacological class as the prescribed medication. Thus, timing of prescription relative to onset and pharmacological class congruence are crucial.

8. Pre‑existing SUD treated differently. Section 10(2) limits subsections 9(8)-9(14) to material contribution or aggravation where the person’s SUD was suffered or contracted before or during but did not arise out of relevant service. Practitioners must establish the timing of the initial SUD relative to service to determine whether the narrower aggravation pathway applies.

9. "Inability to obtain appropriate clinical management" is included but undefined. Subsection 9(14) lists inability to obtain appropriate clinical management as a factor. The SOP does not define what constitutes "appropriate" or what evidence suffices to show inability to obtain it. Parties must therefore flesh this element out with contemporaneous records: attempts to obtain treatment, service availability, referrals, waiting lists and other systemic barriers should be documented.

10. Death causation requires contribution by SUD to terminal event. For death claims, section 7(3) requires that the terminal event or condition be contributed to by the person’s substance use disorder. The Schedule’s terminal event list gives examples (pneumonia, respiratory failure, cardiac arrest, circulatory failure, cessation of brain function). Medical evidence must link SUD to the physiological pathway to the terminal event to meet this element.

11. Cross‑SOP dependency risk. Section 11 requires that where a factor refers to an injury/disease subject to another SOP, that SOP’s factors apply. That can complicate claims where multiple SOPs interact, for example where a category 1A stressor references PTSD. Practitioners must check contemporaneous versions of all relevant SOPs and ensure consistency across them.

12. Administrative timing and version control. Because the SOP supersedes the 2009 version (s4) and was itself amended (Endnotes), claimants and advisers must ensure they rely on the correct SOP version in force at the time of assessment. The compilation notes warn about uncommenced amendments; practitioners should confirm the operative text on the Legislation Register.

These "gotchas" are textual and operational; they do not arise from external case law or policy commentary and therefore must be handled by careful evidence gathering, precise medico‑legal reporting and accurate mapping of facts to the SOP’s definitions and time windows.

Compliance here means preparing and adjudicating claims so that the SOP’s tests are met or properly assessed. The SOP is not a compliance regime with formal statutory obligations and penalties; rather it imposes evidentiary requirements and definitional standards that parties must satisfy within VEA/MRCA claims processes.

For claimants and their advisers

1. Identify the correct SOP and version. Confirm the SOP in force at the time of the claim assessment (the 2017 Determination and any subsequent amendments such as No. 87 of 2018) via the Legislation Register, as the SOP revokes the prior 2009 Determination (s4; Endnotes).

2. Frame the disorder to the SOP’s diagnostic standard. Ensure medical reports explicitly address the DSM‑5‑derived criteria set out in s7(2): the required four or more criteria in a 12‑month period, with attention to tolerance and withdrawal rules and the notes excluding medically supervised use. If the claim concerns death, the medical report must connect the SUD to the terminal event as defined in Schedule 1 (s7(2)-(3); Schedule 1: terminal event).

3. Map factual events to section 9 factors and timing windows. Determine whether the case relies on onset factors (ss9(1)-(7)) or aggravation/worsening factors (ss9(8)-(14)). For stressor‑based factors, confirm the precise event type and the relevant time window (e.g. category 1A/1B within two years, category 2 within six months, death of significant other within five years) and ensure evidence documents dates and the claimant’s exposure (s9).

4. Prove nexus to relevant service. Establish and document how the factor is related to relevant service as required by s10(1). This involves service records, incident reports, deployment logs, witness statements, and contemporaneous medical records linking the stressor to service.

5. If the factor refers to another SOP, apply that SOP’s tests. Where a section 9 factor invokes an injury/disease covered by a different SOP, comply with s11 by addressing the other SOP’s criteria (s11).

6. Address definitional specificity. Use evidence to match Schedule 1 definitions: e.g. for category 1B involving a corpse, demonstrate that the remains were of persons who had met a violent or horrific death and that exposure was not limited to a closed body bag or open‑casket viewing as excluded (Schedule 1).

7. For prescription‑related claims, record pharmacological class and timing. s9(5) requires that at the time of clinical onset a medical or psychiatric condition was present for which a substance was prescribed and that the SUD involves agents from the same pharmacological class.

8. For inability to obtain appropriate clinical management (s9(14)), document attempts to obtain care and barriers such as waiting lists, refusals, service gaps, geographic limitations or other objective evidence of inability to access evidence‑based treatment.

9. Address pre‑existing SUD carefully. If the SUD was suffered or contracted before or during (but did not arise out of) relevant service, subsections 9(8)-9(14) only support findings of material contribution or aggravation (s10(2)). Establish dates of onset and pre‑service history.

10. Use experts who will align opinions to the SOP’s structure. Expert reports should be explicit about dates of clinical onset/worsening, DSM‑5 criteria met, timing of stressors, how the stressor relates to service, and whether the SUD contributed to any terminal event. Experts should also address any cross‑SOP references.

For medical experts and reporting clinicians

1. Adopt the SOP’s DSM‑5‑derived language. Frame diagnoses and causal opinions in terms of the SOP’s criteria (s7(2)). Specify which of the enumerated criteria are met and provide supporting clinical evidence.

2. Address temporal relationships robustly. Experts must identify the date (or reasonable range) of clinical onset and/or worsening and demonstrate whether qualifying stressors occurred within the stipulated windows (s9).

3. Explain medical causal mechanisms for death claims. For deaths alleged to be from SUD, explain how the SUD contributed to the terminal event in medical terms, linking substance effects to physiological deterioration listed in Schedule 1.

4. Tackle definitional issues proactively. If a claim depends on an eyewitness exposure to a corpse, the expert should address the nature of the exposure, whether it was first‑hand, and whether the corpse met the Schedule’s violent/horrific standard (Schedule 1).

5. If relying on “inability to obtain appropriate clinical management”, document standard of care and deviations. Provide evidence or opinion on what constitutes appropriate management for the SUD and whether, objectively, the claimant could access it.

For decision‑makers

1. Apply the applicable SOP version. Confirm which iteration of the SOP applies and ensure prior SOPs have been revoked where indicated (s4; Endnotes).

2. Match the facts to the SOP’s tests point‑by‑point. For each section 9 factor relied upon, determine whether the evidence satisfies the factor and whether the factor is related to relevant service under s10(1).

3. Check cross‑SOP references. If section 9 refers to an injury or disease covered by another SOP, apply that SOP’s factors per s11 and confirm consistency of findings across SOPs.

4. Be attentive to definitional exclusions. For example, do not treat alcohol use disorder as a SUD under this SOP (s7(2) note). Ensure "eyewitness" and "corpse" definitions are correctly interpreted and applied (Schedule 1).

5. Record reasoning on timing and causation. Because the SOP’s practical effect is evidentiary, the administrative record should document how the diagnostic criteria, time windows, and nexus to service were assessed and why the evidence did or did not meet the SOP.

6. If rejecting claim elements, specify which SOP elements were not met. This assists review bodies and provides a clear basis for appeal or remedial evidence gathering.

Practical evidence checklist

• Service records showing dates and nature of relevant service (Schedule 1: relevant service; s10(1)).

• Medical records and psychiatric assessments documenting DSM‑5 criteria and dates of clinical onset/worsening (s7(2)).

• Incident reports, witness statements, operational logs supporting category 1A/1B/2 stressor claims, with dates and details matching Schedule 1 elements.

• Records of prescriptions, medication types and dates, and pharmacological class analysis where s9(5) is relied upon.

• Documentation of attempts to obtain treatment and systemic barriers for s9(14).

• For death claims, coronial or hospital records linking SUD to the terminal event (s7(3); Schedule 1 terminal event list).

• If cross‑SOP elements arise, obtain medical opinions aligned to the other SOP(s) as required by s11.

By mapping evidence to the SOP’s elements, ensuring timing is precise, and using experts who structure their opinions around the instrument’s criteria, parties can comply with the SOP’s requirements for claims assessment.