Statement of Principles
concerning
 
CHRONIC MULTISYMPTOM ILLNESS
No. 56 of 2014
 
for the purposes of the
 
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
Title
1.         This Instrument may be cited as Statement of Principles concerning chronic multisymptom illness No. 56 of 2014.
Determination
2.         This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the VEA).
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about chronic multisymptom illness and death from chronic multisymptom illness.
(b)        For the purposes of this Statement of Principles, "chronic multisymptom illness" means a condition characterised by multiple somatic symptoms which has been diagnosed by a specialist physician or a psychiatrist and which meets the following criteria:
A.                There are one or more current symptoms from two of the following three categories and at least one symptom in each of the categories must be rated as severe:
 
(i)                 fatigue;
(ii)               mood-cognition: feeling depressed, difficulty remembering or concentrating, feeling moody, feeling anxious, trouble finding words or difficulty sleeping; or
(iii)             musculoskeletal: joint pain, joint stiffness or muscle pain; and
B.                The collection of symptoms relied upon to make the diagnosis is distressing and results in severe disruption of social and occupational functioning; and
C.                The collection of symptoms relied upon to make the diagnosis must have persisted for at least six consecutive months; and
D.                Any or all of the symptoms are not better explained by another medical or psychiatric condition.
Basis for determining the factors
4.         After examining the available sound medical-scientific evidence the Repatriation Medical Authority is of the view that it is more probable than not on the sound medical-scientific evidence available, that the only factor that can be related to the cause of or material contribution to or aggravation of chronic multisymptom illness or death from chronic multisymptom illness and which can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA) is that set out in clause 5.
Factors that must be related to service
5.         The factor that must exist before it can be said that, on the balance of probabilities, in relation to the circumstances of a person’s relevant service causing or materially contributing to or aggravating chronic multisymptom illness or death from chronic multisymptom illness is inability to obtain appropriate clinical management for chronic multisymptom illness.
Other definitions
6.         For the purposes of this Statement of Principles:
death from chronic multisymptom illness" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s chronic multisymptom illness;
"relevant service" means:
(a)        eligible war service (other than operational service) under the VEA;
(b)        defence service (other than hazardous service and British nuclear test defence service) under the VEA; or
(c)        peacetime service under the MRCA;
"terminal event" means the proximate or ultimate cause of death and includes:
(a)                pneumonia;
(b)               respiratory failure;
(c)                cardiac arrest;
(d)               circulatory failure; or
(e)                cessation of brain function.
Date of effect
7.         This Instrument takes effect from 14 May 2014.
Dated this  eighth   day of   May   2014
The Common Seal of the                    )
Repatriation Medical Authority          )
was affixed at the direction of:          )
PROFESSOR NICHOLAS SAUNDERS AO
CHAIRPERSON