Statement of Principles concerning SPASMODIC TORTICOLLIS (Reasonable Hypothesis) (No. 63 of 2016) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986. Dated 24 June 2016 The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of: Professor Nicholas Saunders AO Chairperson Contents 1 Name 2 Commencement 3 Authority 4 Revocation 5 Application 6 Definitions 7 Kind of injury, disease or death to which this Statement of Principles relates 8 Basis for determining the factors 9 Factor that must exist 10 Relationship to service Schedule 1 - Dictionary 1 Definitions 1 Name This is the Statement of Principles concerning spasmodic torticollis (Reasonable Hypothesis) (No. 63 of 2016). 2 Commencement This instrument commences on 25 July 2016. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Revocation The Statement of Principles concerning spasmodic torticollis No. 21 of 2008 made under subsection 196B(2) of the VEA is revoked. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies. 6 Definitions The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument. 7 Kind of injury, disease or death to which this Statement of Principles relates (1) This Statement of Principles is about spasmodic torticollis and death from spasmodic torticollis. Meaning of spasmodic torticollis (2) For the purposes of this Statement of Principles, spasmodic torticollis means an acquired chronic focal dystonia, characterised by sustained or intermittent involuntary neck muscle contractions, causing repetitive movements or abnormal postures of the head. The diagnosis is made in the absence of conditions which could account for the dystonia, including: (a) a drug-induced tardive dystonia; or (b) a generalised or hemi-dystonia; or (c) a neurological disorder; or (d) a posttraumatic dystonia; or (e) a structural lesion of the brain or cervical cord; or (f) local lesions of the cervical region. (3) While spasmodic torticollis attracts ICD‑10‑AM code G24.3, in applying this Statement of Principles the meaning of spasmodic torticollis is that given in subsection (2). (4) For subsection (3), a reference to an ICD‑10‑AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD‑10‑AM), Ninth Edition, effective date of 1 July 2015, copyrighted by the Independent Hospital Pricing Authority, ISBN 978‑1‑76007‑020‑5. Death from spasmodic torticollis (5) For the purposes of this Statement of Principles, spasmodic torticollis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's spasmodic torticollis. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 Basis for determining the factors The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that spasmodic torticollis and death from spasmodic torticollis can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA. Note: relevant service is defined in the Schedule 1 – Dictionary. 9 Factor that must exist The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting spasmodic torticollis or death from spasmodic torticollis with the circumstances of a person's relevant service is inability to obtain appropriate clinical management for spasmodic torticollis. 10 Relationship to service The existence in a person of the factor referred to in section 9 applies only to material contribution to, or aggravation of, spasmodic torticollis where the person's spasmodic torticollis was suffered or contracted before or during (but did not arise out of) the person's relevant service. Schedule 1 - Dictionary Note: See Section 6 1 Definitions In this instrument: MRCA means the Military Rehabilitation and Compensation Act 2004. relevant service means: (a) operational service under the VEA; (b) peacekeeping service under the VEA; (c) hazardous service under the VEA; (d) British nuclear test defence service under the VEA; (e) warlike service under the MRCA; or (f) non-warlike service under the MRCA. Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary. spasmodic torticollis—see subsection 7(2). terminal event means the proximate or ultimate cause of death and includes the following: (a) pneumonia; (b) respiratory failure; (c) cardiac arrest; (d) circulatory failure; or (e) cessation of brain function. VEA means the Veterans' Entitlements Act 1986.