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Statement of Principles

Dermatomyositis — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Dermatomyositis. DVA can only accept a claim for Dermatomyositis if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

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Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

Dermatomyositis

RH No. 70 of 2022 · BoP No. 71 of 202222 factors

Meaning of dermatomyositis: For the purposes of this Statement of Principles, dermatomyositis: (a) means a chronic inflammatory disease characterised by inflammatory skin changes, usually accompanied by progressive and symmetric skeletal muscle weakness; and (b) includes amyopathic dermatomyositis.

Reasonable Hypothesis (RH) — Statement of Principles No. 70 of 2022

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting dermatomyositis or death from dermatomyositis with the circumstances of a person's relevant service:

  1. (1)
    taking a drug from the specified list of drugs for at least the 4 weeks before the clinical onset of dermatomyositis;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

  2. (2)
    taking hydroxyurea for at least the 6 months before the clinical onset of dermatomyositis;
  3. (3)
    taking an immune checkpoint inhibitor or interferon alfa within the 1 year before the clinical onset of dermatomyositis;

    Note: Examples of immune checkpoint inhibitors include ipilimumab, nivolumab, pembrolizumab and tremelimumab.

  4. (4)
    taking a drug which is associated in the individual with the clinical onset of dermatomyositis during drug therapy and either: (a) the improvement of dermatomyositis within 2 months of discontinuing or tapering drug therapy; or (b) the redevelopment of dermatomyositis on rechallenge with the same drug; and where taking the drug continued for at least the 7 days before the clinical onset of dermatomyositis;
  5. (5)
    having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, within 5 years of the clinical onset of dermatomyositis;
  6. (6)
    taking a drug from the specified list of drugs for at least the 4 weeks before the clinical worsening of dermatomyositis;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

  7. (7)
    taking hydroxyurea for at least the 6 months before the clinical worsening of dermatomyositis;
  8. (8)
    taking an immune checkpoint inhibitor or interferon alfa within the 1 year before the clinical worsening of dermatomyositis;

    Note: Examples of immune checkpoint inhibitors include ipilimumab, nivolumab, pembrolizumab and tremelimumab.

  9. (9)
    taking a drug which is associated in the individual with: (a) the clinical worsening of dermatomyositis during drug therapy; and (b) the improvement of dermatomyositis within 2 months of discontinuing or tapering drug therapy; and where taking the drug continued for at least the 7 days before the clinical worsening of dermatomyositis;
  10. (10)
    having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, within 5 years of the clinical worsening of dermatomyositis;
  11. (11)
    inability to obtain appropriate clinical management for dermatomyositis;

Aggravation-only factors: the factors in subsections 9(6) to 9(11) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 71 of 2022

11 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, dermatomyositis or death from dermatomyositis is connected with the circumstances of a person's relevant service:

  1. (1)
    taking a drug from the specified list of drugs for at least the 4 weeks before the clinical onset of dermatomyositis;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

  2. (2)
    taking hydroxyurea for at least the 6 months before the clinical onset of dermatomyositis;
  3. (3)
    taking an immune checkpoint inhibitor or interferon alfa within the 1 year before the clinical onset of dermatomyositis;

    Note: Examples of immune checkpoint inhibitors include ipilimumab, nivolumab, pembrolizumab and tremelimumab.

  4. (4)
    taking a drug which is associated in the individual with the clinical onset of dermatomyositis during drug therapy and either: (a) the improvement of dermatomyositis within 2 months of discontinuing or tapering drug therapy; or (b) the redevelopment of dermatomyositis on rechallenge with the same drug; and where taking the drug continued for at least the 7 days before the clinical onset of dermatomyositis;
  5. (5)
    having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, within 5 years of the clinical onset of dermatomyositis;
  6. (6)
    taking a drug from the specified list of drugs for at least the 4 weeks before the clinical worsening of dermatomyositis;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

  7. (7)
    taking hydroxyurea for at least the 6 months before the clinical worsening of dermatomyositis;
  8. (8)
    taking an immune checkpoint inhibitor or interferon alfa within the 1 year before the clinical worsening of dermatomyositis;

    Note: Examples of immune checkpoint inhibitors include ipilimumab, nivolumab, pembrolizumab and tremelimumab.

  9. (9)
    taking a drug which is associated in the individual with: (a) the clinical worsening of dermatomyositis during drug therapy; and (b) the improvement of dermatomyositis within 2 months of discontinuing or tapering drug therapy; and where taking the drug continued for at least the 7 days before the clinical worsening of dermatomyositis;
  10. (10)
    having a malignant neoplasm, other than non-melanotic malignant neoplasm of the skin, within 5 years of the clinical worsening of dermatomyositis;
  11. (11)
    inability to obtain appropriate clinical management for dermatomyositis;

Aggravation-only factors: the factors in subsections 9(6) to 9(11) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

A VHC Diagnostic Assessment addresses each of these factors one by one against your service record and clinical history. See how a VHC DVA claim works, see all fees ($600 + GST per stage) or book an appointment.

About Dr Thomas Perkins

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Founding doctor of the Veterans Health Centre in Ipswich, Queensland, and one of Australia's most experienced practitioners in veterans' medicolegal medicine.

Dr Perkins has spent more than thirteen years working exclusively with current and former ADF members — treating their conditions, writing their reports and navigating the DVA system alongside them. With over 100,000 claims submitted and 2,000 Permanent Impairment Assessments completed, he has seen precisely what separates an accepted claim from a rejected one at every level, from initial liability to the Veterans' Review Board.

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