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Statement of Principles

Narcolepsy — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Narcolepsy. DVA can only accept a claim for Narcolepsy 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.

Narcolepsy

RH No. 11 of 2022 · BoP No. 12 of 202232 factors

Meaning of narcolepsy: For the purposes of this Statement of Principles, narcolepsy: (a) means a chronic neurological disorder of sleep regulation and wakefulness characterised by disabling, excessive and irresistible daytime sleepiness lasting for at least 3 months, with varying amounts of cataplexy, hypnagogic hallucinations, and sleep paralysis; and (b) includes: (i) narcolepsy with cataplexy (narcolepsy type 1); and (ii) narcolepsy without cataplexy (narcolepsy type 2); and (c) excludes: (i) early onset narcolepsy; and (ii) daytime sleepiness caused by another condition which disrupts the duration or quality of sleep.

Reasonable Hypothesis (RH) — Statement of Principles No. 11 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 narcolepsy or death from narcolepsy with the circumstances of a person's relevant service:

  1. (1)
    having concussion or moderate to severe traumatic brain injury within the 2 years before the clinical onset of narcolepsy, and in the case of sustained unconsciousness following injury to the head, the clinical onset of narcolepsy occurred within 2 years of regaining consciousness;
  2. (2)
    having a neurosurgical procedure involving the hypothalamus, midbrain or brainstem, within the 2 years before the clinical onset of narcolepsy;
  3. (3)
    undergoing a course of therapeutic radiation for cancer, where the brain was in the field of radiation, within the 3 years before the clinical onset of narcolepsy;
  4. (4)
    having a neurological disease, neurodegenerative disease or a paraneoplastic neurological syndrome, where the disease or syndrome involves the hypothalamus, midbrain or brainstem, within the 2 years before the clinical onset of narcolepsy; (i) cerebrovascular accident; (ii) disseminated encephalomyelitis; (iii) hypoxic cerebral insult; (iv) multiple sclerosis; (v) neuromyelitis optica spectrum disorder; and (vi) Parkinson's disease;

    Note: Examples of neurological diseases, neurodegenerative diseases or paraneoplastic neurological syndromes that can involve the hypothalamus, midbrain or brainstem include:.

  5. (5)
    having: (a) a benign or malignant neoplasm; or (b) a non-malignant space occupying lesion; involving the hypothalamus, midbrain or brainstem within the 2 years before the clinical onset of narcolepsy;

    Note: Examples of neoplasms that can involve the hypothalamus, midbrain or brainstem include lymphoma, glioma and craniopharyngioma.

    Note: Examples of non-malignant space occupying lesions that can involve the hypothalamus, midbrain or brainstem include neurosarcoidosis and vascular malformations.

  6. (6)
    receiving the adjuvanted influenza H1N1 vaccine PandemrixTM within the 2 years before the clinical onset of narcolepsy;
  7. (7)
    having infection with H1N1 influenza virus within the 2 years before the clinical onset of narcolepsy;
  8. (8)
    having infection of the pharynx with Streptococcus pyogenes within the 3 years before the clinical onset of narcolepsy;
  9. (9)
    having concussion or moderate to severe traumatic brain injury within the 2 years before the clinical worsening of narcolepsy, and in the case of sustained unconsciousness following injury to the head, the clinical worsening of narcolepsy occurred within 2 years of regaining consciousness;
  10. (10)
    having a neurosurgical procedure involving the hypothalamus, midbrain or brainstem, within the 2 years before the clinical worsening of narcolepsy;
  11. (11)
    undergoing a course of therapeutic radiation for cancer, where the brain was in the field of radiation, within the 3 years before the clinical worsening of narcolepsy;
  12. (12)
    having a neurological disease, neurodegenerative disease or a paraneoplastic neurological syndrome, where the disease or syndrome involves the hypothalamus, midbrain or brainstem, within the 2 years before the clinical worsening of narcolepsy; (i) cerebrovascular accident; (ii) disseminated encephalomyelitis; (iii) hypoxic cerebral insult; (iv) multiple sclerosis; (v) neuromyelitis optica spectrum disorder; and (vi) Parkinson's disease;

    Note: Examples of neurological diseases, neurodegenerative diseases or paraneoplastic neurological syndromes that can involve the hypothalamus, midbrain or brainstem include:.

  13. (13)
    having: (a) a benign or malignant neoplasm; or (b) a non-malignant space occupying lesion; involving the hypothalamus, midbrain or brainstem within the 2 years before the clinical worsening of narcolepsy;

    Note: Examples of neoplasms that can involve the hypothalamus, midbrain or brainstem include lymphoma, glioma and craniopharyngioma.

    Note: Examples of non-malignant space occupying lesions that can involve the hypothalamus, midbrain or brainstem include neurosarcoidosis and vascular malformations.

  14. (14)
    receiving the adjuvanted influenza H1N1 vaccine PandemrixTM within the 2 years before the clinical worsening of narcolepsy;
  15. (15)
    having infection with H1N1 influenza virus within the 2 years before the clinical worsening of narcolepsy;
  16. (16)
    having infection of the pharynx with Streptococcus pyogenes within the 3 years before the clinical worsening of narcolepsy;
  17. (17)
    inability to obtain appropriate clinical management for narcolepsy;

Aggravation-only factors: the factors in subsections 9(9) to 9(17) 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. 12 of 2022

15 factors

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

  1. (1)
    having concussion or moderate to severe traumatic brain injury within the 2 years before the clinical onset of narcolepsy, and in the case of sustained unconsciousness following injury to the head, the clinical onset of narcolepsy occurred within 2 years of regaining consciousness;
  2. (2)
    having a neurosurgical procedure involving the hypothalamus, midbrain or brainstem, within the 2 years before the clinical onset of narcolepsy;
  3. (3)
    undergoing a course of therapeutic radiation for cancer, where the brain was in the field of radiation, within the 3 years before the clinical onset of narcolepsy;
  4. (4)
    having a neurological disease, neurodegenerative disease or a paraneoplastic neurological syndrome, where the disease or syndrome involves the hypothalamus, midbrain or brainstem, within the 2 years before the clinical onset of narcolepsy; (i) cerebrovascular accident; (ii) disseminated encephalomyelitis; (iii) hypoxic cerebral insult; (iv) multiple sclerosis; (v) neuromyelitis optica spectrum disorder; and (vi) Parkinson's disease;

    Note: Examples of neurological diseases, neurodegenerative diseases or paraneoplastic neurological syndromes that can involve the hypothalamus, midbrain or brainstem include:.

  5. (5)
    having: (a) a benign or malignant neoplasm; or (b) a non-malignant space occupying lesion; involving the hypothalamus, midbrain or brainstem within the 2 years before the clinical onset of narcolepsy;

    Note: Examples of neoplasms that can involve the hypothalamus, midbrain or brainstem include lymphoma, glioma and craniopharyngioma.

    Note: Examples of non-malignant space occupying lesions that can involve the hypothalamus, midbrain or brainstem include neurosarcoidosis and vascular malformations.

  6. (6)
    receiving the adjuvanted influenza H1N1 vaccine PandemrixTM within the 2 years before the clinical onset of narcolepsy;
  7. (7)
    having infection of the pharynx with Streptococcus pyogenes within the 3 years before the clinical onset of narcolepsy;
  8. (8)
    having concussion or moderate to severe traumatic brain injury within the 2 years before the clinical worsening of narcolepsy, and in the case of sustained unconsciousness following injury to the head, the clinical worsening of narcolepsy occurred within 2 years of regaining consciousness;
  9. (9)
    having a neurosurgical procedure involving the hypothalamus, midbrain or brainstem, within the 2 years before the clinical worsening of narcolepsy;
  10. (10)
    undergoing a course of therapeutic radiation for cancer, where the brain was in the field of radiation, within the 3 years before the clinical worsening of narcolepsy;
  11. (11)
    having a neurological disease, neurodegenerative disease or a paraneoplastic neurological syndrome, where the disease or syndrome involves the hypothalamus, midbrain or brainstem, within the 2 years before the clinical worsening of narcolepsy; (i) cerebrovascular accident; (ii) disseminated encephalomyelitis; (iii) hypoxic cerebral insult; (iv) multiple sclerosis; (v) neuromyelitis optica spectrum disorder; and (vi) Parkinson's disease;

    Note: Examples of neurological diseases, neurodegenerative diseases or paraneoplastic neurological syndromes that can involve the hypothalamus, midbrain or brainstem include:.

  12. (12)
    having: (a) a benign or malignant neoplasm; or (b) a non-malignant space occupying lesion; involving the hypothalamus, midbrain or brainstem within the 2 years before the clinical worsening of narcolepsy;

    Note: Examples of neoplasms that can involve the hypothalamus, midbrain or brainstem include lymphoma, glioma and craniopharyngioma.

    Note: Examples of non-malignant space occupying lesions that can involve the hypothalamus, midbrain or brainstem include neurosarcoidosis and vascular malformations.

  13. (13)
    receiving the adjuvanted influenza H1N1 vaccine PandemrixTM within the 2 years before the clinical worsening of narcolepsy;
  14. (14)
    having infection of the pharynx with Streptococcus pyogenes within the 3 years before the clinical worsening of narcolepsy;
  15. (15)
    inability to obtain appropriate clinical management for narcolepsy;

Aggravation-only factors: the factors in subsections 9(8) to 9(15) 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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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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