Restless legs syndrome

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.

RH No. 113 of 2022 · BoP No. 114 of 202260 factors

Meaning of restless legs syndrome: For the purposes of this Statement of Principles, restless legs syndrome: (a) means a sensorimotor neurological disorder, in which there is: (i) a strong urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs; and (ii) the urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity such as lying or sitting; and (iii) the urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching; and (iv) the urge to move or unpleasant sensations are worse in the evening or night than during the day, or only occur in the evening or night; and (b) these clinical features: (i) occur at least 3 times per week, and have persisted for at least 3 consecutive months; and (ii) cause significant distress, or impairment in behavioural, social, physical or occupational functioning; and (iii) are not solely accounted for by another medical or behavioural condition.

Reasonable Hypothesis (RH) — Statement of Principles No. 113 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 restless legs syndrome or death from restless legs syndrome with the circumstances of a person's relevant service:

(1)
having diabetes mellitus at the time of the clinical onset of restless legs syndrome;
(2)
having iron deficiency at the time of the clinical onset of restless legs syndrome;
Note: iron deficiency is defined in the Schedule 1 - Dictionary.
(3)
having chronic renal failure at the time of the clinical onset of restless legs syndrome;
Note: chronic renal failure is defined in the Schedule 1 - Dictionary.
(4)
having a neurological disorder from the specified list of neurological disorders, involving the lower limbs, at the time of the clinical onset of restless legs syndrome;
Note: specified list of neurological disorders is defined in the Schedule 1 - Dictionary.
(5)
having Parkinson's disease at the time of the clinical onset of restless legs syndrome;
(6)
taking a drug from the specified list of drugs: (a) as prescribed for ongoing use; and (b) within the 30 days before the clinical onset of restless legs syndrome;
Note: specified list of drugs is defined in the Schedule 1 - Dictionary.
(7)
having multiple sclerosis at the time of the clinical onset of restless legs syndrome;
(8)
having a clinically significant disorder of mental health as specified at the time of the clinical onset of restless legs syndrome;
Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.
(9)
receiving spinal anaesthesia within the 30 days before the clinical onset of restless legs syndrome;
(10)
having smoked tobacco products in an amount of at least 5 pack-years before the clinical onset of restless legs syndrome, and if smoking has ceased before the clinical onset of restless legs syndrome, then that onset occurred within 5 years of cessation;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
(11)
being obese for at least the 5 years before the clinical onset of restless legs syndrome;
Note: being obese is defined in the Schedule 1 - Dictionary.
(12)
having narcolepsy or obstructive sleep apnoea at the time of the clinical onset of restless legs syndrome;
(13)
being pregnant at the time of the clinical onset of restless legs syndrome;
(14)
inability to undertake physical activity greater than 3 METs for a continuous period of at least the 1 year before the clinical onset of restless legs syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(15)
having dyslipidaemia for at least the 1 year before the clinical onset of restless legs syndrome;
Note: dyslipidaemia is defined in the Schedule 1 - Dictionary.
(16)
having migraine at the time of the clinical onset of restless legs syndrome;
(17)
having chronic obstructive pulmonary disease or asthma at the time of the clinical onset of restless legs syndrome;
(18)
having a cerebrovascular accident within 3 months before the clinical onset of restless legs syndrome;
(19)
having diabetes mellitus at the time of the clinical worsening of restless legs syndrome;
(20)
having iron deficiency at the time of the clinical worsening of restless legs syndrome;
Note: iron deficiency is defined in the Schedule 1 - Dictionary.
(21)
having chronic renal failure at the time of the clinical worsening of restless legs syndrome;
Note: chronic renal failure is defined in the Schedule 1 - Dictionary.
(22)
having a neurological disorder from the specified list of neurological disorders, involving the lower limbs, at the time of the clinical worsening of restless legs syndrome;
Note: specified list of neurological disorders is defined in the Schedule 1 - Dictionary.
(23)
having Parkinson's disease at the time of the clinical worsening of restless legs syndrome;
(24)
taking a drug from the specified list of drugs: (a) as prescribed for ongoing use; and (b) within the 30 days before the clinical worsening of restless legs syndrome;
Note: specified list of drugs is defined in the Schedule 1 - Dictionary.
(25)
having multiple sclerosis at the time of the clinical worsening of restless legs syndrome;
(26)
having a clinically significant disorder of mental health as specified at the time of the clinical worsening of restless legs syndrome;
Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.
(27)
receiving spinal anaesthesia within the 30 days before the clinical worsening of restless legs syndrome;
(28)
having smoked tobacco products in an amount of at least 5 pack-years before the clinical worsening of restless legs syndrome, and if smoking has ceased before the clinical worsening of restless legs syndrome, then that worsening occurred within 5 years of cessation;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
(29)
being obese for at least the 5 years before the clinical worsening of restless legs syndrome;
Note: being obese is defined in the Schedule 1 - Dictionary.
(30)
having narcolepsy or obstructive sleep apnoea at the time of the clinical worsening of restless legs syndrome;
(31)
being pregnant at the time of the clinical worsening of restless legs syndrome;
(32)
inability to undertake physical activity greater than 3 METs for a continuous period of at least the 1 year before the clinical worsening of restless legs syndrome;
Note: MET is defined in the Schedule 1 - Dictionary.
(33)
having dyslipidaemia for at least the 1 year before the clinical worsening of restless legs syndrome;
Note: dyslipidaemia is defined in the Schedule 1 - Dictionary.
(34)
having migraine at the time of the clinical worsening of restless legs syndrome;
(35)
having chronic obstructive pulmonary disease or asthma at the time of the clinical worsening of restless legs syndrome;
(36)
having a cerebrovascular accident within the 3 months before the clinical worsening of restless legs syndrome;
(37)
for restless legs syndrome augmentation only, taking a dopaminergic agent including levodopa and pramipexole, or tramadol, for a continuous period of at least the 3 months before that clinical worsening of restless legs syndrome;
Note: restless legs syndrome augmentation is defined in the Schedule 1 - Dictionary.
(38)
inability to obtain appropriate clinical management for restless legs syndrome;

Aggravation-only factors: the factors in subsections 9(19) to 9(38) 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. 114 of 2022

22 factors

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

(1)
having diabetes mellitus at the time of the clinical onset of restless legs syndrome;
(2)
having iron deficiency at the time of the clinical onset of restless legs syndrome;
Note: iron deficiency is defined in the Schedule 1 - Dictionary.
(3)
having chronic renal failure at the time of the clinical onset of restless legs syndrome;
Note: chronic renal failure is defined in the Schedule 1 - Dictionary.
(4)
having a neurological disorder from the specified list of neurological disorders, involving the lower limbs, at the time of the clinical onset of restless legs syndrome;
Note: specified list of neurological disorders is defined in the Schedule 1 - Dictionary.
(5)
taking a drug from the specified list of drugs: (a) as prescribed for ongoing use; and (b) for at least the 30 days before the clinical onset of restless legs syndrome;
Note: specified list of drugs is defined in the Schedule 1 - Dictionary.
(6)
having multiple sclerosis at the time of the clinical onset of restless legs syndrome;
(7)
having smoked tobacco products in an amount of at least 10 pack-years before the clinical onset of restless legs syndrome, and if smoking has ceased before the clinical onset of restless legs syndrome, then that onset occurred within 5 years of cessation;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
(8)
being obese for at least the 5 years before the clinical onset of restless legs syndrome;
Note: being obese is defined in the Schedule 1 - Dictionary.
(9)
being pregnant at the time of the clinical onset of restless legs syndrome;
(10)
having diabetes mellitus at the time of the clinical worsening of restless legs syndrome;
(11)
having iron deficiency at the time of the clinical worsening of restless legs syndrome;
Note: iron deficiency is defined in the Schedule 1 - Dictionary.
(12)
having chronic renal failure at the time of the clinical worsening of restless legs syndrome;
Note: chronic renal failure is defined in the Schedule 1 - Dictionary.
(13)
having a neurological disorder from the specified list of neurological disorders, involving the lower limbs, at the time of the clinical worsening of restless legs syndrome;
Note: specified list of neurological disorders is defined in the Schedule 1 - Dictionary.
(14)
taking a drug from the specified list of drugs: (a) as prescribed for ongoing use; and (b) for at least the 30 days before the clinical worsening of restless legs syndrome;
Note: specified list of drugs is defined in the Schedule 1 - Dictionary.
(15)
having multiple sclerosis at the time of the clinical worsening of restless legs syndrome;
(16)
having smoked tobacco products in an amount of at least 10 pack-years before the clinical worsening of restless legs syndrome, and if smoking has ceased before the clinical worsening of restless legs syndrome, then that worsening occurred within 5 years of cessation;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
(17)
being obese for at least the 5 years before the clinical worsening of restless legs syndrome;
Note: being obese is defined in the Schedule 1 - Dictionary.
(18)
being pregnant at the time of the clinical worsening of restless legs syndrome;
(19)
having chronic obstructive pulmonary disease at the time of the clinical worsening of restless legs syndrome;
(20)
having obstructive sleep apnoea at the time of the clinical worsening of restless legs syndrome;
(21)
for restless legs syndrome augmentation only, taking a dopaminergic agent including levodopa and pramipexole, or tramadol, for a continuous period of at least the 3 months before the clinical worsening of restless legs syndrome;
Note: restless legs syndrome augmentation is defined in the Schedule 1 - Dictionary.
(22)
inability to obtain appropriate clinical management for restless legs syndrome;

Aggravation-only factors: the factors in subsections 9(10) to 9(22) 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.

Restless legs syndrome — DVA SoP factors