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SoP Library › Substance use disorder

Statement of Principles

Substance use disorder — DVA SoP factors

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

Substance use disorder

RH No. 59 of 2017 · BoP No. 60 of 201732 factors

Meaning of substance use disorder: For the purposes of this Statement of Principles, substance use disorder means a disorder of mental health that meets the following diagnostic criteria (derived from DSM-5): A problematic pattern of substance use leading to clinically significant impairment or distress, as manifested by at least four of the following criteria, occurring within a 12-month period: A. Substances are often taken in larger amounts or over a longer period than was intended. B. There is a persistent desire or unsuccessful efforts to cut down or control substance use. C. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects. D. Craving, or a strong desire or urge to use substances. E. Recurrent substance use resulting in a failure to fulfil major role obligations at work, school, or home. F. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of substances. G. Important social, occupational, or recreational activities are given up or reduced because of substance use. H. Recurrent substance use in situations in which it is physically hazardous. I. Continued

Reasonable Hypothesis (RH) — Statement of Principles No. 59 of 2017

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 substance use disorder or death from substance use disorder with the circumstances of a person's relevant service:

  1. (1)
    having a clinically significant disorder of mental health as specified at the time of the clinical onset of substance use disorder;

    Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.

  2. (2)
    experiencing a category 1A stressor within the five years before the clinical onset of substance use disorder;

    Note: category 1A stressor is defined in the Schedule 1 - Dictionary.

  3. (3)
    experiencing a category 1B stressor within the five years before the clinical onset of substance use disorder;

    Note: category 1B stressor is defined in the Schedule 1 - Dictionary.

  4. (4)
    experiencing the death of a significant other within the five years before the clinical onset of substance use disorder;

    Note: significant other is defined in the Schedule 1 - Dictionary.

  5. (5)
    having a medical or psychiatric condition for which a substance was medically prescribed, at the time of the clinical onset of substance use disorder, where the substance use disorder involves one or more agents from the same pharmacological class as the prescribed medication;
  6. (6)
    experiencing severe childhood abuse before the clinical onset of substance use disorder;

    Note: severe childhood abuse is defined in the Schedule 1 - Dictionary.

  7. (7)
    having a medical illness or injury which is life-threatening or which results in serious physical or cognitive disability, within the five years before the clinical onset of substance use disorder;
  8. (8)
    experiencing a category 2 stressor within the one year before the clinical onset of substance use disorder;

    Note: category 2 stressor is defined in the Schedule 1 - Dictionary.

  9. (9)
    having persistent pain of at least three months duration at the time of the clinical onset of substance use disorder;

    Note: persistent pain is defined in the Schedule 1 - Dictionary.

  10. (10)
    having a clinically significant disorder of mental health as specified at the time of the clinical worsening of substance use disorder;

    Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.

  11. (11)
    experiencing a category 1A stressor within the five years before the clinical worsening of substance use disorder;

    Note: category 1A stressor is defined in the Schedule 1 - Dictionary.

  12. (12)
    experiencing a category 1B stressor within the five years before the clinical worsening of substance use disorder;

    Note: category 1B stressor is defined in the Schedule 1 - Dictionary.

  13. (13)
    experiencing the death of a significant other within the five years before the clinical worsening of substance use disorder;

    Note: significant other is defined in the Schedule 1 - Dictionary.

  14. (14)
    experiencing severe childhood abuse before the clinical worsening of substance use disorder;

    Note: severe childhood abuse is defined in the Schedule 1 - Dictionary.

  15. (15)
    having a medical illness or injury which is life-threatening or which results in serious physical or cognitive disability, within the five years before the clinical worsening of substance use disorder;
  16. (16)
    experiencing a category 2 stressor within the one year before the clinical worsening of substance use disorder;

    Note: category 2 stressor is defined in the Schedule 1 - Dictionary.

  17. (17)
    having persistent pain of at least three months duration at the time of the clinical worsening of substance use disorder;

    Note: persistent pain is defined in the Schedule 1 - Dictionary.

  18. (18)
    inability to obtain appropriate clinical management for substance use disorder;

Aggravation-only factors: the factors in subsections 9(10) to 9(18) 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. 60 of 2017

14 factors

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

  1. (1)
    having a clinically significant disorder of mental health as specified at the time of the clinical onset of substance use disorder;

    Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.

  2. (2)
    experiencing a category 1A stressor within the two years before the clinical onset of substance use disorder;

    Note: category 1A stressor is defined in the Schedule 1 - Dictionary.

  3. (3)
    experiencing a category 1B stressor within the two years before the clinical onset of substance use disorder;

    Note: category 1B stressor is defined in the Schedule 1 - Dictionary.

  4. (4)
    experiencing the death of a significant other within the five years before the clinical onset of substance use disorder;

    Note: significant other is defined in the Schedule 1 - Dictionary.

  5. (5)
    having a medical or psychiatric condition for which a substance was medically prescribed, at the time of the clinical onset of substance use disorder, where the substance use disorder involves one or more agents from the same pharmacological class as the prescribed medication;
  6. (6)
    experiencing severe childhood abuse before the clinical onset of substance use disorder;

    Note: severe childhood abuse is defined in the Schedule 1 - Dictionary.

  7. (7)
    experiencing a category 2 stressor within the six months before the clinical onset of substance use disorder;

    Note: category 2 stressor is defined in the Schedule 1 - Dictionary.

  8. (8)
    having a clinically significant disorder of mental health as specified at the time of the clinical worsening of substance use disorder;

    Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary.

  9. (9)
    experiencing a category 1A stressor within the two years before the clinical worsening of substance use disorder;

    Note: category 1A stressor is defined in the Schedule 1 - Dictionary.

  10. (10)
    experiencing a category 1B stressor within the two years before the clinical worsening of substance use disorder;

    Note: category 1B stressor is defined in the Schedule 1 - Dictionary.

  11. (11)
    experiencing the death of a significant other within the five years before the clinical worsening of substance use disorder;

    Note: significant other is defined in the Schedule 1 - Dictionary.

  12. (12)
    experiencing severe childhood abuse before the clinical worsening of substance use disorder;

    Note: severe childhood abuse is defined in the Schedule 1 - Dictionary.

  13. (13)
    experiencing a category 2 stressor within the six months before the clinical worsening of substance use disorder;

    Note: category 2 stressor is defined in the Schedule 1 - Dictionary.

  14. (14)
    inability to obtain appropriate clinical management for substance use disorder;

Aggravation-only factors: the factors in subsections 9(8) to 9(14) 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.

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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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