{"id":"F2025L01296","name":"Statement of Principles concerning Barrett oesophagus (Balance of Probabilities) (No. 94 of 2025)","slug":"statement-of-principles-concerning-barrett-oesophagus-balance-of-probabilities-no-94-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443013,"registerId":"F2025L01296-fast-fetch-1775957930564","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning Barrett oesophagus (Balance of Probabilities) (No. 94 of 2025)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nBARRETT OESOPHAGUS  (Balance of Probabilities)\n\n(No. 94 of 2025)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 24 October 2025\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\n\n \n\n   \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n \n\n\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning Barrett oesophagus (Balance of Probabilities) (No. 94 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 24 November 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning Barrett’s oesophagus (Balance of Probabilities) (No. 68 of 2016) (Federal Register of Legislation No. F2016L01137) made under subsection 196B(3) of the VEA is repealed.\n\n1.                Application\n\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about Barrett oesophagus and death from Barrett oesophagus.\n\n\nMeaning of Barrett oesophagus\n\n1.           For the purposes of this Statement of Principles, Barrett oesophagus:\n  1.           means a condition in which there is metaplasia of the epithelium of the lower oesophagus from the normal stratified squamous epithelium to abnormal columnar epithelium; and\n  2.            includes metaplasia at the gastro-oesophageal junction.\n2.           While Barrett oesophagus attracts ICD‑10‑AM code K22.7, in applying this Statement of Principles the meaning of Barrett oesophagus is that given in subsection (2).\n3.           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), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.\n\n\nDeath from Barrett oesophagus\n\n1.           For the purposes of this Statement of Principles, Barrett oesophagus, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's Barrett oesophagus.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that Barrett oesophagus and death from Barrett oesophagus can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.\n\n1.                Factors that must exist\n\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, Barrett oesophagus or death from Barrett oesophagus is connected with the circumstances of a person's relevant service:\n\n1.           having gastro-oesophageal reflux disease for at least the 2 years before clinical onset or clinical worsening;\n2.           having a hiatus hernia before clinical onset or clinical worsening;\n3.           having:\n  1.           a Body Mass Index (BMI) of 30 or greater; or\n  2.           for males, a waist circumference exceeding 102 centimetres; or\n  3.           for females, a waist circumference exceeding 88 centimetres.\n\n\nfor at least the 5 years immediately preceding clinical onset or clinical worsening;\n\nNote: Body Mass Index (BMI) is calculated as W/H2 where:\n\n1.         W is the person's weight in kilograms; and\n\n\n1.        H is the person's height in metres.\n\n\n1.           having systemic sclerosis before clinical onset or clinical worsening;\n\n\nNote: Systemic sclerosis is also known as scleroderma.\n\n1.           inability to obtain appropriate clinical management for Barrett oesophagus before clinical worsening.\n\n\n1.            Relationship to service\n  1.           The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.\n  2.           The clinical worsening aspects of factors set out in section 9 apply only to material contribution to, or aggravation of, Barrett oesophagus where the person's Barrett oesophagus was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 9 applies in relation to a person; and\n2.           that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;\n\n\nthen the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\n \n\n \n\nSchedule 1 - Dictionary  \n\nNote:               See Section 6\n\n1               Definitions\n\nIn this instrument:\n\n                               Barrett oesophagus—see subsection 7(2).\n\n                             MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                             relevant service means:\n\n(a)          eligible war service (other than operational service) under the VEA;\n\n(b)          defence service (other than hazardous service and British nuclear test defence service) under the VEA; or\n\n(c)          peacetime service under the MRCA.\n\nNote: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\n                             terminal event means the proximate or ultimate cause of death and includes the following:\n\n(a)           pneumonia;\n\n(b)           respiratory failure;\n\n(c)           cardiac arrest;\n\n(d)           circulatory failure; or\n\n(e)           cessation of brain function.\n\n                             VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the standard scope of Repatriation Medical Authority Statements of Principles. It replaces the 2016 version (No. 68 of 2016) with updated medical criteria but does not expand beyond the established framework of determining service-relatedness for veteran compensation claims. The structure and purpose remain consistent with the original legislative intent under subsection 196B(3) of the Veterans' Entitlements Act 1986."},"complexity_factors":["Moderate cross-referencing between the main instrument and Schedule 1 (Dictionary)","Nested definitions: 'Barrett oesophagus' defined by reference to 'metaplasia' and 'epithelium' (medical terminology)","Conditional logic in section 9 with multiple alternative pathways (5 different factors, some with sub-factors)","Mathematical formula embedded in text (BMI calculation W/H²)","Temporal requirements ('at least 2 years', 'at least 5 years immediately preceding') that create evidentiary burdens","Dual application framework — applies to two different Acts (VEA and MRCA) with different service definitions","Incorporation by reference of external classification system (ICD-10-AM Tenth Edition)","Specific exclusionary language in section 10(2) regarding clinical worsening claims"],"plain_english_summary":"This instrument sets out how to decide if Australian veterans and defence personnel can get compensation for Barrett oesophagus under the VEA or MRCA. It identifies specific medical risk factors (eg, chronic reflux, hiatus hernia, prolonged obesity, systemic sclerosis, lack of timely treatment) and requires at least one factor to be present and causally linked to military service on the balance of probabilities.\n\nIt also clarifies claims about worsening during service and replaces the 2016 ruling."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals Statement No. 68 of 2016 and replaces it with the present Statement that prescribes specific qualifying medical factors, numerical thresholds and temporal requirements for linking Barrett oesophagus (and death contributed to by it) to relevant service for VEA/MRCA claims. The instrument therefore changes the operative Statement of Principles that applies to claims; the text does not itself contain a side‑by‑side comparison, so whether the net scope is broader or narrower than the repealed Statement cannot be determined from this instrument alone."},"complexity_factors":["Legal proof standard: ties causation to the 'balance of probabilities', requiring legal assessment of medical evidence.","Medical specificity: relies on clinical definitions (metaplasia of lower oesophagus) and technical concepts (e.g. Barrett oesophagus, systemic sclerosis).","Temporal thresholds: distinct time windows for exposure/condition before clinical onset or worsening (2 years for reflux; 5 years for obesity/waist criteria).","Quantitative criteria: BMI ≥30 and sex‑specific waist circumference thresholds, plus provided BMI calculation method.","Service linkage: each qualifying factor must be shown to be 'related to' relevant service as defined under the VEA/MRCA, adding a causation nexus between medical factors and service.","Interaction with other instruments: cross‑references apply where a listed factor is itself covered by another Statement of Principles, creating dependence on other instruments' terms.","Death definition: expands scope to include death from a terminal event 'contributed to by' Barrett oesophagus, requiring assessment of contribution to proximate causes of death.","Repeal clause: replaces a prior Statement (No. 68 of 2016), which may change claim outcomes though no direct comparison text is provided here."],"plain_english_summary":"This instrument replaces the earlier Statement and sets when Barrett oesophagus (and death contributed to by it) is treated as connected to service for claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. It does this by naming specific medical risk factors and time thresholds that must be proven on the balance of probabilities. \n\nIt affects veterans and serving members claiming compensation: qualifying factors include chronic gastro‑oesophageal reflux, hiatus hernia, certain obesity measures, systemic sclerosis, or inability to obtain appropriate clinical management, with required pre‑onset durations and a link to relevant service."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-balance-of-probabilities-no-94-of-2025","history":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-balance-of-probabilities-no-94-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-balance-of-probabilities-no-94-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-balance-of-probabilities-no-94-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-balance-of-probabilities-no-94-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-balance-of-probabilities-no-94-of-2025/documents"}}