{"id":"F2025L01295","name":"Statement of Principles concerning Barrett oesophagus (Reasonable Hypothesis) (No. 93 of 2025)","slug":"statement-of-principles-concerning-barrett-oesophagus-reasonable-hypothesis-no-93-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443015,"registerId":"F2025L01295-fast-fetch-1775957930569","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning Barrett oesophagus (Reasonable Hypothesis) (No. 93 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  (Reasonable Hypothesis)\n\n(No. 93 of 2025)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) 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   \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 (Reasonable Hypothesis) (No. 93 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(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning Barrett’s oesophagus (Reasonable Hypothesis) (No. 67 of 2016) (Federal Register of Legislation No. F2016L01135) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that Barrett oesophagus and death from Barrett oesophagus can be related to relevant service rendered by veterans, members of Peacekeeping Forces, 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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting Barrett oesophagus or death from Barrett oesophagus with the circumstances of a person's relevant service:\n\n1.           having gastro-oesophageal reflux disease for at least the 1 year 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 consume an average of at least 200 g/day of any combination of fruit and vegetables, for at least the 5 years before clinical onset or clinical worsening;\n2.           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(2) 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)          operational service under the VEA;\n\n(b)          peacekeeping service under the VEA;\n\n(c)          hazardous service under the VEA;\n\n(d)          British nuclear test defence service under the VEA;\n\n(e)          warlike service under the MRCA; or\n\n(f)           non-warlike service under the MRCA.\n\nNote: MRCA and VEA are 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":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the standard scope of a Repatriation Medical Authority Statement of Principles. It addresses one specific medical condition (Barrett oesophagus) for the purpose of determining veterans' compensation claims under the reasonable hypothesis test. The 2025 version updates and repeals the 2016 version but does not expand beyond the original purpose of establishing medical connection factors for this condition."},"complexity_factors":["Short, focused instrument (approximately 1,500 words) with single medical condition scope","Only 6 defined terms in the Dictionary (Barrett oesophagus, MRCA, relevant service, terminal event, VEA, plus BMI calculation note)","Clear, numbered list of 6 factors in section 9 with minimal cross-referencing","Simple conditional structure: 'at least one factor must exist' — no nested exceptions or complex logical operators","Single cross-reference mechanism in section 11 (referral to other Statements of Principles)","Standard template structure common to all Repatriation Medical Authority instruments, making it predictable for users familiar with the scheme"],"plain_english_summary":"This instrument updates the medical rules for when veterans, peacekeepers, and current or former defence members can claim compensation for Barrett oesophagus, replacing the 2016 statement. It applies under both veterans’ compensation schemes and uses a “reasonable hypothesis” test — listing service‑related medical and lifestyle risk factors (eg chronic reflux/hiatus hernia, obesity, certain autoimmune disease, poor diet, inadequate treatment) to establish a plausible link. It matters because it governs access to pensions, treatment and other benefits."},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2016 Statement of Principles (No. 67 of 2016) and replaces it with updated definitions and a new list of qualifying factors and temporal requirements for linking Barrett oesophagus (and death from it) to relevant service (see s4, s7–s10). The text does not contain a side‑by‑side comparison, so whether each substantive criterion is stricter or looser than the 2016 version cannot be determined from this instrument alone."},"complexity_factors":["Detailed medical thresholds and temporal windows (e.g. GERD ≥1 year; certain BMI/waist measures for ≥5 years) — s9","Requirement that qualifying factors be causally related to the person's relevant service, adding a linkage evidentiary step — s10","Cross-reference mechanism to other Statements of Principles when factors overlap with other conditions, creating inter-instrument dependency — s11","Definitions, ICD‑10‑AM code reference, and inclusion of death from terminal events, requiring precise interpretation of medical records — s7(2)–(3), Sch1","Application limited to claims under the VEA/MRCA, so legal scope ties to specific entitlement regimes — s5, Sch1","Replacement of an earlier Statement (repeal), requiring administrators to track versioning and apply the current instrument — s4","Standarding language 'reasonable hypothesis' and RMA's evidentiary basis statement introduce administrative discretion in claim assessment — s8","Claimant evidence burden: proving both existence of factors and their relation to service increases documentary and medical-evidence needs — s9, s10"],"plain_english_summary":"This instrument, commencing 24 November 2025, is a Repatriation Medical Authority Statement of Principles that sets the medical criteria used to determine whether Barrett oesophagus (and death from it) can be connected to a person’s relevant military service for VEA/MRCA claims. It lists specific qualifying factors (for example, gastro‑oesophageal reflux, hiatus hernia, obesity thresholds, systemic sclerosis, dietary deficit, or lack of appropriate clinical management) and requires those factors to be related to the person’s relevant service. (See ss.2–5, 7–10.)"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-reasonable-hypothesis-no-93-of-2025","history":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-reasonable-hypothesis-no-93-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-reasonable-hypothesis-no-93-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-reasonable-hypothesis-no-93-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-reasonable-hypothesis-no-93-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-barrett-oesophagus-reasonable-hypothesis-no-93-of-2025/documents"}}