{"id":"F2019L00252","name":"Statement of Principles concerning blepharitis (Balance of Probabilities) (No. 30 of 2019)","slug":"statement-of-principles-concerning-blepharitis-balance-of-probabilities-no-30-of-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439963,"registerId":"F2019L00252-fast-fetch-1775955780908","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning blepharitis (Balance of Probabilities) (No. 30 of 2019)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nBLEPHARITIS (Balance of Probabilities)\n\n(No. 30 of 2019)\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 1 March 2019\n\n \n\n \n\n \n\n \n\n \n\n| The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:
|\n| --- |\n| 
Professor Nicholas Saunders AO
Chairperson
|\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\n1 Name\n\nThis is the Statement of Principles concerning blepharitis (Balance of Probabilities) (No. 30 of 2019).\n\n2 Commencement\n\n This instrument commences on 25 March 2019.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning blepharitis No. 64 of 2010 (Federal Register of Legislation No. F2010L02303) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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\n6 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about blepharitis and death from blepharitis.\n\nMeaning of blepharitis\n\n(2) For the purposes of this Statement of Principles, blepharitis:\n\n(a) means inflammation of the eyelid margins or glands of the eyelid; and\n\n(b) includes acute blepharitis, chronic blepharitis, chalazion (Meibomian cyst) and hordeolum (stye); and\n\n(c) excludes orbital or periorbital cellulitis, dacryoadenitis and dacryocystitis.\n\nNote 1: Blepharitis typically presents with itchiness, redness, flaking and crusting of the eyelids.\n\nNote 2: Chalazion typically presents as a painless, localised eyelid swelling or cyst.\n\nNote 3: Hordeolum typically presents as an abscess or cyst of the eyelid, with localised, painful, red swelling of the eyelid.\n\nDeath from blepharitis\n\n(3) For the purposes of this Statement of Principles, blepharitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's blepharitis.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that blepharitis and death from blepharitis 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\n9 Factors that must exist\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, blepharitis or death from blepharitis is connected with the circumstances of a person's relevant service:\n\n(1) having an infection of the affected eyelid at the time of the clinical onset of blepharitis;\n\nNote: infection of the affected eyelid is defined in the Schedule 1 - Dictionary. \n\n(2) having an infestation of the affected eyelid region, due to a parasite from the specified list of parasites, at the time of the clinical onset of blepharitis;\n\nNote: specified list of parasites is defined in the Schedule 1 - Dictionary. \n\n(3) having a smallpox immunisation within the two weeks before the clinical onset of blepharitis;\n\n(4) having seborrhoeic dermatitis of the periocular region at the time of the clinical onset of blepharitis;\n\n(5) having rosacea of the periocular region at the time of the clinical onset of blepharitis;\n\n(6) having psoriasis of the periocular region at the time of the clinical onset of blepharitis;\n\n(7) having discoid lupus erythematosus of the periocular region at the time of the clinical onset of blepharitis;\n\n(8) having ocular or periocular exposure to an allergen within the 48 hours before the clinical onset of blepharitis;\n\nNote: allergen is defined in the Schedule 1 - Dictionary. \n\n(9) having an irritant substance exposure to the region of the affected eye at the time of the clinical onset of blepharitis;\n\nNote: irritant substance is defined in the Schedule 1 - Dictionary. \n\n(10) having mustard gas exposure to the region of the affected eye at the time of the clinical onset of blepharitis;\n\n(11) undergoing a course of therapeutic radiation for cancer, where the region of the affected eye was in the field of radiation, at the time of the clinical onset of blepharitis;\n\n(12) having a benign or malignant neoplasm affecting the affected eyelid at the time of the clinical onset of blepharitis;\n\n(13) having dry eye disease at the time of the clinical onset of blepharitis;\n\nNote: dry eye disease is defined in the Schedule 1 - Dictionary. \n\n(14) being in an immunocompromised state as specified at the time of the clinical onset of blepharitis;\n\nNote: immunocompromised state as specified is defined in the Schedule 1 - Dictionary. \n\n(15) taking oral isotretinoin or oral acitretin for a continuous period of at least one year before the clinical onset of blepharitis, and where treatment has ceased, the clinical onset of blepharitis has occurred within 30 days of cessation;\n\n(16) having an infection of the affected eyelid at the time of the clinical worsening of blepharitis;\n\nNote: infection of the affected eyelid is defined in the Schedule 1 - Dictionary. \n\n(17) having an infestation of the affected eyelid region, due to a parasite from the specified list of parasites, at the time of the clinical worsening of blepharitis;\n\nNote: specified list of parasites is defined in the Schedule 1 - Dictionary. \n\n(18) having seborrhoeic dermatitis of the periocular region at the time of the clinical worsening of blepharitis;\n\n(19) having rosacea of the periocular region at the time of the clinical worsening of blepharitis;\n\n(20) having psoriasis of the periocular region at the time of the clinical worsening of blepharitis;\n\n(21) having discoid lupus erythematosus of the periocular region at the time of the clinical worsening of blepharitis;\n\n(22) having ocular or periocular exposure to an allergen within the 48 hours before the clinical worsening of blepharitis;\n\nNote: allergen is defined in the Schedule 1 - Dictionary. \n\n(23) having an irritant substance exposure to the region of the affected eye at the time of the clinical worsening of blepharitis;\n\nNote: irritant substance is defined in the Schedule 1 - Dictionary. \n\n(24) having mustard gas exposure to the region of the affected eye at the time of the clinical worsening of blepharitis;\n\n(25) undergoing a course of therapeutic radiation for cancer, where the region of the affected eye was in the field of radiation, at the time of the clinical worsening of blepharitis;\n\n(26) having a benign or malignant neoplasm affecting the affected eyelid at the time of the clinical worsening of blepharitis;\n\n(27) having dry eye disease at the time of the clinical worsening of blepharitis;\n\nNote: dry eye disease is defined in the Schedule 1 - Dictionary. \n\n(28) being in an immunocompromised state as specified at the time of the clinical worsening of blepharitis;\n\nNote: immunocompromised state as specified is defined in the Schedule 1 - Dictionary. \n\n(29) inability to obtain appropriate clinical management for blepharitis.\n\n10 Relationship to service\n\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\n(2) The factors set out in subsections 9(16) to 9(29) apply only to material contribution to, or aggravation of, blepharitis where the person's blepharitis was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nIn this Statement of Principles:\n\n(1) if a factor referred to in section 9 applies in relation to a person; and\n\n(2) 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\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\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n allergen means an antigenic substance capable of producing an immune response leading to allergic contact dermatitis.\n\n blepharitis—see subsection 7(2).\n\n chronic renal failure means:\n\n(a) having a glomerular filtration rate of less than 15 mL/min/1.73 m2 for a period of at least three months; or\n\n(b) a need for renal replacement therapy (dialysis or transplantation) for treatment of complications of decreased glomerular filtration rate which would otherwise increase the risk of morbidity and mortality; or\n\n(c) undergoing chronic dialysis.\n\n dry eye disease means a disease caused by a chronic lack of sufficient lubrication and moisture on the surface of the affected eye.\n\nNote: Examples of conditions associated with a chronic lack of sufficient lubrication and moisture on the surface of the eye include, but are not limited to:\n\n(a) dysfunctional tear syndrome;\n\n(b) keratitis sicca;\n\n(c) keratoconjunctivitis sicca;\n\n(d) Meibomian gland dysfunction; \n\n(e) Sjögren syndrome;\n\n(f) vitamin A deficiency; or\n\n(g) xerophthalmia.\n\nimmunocompromised state as specified means a condition of substantially lowered immune function, such as would occur in the following conditions or circumstances:\n\n(a) being treated with an immunosuppressive drug;\n\n(b) having a haematological or solid organ malignancy;\n\n(c) having chronic renal failure;\n\n(d) having infection with human immunodeficiency virus;\n\n(e) having severe malnutrition; or\n\n(f) undergoing solid organ, stem cell or bone marrow transplantation.\n\nNote: chronic renal failure and immunosuppressive drug are also defined in the Schedule 1 - Dictionary.\n\n immunosuppressive drug means a drug or an agent which results in substantial suppression of immune responses.\n\nNote: Examples of an immunosuppressive drug include, but are not limited to:\n\n(a) chemotherapeutic agents used for the treatment of cancer;\n\n(b) corticosteroids, other than inhaled or topical corticosteroids;\n\n(c) drugs used to prevent transplant rejection; or\n\n(d) tumour necrosis factor-α inhibitors.\n\n infection of the affected eyelid means a bacterial, viral or fungal infection involving the skin, hair follicles or glands of the affected eyelid.\n\n irritant substance means a chemical which causes an inflammatory effect on living tissue by chemical action at the site of contact, leading to irritant contact dermatitis.\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 specified list of parasites means:\n\n(a) Demodex folliculorum or Demodex brevis mites; or\n\n(b) Phthirus pubis lice.\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":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard replacement Statement of Principles under the Veterans' Entitlements Act framework. It maintains the established scope of determining service connection for a specific medical condition (blepharitis) and does not expand beyond the original legislative purpose of providing medical criteria for veterans' compensation claims. The 2019 version updates the 2010 predecessor but remains within the same statutory boundaries."},"complexity_factors":["29 distinct factual factors with specific temporal requirements (e.g., 'within 48 hours', 'within two weeks', 'continuous period of at least one year')","14 defined terms in Schedule 1, some with nested definitions (e.g., 'immunocompromised state as specified' contains 6 sub-categories and cross-references to other defined terms)","Dual structure for onset vs. worsening — factors 1-15 for clinical onset, factors 16-28 for clinical worsening, requiring careful matching","Cross-referencing mechanism in section 11 allowing incorporation of other Statements of Principles by reference","Specific exclusion of related conditions (orbital cellulitis, dacryoadenitis, dacryocystitis) in the definition of blepharitis","Conditional logic in section 10(2) restricting factors 16-29 to aggravation cases where condition pre-existed service"],"plain_english_summary":"This instrument sets how Australian veterans and defence members can establish that blepharitis is connected to their service for compensation, using a \"balance of probabilities\" test and a specified list of 29 connection factors. It applies to claims under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004.\n\nBy updating the 2010 guidance, it clarifies when service causes or worsens eyelid inflammation so claims are assessed consistently and eligible veterans can access pensions or compensation."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2010 Statement of Principles (section 4) and reissues the principles governing blepharitis claims. It restates the qualifying medical factors, timing rules for onset and aggravation, and definitions (Schedule 1), and explicitly covers death contributed to by blepharitis (section 7(3)). The instrument therefore replaces the prior instrument and updates the operative Statement of Principles applicable to VEA/MRCA claims."},"complexity_factors":["Enumerated medical causation and exposure factors (infection, infestations, immunocompromise, allergens, irritants, mustard gas, radiation, neoplasm, dry eye disease, specific drugs) — section 9; Schedule 1","Separate timing rules for clinical onset versus clinical worsening and limits on when factors apply (onset, within 48 hours, within 2 weeks, within 30 days of drug cessation) — sections 9(3), 9(8), 9(15), 9(22), 9(24), 10(2)","Multiple defined medical and technical terms that determine scope (dry eye disease, immunocompromised state, infection of the affected eyelid, specified parasites, allergen, irritant substance) — Schedule 1","Interplay with other Statements of Principles where factors reference other injuries/diseases (incorporation by reference) — section 11","Legal framing and application to entitlement schemes (VEA/MRCA claims), including repeal of prior Statement — sections 3, 4, 5","Inclusion of inability to obtain appropriate clinical management as a factor, introducing non-biological evidentiary considerations — section 9(29)"],"plain_english_summary":"This instrument sets the medical rules for deciding whether blepharitis (including chalazion and hordeolum) is connected to a veteran's or member's relevant service for claims under the VEA and MRCA. It lists specific medical causes, exposures, treatments and timing rules that, on the balance of probabilities, establish connection to service and also covers death contributed to by blepharitis. It replaces an earlier Statement of Principles from 2010."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-blepharitis-balance-of-probabilities-no-30-of-2019","history":"/api/acts/statement-of-principles-concerning-blepharitis-balance-of-probabilities-no-30-of-2019/history","analysis":"/api/acts/statement-of-principles-concerning-blepharitis-balance-of-probabilities-no-30-of-2019/analysis","conflicts":"/api/acts/statement-of-principles-concerning-blepharitis-balance-of-probabilities-no-30-of-2019/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-blepharitis-balance-of-probabilities-no-30-of-2019/important-cases","documents":"/api/acts/statement-of-principles-concerning-blepharitis-balance-of-probabilities-no-30-of-2019/documents"}}