{"id":"F2017L00467","name":"Statement of Principles concerning bronchiectasis (Reasonable Hypothesis) (No. 30 of 2017)","slug":"statement-of-principles-concerning-bronchiectasis-reasonable-hypothesis-no-30-of-2017","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439178,"registerId":"F2017L00467-fast-fetch-1775955291657","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning bronchiectasis (Reasonable Hypothesis) (No. 30 of 2017)","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\nBRONCHIECTASIS (Reasonable Hypothesis)\n\n(No. 30 of 2017)\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 21 April 2017\n\n \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 Revocation\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 bronchiectasis (Reasonable Hypothesis) (No. 30 of 2017).\n\n2 Commencement\n\n This instrument commences on 22 May 2017.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 Revocation\n\nThe Statement of Principles concerning bronchiectasis No. 17 of 2009 made under subsection 196B(2) of the VEA is revoked.\n\n5 Application\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\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 bronchiectasis and death from bronchiectasis.\n\nMeaning of bronchiectasis\n\n(2) For the purposes of this Statement of Principles, bronchiectasis means:\n\n(a) an acquired lung disease with permanent and irreversible, abnormal dilatation of bronchi and bronchioles; and\n\n(b) excludes congenital bronchiectasis, and bronchiectasis associated with cystic fibrosis, alpha-1-antitrypsin deficiency, common variable immune deficiency and other genetic disorders.\n\nDeath from bronchiectasis\n\n(3) For the purposes of this Statement of Principles, bronchiectasis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's bronchiectasis.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that bronchiectasis and death from bronchiectasis 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: relevant service is defined in the Schedule 1 – Dictionary.\n\n9 Factors that must exist\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 bronchiectasis or death from bronchiectasis with the circumstances of a person's relevant service:\n\n(1) having viral or bacterial pneumonia within the ten years before the clinical onset of bronchiectasis;\n\n(2) having pertussis within the ten years before the clinical onset of bronchiectasis;\n\n(3) having pulmonary tuberculosis or non-tuberculous mycobacterial infection of the lung, before the clinical onset of bronchiectasis;\n\n(4) having sarcoidosis of the lung before the clinical onset of bronchiectasis;\n\n(5) having bronchial obstruction before the clinical onset of bronchiectasis, where the bronchiectasis is distal to that obstruction;\n\nNote: bronchial obstruction is defined in the Schedule 1 - Dictionary. \n\n(6) inhaling vapours, gases or fumes of a chemical agent from the specified list of chemical agents:\n\n(a) resulting in signs and symptoms of severe acute lower respiratory damage requiring medical attention within 48 hours after exposure; and\n\n(b) the persistence of respiratory symptoms and signs for at least one week after exposure,\n\nwithin the five years before the clinical onset of bronchiectasis;\n\nNote: specified list of chemical agents is defined in the Schedule 1 - Dictionary. \n\n(7) having an occupational lung disease from the specified list of occupational lung diseases at the time of the clinical onset of bronchiectasis;\n\nNote: specified list of occupational lung diseases is defined in the Schedule 1 - Dictionary. \n\n(8) inhaling sulphur mustard (mustard gas) before the clinical onset of bronchiectasis;\n\n(9) having aspiration pneumonitis within the five years before the clinical onset of bronchiectasis;\n\nNote: aspiration pneumonitis is defined in the Schedule 1 - Dictionary. \n\n(10) having gastro-oesophageal reflux disease, with erosive oesophagitis or oesophageal stricture, within the two years before the clinical onset of bronchiectasis;\n\n(11) having allergic bronchopulmonary aspergillosis at the time of the clinical onset of bronchiectasis;\n\nNote: allergic bronchopulmonary aspergillosis is defined in the Schedule 1 - Dictionary. \n\n(12) undergoing solid organ or bone marrow transplantation before the clinical onset of bronchiectasis;\n\n(13) having fibrosis or fibrosing interstitial lung disease, involving the segment of the lung affected by bronchiectasis, before the clinical onset of bronchiectasis;\n\n(14) being exposed to arsenic as specified before the clinical onset of bronchiectasis;\n\nNote: being exposed to arsenic as specified is defined in the Schedule 1 - Dictionary. \n\n(15) having a disease from the specified list of connective tissue diseases at the time of the clinical onset of bronchiectasis;\n\nNote: specified list of connective tissue diseases is defined in the Schedule 1 - Dictionary. \n\n(16) being infected with human immunodeficiency virus before the clinical onset of bronchiectasis;\n\n(17) having a haematological malignancy at the time of the clinical onset of bronchiectasis;\n\n(18) being treated with an immunosuppressive drug within the five years before the clinical onset of bronchiectasis;\n\nNote: immunosuppressive drug is defined in the Schedule 1 - Dictionary. \n\n(19) being infected with human T-cell lymphotropic virus type 1 before the clinical onset of bronchiectasis;\n\n(20) having inflammatory bowel disease at the time of the clinical onset of bronchiectasis;\n\n(21) having severe and persistent asthma within the five years before the clinical onset of bronchiectasis;\n\nNote: severe and persistent asthma is defined in the Schedule 1 - Dictionary. \n\n(22) having chronic obstructive pulmonary disease at the time of the clinical onset of bronchiectasis;\n\n(23) having an episode of acute viral or bacterial lower respiratory tract infection requiring medical treatment, within the one year before the clinical worsening of bronchiectasis;\n\n(24) having pertussis within the ten years before the clinical worsening of bronchiectasis;\n\n(25) having pulmonary tuberculosis or non-tuberculous mycobacterial infection of the lung before the clinical worsening of bronchiectasis;\n\n(26) having sarcoidosis of the lung before the clinical worsening of bronchiectasis;\n\n(27) having bronchial obstruction before the clinical worsening of bronchiectasis, where the bronchiectasis is distal to that obstruction;\n\nNote: bronchial obstruction is defined in the Schedule 1 - Dictionary. \n\n(28) inhaling vapours, gases or fumes of a chemical agent from the specified list of chemical agents:\n\n(a) resulting in signs and symptoms of severe acute lower respiratory damage requiring medical attention within 48 hours after exposure; and\n\n(b) the persistence of respiratory symptoms and signs for at least one week after exposure,\n\nwithin the five years before the clinical worsening of bronchiectasis;\n\nNote: specified list of chemical agents is defined in the Schedule 1 - Dictionary. \n\n(29) having an occupational lung disease from the specified list of occupational lung diseases at the time of the clinical worsening of bronchiectasis;\n\nNote: specified list of occupational lung diseases is defined in the Schedule 1 - Dictionary. \n\n(30) inhaling sulphur mustard (mustard gas) before the clinical worsening of bronchiectasis;\n\n(31) having aspiration pneumonitis within the five years before the clinical worsening of bronchiectasis;\n\nNote: aspiration pneumonitis is defined in the Schedule 1 - Dictionary. \n\n(32) having gastro-oesophageal reflux disease, with erosive oesophagitis or oesophageal stricture, within the two years before the clinical worsening of bronchiectasis;\n\n(33) having allergic bronchopulmonary aspergillosis at the time of the clinical worsening of bronchiectasis;\n\nNote: allergic bronchopulmonary aspergillosis is defined in the Schedule 1 - Dictionary. \n\n(34) undergoing solid organ or bone marrow transplantation before the clinical worsening of bronchiectasis;\n\n(35) having fibrosis or fibrosing interstitial lung disease, involving the segment of the lung affected by bronchiectasis, before the clinical worsening of bronchiectasis;\n\n(36) being exposed to arsenic as specified before the clinical worsening of bronchiectasis;\n\nNote: being exposed to arsenic as specified is defined in the Schedule 1 - Dictionary. \n\n(37) having a disease from the specified list of connective tissue diseases at the time of the clinical worsening of bronchiectasis;\n\nNote: specified list of connective tissue diseases is defined in the Schedule 1 - Dictionary. \n\n(38) being infected with human immunodeficiency virus before the clinical worsening of bronchiectasis;\n\n(39) having a haematological malignancy at the time of the clinical worsening of bronchiectasis;\n\n(40) being treated with an immunosuppressive drug within the five years before the clinical worsening of bronchiectasis;\n\nNote: immunosuppressive drug is defined in the Schedule 1 - Dictionary. \n\n(41) being infected with human T-cell lymphotropic virus type 1 before the clinical worsening of bronchiectasis;\n\n(42) having inflammatory bowel disease at the time of the clinical worsening of bronchiectasis;\n\n(43) having severe and persistent asthma within the five years before the clinical worsening of bronchiectasis;\n\nNote: severe and persistent asthma is defined in the Schedule 1 - Dictionary. \n\n(44) having chronic obstructive pulmonary disease at the time of the clinical worsening of bronchiectasis;\n\n(45) inability to obtain appropriate clinical management for bronchiectasis.\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(23) to 9(45) apply only to material contribution to, or aggravation of, bronchiectasis where the person's bronchiectasis 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(2) 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\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n allergic bronchopulmonary aspergillosis means infection of the bronchi and lungs by species of Aspergillus accompanied by wheeze, often with expectoration of yellow or brown bronchial plugs composed of eosinophils and fungal hyphae.\n\n aspiration pneumonitis means inflammation of the lungs with clinical or radiological evidence of consolidation due to the deposition into the respiratory tract of a substance or material from the upper aerodigestive tract.\n\nNote: Examples of a substance or material that may be deposited from the upper aerodigestive tract include food particles, oral secretions or gastric contents.\n\n being exposed to arsenic as specified means:\n\n(a) consuming drinking water with an average arsenic concentration of at least 50 micrograms per litre for a cumulative period of at least ten years; or\n\n(b) having clinical evidence of excessive chronic arsenic exposure.\n\n bronchial obstruction means partial or complete blockage of the lumen of a bronchus.\n\nNote: Examples of a cause of bronchial obstruction include an inhaled foreign body, broncholith or neoplasm, extrinsic narrowing due to enlarged lymph nodes, twisting or displacement of the airways after a lobar resection, or middle lobe syndrome.\n\n bronchiectasis—see subsection 7(2).\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 corticosteroids other than inhaled or topical corticosteroids, drugs used to prevent transplant rejection, tumour necrosis factor-α inhibitors and chemotherapeutic agents used for the treatment of cancer.\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 also defined in the Schedule 1 - Dictionary.\n\n\n\n\n severe and persistent asthma means asthma having any of the following specified characteristics, alone or in combination, for a cumulative period of at least six months within a continuous one year period:\n\n(a) FEV1 (forced expiratory volume in one second) of 60% or less of expected value;\n\n(b) wheeze, tightness, cough, dyspnoea or other symptoms occurring throughout each day;\n\n(c) frequent flare-ups;\n\n(d) the presence of night-time symptoms on more than one night per week; or\n\n(e) symptoms frequently restrict activity or sleep.\n\n specified list of chemical agents means:\n\n(a) ammonia;\n\n(b) chlorine;\n\n(c) oxides of nitrogen;\n\n(d) oxides of sulphur;\n\n(e) paraquat;\n\n(f) phosgene; or\n\n(g) smoke from fires.\n\n specified list of connective tissue diseases means:\n\n(a) ankylosing spondylitis;\n\n(b) dermatomyositis;\n\n(c) eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome);\n\n(d) granulomatosis with polyangiitis (Wegener's granulomatosis);\n\n(e) microscopic polyangiitis;\n\n(f) mixed connective tissue disease; \n\n(g) polymyositis;\n\n(h) relapsing polychondritis;\n\n(i) rheumatoid arthritis;\n\n(j) Sjogren's syndrome;\n\n(k) systemic lupus erythematosus;\n\n(l) systemic sclerosis; or\n\n(m) Takayasu arteritis.\n\n specified list of occupational lung diseases means:\n\n(a) asbestosis;\n\n(b) byssinosis;\n\n(c) coal worker's pneumoconiosis;\n\n(d) extrinsic allergic alveolitis;\n\n(e) flavour worker's lung;\n\n(f) hard metal pneumoconiosis; or\n\n(g) silicosis.\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\n \n\n \n\n \n\n \n","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument revokes the earlier Statement of Principles No.17 of 2009 (section 4) and replaces it with criteria that explicitly exclude congenital and certain genetic causes (section 7(2)), set out a detailed, enumerated list of causative or aggravating factors with specific time windows (section 9), and limits application to claims under section 120A of the VEA or section 338 of the MRCA (section 5). It also formalises cross-references to other Statements (section 11). On the face of this text, those elements indicate a change in scope and detail compared with the revoked instrument."},"complexity_factors":["Large enumerated list of medical and exposure-based factors with differing time limits and applicability (section 9).","Distinct legal effects for clinical onset versus clinical worsening and limits on when aggravation/material contribution rules apply (sections 9; 10(2)).","Cross-reference mechanism to other Statements of Principles where overlapping injuries/diseases are involved (section 11), increasing interpretive dependency.","Detailed definitions and specified lists in Schedule 1 (chemical agents, occupational lung diseases, connective tissue diseases, exposures, medical terms) that materially affect scope and proof.","Explicit exclusions of congenital and specific genetic causes of bronchiectasis (section 7(2)), narrowing coverage in defined ways.","Requirement that any listed factor be related to the person's relevant service before it can form a reasonable hypothesis (section 10(1)), imposing a causal link to be demonstrated.","Revocation of a prior Statement (No.17 of 2009) creates a transition in applicable criteria (section 4).","Instrumental application limited to claims under particular statutory sections, which channels how decision-makers and claimants engage the test (section 5).","Medical-scientific basis stated but the operational burden of proving exposures, timeframes and clinical relationships rests on claim evidence and decision-maker assessment (section 8; section 9 time windows; Schedule 1 exposure definitions)."],"plain_english_summary":"This Statement of Principles sets the medical rules the Repatriation Medical Authority uses to decide whether bronchiectasis (or death from it) can be reasonably connected to a person's relevant service, affecting veterans and eligible service members making claims under the VEA or MRCA (see ss.3,5,7,8). It lists specific infections, diseases, exposures and time-limited windows that, if at least one applies, raise a reasonable hypothesis for entitlement decisions and cross‑refers to other Statements and defined terms (see s.9, s.11, Schedule 1)."},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard replacement Statement of Principles that maintains the established scope of the Repatriation Medical Authority's determinations. It updates the 2009 version with current medical evidence but does not expand beyond the original purpose of establishing service connection criteria for bronchiectasis in the veterans' compensation scheme."},"complexity_factors":["45 distinct factors with specific temporal requirements (ranging from 1 year to 'before clinical onset' with no time limit)","22 defined terms in Schedule 1, many with nested sub-definitions and examples","Dual structure covering both 'clinical onset' (factors 1-22) and 'clinical worsening' (factors 23-44) with nearly parallel but not identical factor lists","Cross-references to other Statements of Principles for conditions mentioned as factors (section 11)","Conditional logic in section 10(2) restricting application of worsening factors to pre-existing conditions","Specific quantitative thresholds in definitions (e.g., '50 micrograms per litre' for arsenic, '60% or less' for FEV1, 'six months within a continuous one year period' for asthma)","Exclusion clauses in the disease definition (congenital bronchiectasis, cystic fibrosis, genetic disorders excluded from scope)"],"plain_english_summary":"This Statement of Principles sets the medical rules the Department of Veterans’ Affairs uses to decide when bronchiectasis (or death from it) is linked to military service for compensation—replacing the 2009 version. It affects veterans and current/former defence members claiming under the VEA or MRCA. The instrument lists 45 medical factors; a claimant needs at least one factor connected to service (with worsening factors limited to pre‑existing disease) for entitlement."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-bronchiectasis-reasonable-hypothesis-no-30-of-2017","history":"/api/acts/statement-of-principles-concerning-bronchiectasis-reasonable-hypothesis-no-30-of-2017/history","analysis":"/api/acts/statement-of-principles-concerning-bronchiectasis-reasonable-hypothesis-no-30-of-2017/analysis","conflicts":"/api/acts/statement-of-principles-concerning-bronchiectasis-reasonable-hypothesis-no-30-of-2017/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-bronchiectasis-reasonable-hypothesis-no-30-of-2017/important-cases","documents":"/api/acts/statement-of-principles-concerning-bronchiectasis-reasonable-hypothesis-no-30-of-2017/documents"}}