{"id":"F2026L00140","name":"Statement of Principles concerning cataract (Balance of Probabilities) (No. 16 of 2026)","slug":"statement-of-principles-concerning-cataract-balance-of-probabilities-no-16-of-2026","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443149,"registerId":"F2026L00140-fast-fetch-1775958063966","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning cataract (Balance of Probabilities) (No. 16 of 2026)","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\nCATARACT  (Balance of Probabilities)\n\n(No. 16 of 2026)\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 20 February 2026\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 cataract (Balance of Probabilities) (No. 16 of 2026).\n\n1.                Commencement\n\n\n              This instrument commences on 23 March 2026.\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 acquired cataract (Balance of Probabilities) (No. 88 of 2016) (Federal Register of Legislation No. F2016L01695) made under subsections 196B(3) of the VEA is repealed.\n\n1.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 cataract and death from cataract.\n\n\nMeaning of cataract\n\n1.           For the purposes of this Statement of Principles, cataract:\n  1.           means partial or complete opacification of the lens or lens capsule of the eye, which causes visual impairment; and\n  2.           excludes congenital or infantile cataract and lens malformation.\n2.           While cataract attracts ICD‑10‑AM code H25, H26.1-H26.9, H28.1 or H28.2, in applying this Statement of Principles the meaning of cataract 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 cataract\n\n1.           For the purposes of this Statement of Principles, cataract, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's cataract.\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 cataract and death from cataract 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, cataract or death from cataract is connected with the circumstances of a person's relevant service:\n\n1.           having sunlight exposure to the unprotected eye for a cumulative period of at least 4,500 latitude equivalent hours before clinical onset or clinical worsening;\n\n\nNote: latitude equivalent hours and unprotected eye are defined in the Schedule 1 - Dictionary\n\n1.           having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the affected eye before clinical onset or clinical worsening;\n\n\nNote: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.\n\n1.           having penetrating trauma to the affected eye within the 10 years before clinical onset or clinical worsening;\n\n\nNote: Penetrating trauma to the affected eye includes having a foreign body embedded in the affected eye.\n\n1.           having blunt trauma to the affected eye, resulting in symptoms and signs lasting at least 3 days, within the 10 years before clinical onset or clinical worsening;\n\n\nNote: Symptoms and signs that are associated with blunt trauma to the eye include, but are not limited to, blurry vision, ocular pain, orbital fracture, blood in the anterior chamber of the eye and decreased visual acuity.\n\n1.           having intraocular surgery to the affected eye within the 2 years immediately preceding clinical onset or clinical worsening;\n2.           having a severe thermal or chemical burn to the affected eye, involving at least one of the following clinical features:\n  1.           corneal anaesthesia;\n  2.           corneal opacification;\n  3.           symptoms and signs lasting at least 3 days and requiring medical attention;\n  4.           for chemical burns only, penetration of the chemical into the anterior chamber;\n\n\nwithin the 6 months immediately preceding clinical onset or clinical worsening;\n\n1.           being exposed to an explosive blast within the 3 months immediately preceding clinical onset or clinical worsening;\n2.           having an electrical injury within the 5 years immediately preceding clinical onset or clinical worsening;\n\n\nNote: Electrical injury includes, but is not limited to, low-voltage electrical injury to the head or neck and high-voltage electrical injury to the body.\n\n1.           having uveitis of the affected eye before clinical onset or clinical worsening;\n2.       having a Body Mass Index (BMI) of 30 or greater for at least the 5 years immediately preceding clinical onset or clinical worsening;\n\n\nNote: Body Mass Index (BMI) is calculated as W/H2 where:\n\n1.      W is the person's weight in kilograms; and\n2.      H is the person's height in metres.\n  1.       having diabetes mellitus for at least the 5 years immediately preceding clinical onset or clinical worsening;\n  2.       having chronic hypoparathyroidism with hypocalcaemia for at least 3 months before clinical onset or clinical worsening of cortical or subcapsular cataract;\n  3.       being exposed to corticosteroids in any of the following circumstances within the 10 years before clinical onset or clinical worsening:\n    1.           applying a topical corticosteroid to the cornea of the affected eye equivalent to a cumulative dose of at least 200 drops of 0.1% dexamethasone;\n    1.           having an intravitreal corticosteroid implant in the affected eye for at least 6 months;\n    2.           taking an oral corticosteroid equivalent to a cumulative dose of at least 900 milligrams of prednisone;\n    3.           using an inhalational corticosteroid equivalent to a cumulative dose of at least 2,000 milligrams of budesonide;\n  4.       being treated with a cumulative dose of at least 30 grams of tamoxifen before clinical onset or clinical worsening;\n  5.       having smoked at least 20 pack-years before clinical onset or clinical worsening;\n\n\nNote: one pack-year is defined in the Schedule 1 – Dictionary.\n\n1.       when aged under 60 years only, having chronic renal failure at the time of clinical onset or clinical worsening as indicated by:\n  1.           a glomerular filtration rate of less than 15 mL/min/1.73 m2 for a period of at least 3 months; or\n  1.           undergoing chronic dialysis for renal failure.\n2.       inhaling or having cutaneous contact with 2,4,6-trinitrotoluene (TNT) on more days than not, for at least 10 years before clinical onset or clinical worsening;\n3.       inability to obtain appropriate clinical management for cataract 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 aspect of factors set out in section 9 apply only to material contribution to, or aggravation of, cataract where the person's cataract 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                               cataract—see subsection 7(2).\n\n                               cumulative equivalent dose means the total dose of ionising radiation received by the particular organ or tissue from external exposure, internal exposure or both, apart from normal background radiation exposure in Australia, calculated in accordance with the methodology set out in Guide to calculation of 'cumulative equivalent dose' for the purpose of applying ionising radiation factors contained in Statements of Principles determined under Part XIA of the Veterans' Entitlements Act 1986 (Cth), Australian Radiation Protection and Nuclear Safety Agency, as in force on 2 August 2017.\n\nNote 1: Examples of circumstances that might lead to exposure to ionising radiation include being present during or subsequent to the testing or use of nuclear weapons, undergoing diagnostic or therapeutic medical procedures involving ionising radiation, and being a member of an aircrew, leading to increased levels of exposure to cosmic radiation.\n\nNote 2: For the purpose of dose reconstruction, dose is calculated as an average over the mass of a specific tissue or organ. If a tissue is exposed to multiple sources of ionising radiation, the various dose estimates for each type of radiation must be combined.\n\n                               latitude equivalent hours means hours of sunlight exposure multiplied by the appropriate latitude weighting factor as follows:\n\n(a)          For tropical latitudes (23.5° South to 23.5° North) multiply by 1.0;\n\n(b)          For subtropical latitudes (23.6° - 35°) multiply by 0.75;\n\n(c)          For warm temperate latitudes (35.1° - 45°) multiply by 0.5;\n\n(d)          For cool temperate latitudes (45.1° - 65°) multiply by 0.25.\n\nNote: Sunlight exposure is calculated as the sum of sunlight exposure in each separate latitude, accounting for the different sunlight intensity in each latitude (weighting factor).\n\nSum of sunlight exposure = (hours spent in tropical latitude x tropical latitude weighting factor) + (hours spent in subtropical latitude x subtropical latitude weighting factor) + (hours spent in warm temperate latitude x warm temperate latitude weighting factor) + (hours spent in cool temperate latitude x cool temperate latitude weighting factor).\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                               one pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.\n\nNote 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.\n\nNote 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.\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                               unprotected eye means an eye that is directly exposed to the sun and is not protected by sunglasses with lenses that provide good ultraviolet radiation protection such as lens category 2 or above, a brimmed hat or other physical barrier.\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":6,"scope_assessment":{"changed":false,"description":"This is a standard replacement of an expired Statement of Principles under the Veterans' Entitlements Act framework. It maintains the same fundamental purpose as its 2016 predecessor: establishing medical criteria for service-related cataract claims. While it updates medical science and expands some factors (notably the detailed corticosteroid exposure categories and refined radiation calculations), it has not expanded beyond the original scope of determining compensation eligibility for cataracts in the veteran population."},"complexity_factors":["Multiple nested definitions requiring cross-referencing (e.g., 'latitude equivalent hours' involves a four-tier calculation formula with geographic multipliers)","17 distinct causal factors with varying temporal windows (ranging from 3 months to 10+ years) and specific quantitative thresholds","Technical medical terminology requiring specialised knowledge (sieverts, glomerular filtration rates, ICD-10-AM codes, intravitreal implants)","Complex cumulative dose calculations for radiation, corticosteroids, and tobacco with different measurement units and equivalency formulas","Conditional logic for age-restricted factors (factor 16 applies 'when aged under 60 years only')","Dual application structure covering both clinical onset and clinical worsening with different rules for each","Incorporation by reference to external documents (ICD-10-AM Tenth Edition, ARPANSA radiation dose calculation guide from 2017)","Interlocking definitions across the Dictionary and main body (e.g., 'terminal event' defined separately but used in death provisions)"],"plain_english_summary":"This instrument sets the medical tests the Repatriation Medical Authority uses to decide when cataracts can be accepted as related to Australian defence service for veterans and current/former ADF members seeking compensation. It identifies 17 risk factors (environmental exposures, trauma, medical conditions, chemicals/medications, and access to care) with specific thresholds and time limits, replaces the 2016 Statement of Principles, and therefore determines whether vision loss qualifies for entitlements."},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2016 Statement and replaces it with an updated Statement that defines cataract (excluding congenital/infantile), explicitly includes death from cataract, and sets a new list of specific factors, numeric thresholds and timeframes to establish a service connection for VEA/MRCA claims. The instrument itself does not state whether the net effect is a broadening or narrowing of entitlement compared with the 2016 version; that comparative determination requires side‑by‑side analysis of the prior text."},"complexity_factors":["Multiple technical exposure thresholds with numeric cut-offs (e.g. 4,500 latitude equivalent hours; 0.5 sievert; 20 pack‑years) requiring precise measurement or reconstruction.","Varied and specific temporal windows for different factors (from 3 months to 10 years) creating case-by-case timing analysis.","Specialised defined terms and calculation methods (latitude equivalent hours; cumulative equivalent dose; pack‑year) requiring methodological application and record evidence.","Cross-reference to other Statements of Principles for factors that overlap with other injuries/diseases, introducing dependency on other instruments.","Requirement to connect listed factors to 'relevant service' under VEA/MRCA, producing legal and evidentiary linkage work for claimants.","Clinical concepts like 'clinical onset' and 'clinical worsening' trigger different tests and evidentiary burdens, especially where pre‑existing cataract exists.","Evidence reconstruction burdens (e.g. dose reconstruction for ionising radiation) and medical interpretation (e.g. severity of burns, intraocular surgery timing).","Exclusions and inclusions (e.g. excludes congenital/infantile cataract; includes death where cataract contributed) that affect claim scope and outcomes."],"plain_english_summary":"Replaces the 2016 Statement and sets the medical criteria the Repatriation Medical Authority uses to decide if cataract (excluding congenital/infantile) and death from cataract are connected to veterans' or members' service for claims under the VEA and MRCA. It prescribes specific exposure and clinical thresholds (for example: sunlight, ionising radiation, eye trauma/surgery, burns, blasts, electrical injury, uveitis, BMI/diabetes, corticosteroids, tamoxifen, smoking, TNT exposure, and access to care) and time limits; the RMA says, on available medical evidence, a service link is \"more probable than not.\""}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-cataract-balance-of-probabilities-no-16-of-2026","history":"/api/acts/statement-of-principles-concerning-cataract-balance-of-probabilities-no-16-of-2026/history","analysis":"/api/acts/statement-of-principles-concerning-cataract-balance-of-probabilities-no-16-of-2026/analysis","conflicts":"/api/acts/statement-of-principles-concerning-cataract-balance-of-probabilities-no-16-of-2026/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-cataract-balance-of-probabilities-no-16-of-2026/important-cases","documents":"/api/acts/statement-of-principles-concerning-cataract-balance-of-probabilities-no-16-of-2026/documents"}}