{"id":"F2018L00553","name":"Statement of Principles concerning central serous chorioretinopathy (Balance of Probabilities) (No. 46 of 2018)","slug":"statement-of-principles-concerning-central-serous-chorioretinopathy-balance-of-probabilities-no-46-o","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439605,"registerId":"F2018L00553-fast-fetch-1775955565977","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning central serous chorioretinopathy (Balance of Probabilities) (No. 46 of 2018)","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\nCENTRAL SEROUS CHORIORETINOPATHY (Balance of Probabilities)\n\n(No. 46 of 2018)\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 27 April 2018\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 Application\n\n5 Definitions\n\n6 Kind of injury, disease or death to which this Statement of Principles relates\n\n7 Basis for determining the factors\n\n8 Factors that must exist\n\n9 Relationship to service\n\n10 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 central serous chorioretinopathy (Balance of Probabilities) (No. 46 of 2018).\n\n2 Commencement\n\n This instrument commences on 28 May 2018.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 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\n5 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n6 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about central serous chorioretinopathy and death from central serous chorioretinopathy.\n\nMeaning of central serous chorioretinopathy\n\n(2) For the purposes of this Statement of Principles, central serous chorioretinopathy:\n\n(a) means a serous detachment of the neurosensory retina affecting central vision; and\n\n(b) includes acute, recurrent and chronic serous retinal detachment; and\n\n(c) excludes retinal detachment due to a retinal tear (rhegmatogenous retinal detachment), and leakage through the retinal pigment epithelium caused by diseases of the choroid, including choroidal neovascularisation, choroidal vasculopathy, choroidal tumours, choroidal metastases and posterior uveitis.\n\n(3) While central serous chorioretinopathy attracts ICD‑10‑AM code H35.7, in applying this Statement of Principles the meaning of central serous chorioretinopathy is that given in subsection (2).\n\n(4) 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\nDeath from central serous chorioretinopathy\n\n(5) For the purposes of this Statement of Principles, central serous chorioretinopathy, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's central serous chorioretinopathy.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n7 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 central serous chorioretinopathy and death from central serous chorioretinopathy 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\n8 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, central serous chorioretinopathy or death from central serous chorioretinopathy is connected with the circumstances of a person's relevant service:\n\n(1) being treated with a corticosteroid, other than an inhaled corticosteroid, within the 30 days before the clinical onset of central serous chorioretinopathy;\n\n(2) taking a drug or a drug from a class of drugs from the specified list of drugs at the time of the clinical onset of central serous chorioretinopathy;\n\nNote: specified list of drugs is defined in the Schedule 1 - Dictionary. \n\n(3) having Cushing syndrome in the one year before the clinical onset of central serous chorioretinopathy;\n\n(4) being in the second or third trimester of pregnancy at the time of the clinical onset of central serous chorioretinopathy;\n\n(5) having chronic renal failure at the time of the clinical onset of central serous chorioretinopathy;\n\nNote: chronic renal failure is defined in the Schedule 1 - Dictionary. \n\n(6) being treated with a corticosteroid, other than an inhaled corticosteroid, within the 30 days before the clinical worsening of central serous chorioretinopathy;\n\n(7) taking a drug or a drug from a class of drugs from the specified list of drugs at the time of the clinical worsening of central serous chorioretinopathy;\n\nNote: specified list of drugs is defined in the Schedule 1 - Dictionary. \n\n(8) having Cushing syndrome in the one year before the clinical worsening of central serous chorioretinopathy;\n\n(9) being in the second or third trimester of pregnancy at the time of the clinical worsening of central serous chorioretinopathy;\n\n(10) having chronic renal failure at the time of the clinical worsening of central serous chorioretinopathy;\n\nNote: chronic renal failure is defined in the Schedule 1 - Dictionary. \n\n(11) inability to obtain appropriate clinical management for central serous chorioretinopathy.\n\n9 Relationship to service\n\n(1) The existence in a person of any factor referred to in section 8, must be related to the relevant service rendered by the person.\n\n(2) The factors set out in subsections 8(6) to 8(11) apply only to material contribution to, or aggravation of, central serous chorioretinopathy where the person's central serous chorioretinopathy was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n10 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 8 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\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 5\n\n1 Definitions\n\nIn this instrument:\n\n central serous chorioretinopathy—see subsection 6(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 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 drugs means:\n\n(a) ephedrine;\n\n(b) fingolimod;\n\n(c) MEK (mitogen-activated protein kinase/extracellular signal-regulated kinase) inhibitors;\n\n(d) methylenedioxymethamphetamine (ecstasy);\n\n(e) nasal sympathomimetic decongestants;\n\n(f) ocriplasmin; or\n\n(g) pseudoephedrine.\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 its original narrow scope. It addresses a single specific medical condition (central serous chorioretinopathy) and establishes the causal factors required to connect that condition to military service. The structure follows the standard template for Repatriation Medical Authority Statements of Principles without expansion beyond the medical-scientific determination required by subsection 196B(3) of the Veterans' Entitlements Act 1986."},"complexity_factors":["Moderate cross-referencing between the main body and Schedule 1 (Dictionary) for defined terms","Dual application framework—distinguishing between 'clinical onset' and 'clinical worsening' with slightly different rules for each","Conditional logic in section 9(2) restricting certain factors to aggravation cases only","Nested definitions: 'chronic renal failure' and 'terminal event' have multi-part technical definitions","Reference to external classification system (ICD-10-AM) with specific edition and ISBN","Incorporation by reference of other Statements of Principles in section 10"],"plain_english_summary":"This instrument sets the medical test the government uses to decide compensation claims for central serous chorioretinopathy (CSC) by veterans and current/former defence members under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. It links CSC onset or worsening to service when one or more specified medical factors are present—examples include recent systemic steroid use, certain stimulant/vasoconstrictor drugs, pregnancy, Cushing syndrome, chronic kidney failure, or lack of access to appropriate treatment. It also limits claims for pre-existing disease to service-related worsening."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument sets out the criteria for linking CSC to relevant service and does not purport to broaden or narrow entitlements beyond that stated purpose. It defines the condition, prescribes the specific medical and service‑relationship factors needed to establish connection on the balance of probabilities, and applies to claims under section 120B of the VEA or section 339 of the MRCA (see ss.4,6–9)."},"complexity_factors":["Reliance on contemporaneous clinical timing (clinical onset and clinical worsening) to link exposure to disease (ss.8,9).","Multiple medical risk factors with different temporal windows (e.g. recent systemic corticosteroid use, pregnancy, Cushing syndrome, chronic renal failure) requiring medical evidence (s.8 and Schedule).","Discrete specified list of drugs requiring verification of medication exposure and class membership (Schedule: specified list of drugs).","Use of the civil causation standard ‘balance of probabilities’ but with statutory rules on material contribution and aggravation for pre-existing disease (s.7, s.9(2)).","Cross-references to other Statements of Principles where a factor refers to another condition, creating dependence on other instruments (s.10).","Defined clinical thresholds (eg. chronic renal failure by GFR, dialysis) that require quantitative medical proof (Schedule).","Open-ended criterion ‘inability to obtain appropriate clinical management’ which may require factual and contextual proof and administrative interpretation (s.8(11)).","Legal linkage to entitlement schemes (VEA and MRCA) and the requirement that factors be related to ‘relevant service’ creating evidentiary and jurisdictional framing (s.4, Schedule)."],"plain_english_summary":"This Statement of Principles sets the medical rules used to decide whether central serous chorioretinopathy (CSC) or death from CSC is connected to a veteran’s relevant service under the VEA or MRCA. It defines CSC, lists the clinical risk factors and circumstances that, if present and linked to service, satisfy the ‘balance of probabilities’ test, and notes how deaths attributed to CSC are treated. It matters because those medical findings determine entitlement decisions and proof burdens for claimants."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-central-serous-chorioretinopathy-balance-of-probabilities-no-46-o","history":"/api/acts/statement-of-principles-concerning-central-serous-chorioretinopathy-balance-of-probabilities-no-46-o/history","analysis":"/api/acts/statement-of-principles-concerning-central-serous-chorioretinopathy-balance-of-probabilities-no-46-o/analysis","conflicts":"/api/acts/statement-of-principles-concerning-central-serous-chorioretinopathy-balance-of-probabilities-no-46-o/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-central-serous-chorioretinopathy-balance-of-probabilities-no-46-o/important-cases","documents":"/api/acts/statement-of-principles-concerning-central-serous-chorioretinopathy-balance-of-probabilities-no-46-o/documents"}}