{"id":"F2020L01102","name":"Statement of Principles concerning chronic pancreatitis (Reasonable Hypothesis) (No. 64 of 2020)","slug":"statement-of-principles-concerning-chronic-pancreatitis-reasonable-hypothesis-no-64-of-2020","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":113523,"registerId":"commonwealth-F2020L01102-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning chronic pancreatitis (Reasonable Hypothesis) (No. 64 of 2020)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning chronic pancreatitis (Reasonable Hypothesis) (No. 64 of 2020)\n\nmade under subsection 196B(2) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 19 September 2022\n\nIncludes amendments up to: Veterans' Entitlements (Statements of Principles—definition of \"one pack-year\") Amendment Determination 2022 (No. 94 of 2022) (F2022L01128)\n\nThe day of commencement of this Amendment Determination is 19 September 2022.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning chronic pancreatitis (Reasonable Hypothesis) (No. 64 of 2020) that shows the text of the law as amended and in force on 19 September 2022.\n\nThe notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.\n\nUncommenced amendments\n\nThe effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.\n\nApplication, saving and transitional provisions for provisions and amendments\n\nIf the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.\n\nModifications\n\nIf the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.\n\nSelf‑repealing provisions\n\nIf a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.\n\nContents\n\n1 Name\n\n3 Authority\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\nEndnotes\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\n  \n\n1 Name\n\nThis is the Statement of Principles concerning chronic pancreatitis (Reasonable Hypothesis) (No. 64 of 2020).\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\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 chronic pancreatitis and death from chronic pancreatitis.\n\nMeaning of chronic pancreatitis\n\n(2) For the purposes of this Statement of Principles, chronic pancreatitis means a progressive inflammatory disease of the pancreas resulting in irreversible morphological change with parenchymal damage and fibrosis of the organ.\n\n> Note: Chronic pancreatitis typically presents with abdominal pain, malnutrition and loss of exocrine and endocrine pancreatic function.\n\n(3) While chronic pancreatitis attracts ICD‑10‑AM code K86.0 or K86.1, in applying this Statement of Principles the meaning of chronic pancreatitis 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 chronic pancreatitis\n\n(5) For the purposes of this Statement of Principles, chronic pancreatitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's chronic pancreatitis.\n\n> Note: 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 chronic pancreatitis and death from chronic pancreatitis 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\n> Note: 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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting chronic pancreatitis or death from chronic pancreatitis with the circumstances of a person's relevant service:\n\n(1) having smoked at least 20 pack-years of tobacco products before the clinical onset of chronic pancreatitis, and where smoking has ceased, the clinical onset of chronic pancreatitis has occurred within ten years of cessation;\n\n> Note: one pack-year is defined in the Schedule 1 \\- Dictionary.\n\n(2) having consumed a cumulative total of at least 90 kilograms of alcohol within any five year period before the clinical onset of chronic pancreatitis and where alcohol consumption has ceased, the clinical onset of chronic pancreatitis has occurred within ten years of cessation;\n\n> Note: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.\n\n(3) undergoing a course of therapeutic radiation for cancer, where the pancreas was in the field of radiation, at least one year before the clinical onset of chronic pancreatitis;\n\n(4) having complete or partial obstruction of the ductal system draining the secretions of the exocrine pancreas at the time of the clinical onset of chronic pancreatitis;\n\n(5) having cholelithiasis at the time of the clinical onset of chronic pancreatitis;\n\n(6) having hyperparathyroidism at the time of the clinical onset of chronic pancreatitis;\n\n(7) having hypertriglyceridaemia resulting in triglyceride levels above 11.3 millimoles per litre (or 1,000 milligrams per decilitre) at the time of the clinical onset of chronic pancreatitis;\n\n(8) having an episode of acute pancreatitis before the clinical onset of chronic pancreatitis;\n\n(9) having chronic renal failure before the clinical onset of chronic pancreatitis;\n\n> Note: chronic renal failure is defined in the Schedule 1 - Dictionary.\n\n(10) inability to obtain appropriate clinical management for chronic pancreatitis.\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 factor set out in subsection 9(10) applies only to material contribution to, or aggravation of, chronic pancreatitis where the person's chronic pancreatitis 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\nchronic pancreatitis—see subsection 7(2).\n\nchronic 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\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\none 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\n> Note 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\n> Note 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\nrelevant 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\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\nterminal 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\nVEA means the Veterans' Entitlements Act 1986.\n\n> Note: Endnotes\n\n> Note: Endnote 1—About the endnotes\n\nThe endnotes provide information about this compilation and the compiled law.\n\nThe following endnotes are included in every compilation:\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\nAbbreviation key—Endnote 2\n\nThe abbreviation key sets out abbreviations that may be used in the endnotes.\n\nLegislation history and amendment history—Endnotes 3 and 4\n\nAmending laws are annotated in the legislation history and amendment history.\n\nThe legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.\n\nThe amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.\n\nMisdescribed amendments\n\nA misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.\n\nIf a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.\n\n> Note: Endnote 2—Abbreviation key\n\n|                                                | o = order(s)                        |\n| ---------------------------------------------- | ----------------------------------- |\n| ad = added or inserted                         | Ord = Ordinance                     |\n| am = amended                                   | orig = original                     |\n| amdt = amendment                               | par = paragraph(s)/subparagraph(s)  |\n| c = clause(s)                                  | /sub‑subparagraph(s)                |\n| C[x] = Compilation No. x                       | pres = present                      |\n| Ch = Chapter(s)                                | prev = previous                     |\n| def = definition(s)                            | (prev…) = previously                |\n| Dict = Dictionary                              | Pt = Part(s)                        |\n| disallowed = disallowed by Parliament          | r = regulation(s)/rule(s)           |\n| Div = Division(s)                              |                                     |\n| exp = expires/expired or ceases/ceased to have | reloc = relocated                   |\n| effect                                         | renum = renumbered                  |\n| F = Federal Register of Legislation            | rep = repealed                      |\n| gaz = gazette                                  | rs = repealed and substituted       |\n| LA = Legislation Act 2003                      | s = section(s)/subsection(s)        |\n| LIA = Legislative Instruments Act 2003         | Sch = Schedule(s)                   |\n| (md) = misdescribed amendment can be given     | Sdiv = Subdivision(s)               |\n| effect                                         | SLI = Select Legislative Instrument |\n| (md not incorp) = misdescribed amendment       | SR = Statutory Rules                |\n| cannot be given effect                         | Sub‑Ch = Sub‑Chapter(s)             |\n| mod = modified/modification                    | SubPt = Subpart(s)                  |\n| No. = Number(s)                                | underlining = whole or part not     |\n|                                                | commenced or to be commenced        |\n\n> Note: Endnote 3—Legislation history\n\n| Name                                                                                                                          | Registration              | Commencement      | Application, saving and transitional provisions |\n| ----------------------------------------------------------------------------------------------------------------------------- | ------------------------- | ----------------- | ----------------------------------------------- |\n| Statement of Principles concerning chronic pancreatitis (Reasonable Hypothesis) (No. 64 of 2020)                              | 31 August 2020F2020L01102 | 28 September 2020 |                                                 |\n| Veterans' Entitlements (Statements of Principles—definition of \"one pack-year\") Amendment Determination 2022 (No. 94 of 2022) | 26 August 2022F2022L01128 | 19 September 2022 |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected                             | How affected      |\n| ---------------------------------------------- | ----------------- |\n| Section 2……………….                               | rep LA s 48D      |\n| Section 4……………….                               | rep LA s 48C      |\n| Subsection 9(1) note….                         | rs No. 94 of 2022 |\n| Schedule 1 – Dictionary – one pack-year...…….. | rs No. 94 of 2022 |","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"The instrument has been amended (to 19 September 2022) to change the definition and calculation guidance for \"one pack‑year\" and to update a note to subsection 9(1). Those amendments affect how smoking exposure is quantified for claims (see Endnote 4 and Schedule 1 definition of one pack‑year)."},"complexity_factors":["Legal/evidential standard: uses the \"reasonable hypothesis\" threshold rather than balance of probabilities (s9 introductory text; s8).","Multiple quantified medical thresholds to apply (smoking pack‑years, 90 kg alcohol in 5 years, triglycerides >11.3 mmol/L) (s9(1)–(2),(7)).","Temporal rules for cessation and onset (clinical onset within 10 years of cessation for smoking or alcohol) (s9(1)–(2)).","Interaction with other Statements of Principles where a factor references another injury/disease (s11).","Definitions and measurement rules in the Dictionary affect application (eg. one pack‑year, chronic renal failure, terminal event) (Schedule 1).","Scope of application tied to two statutes (VEA s120A claims; MRCA s338 claims) so administrative and statutory interfaces matter (s5; Schedule 1 definitions of VEA/MRCA).","Clinically phrased concepts (eg. \"inability to obtain appropriate clinical management\") introduce discretionary medical assessment and fact‑finding (s9(10); s10(2)).","Reference to ICD‑10‑AM codes for classification while specifying its own definitional meaning for chronic pancreatitis (s7(2)–(4)).","Amendments to definitions (eg. \"one pack‑year\") alter exposure calculations and require attention to amendment history (Endnote 4; Schedule 1)."],"plain_english_summary":"This Statement of Principles sets the medical criteria the Repatriation Medical Authority uses to decide whether chronic pancreatitis (including death from it) can be connected to a veteran’s or service member’s eligible service for claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. It specifies measurable risk thresholds and clinical conditions and timing rules (for example smoking pack‑years, cumulative alcohol intake, radiation exposure, obstructive disease and certain metabolic or renal disorders) that must be present to raise a “reasonable hypothesis” linking the disease to service."},"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 remains tightly focused on its original purpose: establishing the medical criteria for linking chronic pancreatitis to military service. The 2022 amendment updated only the definition of 'one pack-year' for calculation clarity, without expanding the scope beyond chronic pancreatitis or altering the fundamental structure of the reasonable hypothesis test."},"complexity_factors":["Moderate cross-referencing between the main text and Schedule 1 Dictionary (6 defined terms)","Nested conditional logic in factors — e.g., factor 9(1) requires both the smoking threshold AND a 10-year temporal limitation if smoking ceased","Technical medical terminology requiring ICD-10-AM code references (subsection 7(4))","Mathematical calculation requirements for 'pack-years' with conversion formulas for non-cigarette tobacco products","Dual legislative framework application (VEA and MRCA) with different service definitions","Incorporation by reference of other Statements of Principles (section 11) creating external dependencies","Specific quantitative thresholds throughout (20 pack-years, 90kg alcohol, 11.3 mmol/L triglycerides, 15 mL/min GFR)"],"plain_english_summary":"This Statement of Principles governs claims for chronic pancreatitis under the Veterans' Entitlements Act and MRCA. It affects current and former ADF members, veterans, peacekeepers and their families, and uses the lower \"reasonable hypothesis\" test: if a veteran can show at least one listed medical or exposure risk factor existed and is connected to their relevant service, they may be compensated without proving definite causation. The instrument also defines measures used in assessment (eg. pack‑years for smoking)."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-chronic-pancreatitis-reasonable-hypothesis-no-64-of-2020","history":"/api/acts/statement-of-principles-concerning-chronic-pancreatitis-reasonable-hypothesis-no-64-of-2020/history","analysis":"/api/acts/statement-of-principles-concerning-chronic-pancreatitis-reasonable-hypothesis-no-64-of-2020/analysis","conflicts":"/api/acts/statement-of-principles-concerning-chronic-pancreatitis-reasonable-hypothesis-no-64-of-2020/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-chronic-pancreatitis-reasonable-hypothesis-no-64-of-2020/important-cases","documents":"/api/acts/statement-of-principles-concerning-chronic-pancreatitis-reasonable-hypothesis-no-64-of-2020/documents"}}