{"id":"F2023L00464","name":"Statement of Principles concerning decompression illness (Reasonable Hypothesis) (No. 23 of 2023)","slug":"statement-of-principles-concerning-decompression-illness-reasonable-hypothesis-no-23-of-2023","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441807,"registerId":"F2023L00464-fast-fetch-1775957012044","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning decompression illness (Reasonable Hypothesis) (No. 23 of 2023)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 22.10.0\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nDECOMPRESSION ILLNESS (Reasonable Hypothesis)\n\n(No. 23 of 2023)\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 24 April 2023.\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 Terence Campbell AM
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 decompression illness (Reasonable Hypothesis) (No. 23 of 2023).\n\n2 Commencement\n\n This instrument commences on 23 May 2023.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning decompression sickness No. 13 of 2015 (Federal Register of Legislation No. F2014L01830) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 decompression illness and death from decompression illness.\n\nMeaning of decompression illness\n\n(2) For the purposes of this Statement of Principles, decompression illness:\n\n(a) means an injury caused by the formation of bubbles of nitrogen and other inert gases within tissues and blood vessels, as a result of a reduction in the pressure surrounding the person, and;\n\n(b) includes:\n\n(i) arterial gas embolism not due to pulmonary barotrauma; and\n\n(ii) decompression sickness; and\n\n(c) excludes:\n\n(i) altitude illness;\n\n(ii) arterial gas embolism due to pulmonary barotrauma;\n\n(iii) barotrauma;\n\n(iv) ebullism;\n\n(v) osteonecrosis;\n\n(vi) high pressure neurological syndrome/inert gas narcosis; and\n\n(vii) cerebrovascular accident not due to an arterial gas embolism.\n\nNote 1: Clinical manifestation of decompression illness includes musculoskeletal, cutaneous, lymphatic, cardiopulmonary, inner ear or neurological signs or symptoms.\n\nNote 2: Inert gases include nitrogen, argon, helium, xenon and krypton.\n\nDeath from decompression illness\n\n(3) For the purposes of this Statement of Principles, decompression illness, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's decompression illness.\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 decompression illness and death from decompression illness 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: 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 decompression illness or death from decompression illness with the circumstances of a person's relevant service:\n\n(1) experiencing a substantial episode of decompression whilst:\n\n(a) surfacing from an underwater dive that required decompression stops according to relevant diving decompression tables;\n\n(b) flying at >5,486 metres (>18,000 feet) altitude in an unpressurised aircraft, high altitude balloon or high altitude parachute;\n\n(c) flying, parachuting or ballooning within the no flying time interval after underwater diving, where the relevant diving decompression tables recommended a no flying time interval;\n\n(d) ascending to the surface from a submerged submarine or vessel at >90 metres seawater (296 feet seawater) with a normal internal pressure, or ascending to the surface from a submerged submarine or vessel at increased internal pressure;\n\n(e) suffering loss of cabin pressure in an aircraft flying at >5,486 metres (>18,000 feet) altitude or in a spacecraft above the von Karman line;\n\n(f) returning to surface air pressure after working in a hyperbaric compressed air environment including working in a tunnel, caisson or tunnel boring machine;\n\n(g) transferring from a higher pressure to a lower pressure environment whilst in space including donning an extravehicular space suit;\n\n(h) being in a hypobaric chamber;\n\n(i) returning to surface air pressure after being in a hyperbaric chamber including hyperbaric oxygen therapy chambers; or\n\n(j) returning to surface air pressure after being within a pressure vessel during hyperbaric pressure testing including aircraft cabin excessive leak testing, submarine pressure testing, and nuclear power station pressure testing;\n\nwithin 7 days before the clinical onset of decompression illness;\n\nNote 1: Substantial episodes of decompression involves a rapid substantial reduction in the ambient pressure exerted by the envelope of gas or water surrounding the person where the person had been at higher pressure for a substantial period.\n\nNote 2: Underwater diving includes breath hold diving, yo-yo or bounce diving, umbilical/hookah/hard hat diving, SCUBA diving, rebreather diving, and saturation diving. This underwater diving does not including diving within normobaric diving bells or armoured suits.\n\nNote 3: A decompression stop is a procedure where the diver is required to stop at a specified depth for a specified time interval to allow the inert gas to clear from their body.\n\n(2) inability to obtain appropriate clinical management for decompression illness.\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(2) applies only to material contribution to, or aggravation of, decompression illness where the person's decompression illness 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 decompression illness—see subsection 7(2).\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 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":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the prior Statement of Principles (s4) and replaces it with the current definitions, covered exposures, exclusions, qualifying factors and temporal nexus (see ss7–11 and Schedule). The repeal (s4) means the earlier instrument no longer applies and claims must be assessed under the terms of this Statement (see s5)."},"complexity_factors":["Technical medical definitions and enumerated exclusions (see s7(2) – includes and excludes specific conditions).","Multiplicity of covered exposures and precise event types that can qualify (see s9(1)(a)–(j): diving, high‑altitude flight, submarine ascents, hyperbaric work/testing, space activities, hypobaric chambers).","Temporal nexus requirement (7‑day window before clinical onset) that governs causation timing (s9(1) and Note 1).","Legal causation threshold framed as a 'reasonable hypothesis' and reliance on medical‑scientific view (s8 and s9 heading), creating interpretive judgment for decision‑makers.","Inclusion of inability to obtain appropriate clinical management as a separate qualifying factor (s9(2)), introducing administrative and evidentiary burdens about access to care.","Interaction with claims frameworks under the VEA and MRCA and cross‑references to other Statements of Principles (s5, s11 and Schedule definitions).","Provision covering death via contribution to a terminal event (s7(3) and Schedule definition of 'terminal event'), requiring linking death causes to earlier decompression illness.","Formal repeal of the earlier Statement (s4) means practitioners and decision‑makers must apply the new definitions and factors (s4)."],"plain_english_summary":"This instrument repeals the 2015 Statement and sets the medical and legal criteria for treating decompression illness as connected to service for VEA/MRCA claims. \n\nIt defines decompression illness (including arterial gas embolism and decompression sickness, excluding specified conditions), lists covered pressure‑change exposures and a 7‑day onset window that can raise a “reasonable hypothesis” of service connection, and makes lack of appropriate clinical management a qualifying factor."},"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":true,"description":"The legislation has expanded significantly beyond traditional 'decompression sickness' (the 2015 title). The 2023 version explicitly adds: space operations and EVA suit donning (factor 9(1)(g)), specific aviation thresholds (18,000 feet), submarine escape scenarios, nuclear power station pressure testing, and clarifies that death includes terminal events contributed to by the illness. The definition also now explicitly excludes several related conditions (altitude illness, barotrauma, osteonecrosis) that were likely ambiguous before, creating clearer boundaries but a broader operational scope for claims."},"complexity_factors":["Moderate cross-referencing between the VEA and MRCA compensation schemes","Nested definitions requiring lookup in Schedule 1 (e.g., 'relevant service' has 6 sub-categories)","Technical medical and engineering terminology requiring specialist knowledge (hyperbaric, hypobaric, von Karman line, caisson, saturation diving)","Conditional logic with 10 distinct scenarios in section 9(1) plus an alternative factor in 9(2)","Specific numerical thresholds throughout (7 days, 5,486 metres, 90 metres, 18,000 feet, 296 feet)","Exclusion list with 7 specific conditions that are NOT covered despite similar symptoms","Incorporation by reference to other Statements of Principles in section 11"],"plain_english_summary":"This instrument sets the medical rules for when veterans, current or former defence force and peacekeeping personnel can claim compensation for decompression illness (the bends) or death from it under the VEA and MRCA. \n\nIt requires a qualifying pressure-related event within seven days before symptoms and clarifies scope compared with the 2015 version — explicitly covering modern activities (including space operations), specifying an 18,000‑foot aviation threshold, and treating deaths where decompression illness contributed as compensable."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-decompression-illness-reasonable-hypothesis-no-23-of-2023","history":"/api/acts/statement-of-principles-concerning-decompression-illness-reasonable-hypothesis-no-23-of-2023/history","analysis":"/api/acts/statement-of-principles-concerning-decompression-illness-reasonable-hypothesis-no-23-of-2023/analysis","conflicts":"/api/acts/statement-of-principles-concerning-decompression-illness-reasonable-hypothesis-no-23-of-2023/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-decompression-illness-reasonable-hypothesis-no-23-of-2023/important-cases","documents":"/api/acts/statement-of-principles-concerning-decompression-illness-reasonable-hypothesis-no-23-of-2023/documents"}}