{"id":"F2025L00506","name":"Statement of Principles concerning diverticular disease of the colon (Reasonable Hypothesis) (No. 51 of 2025)","slug":"statement-of-principles-concerning-diverticular-disease-of-the-colon-reasonable-hypothesis-no-51-of-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442822,"registerId":"F2025L00506-fast-fetch-1775957750078","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning diverticular disease of the colon (Reasonable Hypothesis) (No. 51 of 2025)","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\nDIVERTICULAR DISEASE OF THE COLON  (Reasonable Hypothesis)\n\n(No. 51 of 2025)\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    15 April 2025\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   \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 diverticular disease of the colon (Reasonable Hypothesis) (No. 51 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 19 May 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning diverticular disease of the colon (Reasonable Hypothesis) (No. 15 of 2016 (Federal Register of Legislation No. F2016L00265) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\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\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 diverticular disease of the colon and death from diverticular disease of the colon.\n\n\nMeaning of diverticular disease of the colon\n\n1.           For the purposes of this Statement of Principles, diverticular disease of the colon:\n  1.           means acquired herniation of the mucosa and submucosa through the muscular layer of the colon wall, which may manifest without inflammation, as diverticulosis, or with inflammation, as diverticulitis; and\n  2.           includes:\n    1.             diverticular abscess;\n    2.          diverticular bleeding;\n    3.        diverticular stricture:\n    4.         diverticulitis complicated by bowel obstruction;\n    5.           diverticulitis complicated by fistula; and\n    6.         perforation of a diverticulum.\n2.           While diverticular disease of the colon attracts ICD‑10‑AM codes K57.2 or K57.3, in applying this Statement of Principles the meaning of diverticular disease of the colon 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 diverticular disease of the colon\n\n1.           For the purposes of this Statement of Principles, diverticular disease of the colon, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's diverticular disease of the colon.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that diverticular disease of the colon and death from diverticular disease of the colon 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\n1.                Factors that must exist\n\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 diverticular disease of the colon or death from diverticular disease of the colon with the circumstances of a person's relevant service:\n\n1.           having systemic sclerosis (scleroderma) before clinical onset;\n2.           having a Body Mass Index (BMI) of 25 or greater (being overweight) for at least the 5 years before clinical onset or clinical worsening;\n\n\nNote:  Body mass index (BMI) is calculated as W/H2 and where:\n\n(a) W is the person’s weight in kilograms; and\n\n(b) H is the person’s height in metres.\n\n1.           having diabetes mellitus at the time of clinical onset or clinical worsening of diverticular bleeding;\n2.           inability to undertake any physical activity greater than 3 METs for at least the 5 years before clinical onset or clinical worsening;\n\n\nNote: MET (metabolic equivalent) is a unit of measure of the level of physical capability of the cardiorespiratory system. For example, 1 MET = cardiorespiratory effort associated with a person sitting, 3-4 METs = cardiorespiratory effort associated with a person walking at average walking pace (5 km/h) or light gardening.\n\n1.           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  2.           undergoing chronic dialysis for renal failure;\n2.           having a solid organ transplant (excluding corneal transplant) before clinical worsening;\n3.           taking one of the following immunosuppressive medications within the 30 days before clinical onset of diverticular perforation, abscess or fistula:\n  1.           corticosteroids other than inhaled or topical corticosteroids;\n  2.           drugs used to prevent transplant rejection;\n  3.           tumour necrosis factor-α inhibitors;\n  4.           chemotherapeutic agents used for the treatment of cancer;\n  5.           interleukin-6 inhibitors;\n4.           taking one of the following immunosuppressive medications within the 30 days before clinical worsening:\n  1.           corticosteroids other than inhaled or topical corticosteroids;\n  2.           drugs used to prevent transplant rejection;\n  3.           tumour necrosis factor-α inhibitors;\n  4.           chemotherapeutic agents used for the treatment of cancer;\n  5.           interleukin-6 inhibitors;\n5.           taking a nonsteroidal anti-inflammatory medication, excluding aspirin and paracetamol, for a continuous period of at least 4 weeks before clinical onset, where the last dose of the medication within that period was taken within the 7 days before clinical onset of diverticular bleeding, perforation, abscess or fistula;\n6.       taking a nonsteroidal anti-inflammatory medication, excluding aspirin and paracetamol, for a continuous period of at least 4 weeks before clinical worsening, where the last dose of the medication within that period was taken within the 7 days before clinical worsening;\n7.       taking an antiplatelet medication that blocks platelet adhesion or aggregation before clinical onset, where the last dose of the antiplatelet medication was taken within the 7 days before clinical onset of diverticular bleeding;\n\n\nNote: Examples of an antiplatelet medication include aspirin, clopidogrel and dipyridamole.\n\n1.       taking an antiplatelet medication that blocks platelet adhesion or aggregation before clinical worsening, where the last dose of the antiplatelet medication was taken within the 7 days before clinical worsening;\n\n\nNote: Examples of an antiplatelet medication include aspirin, clopidogrel and dipyridamole.\n\n1.       taking an opioid for a continuous period of at least 4 weeks before clinical worsening, where the last dose of the opioid within that period was taken within the 7 days before clinical worsening;\n2.       taking menopausal hormone therapy for at least 1 year before clinical onset;\n\n\nNote: menopausal hormone therapy is defined in the Schedule 1 - Dictionary.\n\n1.       having smoked at least 10 pack-years before clinical onset or clinical worsening, and where smoking has ceased, clinical onset or clinical worsening occurred within 10 years of cessation;\n\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n1.       consuming at least 180 kilograms of alcohol within the 10 years before clinical onset;\n\n\nNote: Alcohol consumption calculations utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.\n\n1.       inability to consume an average of at least 30 grams per day of fibre in food, for at least 5 consecutive years within the 10 years before clinical onset;\n\n\nNote: fibre in food is defined in the Schedule 1 - Dictionary.\n\n1.       consuming an average of at least 200 grams per day of red meat, for at least the 5 years before clinical onset;\n\n\nNote: red meat is defined in the Schedule 1 - Dictionary.\n\n1.       having contact with a foreign object or extraneous material at the affected site at the time of clinical worsening;\n\n\nNote: Examples of a foreign object or extraneous material include chicken or fish bones, toothpicks and biliary stents.\n\n1.       inability to obtain appropriate clinical management for diverticular disease of the colon 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 aspects of factors in section 9 apply only to material contribution to, or aggravation of, diverticular disease of the colon where the person's diverticular disease of the colon 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(2) 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\nSchedule 1 - Dictionary  \n\nNote:               See Section 6\n\n1               Definitions\n\nIn this instrument:\n\n                               diverticular disease of the colon—see subsection 7(2).\n\n                                fibre in food means complex carbohydrates of plant origin consumed as vegetables, fruits or cereals which resist digestion by gastrointestinal enzymes in the gastrointestinal tract, and include plant cell walls and non-starch polysaccharides from sources other than cell walls, including cellulose and pectins.\n\n                               hormone therapy means administration of estrogen preparations, often in combination with a progestogen, to offset a hormone deficiency following surgically induced or naturally occurring menopause\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\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                               red meat means all types of mammalian meat, such as beef, veal, pork, lamb, mutton, horse and goat.\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 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","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the earlier Statement of Principles (No. 15 of 2016) and replaces it with a new Statement (No. 51 of 2025). It continues to apply to claims under section 120A of the VEA and section 338 of the MRCA and to persons with relevant service (operational, peacekeeping, hazardous, British nuclear test, warlike and non‑warlike). The practical scope change is that the Authority has promulgated a new set of defined medical criteria, thresholds and temporal rules for linking diverticular disease of the colon (and death from it) to relevant service; the instrument does not broaden coverage beyond those persons with claims under the cited VEA/MRCA provisions."},"complexity_factors":["Technical medical terminology and diagnostic framing (diverticulosis vs diverticulitis; ICD‑10‑AM coding)","Multiple quantitative thresholds (BMI ≥25 for 5 years; ≥10 pack‑years; 180 kg alcohol over 10 years; 30 g/day fibre for 5 years; 200 g/day red meat for 5 years)","Temporal windows and timing distinctions (clinical onset vs clinical worsening; medication within 30 days or 7 days; continuous periods of 4 weeks or 1 year)","List of specific medications and clinical states (immunosuppressants, NSAIDs, antiplatelets, opioids, chronic renal failure, organ transplant) requiring verification","Interplay between pre‑existing disease, aggravation during service, and requirement that factors be related to relevant service","Cross‑references to other Statements of Principles and to external standards (ICD‑10‑AM)","Evidence and proof burdens implicit in criteria (medical records, measurements, and histories to demonstrate thresholds)","Definitions that embed measurement rules (pack‑year calculation, fibre and red meat definitions) affecting evidentiary assessment"],"plain_english_summary":"This instrument (No. 51 of 2025) sets the medical criteria the Repatriation Medical Authority will use to decide if diverticular disease of the colon (or death from it) can be linked to a person’s relevant military service for claims under the VEA or MRCA. It lists specific medical definitions, risk factors (for example BMI, smoking, medications, alcohol, diet, infections, transplants), timing rules and required thresholds that veterans or their advisers must meet to raise a reasonable hypothesis of service connection."},"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 Statement of Principles maintaining the established scope of the Repatriation Medical Authority's function. It updates the 2016 version with current medical evidence but does not expand beyond the original purpose of determining compensation eligibility for diverticular disease in the veteran population. The structure and approach remain consistent with the long-established statutory framework under section 196B(2) of the Veterans' Entitlements Act 1986."},"complexity_factors":["18 distinct factors with varying applicability—some apply only to onset, some only to worsening, and some to specific complications (bleeding, perforation, abscess, fistula)","Precise temporal requirements throughout: 5-year periods, 10-year periods, 30-day windows, 7-day windows, 4-week continuous periods, 1-year minimums","Nested conditional logic: Factor applicability depends on whether claiming for onset vs. worsening, and which specific complication is involved","Cross-references to other Statements of Principles for conditions like systemic sclerosis and diabetes (section 11)","Mathematical calculations required: BMI formula, pack-year calculations, alcohol consumption conversions using Australian Standard of 10g per drink","Medical terminology requiring definitions: METs (metabolic equivalents), glomerular filtration rates, specific drug classes (TNF-α inhibitors, interleukin-6 inhibitors)","Dual statutory framework application: must operate under both VEA and MRCA with different service definitions","Specific exclusions within factors: 'excluding inhaled or topical corticosteroids', 'excluding aspirin and paracetamol'"],"plain_english_summary":"This instrument updates the medical rules for awarding compensation for diverticular disease to Australian veterans and current/former defence members under the VEA and MRCA, replacing the 2016 version.  \n\nTo succeed a claim, a veteran must link their diagnosis or worsening to service by showing at least one specified risk factor from a detailed list; the rules are precise about timing, medication windows and onset versus clinical worsening."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-diverticular-disease-of-the-colon-reasonable-hypothesis-no-51-of-","history":"/api/acts/statement-of-principles-concerning-diverticular-disease-of-the-colon-reasonable-hypothesis-no-51-of-/history","analysis":"/api/acts/statement-of-principles-concerning-diverticular-disease-of-the-colon-reasonable-hypothesis-no-51-of-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-diverticular-disease-of-the-colon-reasonable-hypothesis-no-51-of-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-diverticular-disease-of-the-colon-reasonable-hypothesis-no-51-of-/important-cases","documents":"/api/acts/statement-of-principles-concerning-diverticular-disease-of-the-colon-reasonable-hypothesis-no-51-of-/documents"}}