{"id":"F2022L00267","name":"Statement of Principles concerning eosinophilic oesophagitis (Balance of Probabilities) (No. 30 of 2022)","slug":"statement-of-principles-concerning-eosinophilic-oesophagitis-balance-of-probabilities-no-30-of-2022","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441255,"registerId":"F2022L00267-fast-fetch-1775956615104","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning eosinophilic oesophagitis (Balance of Probabilities) (No. 30 of 2022)","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\nEosinophilic oesophagitis (Balance of Probabilities)\n\n(No. 30 of 2022)\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 4 March 2022\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 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 eosinophilic oesophagitis (Balance of Probabilities) (No. 30 of 2022).\n\n2 Commencement\n\n This instrument commences on 4 April 2022.\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 eosinophilic oesophagitis and death from eosinophilic oesophagitis.\n\nMeaning of eosinophilic oesophagitis\n\n(2) For the purposes of this Statement of Principles, eosinophilic oesophagitis means a chronic, immune-mediated oesophageal disease, characterised by symptoms related to oesophageal dysfunction, together with eosinophil-predominant inflammation of the oesophageal epithelium.\n\nNote 1: Typical symptoms of oesophageal dysfunction in adults include difficulty swallowing, chest pain, upper abdominal pain, heartburn and acute food bolus obstruction.\n\nNote 2: Eosinophil-predominant infiltration of the oesophageal epithelium is demonstrated by peak values of at least 15 eosinophils per high-power field on oesophageal biopsy.\n\nNote 3: Endoscopic findings which may increase suspicion of a diagnosis of eosinophilic oesophagitis include rings, furrows, exudates, oedema, stricture, narrowing and crepe-paper mucosa.\n\nNote 4: A clinical assessment should fully evaluate any condition that could account for oesophageal tissue eosinophilia, including gastro-oesophageal reflux disease, Crohn disease, infections and connective tissue disorders.\n\nDeath from eosinophilic oesophagitis\n\n(3) For the purposes of this Statement of Principles, eosinophilic oesophagitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's eosinophilic oesophagitis.\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 eosinophilic oesophagitis and death from eosinophilic oesophagitis 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, eosinophilic oesophagitis or death from eosinophilic oesophagitis is connected with the circumstances of a person's relevant service:\n\n(1) taking an average of at least 600 milligrams of aspirin per day for the desensitisation of aspirin-exacerbated respiratory disease for at least the 3 months before the clinical onset of eosinophilic oesophagitis; \n\n(2) taking carbamazepine daily for at least the 7 days before the clinical onset of eosinophilic oesophagitis; \n\n(3) having oral or sublingual allergen immunotherapy at the time of the clinical onset of eosinophilic oesophagitis;\n\n(4) taking an average of at least 600 milligrams of aspirin per day for the desensitisation of aspirin-exacerbated respiratory disease for at least the 3 months before the clinical worsening of eosinophilic oesophagitis; \n\n(5) taking carbamazepine daily for at least the 7 days before the clinical worsening of eosinophilic oesophagitis; \n\n(6) having oral or sublingual allergen immunotherapy at the time of the clinical worsening of eosinophilic oesophagitis;\n\n(7) inability to obtain appropriate clinical management for eosinophilic oesophagitis.\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(4) to 8(7) apply only to material contribution to, or aggravation of, eosinophilic oesophagitis where the person's eosinophilic oesophagitis 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 eosinophilic oesophagitis—see subsection 6(2).\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 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":3,"scope_assessment":{"changed":false,"description":"This is a standard, purpose-built Statement of Principles under the Veterans' Entitlements Act 1986. It addresses exactly what it purports to cover: establishing the causal factors for eosinophilic oesophagitis in the veterans' compensation context. There is no evidence of scope creep or expansion beyond the original statutory purpose of determining service-relatedness for this specific condition."},"complexity_factors":["Short, self-contained instrument (approximately 4 pages)","Only 5 defined terms in the Dictionary (eosinophilic oesophagitis, MRCA, relevant service, terminal event, VEA)","Simple conditional structure: 7 alternative factors in section 8, where only one must be satisfied","Minimal cross-referencing — only internal references to the Dictionary and other Statements of Principles in section 10","No nested exceptions or complex temporal calculations beyond straightforward 'at least X days/months before' timeframes","Clear delineation between factors for 'clinical onset' (first 3 factors) and 'clinical worsening' (factors 4-6), plus a standalone factor (7) for treatment access"],"plain_english_summary":"This Statement of Principles sets the medical test for linking eosinophilic oesophagitis (chronic, biopsy-confirmed inflammation of the oesophagus) to Australian defence service, using the lower \"balance of probabilities\" standard. It affects veterans and current/former defence members claiming under the VEA or MRCA. Compensation can be triggered by service‑related factors such as prolonged high‑dose aspirin, carbamazepine use, allergy immunotherapy, or inability to access treatment; death from the condition is also covered."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument sets evidentiary criteria for linking eosinophilic oesophagitis to 'relevant service' under existing VEA/MRCA frameworks (see s4; Schedule 1). It provides pathways and thresholds for establishing service connection but does not itself redefine who qualifies as having relevant service or expand statutory coverage beyond the VEA/MRCA definitions set out in the instrument."},"complexity_factors":["Defined medical diagnostic thresholds and required clinical evidence (e.g. >=15 eosinophils per high‑power field; endoscopic findings) (s6(2) Notes).","Precise exposure/medication timing and dosage requirements (e.g. aspirin >=600 mg/day for >=3 months; carbamazepine daily for >=7 days; oral/sublingual immunotherapy) create factual proof burdens (s8(1)–(6)).","Application limited to 'relevant service' under VEA/MRCA; claimants and decision makers must map exposures to that statutory service category (s4; Schedule 1).","Requirement that each listed factor be related to the person's relevant service imposes a causal nexus assessment (s9(1)).","Material contribution/aggravation rules apply only where disease pre‑existed service, adding a temporal/legal constraint on aggravation claims (s9(2)).","Factor 7 ('inability to obtain appropriate clinical management') is open‑ended and fact‑specific, increasing evidentiary and administrative uncertainty (s8(7)).","Interaction with other Statements of Principles requires cross‑reference when a factor refers to another injury/disease, creating potential interpretive complexity (s10).","Inclusion of death via contribution to a terminal event links clinical causation with proximate causes of death, requiring multidisciplinary evidence (s6(3); Schedule).","Standard of proof is balance of probabilities, but the instrument prescribes specific presumptive factors which change how evidence is weighed in practice (s7)."],"plain_english_summary":"Mechanically, this Statement sets specific medical and service-related criteria that, if met, establish on the balance of probabilities that eosinophilic oesophagitis (and death from it) is connected with a person’s relevant service for VEA/MRCA claims (see ss 6–9). It affects veterans and current or former members of the Forces lodging compensation or rehabilitation claims because it defines the clinical findings, exposures and service nexus decision‑makers must accept to find a service connection."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-balance-of-probabilities-no-30-of-2022","history":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-balance-of-probabilities-no-30-of-2022/history","analysis":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-balance-of-probabilities-no-30-of-2022/analysis","conflicts":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-balance-of-probabilities-no-30-of-2022/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-balance-of-probabilities-no-30-of-2022/important-cases","documents":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-balance-of-probabilities-no-30-of-2022/documents"}}