{"id":"F2022L00266","name":"Statement of Principles concerning eosinophilic oesophagitis (Reasonable Hypothesis) (No. 29 of 2022)","slug":"statement-of-principles-concerning-eosinophilic-oesophagitis-reasonable-hypothesis-no-29-of-2022","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441252,"registerId":"F2022L00266-fast-fetch-1775956614975","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning eosinophilic oesophagitis (Reasonable Hypothesis) (No. 29 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\n\n(No. 29 of 2022)\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 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 (Reasonable Hypothesis) (No. 29 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(2) of the Veterans' Entitlements Act 1986.\n\n4 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\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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that eosinophilic oesophagitis and death from eosinophilic oesophagitis 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\n8 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 eosinophilic oesophagitis or death from eosinophilic oesophagitis 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) undergoing organ or tissue transplantation, excluding corneal transplant, before the clinical onset of eosinophilic oesophagitis;\n\nNote: organ or tissue transplantation is defined in the Schedule 1 – Dictionary.\n\n(5) 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(6) taking carbamazepine daily for at least the 7 days before the clinical worsening of eosinophilic oesophagitis;\n\n(7) having oral or sublingual allergen immunotherapy at the time of the clinical worsening of eosinophilic oesophagitis;\n\n(8) undergoing organ or tissue transplantation, excluding corneal transplant, before the clinical worsening of eosinophilic oesophagitis;\n\nNote: organ or tissue transplantation is defined in the Schedule 1 – Dictionary.\n\n(9) 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(5) to 8(9) 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(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 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 organ or tissue transplantation means the transplantation of:\n\n(a) all or part of an organ or tissue; or\n\n(b) a substance obtained from an organ or tissue.\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":6,"scope_assessment":{"changed":false,"description":"This instrument establishes a new Statement of Principles for eosinophilic oesophagitis and does not itself amend other legislation. It applies to claims under s 120A VEA and s 338 MRCA (s 4) and sets specific causal factors and limits (notably s 9(2) limiting certain factors to material contribution/aggravation where EoE pre‑existed). The text gives no express indication that it broadens or narrows the statutory definition of 'relevant service' or otherwise changes the statutory scheme beyond specifying these factors."},"complexity_factors":["Precise medical diagnostic threshold: eosinophil‑predominant infiltration defined as peak ≥15 eosinophils per high‑power field on biopsy (s 6(2) Note 2).","Detailed exposure thresholds and timing requirements (aspirin ≥600 mg/day for ≥3 months (s 8(1),(5)); carbamazepine daily ≥7 days (s 8(2),(6))).","Specific clinical interventions identified as causal factors (oral/sublingual allergen immunotherapy (s 8(3),(7)); organ/tissue transplantation excluding corneal (s 8(4),(8))).","Inclusion of a broadly framed, interpretive factor: 'inability to obtain appropriate clinical management' (s 8(9)) increases evidentiary and factual uncertainty.","Requirement that any listed factor be related to the person’s relevant service (s 9(1)), and limitation that subsections 8(5)–8(9) only apply to material contribution or aggravation where EoE pre‑existed or was suffered during but not caused by service (s 9(2)).","Cross‑reference mechanism to other Statements of Principles where a listed factor arises from another disease (s 10), creating interdependencies.","Narrow statutory application to claims under s 120A of the VEA or s 338 of the MRCA (s 4), requiring administrators to map veterans’ service type (Schedule 1 definitions).","Several defined terms and Schedule definitions (relevant service, terminal event, organ or tissue transplantation, MRCA, VEA) that affect interpretation and application (Schedule 1).","Administrative and evidentiary burden on claimants and decision‑makers to prove exposures, timings, clinical diagnosis and causal link to service (implicit across ss 6–9)."],"plain_english_summary":"This instrument sets out a Statement of Principles that explains when eosinophilic oesophagitis (EoE) or death from EoE can be reasonably linked to a person’s relevant military service for veterans’ compensation claims. It defines the medical condition, lists specific medical exposures and events (for example high‑dose aspirin desensitisation, carbamazepine use, oral/sublingual allergen immunotherapy, organ transplantation, or lack of appropriate care) that can raise a reasonable hypothesis, and requires those factors be connected to the person’s relevant service (s 9)."},"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":3,"scope_assessment":{"changed":false,"description":"This is a standard, discrete Statement of Principles made under the Veterans' Entitlements Act. It addresses a single medical condition (eosinophilic oesophagitis) and follows the established template for such instruments. There is no indication of scope creep beyond the original purpose of determining service connection for this specific disease."},"complexity_factors":["Short, self-contained instrument (approximately 1,500 words)","Only 5 defined terms in the Dictionary (eosinophilic oesophagitis, MRCA, organ or tissue transplantation, relevant service, terminal event, VEA)","Simple conditional structure: 'at least one of the following factors must exist'","Minimal cross-referencing (only to other Statements of Principles in section 10 and standard definitions)","Clear delineation between 'clinical onset' and 'clinical worsening' factors","No nested exceptions or complex temporal calculations beyond straightforward day/month counts"],"plain_english_summary":"This instrument sets medical criteria for linking eosinophilic oesophagitis to Australian defence service, affecting current and former ADF members claiming under the Veterans' Entitlements Act 1986 or Military Rehabilitation and Compensation Act 2004. It identifies nine specific medical factors that, if connected to service, create a “reasonable hypothesis” of service causation — including factors for new onset and for aggravation of pre‑existing disease. This determines entitlement to compensation, treatment and rehabilitation."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-reasonable-hypothesis-no-29-of-2022","history":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-reasonable-hypothesis-no-29-of-2022/history","analysis":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-reasonable-hypothesis-no-29-of-2022/analysis","conflicts":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-reasonable-hypothesis-no-29-of-2022/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-reasonable-hypothesis-no-29-of-2022/important-cases","documents":"/api/acts/statement-of-principles-concerning-eosinophilic-oesophagitis-reasonable-hypothesis-no-29-of-2022/documents"}}