{"id":"F2020L00206","name":"Statement of Principles concerning hypersensitivity pneumonitis (Balance of Probabilities) (No. 8 of 2020)","slug":"statement-of-principles-concerning-hypersensitivity-pneumonitis-balance-of-probabilities-no-8-of-202","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440395,"registerId":"F2020L00206-fast-fetch-1775956037859","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning hypersensitivity pneumonitis (Balance of Probabilities) (No. 8 of 2020)","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\nHYPERSENSITIVITY PNEUMONITIS (Balance of Probabilities)\n\n(No. 8 of 2020)\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 28 February 2020\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 Nicholas Saunders AO
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 hypersensitivity pneumonitis (Balance of Probabilities) (No. 8 of 2020).\n\n2 Commencement\n\n This instrument commences on 23 March 2020.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning extrinsic allergic alveolitis No. 88 of 2011 (Federal Register of Legislation No. F2011L01447) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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\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 hypersensitivity pneumonitis and death from hypersensitivity pneumonitis.\n\nMeaning of hypersensitivity pneumonitis\n\n(2) For the purposes of this Statement of Principles, hypersensitivity pneumonitis:\n\n(a) means a non-infectious, immunological inflammation of the lung parenchyma secondary to inhalation, by a sensitised subject, of any one of a variety of external antigens; and\n\n(b) includes acute, subacute and chronic hypersensitivity pneumonitis; and\n\n(c) excludes fibrosing interstitial lung disease, bronchiolitis obliterans organising pneumonia, and lung inflammation resulting from antigen exposure by means other than inhalation, such as ingested drugs and acute anaphylaxis.\n\nNote 1: Hypersensitivity pneumonitis is also known as extrinsic allergic alveolitis.\n\nNote 2: The inflammation of the lung parenchyma mainly involves the alveoli, terminal bronchioles and interstitium. The inflammation often organises into granulomas and may progress to fibrosis in chronic cases.\n\n(3) While hypersensitivity pneumonitis attracts ICD‑10‑AM code J67, in applying this Statement of Principles the meaning of hypersensitivity pneumonitis 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 hypersensitivity pneumonitis\n\n(5) For the purposes of this Statement of Principles, hypersensitivity pneumonitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's hypersensitivity pneumonitis.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 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 hypersensitivity pneumonitis and death from hypersensitivity pneumonitis 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\n9 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, hypersensitivity pneumonitis or death from hypersensitivity pneumonitis is connected with the circumstances of a person's relevant service:\n\n(1) inhaling the specific antigen responsible for the hypersensitivity pneumonitis before the clinical onset of hypersensitivity pneumonitis;\n\nNote: antigen and specific antigen responsible for the hypersensitivity pneumonitis are defined in the Schedule 1 - Dictionary. \n\n(2) inhaling the specific antigen responsible for the hypersensitivity pneumonitis within the 30 days before the clinical worsening of hypersensitivity pneumonitis;\n\nNote: antigen and specific antigen responsible for the hypersensitivity pneumonitis are defined in the Schedule 1 - Dictionary. \n\n(3) inability to obtain appropriate clinical management for hypersensitivity pneumonitis.\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 factors set out in subsections 9(2) and 9(3) apply only to material contribution to, or aggravation of, hypersensitivity pneumonitis where the person's hypersensitivity pneumonitis 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(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 6\n\n1 Definitions\n\nIn this instrument:\n\n antigen means an exogenous substance which is capable of stimulating a type III or type IV hypersensitivity reaction in individuals through non‑Immunoglobulin E (non-IgE) responses, and reacting with the resulting specific antibody or specifically sensitised T-lymphocytes.\n\n hypersensitivity pneumonitis—see subsection 7(2).\n\n specific antigen responsible for the hypersensitivity pneumonitis means the antigen which the available clinical or laboratory evidence implicates as the cause of hypersensitivity pneumonitis in the patient.\n\nNote 1: Examples of sources of antigens responsible for causing hypersensitivity pneumonitis include, but are not limited to:\n\n(a) animal dust, dander or hair particles;\n\n(b) bird droppings or feathers;\n\n(c) detergent powder;\n\n(d) metalworking fluid contaminated with micro-organisms;\n\n(e) mouldy timber dust;\n\n(f) polyurethane varnishes and lacquers containing toluene diisocyanate or methylene diphenyl diisocyanate;\n\n(g) heated epoxy resin or dyes containing phthalic anhydride;\n\n(h) sewage sludge contaminated with micro-organisms; and\n\n(i) spores from Lycoperdon puffballs.\n\nNote 2: antigen is also defined in the Schedule 1 – Dictionary.\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":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier extrinsic allergic alveolitis Statement (s4) and replaces it with an updated Statement titled for hypersensitivity pneumonitis. It narrows and clarifies scope by defining included forms and explicit exclusions (s7(2)), updating reliance on ICD‑10 coding (s7(3)–(4)), and revising causation factors to include specific antigen exposure and inability to obtain appropriate clinical management (s9). It continues to apply to claims under the VEA and MRCA (s5) but adjusts the factual and evidentiary framework for linking disease to service."},"complexity_factors":["Technical medical definitions and distinctions (acute/subacute/chronic, exclusion of certain lung diseases) (s7(2))","Requirement for clinical or laboratory identification of a specific antigen as causal (Schedule 1 definitions)","Multiple causation factors with temporal limits and different legal effects (s9, s10)","Interaction with two statutes (VEA and MRCA) and repeal of a prior Statement (s3–s5, s4)","Reference to external medical classification (ICD‑10‑AM) increasing diagnostic anchoring (s7(3)–(4))","Inclusion of death/terminal event definitions and their linkage to disease (s7(5), Schedule 1)","Cross‑reference mechanism to other Statements of Principles for overlapping conditions (s11)","Evidentiary standard is legal (balance of probabilities) but reliant on medical science, raising administrative assessment complexity (s8)"],"plain_english_summary":"This instrument sets the medical rules the Repatriation Medical Authority uses to decide, on the balance of probabilities, whether hypersensitivity pneumonitis (acute, subacute or chronic) and deaths from it are connected to a veteran’s service for claims under the VEA or MRCA. It replaces an earlier Statement of Principles, defines key medical terms and examples of causative antigens, and lists the exposure and treatment‑access conditions claimants must meet. It affects veterans (who must produce clinical/laboratory evidence) and the Department that may meet entitlement costs."},"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 maintains the same scope as its predecessor (No. 88 of 2011). It updates the medical terminology (changing 'extrinsic allergic alveolitis' to 'hypersensitivity pneumonitis' to match modern medical usage) and references current ICD-10-AM codes, but does not expand the class of claimants, the types of service covered, or the fundamental compensation framework. The three-factor test structure remains consistent with standard Repatriation Medical Authority Statements of Principles."},"complexity_factors":["Moderate medical terminology requiring definitions (antigen, ICD-10-AM codes, immunological mechanisms)","Cross-references to two separate Acts (VEA and MRCA) with different service definitions","Conditional logic in section 9 requiring only one of three factors to be satisfied","Nested definitions in Schedule 1 with circular references (e.g., 'hypersensitivity pneumonitis—see subsection 7(2)')","Specific temporal requirements (30-day window for clinical worsening)","Exclusion clauses in the disease definition that require medical knowledge to interpret","Incorporation of external medical classification systems (ICD-10-AM Tenth Edition) by specific ISBN reference"],"plain_english_summary":"This instrument sets the medical rules for deciding whether hypersensitivity pneumonitis (extrinsic allergic alveolitis) in current or former Australian Defence Force members is connected to military service, defining the condition and applying the \"balance of probabilities\" test. It identifies service‑related exposure or lack of timely treatment as qualifying links and replaces the 2011 statement on the condition.\n\nIt affects veterans claiming under the Veterans' Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004 and determines access to pensions, treatment and other benefits."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-balance-of-probabilities-no-8-of-202","history":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-balance-of-probabilities-no-8-of-202/history","analysis":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-balance-of-probabilities-no-8-of-202/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-balance-of-probabilities-no-8-of-202/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-balance-of-probabilities-no-8-of-202/important-cases","documents":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-balance-of-probabilities-no-8-of-202/documents"}}