{"id":"F2020L00205","name":"Statement of Principles concerning hypersensitivity pneumonitis (Reasonable Hypothesis) (No. 7 of 2020)","slug":"statement-of-principles-concerning-hypersensitivity-pneumonitis-reasonable-hypothesis-no-7-of-2020","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440390,"registerId":"F2020L00205-fast-fetch-1775956035506","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning hypersensitivity pneumonitis (Reasonable Hypothesis) (No. 7 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 (Reasonable Hypothesis)\n\n(No. 7 of 2020)\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 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 (Reasonable Hypothesis) (No. 7 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning extrinsic allergic alveolitis No. 87 of 2011 (Federal Register of Legislation No. F2011L01445) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that hypersensitivity pneumonitis and death from hypersensitivity pneumonitis 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 hypersensitivity pneumonitis or death from hypersensitivity pneumonitis 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(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 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) 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","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard replacement Statement of Principles updating terminology (changing 'extrinsic allergic alveolitis' to 'hypersensitivity pneumonitis' to match modern medical usage) and refreshing the medical-scientific basis. It maintains the same scope as its 2011 predecessor — establishing causal factors for a specific respiratory condition in the veterans' compensation scheme. No significant expansion beyond the original purpose."},"complexity_factors":["Moderate cross-referencing between the main body and Schedule 1 (Dictionary) for defined terms","Nested definitions: 'specific antigen responsible for the hypersensitivity pneumonitis' refers back to 'antigen' which has a technical immunological definition involving type III/type IV hypersensitivity reactions and non-IgE responses","Conditional logic in section 10(2) limiting factors 9(2) and 9(3) to aggravation cases where disease pre-existed service","Incorporation by reference to ICD-10-AM Tenth Edition (external classification system)","Dual statutory framework application (VEA and MRCA with different service categories)","Section 11 creates dynamic incorporation of other Statements of Principles 'as in force from time to time'"],"plain_english_summary":"This instrument updates the 2011 rule and sets the medical test for when hypersensitivity pneumonitis (extrinsic allergic alveolitis) can be linked to military service for compensation. It defines the disease and requires at least one of three specific service-related circumstances (exposure before onset, recent exposure before worsening, or inability to obtain treatment) to form a reasonable hypothesis. It applies to veterans and defence members under the VEA and MRCA and covers death where the condition contributed."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier Statement of Principles concerning extrinsic allergic alveolitis No. 87 of 2011 (s4) and replaces it with a Statement defining hypersensitivity pneumonitis (including acute/subacute/chronic forms and specified exclusions) and setting three minimum factors that raise a reasonable hypothesis linking disease or death to relevant service. It expressly applies to claims under the VEA and the MRCA (s5) and clarifies interaction with other Statements (s11)."},"complexity_factors":["Medical-technical definitions and exclusions for the disease (see s7(2), Schedule 1) increase technical interpretation needs.","Evidentiary threshold is the 'reasonable hypothesis' standard tied to listed factors rather than strict causation (see s8, s9).","Service-connection constraints require the factor to be related to 'relevant service' and limit application of some factors to material contribution or aggravation (see s10).","Cross-references to other compensation statutes and prior Statements (application under VEA/MRCA s5; repeal of earlier Statement s4) create inter-instrument interaction.","Interaction with other Statements of Principles when factors reference other injuries/diseases necessitates cross-instrument interpretation (see s11).","Reliance on ICD-10-AM code and clinical/laboratory identification of a 'specific antigen' introduces diagnostic and evidentiary demands (see s7(3)-(4), Schedule 1)."],"plain_english_summary":"This instrument replaces a prior Statement and sets the medical criteria that must be present to raise a “reasonable hypothesis” that hypersensitivity pneumonitis is connected to a person’s relevant military service. It applies to claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. \n\nMechanically, it defines hypersensitivity pneumonitis (including acute, subacute and chronic forms, and certain exclusions), lists the minimum factors that can link the disease or death to service (notably inhalation of the implicated antigen or lack of appropriate clinical management), and requires those factors to be related to service."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-reasonable-hypothesis-no-7-of-2020","history":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-reasonable-hypothesis-no-7-of-2020/history","analysis":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-reasonable-hypothesis-no-7-of-2020/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-reasonable-hypothesis-no-7-of-2020/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-reasonable-hypothesis-no-7-of-2020/important-cases","documents":"/api/acts/statement-of-principles-concerning-hypersensitivity-pneumonitis-reasonable-hypothesis-no-7-of-2020/documents"}}