{"id":"F2017L00468","name":"Statement of Principles concerning immersion pulmonary oedema (Balance of Probabilities) (No. 35 of 2017)","slug":"statement-of-principles-concerning-immersion-pulmonary-oedema-balance-of-probabilities-no-35-of-2017","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439180,"registerId":"F2017L00468-fast-fetch-1775955291663","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning immersion pulmonary oedema (Balance of Probabilities) (No. 35 of 2017)","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\nIMMERSION PULMONARY OEDEMA (Balance of Probabilities)\n\n(No. 35 of 2017)\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 21 April 2017\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 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 immersion pulmonary oedema (Balance of Probabilities) (No. 35 of 2017).\n\n2 Commencement\n\n This instrument commences on 22 May 2017.\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 immersion pulmonary oedema and death from immersion pulmonary oedema.\n\nMeaning of immersion pulmonary oedema\n\n(2) For the purposes of this Statement of Principles, immersion pulmonary oedema means:\n\n(a) a condition in which acute pulmonary oedema develops while swimming or diving; and\n\n(b) excludes acute pulmonary oedema attributed to pulmonary decompression sickness, acute myocardial infarction or an acute exacerbation of chronic heart failure.\n\nNote: Immersion pulmonary oedema typically presents with breathlessness, cough, haemoptysis, pink frothy sputum and hypoxaemia.\n\nDeath from immersion pulmonary oedema\n\n(3) For the purposes of this Statement of Principles, immersion pulmonary oedema, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's immersion pulmonary oedema.\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 immersion pulmonary oedema and death from immersion pulmonary oedema can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\nNote: relevant service is 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, immersion pulmonary oedema or death from immersion pulmonary oedema is connected with the circumstances of a person's relevant service:\n\n(1) undertaking swimming or underwater diving at the time of the clinical onset of immersion pulmonary oedema;\n\n(2) inability to obtain appropriate clinical management for immersion pulmonary oedema.\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 factor set out in subsection 8(2) applies only to material contribution to, or aggravation of, immersion pulmonary oedema where the person's immersion pulmonary oedema 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 immersion pulmonary oedema—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":"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 instrument maintains its original narrow scope. It addresses exactly one medical condition (immersion pulmonary oedema) for a specific cohort (veterans and defence members with non-operational service). The definition explicitly excludes related conditions handled by other Statements of Principles, preventing scope creep. The structure follows the standard template for Repatriation Medical Authority Statements of Principles without expansion beyond the original legislative intent."},"complexity_factors":["Short, single-purpose instrument (approximately 1,500 words)","Only 6 defined terms in the Dictionary (immersion pulmonary oedema, MRCA, relevant service, terminal event, VEA, plus implicit definitions)","Simple binary test structure: exactly 2 alternative factors in section 8, with only one requiring additional conditions in section 9(2)","Minimal cross-referencing: only refers to parent Acts (VEA and MRCA) and incorporates other Statements of Principles by reference in section 10","Clear exclusion clause in section 6(2)(b) that narrows rather than expands scope","No nested exceptions or conditional logic beyond the basic 'at least one factor' requirement and the single limitation in section 9(2)"],"plain_english_summary":"This Statement of Principles sets the medical test for awarding compensation for immersion pulmonary oedema (and deaths from it) to veterans and current/former ADF members under the VEA and MRCA for peacetime or certain non‑operational service. \n\nIt says service connection is accepted only if the condition began while swimming or diving, or if inadequate treatment during/after service worsened a pre‑existing condition. It’s a gatekeeper—not automatic entitlement."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument itself defines the scope of application (immersion pulmonary oedema and related death) and specifies application to VEA/MRCA claims (s.4, s.6). It does not state that it amends or narrows a prior instrument; rather it establishes the conditions, exclusions and procedural connections (including to other Statements of Principles) that will govern claim adjudication. Any change to pre‑existing scope is not indicated within this text."},"complexity_factors":["Cross‑reference dependence on the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, and on other Statements of Principles, which creates inter-instrument application complexity (s.4, s.10, Schedule 1).","Medical definition includes explicit exclusions (pulmonary decompression sickness, acute myocardial infarction, acute exacerbation of chronic heart failure), requiring differential clinical judgment to apply (s.6(2)).","Causal nexus requirement: at least one specified factor must exist and be related to the person's relevant service, so adjudicators must assess both factual occurrence and service‑connection (s.8, s.9(1)).","Evidentiary standard: determinations are made on the balance of probabilities informed by 'sound medical‑scientific evidence', which can require specialist medical evidence and raises evidentiary interpretation tasks (title, s.7).","Narrow conditional factor (inability to obtain appropriate clinical management) applies only where the condition was suffered or contracted before or during but did not arise out of service, requiring temporal and causation analysis (s.8(2), s.9(2)).","Definitions (e.g. 'relevant service', 'terminal event') are technical and directly affect scope and outcome of claims decisions (Schedule 1).","Administrative implication: it directly governs claims decision‑making processes and may increase requirements for medical reports and cross‑checking with other SOPs (s.4, s.10)."],"plain_english_summary":"This Statement of Principles sets out when immersion pulmonary oedema (acute pulmonary oedema developing while swimming or diving) can be accepted as connected to a veteran’s relevant service for VEA/MRCA claims. It gives a medical definition with specific exclusions, lists the factual factors that must be present for a service connection, and explains how those factors must be related to the person’s relevant service. It matters because it governs entitlement decisions and the evidence needed to establish a service nexus."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-immersion-pulmonary-oedema-balance-of-probabilities-no-35-of-2017","history":"/api/acts/statement-of-principles-concerning-immersion-pulmonary-oedema-balance-of-probabilities-no-35-of-2017/history","analysis":"/api/acts/statement-of-principles-concerning-immersion-pulmonary-oedema-balance-of-probabilities-no-35-of-2017/analysis","conflicts":"/api/acts/statement-of-principles-concerning-immersion-pulmonary-oedema-balance-of-probabilities-no-35-of-2017/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-immersion-pulmonary-oedema-balance-of-probabilities-no-35-of-2017/important-cases","documents":"/api/acts/statement-of-principles-concerning-immersion-pulmonary-oedema-balance-of-probabilities-no-35-of-2017/documents"}}