{"id":"F2019L00860","name":"Statement of Principles concerning irritable bowel syndrome (Balance of Probabilities) (No. 66 of 2019)","slug":"statement-of-principles-concerning-irritable-bowel-syndrome-balance-of-probabilities-no-66-of-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440135,"registerId":"F2019L00860-fast-fetch-1775955885236","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning irritable bowel syndrome (Balance of Probabilities) (No. 66 of 2019)","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\nIRRITABLE BOWEL SYNDROME (Balance of Probabilities)\n\n(No. 66 of 2019)\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 June 2019\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 irritable bowel syndrome (Balance of Probabilities) (No. 66 of 2019).\n\n2 Commencement\n\n This instrument commences on 22 July 2019.\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 irritable bowel syndrome No. 28 of 2011 (Federal Register of Legislation No. F2011L00766) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 irritable bowel syndrome and death from irritable bowel syndrome.\n\nMeaning of irritable bowel syndrome\n\n(2) For the purposes of this Statement of Principles, irritable bowel syndrome means recurrent abdominal pain occurring on average at least one day per week for at least three months, where the pain is associated with two or more of the following:\n\n(a) defaecation;\n\n(b) a change in the frequency of stool; or\n\n(c) a change in the form (appearance) of stool;\n\nwith the symptom onset at least six months prior to the diagnosis.\n\n(3) While irritable bowel syndrome attracts ICD‑10‑AM code K58, in applying this Statement of Principles the meaning of irritable bowel syndrome 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 irritable bowel syndrome\n\n(5) For the purposes of this Statement of Principles, irritable bowel syndrome, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's irritable bowel syndrome.\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 irritable bowel syndrome and death from irritable bowel syndrome 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, irritable bowel syndrome or death from irritable bowel syndrome is connected with the circumstances of a person's relevant service:\n\n(1) having a clinically significant disorder of mental health as specified within the six months before the clinical onset of irritable bowel syndrome;\n\nNote: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary. \n\n(2) having an episode of severe diarrhoea within the three months before the clinical onset of irritable bowel syndrome;\n\nNote: episode of severe diarrhoea is defined in the Schedule 1 - Dictionary. \n\n(3) experiencing severe childhood abuse before the clinical onset of irritable bowel syndrome;\n\nNote: severe childhood abuse is defined in the Schedule 1 - Dictionary.\n\n(4) having a clinically significant disorder of mental health as specified within the six months before the clinical worsening of irritable bowel syndrome;\n\nNote: clinically significant disorder of mental health as specified is defined in the Schedule 1 - Dictionary. \n\n(5) having an episode of severe diarrhoea within the three months before the clinical worsening of irritable bowel syndrome;\n\nNote: episode of severe diarrhoea is defined in the Schedule 1 - Dictionary. \n\n(6) inability to obtain appropriate clinical management for irritable bowel syndrome.\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(4) to 9(6) apply only to material contribution to, or aggravation of, irritable bowel syndrome where the person's irritable bowel syndrome 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 clinically significant disorder of mental health as specified means one of the following conditions, which is of sufficient severity to warrant ongoing management:\n\n(a) agoraphobia;\n\n(b) alcohol use disorder;\n\n(c) anxiety disorder;\n\n(d) bipolar disorder;\n\n(e) depressive disorder;\n\n(f) eating disorder;\n\n(g) obsessive compulsive disorder;\n\n(h) panic disorder; or\n\n(i) posttraumatic stress disorder.\n\nNote 1: Management of the condition may involve regular visits (for example, at least monthly) to a psychiatrist, counsellor or general practitioner.\n\nNote 2: To warrant ongoing management does not require that any actual management was received or given for the condition.\n\n episode of severe diarrhoea means an acute illness characterised by the passage of frequent, loose, watery motions assessed as being caused by an infective organism, and of sufficient severity to warrant medical attention, or in the absence of medical intervention, lasting at least four days.\n\n irritable bowel syndrome—see subsection 7(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 severe childhood abuse means:\n\n(a) serious physical, emotional, psychological or sexual harm whilst a child aged under 16 years; or\n\n(b) neglect involving a serious failure to provide the necessities for health, physical and emotional development, or wellbeing whilst a child aged under 16 years;\n\nwhere such serious harm or neglect has been perpetrated by a parent, a care provider, an adult who works with or around that child, or any other adult in contact with that child.\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":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Repatriation Medical Authority Statements of Principles. It replaces the 2011 version (No. 28 of 2011) with updated medical definitions and factors, but does not expand beyond the traditional purpose of determining service connection for specific diseases under veterans' compensation legislation. The structure follows the standard template for such instruments."},"complexity_factors":["Moderate cross-referencing: links to two other Acts (VEA and MRCA) and incorporates definitions from other Statements of Principles via section 11","Conditional logic in section 10(2): creates a specific limitation where worsening factors only apply to pre-existing conditions not arising from service","Nested definitions: 8 defined terms in Schedule 1, with some definitions containing sub-lists (e.g., 9 specific mental health conditions, 5 terminal events)","Temporal requirements: multiple time-bound conditions (6 months before onset, 3 months before onset, 6 months before worsening, 3 months before worsening) that must be precisely tracked","Dual pathway structure: distinguishes between 'clinical onset' (getting IBS) and 'clinical worsening' (existing IBS getting worse), with different rules for each","Medical-legal hybrid language: combines clinical criteria (ICD-10-AM codes, symptom descriptions) with legal standards (balance of probabilities, relevant service definitions)"],"plain_english_summary":"This Statement of Principles from the Repatriation Medical Authority defines irritable bowel syndrome for veterans’ compensation and sets the legal test for claims under the VEA and MRCA. \n\nTo succeed, a claimant must meet the new medical definition and show at least one specified service‑related factor (such as a recent clinically significant mental disorder, severe post‑infective diarrhoea, serious childhood abuse, or lack of access to treatment for worsening) linking the IBS to service; otherwise the claim will likely be rejected."},"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"},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This 2019 instrument expressly repeals the 2011 Statement of Principles (section 4) and replaces it. It applies to claims under section 120B of the VEA and section 339 of the MRCA (section 5), and establishes detailed definitions, specified qualifying factors and temporal limits for treating IBS as connected with relevant service (sections 7–11 and Schedule 1). The instrument therefore alters the governing Statement of Principles that decision‑makers must apply to such claims."},"complexity_factors":["Technical medical definition of IBS with diagnostic timing and symptom criteria (see subsection 7(2)).","Discrete temporal windows for qualifying events (e.g. six months for mental health, three months for diarrhoea) (section 9; Schedule).","Multiple defined terms with legal consequences (clinically significant disorder of mental health, episode of severe diarrhoea, severe childhood abuse, terminal event) (Schedule 1).","Interplay between ‘service connection’ and ‘aggravation’ limitations (section 10(2)).","Requirement that any listed factor be related to the person’s relevant service (section 10(1)).","Cross‑references to other Statements of Principles where factors overlap (section 11).","Operates under the legal standard ‘balance of probabilities’ and is intended for administrative claims decision‑making (section 8).","Repeal and replacement of an earlier 2011 Statement of Principles, requiring administrators to apply the updated instrument (section 4)."],"plain_english_summary":"This instrument, made by the Repatriation Medical Authority, sets the medical test for linking irritable bowel syndrome (IBS) to a person's relevant service for claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act (sec 3, 5). It defines IBS, lists specific qualifying factors and time windows (mental health disorder within six months, severe diarrhoea within three months, severe childhood abuse, inability to obtain appropriate management), and governs when service connection or aggravation is found on the balance of probabilities (secs 7–11, 9)."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-irritable-bowel-syndrome-balance-of-probabilities-no-66-of-2019","history":"/api/acts/statement-of-principles-concerning-irritable-bowel-syndrome-balance-of-probabilities-no-66-of-2019/history","analysis":"/api/acts/statement-of-principles-concerning-irritable-bowel-syndrome-balance-of-probabilities-no-66-of-2019/analysis","conflicts":"/api/acts/statement-of-principles-concerning-irritable-bowel-syndrome-balance-of-probabilities-no-66-of-2019/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-irritable-bowel-syndrome-balance-of-probabilities-no-66-of-2019/important-cases","documents":"/api/acts/statement-of-principles-concerning-irritable-bowel-syndrome-balance-of-probabilities-no-66-of-2019/documents"}}