{"id":"F2024L01048","name":"Statement of Principles concerning Meniere disease and Meniere syndrome (Balance of Probabilities) (No. 69 of 2024)","slug":"statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-balance-of-probabilities-no-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442536,"registerId":"F2024L01048-fast-fetch-1775957511943","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning Meniere disease and Meniere syndrome (Balance of Probabilities) (No. 69 of 2024)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nMENIERE DISEASE AND MENIERE SYNDROME (Balance of Probabilities)\n\n(No. 69 of 2024)\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 20 August 2024.\n\n \n\n \n\n \n\n \n\n \n\n|
Professor Terence Campbell AM
Chairperson
by and on behalf of
The Repatriation Medical Authority |\n| --- |\n| |\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 Meniere disease and Meniere syndrome (Balance of Probabilities) (No. 69 of 2024).\n\n2 Commencement\n\n This instrument commences on 24 September 2024.\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 Meniere's disease No. 109 of 2015 (Federal Register of Legislation No. F2015L01329) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 Meniere disease and Meniere syndrome and death from Meniere disease and Meniere syndrome.\n\nMeaning of Meniere disease and Meniere syndrome\n\n(2) For the purposes of this Statement of Principles, Meniere disease:\n\n(a) means a primary (idiopathic) pathology affecting both the cochlea and the vestibular apparatus of the labyrinth on the same side with clinical manifestations of episodic attacks of:\n\n(i) vertigo;\n\n(ii) sensorineural hearing loss; and/or\n\n(iii) tinnitus;\n\n(iv) occurring all on the same side; and\n\n(b) includes primary endolymphatic hydrops; and\n\n(c) excludes vestibular migraine.\n\nNote 1: Meniere disease can lead to a progressive hearing loss that can remain in between Meniere disease episodes, and this is considered a component of Meniere disease.\n\nNote 2: Meniere disease can occur in either ear, with the SoP being invoked twice for bilateral involvement.\n\n(3) For the purposes of this Statement of Principles, Meniere syndrome:\n\n(a) means a secondary pathology permanently affecting both the cochlea, and the vestibular apparatus or the vestibulocochlear nerve on the same side with clinical manifestations of:\n\n(i) vertigo;\n\n(ii) sensorineural hearing loss; and/or\n\n(iii) tinnitus;\n\n(iv) occurring all on the same side; and\n\n(b) includes secondary endolymphatic hydrops; and\n\n(c) excludes vestibular migraine.\n\nNote: Meniere syndrome can occur in either ear, with the SoP being invoked twice for bilateral involvement.\n\n(4) While Meniere disease and Meniere syndrome attracts ICD‑10‑AM code H81.0, in applying this Statement of Principles the meaning of Meniere disease and Meniere syndrome is that given in subsections (2) and (3).\n\n(5) For subsection (4), 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 Meniere disease and Meniere syndrome\n\n(6) For the purposes of this Statement of Principles, Meniere disease and Meniere syndrome, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's Meniere disease and Meniere 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 Meniere disease and Meniere syndrome and death from Meniere disease and Meniere 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, Meniere disease and Meniere syndrome or death from Meniere disease and Meniere syndrome is connected with the circumstances of a person's relevant service:\n\n(1) having a moderate to severe traumatic brain injury within the 3 months, before clinical onset or clinical worsening;\n\n(2) having otosyphilis of the affected ear at the time of clinical onset;\n\n(3) having middle ear or inner ear surgery at least 2 months before clinical onset;\n\n(4) inability to obtain appropriate clinical management for Meniere disease and Meniere syndrome before clinical worsening.\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 clinical worsening aspects of factors set out in section 9 apply only to material contribution to, or aggravation of, Meniere disease and Meniere syndrome where the person's Meniere disease and Meniere 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 Meniere disease and Meniere 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 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"},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2015 Statement of Principles (s4) and replaces it with updated definitions and application rules. It clarifies the meaning of Meniere disease and separately defines Meniere syndrome, explicitly includes death from the condition (with a defined list of terminal events), references ICD‑10‑AM coding, and sets a limited list of medical circumstances that, if related to relevant service, satisfy the balance‑of‑probabilities test for service connection (s7, s9, Schedule)."},"complexity_factors":["Targeted scope and short length — single condition with focused criteria (s7, s9).","Defined medical definitions and exclusions (Meniere disease/syndrome; excludes vestibular migraine) requiring clinical interpretation (s7(2)–(4)).","Causation standard is balance of probabilities but requires temporal and service linkage for listed factors (s8, s9, s10).","Cross‑reference to other Statements of Principles where factors refer to other injuries/diseases (s11).","Technical references to ICD‑10‑AM coding and terminal events that may require medical record matching (s7(4)–(5), Schedule).","Interaction with two statutes and claims processes (VEA and MRCA), so administrative application sits across different compensation schemes (s3, s5)."],"plain_english_summary":"This Statement of Principles, made by the Repatriation Medical Authority under subsection 196B(3) of the Veterans' Entitlements Act 1986, sets the medical criteria used to decide whether Meniere disease or Meniere syndrome (and related death) is connected to relevant service for claims under the VEA and the Military Rehabilitation and Compensation Act (s3, s5, s7). It identifies a short list of medical circumstances that, if present and linked to service, make it more probable than not that the condition is service‑related and so shapes entitlement assessments and the clinical evidence decision‑makers will require (s8–s11)."},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":true,"description":"The original 2015 instrument covered only 'Meniere's disease' (singular). This 2024 version expands scope to cover both 'Meniere disease' (idiopathic/primary) AND 'Meniere syndrome' (secondary), effectively doubling the covered conditions. It also adds explicit exclusion of vestibular migraine, clarifies that progressive hearing loss between episodes is included, and updates the ICD-10-AM reference from an earlier edition to the Tenth Edition (2017). The addition of Meniere syndrome as a distinct covered condition represents a significant expansion beyond the original instrument's intent."},"complexity_factors":["Medical terminology requiring clinical knowledge (otosyphilis, endolymphatic hydrops, vestibular apparatus, sensorineural hearing loss)","Dual condition structure with subtle distinctions between primary (disease) and secondary (syndrome) pathology","Cross-references to other Statements of Principles for related conditions (section 11)","Temporal requirements with specific windows (3 months for TBI, 2 months for surgery)","Bilateral application rule requiring separate invocation for each ear","Conditional logic distinguishing between clinical onset and clinical worsening (factor 4 only applies to worsening)","Reference to external classification system (ICD-10-AM Tenth Edition)","Nested definitions requiring consultation of Schedule 1 Dictionary for key terms"],"plain_english_summary":"This instrument tells when Meniere disease or Meniere syndrome can be treated as service‑related for veterans’ compensation. It applies to claimants under the VEA and serving/former defence members under the MRCA, and requires evidence that service‑related events or lack of treatment plausibly caused or worsened the ear condition.\n\nIt replaces the 2015 statement, clarifies that progressive hearing loss between attacks counts, excludes vestibular migraine, and uses the balance‑of‑probabilities test."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-balance-of-probabilities-no-","history":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-balance-of-probabilities-no-/history","analysis":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-balance-of-probabilities-no-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-balance-of-probabilities-no-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-balance-of-probabilities-no-/important-cases","documents":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-balance-of-probabilities-no-/documents"}}