{"id":"F2024L01047","name":"Statement of Principles concerning Meniere disease and Meniere syndrome (Reasonable Hypothesis) (No. 68 of 2024)","slug":"statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-reasonable-hypothesis-no-68-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442538,"registerId":"F2024L01047-fast-fetch-1775957511946","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 (Reasonable Hypothesis) (No. 68 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 (Reasonable Hypothesis)\n\n(No. 68 of 2024)\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 20 August 2024.\n\n \n\n \n\n \n\n \n\n \n\n \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 (Reasonable Hypothesis) (No. 68 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning Meniere's disease No. 108 of 2015 (Federal Register of Legislation No. F2015L01328) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that Meniere disease and Meniere syndrome and death from Meniere disease and Meniere syndrome 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 Meniere disease and Meniere syndrome or death from Meniere disease and Meniere syndrome with the circumstances of a person's relevant service:\n\n(1) having a moderate to severe traumatic brain injury within the 6 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 any of the following autoimmune diseases before clinical onset;\n\n(a) ankylosing spondylitis;\n\n(b) Hashimoto thyroiditis;\n\n(c) rheumatoid arthritis;\n\n(d) systemic lupus erythematosus;\n\n(e) Cogan syndrome;\n\n(f) Susac syndrome;\n\n(g) Vogt-Koyanagi-Harada syndrome; or\n\n(h) psoriatic arthritis.\n\n(4) having middle ear or inner ear surgery at least 2 months before clinical onset;\n\n(5) taking hydroxychloroquine in the 5 months before clinical onset;\n\n(6) taking amikacin, gentamicin, or tobramycin before clinical onset;\n\n(7) 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(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 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) 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 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":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":true,"description":"The original 2015 instrument covered only 'Meniere's disease'. This 2024 version expands scope to cover both 'Meniere disease' (primary) and 'Meniere syndrome' (secondary), effectively doubling the potential claimant pool by including secondary endolymphatic hydrops cases. It also adds new factors not present in the 2015 version, including traumatic brain injury, hydroxychloroquine use, and specific antibiotic exposures, reflecting updated medical evidence."},"complexity_factors":["Moderate medical terminology requiring definitions (idiopathic, endolymphatic hydrops, vestibular apparatus)","Distinction between primary (disease) and secondary (syndrome) forms with slightly different definitions","Cross-references to other Statements of Principles for related conditions (section 11)","Specific temporal requirements ('within 6 months', 'at least 2 months before', 'in the 5 months before')","Dual legislative framework application (VEA and MRCA with different service definitions)","Conditional logic for clinical worsening vs clinical onset (section 10)","Bilateral invocation rule (can be applied twice for both ears)"],"plain_english_summary":"The Repatriation Medical Authority’s Statement of Principles sets the medical rules for deciding if veterans, peacekeepers and current/former defence members can get compensation for Meniere disease or Meniere syndrome. It replaces the 2015 SoP and identifies specific service‑related factors (for example, head injury, certain ear surgery or medications, or lack of timely care) that can establish a reasonable hypothesis linking the condition to service.\n\nThis SoP is the legal gateway determining access to pensions and treatment through the Department of Veterans’ Affairs."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the prior Statement of Principles concerning Meniere's disease No. 108 of 2015 (s4) and replaces it with updated definitions and a new list of qualifying factors. It applies to claims falling under section 120A of the VEA or section 338 of the MRCA (s5), thereby altering the criteria used to assess whether a reasonable hypothesis connects Meniere disease or syndrome (and related death) to relevant service."},"complexity_factors":["Technical medical definitions and exclusions for Meniere disease and Meniere syndrome (s7(2)–(4))","Temporal and clinical thresholds (eg. TBI within 6 months before onset; surgery at least 2 months before onset) that require precise medical evidence (s9(1), s9(4))","Multiple discrete qualifying factors spanning infections, autoimmune diseases, drugs, surgery and access-to-care issues (s9(1)–(7))","Requirement that any listed factor be related to the person’s relevant service, and special rules for clinical worsening (s10(1)–(2))","Cross-references to other Statements of Principles and to provisions of the VEA and MRCA, creating interaction effects (s3, s5, s11; Schedule)","Repeal of the 2015 Statement of Principles, requiring assessors to apply the new instrument (s4)","Potential evidentiary and interpretive burden in proving subjective or system-level factors, notably 'inability to obtain appropriate clinical management' (s9(7))","Inclusion of death via contribution to a terminal event and definition of 'terminal event', which broadens causation enquiries (s7(6); Schedule)"],"plain_english_summary":"This Statement of Principles, set by the Repatriation Medical Authority, establishes the medical criteria that create a “reasonable hypothesis” linking Meniere disease or Meniere syndrome (and related death) to a person’s military service for claims under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. It defines the conditions, lists specific qualifying factors (for example, recent moderate–severe traumatic brain injury, certain infections, listed autoimmune diseases, ear surgery, particular drugs, or inability to obtain appropriate care) and requires those factors be related to the person’s relevant 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-meniere-disease-and-meniere-syndrome-reasonable-hypothesis-no-68-","history":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-reasonable-hypothesis-no-68-/history","analysis":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-reasonable-hypothesis-no-68-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-reasonable-hypothesis-no-68-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-reasonable-hypothesis-no-68-/important-cases","documents":"/api/acts/statement-of-principles-concerning-meniere-disease-and-meniere-syndrome-reasonable-hypothesis-no-68-/documents"}}