{"id":"F2020L01080","name":"Statement of Principles concerning non-aneurysmal aortic atherosclerotic disease (Reasonable Hypothesis) (No. 52 of 2020)","slug":"statement-of-principles-concerning-non-aneurysmal-aortic-atherosclerotic-disease-reasonable-hypothes","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":113504,"registerId":"commonwealth-F2020L01080-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning non-aneurysmal aortic atherosclerotic disease (Reasonable Hypothesis) (No. 52 of 2020)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning non-aneurysmal aortic atherosclerotic disease (Reasonable Hypothesis) (No. 52 of 2020)\n\nmade under subsection 196B(2) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 19 September 2022\n\nIncludes amendments up to: Veterans' Entitlements (Statements of Principles—definition of \"one pack-year\") Amendment Determination 2022 (No. 94 of 2022) (F2022L01128)\n\nThe day of commencement of this Amendment Determination is 19 September 2022.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning non-aneurysmal aortic atherosclerotic disease (Reasonable Hypothesis) (No. 52 of 2020) that shows the text of the law as amended and in force on 19 September 2022.\n\nThe notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.\n\nUncommenced amendments\n\nThe effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.\n\nApplication, saving and transitional provisions for provisions and amendments\n\nIf the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.\n\nModifications\n\nIf the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.\n\nSelf‑repealing provisions\n\nIf a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.\n\nContents\n\n1 Name\n\n3 Authority\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\nEndnotes\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\n  \n\n1 Name\n\nThis is the Statement of Principles concerning non-aneurysmal aortic atherosclerotic disease (Reasonable Hypothesis) (No. 52 of 2020).\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\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 non-aneurysmal aortic atherosclerotic disease and death from non-aneurysmal aortic atherosclerotic disease.\n\nMeaning of non-aneurysmal aortic atherosclerotic disease\n\n(2) For the purposes of this Statement of Principles, non-aneurysmal aortic atherosclerotic disease means atherosclerosis of the abdominal aorta which causes partial or complete occlusion of the aorta and either:\n\n(a) warrants medical treatment; or\n\n(b) results in at least one of the following clinical manifestations:\n\n(i) claudication in the lower back, buttocks, hips, thighs or calves;\n\n(ii) erectile dysfunction;\n\n(iii) pallor and coldness of the lower extremities; or\n\n(iv) reduced pulsation in the femoral arteries.\n\n(3) While non-aneurysmal aortic atherosclerotic disease attracts ICD‑10‑AM code I70.0, in applying this Statement of Principles the meaning of non-aneurysmal aortic atherosclerotic disease 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 non-aneurysmal aortic atherosclerotic disease\n\n(5) For the purposes of this Statement of Principles, non-aneurysmal aortic atherosclerotic disease, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's non-aneurysmal aortic atherosclerotic disease.\n\n> Note: 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 non-aneurysmal aortic atherosclerotic disease and death from non-aneurysmal aortic atherosclerotic disease 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\n> Note: 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 non-aneurysmal aortic atherosclerotic disease or death from non-aneurysmal aortic atherosclerotic disease with the circumstances of a person's relevant service:\n\n(1) having hypertension before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n(2) having diabetes mellitus before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n(3) being obese for at least five years within the 20 years before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: being obese is defined in the Schedule 1 - Dictionary.\n\n(4) having dyslipidaemia before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: dyslipidaemia is defined in the Schedule 1 - Dictionary.\n\n(5) where smoking has not permanently ceased, having smoked at least one pack-year of tobacco products before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(6) where smoking has permanently ceased before the clinical onset of non-aneurysmal aortic atherosclerotic disease:\n\n(a) having smoked at least five pack-years of tobacco products; or\n\n(b) having smoked at least one pack-year but less than five pack-years of tobacco products, and the clinical onset of non-aneurysmal aortic atherosclerotic disease has occurred within 20 years of smoking cessation;\n\n> Note: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(7) where exposure to second-hand smoke has not permanently ceased, being exposed to second-hand smoke for at least 1,000 hours before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.\n\n(8) where exposure to second-hand smoke has permanently ceased before the clinical onset of non-aneurysmal aortic atherosclerotic disease:\n\n(a) being exposed to second-hand smoke for at least 5,000 hours; or\n\n(b) being exposed to second-hand smoke for at least 1,000 hours but less than 5,000 hours, and the clinical onset of non-aneurysmal aortic atherosclerotic disease has occurred within five years of the last exposure to second-hand smoke;\n\n> Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.\n\n(9) having hyperhomocysteinaemia before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n(10) an inability to undertake any physical activity greater than three METs for at least five years within the 20 years before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: MET is defined in the Schedule 1 - Dictionary.\n\n(11) having chronic kidney disease before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: chronic kidney disease is defined in the Schedule 1 - Dictionary.\n\n(12) undergoing a course of therapeutic radiation for cancer, where the aorta was in the field of radiation, before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n(13) having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the aorta before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.\n\n(14) an inability to consume an average of at least 100 grams per day of any combination of fruit and vegetables, for at least five consecutive years within the 20 years before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n(15) having infection with human immunodeficiency virus or hepatitis C virus at the time of the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n(16) having periodontitis for at least the two years before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n(17) having an autoimmune disease before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n(18) having a clinically significant disorder of mental health as specified for at least five years before the clinical onset of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 \\- Dictionary.\n\n(19) having hypertension before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n(20) having diabetes mellitus before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n(21) being obese for at least five years within the 20 years before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: being obese is defined in the Schedule 1 - Dictionary.\n\n(22) having dyslipidaemia before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: dyslipidaemia is defined in the Schedule 1 - Dictionary.\n\n(23) where smoking has not permanently ceased, having smoked at least one pack-year of tobacco products before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(24) where smoking has permanently ceased before the clinical worsening of non-aneurysmal aortic atherosclerotic disease:\n\n(a) having smoked at least five pack-years of tobacco products; or\n\n(b) having smoked at least one pack-year but less than five pack-years of tobacco products, and the clinical worsening of non-aneurysmal aortic atherosclerotic disease has occurred within 20 years of smoking cessation;\n\n> Note: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(25) where exposure to second-hand smoke has not permanently ceased, being exposed to second-hand smoke for at least 1,000 hours before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.\n\n(26) where exposure to second-hand smoke has permanently ceased before the clinical worsening of non-aneurysmal aortic atherosclerotic disease:\n\n(a) being exposed to second-hand smoke for at least 5,000 hours; or\n\n(b) being exposed to second-hand smoke for at least 1,000 hours but less than 5,000 hours, and the clinical worsening of non-aneurysmal aortic atherosclerotic disease has occurred within five years of the last exposure to second-hand smoke;\n\n> Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.\n\n(27) having hyperhomocysteinaemia before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n(28) an inability to undertake any physical activity greater than three METs for at least five years within the 20 years before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: MET is defined in the Schedule 1 - Dictionary.\n\n(29) having chronic kidney disease before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: chronic kidney disease is defined in the Schedule 1 - Dictionary.\n\n(30) undergoing a course of therapeutic radiation for cancer, where the aorta was in the field of radiation, before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n(31) having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the aorta before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.\n\n(32) an inability to consume an average of at least 100 grams per day of any combination of fruit and vegetables, for at least five consecutive years within the 20 years before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n(33) having infection with human immunodeficiency virus or hepatitis C virus at the time of the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n(34) having periodontitis for at least the two years before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n(35) having an autoimmune disease before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n(36) having a clinically significant disorder of mental health as specified for at least five years before the clinical worsening of non-aneurysmal aortic atherosclerotic disease;\n\n> Note: clinically significant disorder of mental health as specified is defined in the Schedule 1 \\- Dictionary.\n\n(37) inability to obtain appropriate clinical management for non-aneurysmal aortic atherosclerotic disease.\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(19) to 9(37) apply only to material contribution to, or aggravation of, non-aneurysmal aortic atherosclerotic disease where the person's non-aneurysmal aortic atherosclerotic disease 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\nabnormality of kidney structure or function means:\n\n(a) having a glomerular filtration rate of less than 60 mL/min/1.73 m2; or\n\n(b) having kidney damage, as evidenced by renal biopsy, imaging studies, albuminuria, urinary sediment abnormalities or other markers of abnormal renal function; or\n\n(c) having had a kidney transplant.\n\nbeing exposed to second-hand smoke means being in an enclosed space and inhaling smoke from burning tobacco products or smoke that has been exhaled by another person who is smoking.\n\nbeing obese means having a Body Mass Index (BMI) of 30 or greater.\n\n> Note: BMI is also defined in the Schedule 1 - Dictionary.\n\nBMI means W/H2 where:\n\n(a) W is the person's weight in kilograms; and\n\n(b) H is the person's height in metres.\n\nchronic kidney disease means an abnormality of kidney structure or function that has been present for at least three months.\n\n> Note: abnormality of kidney structure or function is also defined in the Schedule 1 - Dictionary.\n\nclinically 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) depressive disorder; or\n\n(b) schizophrenia.\n\n> Note 1: Management of the condition may involve regular visits (for example, at least monthly) to a psychiatrist, counsellor or general practitioner.\n\n> Note 2: To warrant ongoing management does not require that any actual management was received or given for the condition.\n\ncumulative equivalent dose means the total dose of ionising radiation received by the particular organ or tissue from external exposure, internal exposure or both, apart from normal background radiation exposure in Australia, calculated in accordance with the methodology set out in Guide to calculation of 'cumulative equivalent dose' for the purpose of applying ionising radiation factors contained in Statements of Principles determined under Part XIA of the Veterans' Entitlements Act 1986 (Cth), Australian Radiation Protection and Nuclear Safety Agency, as in force on 2 August 2017.\n\n> Note 1: Examples of circumstances that might lead to exposure to ionising radiation include being present during or subsequent to the testing or use of nuclear weapons, undergoing diagnostic or therapeutic medical procedures involving ionising radiation, and being a member of an aircrew, leading to increased levels of exposure to cosmic radiation.\n\n> Note 2: For the purpose of dose reconstruction, dose is calculated as an average over the mass of a specific tissue or organ. If a tissue is exposed to multiple sources of ionising radiation, the various dose estimates for each type of radiation must be combined.\n\ndyslipidaemia means persistently abnormal blood lipid levels, diagnosed by a medical practitioner and evidenced by:\n\n(a) a serum high density lipoprotein cholesterol level less than 1.0 mmol/L; or\n\n(b) a serum low density lipoprotein level greater than 4.0 mmol/L; or\n\n(c) a serum triglyceride level greater than or equal to 2.0 mmol/L; or\n\n(d) a total serum cholesterol level greater than 5.5 mmol/L; or\n\n(e) the regular administration of drug therapy to normalise blood lipid levels.\n\nMET means a unit of measurement of the level of physical exertion. 1 MET = 3.5 mL of oxygen/kg of body weight per minute, 1.0 kcal/kg of body weight per hour or resting metabolic rate.\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\nnon-aneurysmal aortic atherosclerotic disease—see subsection 7(2).\n\none pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.\n\n> Note 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.\n\n> Note 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.\n\nrelevant 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\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\nterminal 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\nVEA means the Veterans' Entitlements Act 1986.\n\n> Note: Endnotes\n\n> Note: Endnote 1—About the endnotes\n\nThe endnotes provide information about this compilation and the compiled law.\n\nThe following endnotes are included in every compilation:\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\nAbbreviation key—Endnote 2\n\nThe abbreviation key sets out abbreviations that may be used in the endnotes.\n\nLegislation history and amendment history—Endnotes 3 and 4\n\nAmending laws are annotated in the legislation history and amendment history.\n\nThe legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.\n\nThe amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.\n\nMisdescribed amendments\n\nA misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.\n\nIf a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.\n\n> Note: Endnote 2—Abbreviation key\n\n|                                                | o = order(s)                        |\n| ---------------------------------------------- | ----------------------------------- |\n| ad = added or inserted                         | Ord = Ordinance                     |\n| am = amended                                   | orig = original                     |\n| amdt = amendment                               | par = paragraph(s)/subparagraph(s)  |\n| c = clause(s)                                  | /sub‑subparagraph(s)                |\n| C[x] = Compilation No. x                       | pres = present                      |\n| Ch = Chapter(s)                                | prev = previous                     |\n| def = definition(s)                            | (prev…) = previously                |\n| Dict = Dictionary                              | Pt = Part(s)                        |\n| disallowed = disallowed by Parliament          | r = regulation(s)/rule(s)           |\n| Div = Division(s)                              |                                     |\n| exp = expires/expired or ceases/ceased to have | reloc = relocated                   |\n| effect                                         | renum = renumbered                  |\n| F = Federal Register of Legislation            | rep = repealed                      |\n| gaz = gazette                                  | rs = repealed and substituted       |\n| LA = Legislation Act 2003                      | s = section(s)/subsection(s)        |\n| LIA = Legislative Instruments Act 2003         | Sch = Schedule(s)                   |\n| (md) = misdescribed amendment can be given     | Sdiv = Subdivision(s)               |\n| effect                                         | SLI = Select Legislative Instrument |\n| (md not incorp) = misdescribed amendment       | SR = Statutory Rules                |\n| cannot be given effect                         | Sub‑Ch = Sub‑Chapter(s)             |\n| mod = modified/modification                    | SubPt = Subpart(s)                  |\n| No. = Number(s)                                | underlining = whole or part not     |\n|                                                | commenced or to be commenced        |\n\n> Note: Endnote 3—Legislation history\n\n| Name                                                                                                                          | Registration              | Commencement      | Application, saving and transitional provisions |\n| ----------------------------------------------------------------------------------------------------------------------------- | ------------------------- | ----------------- | ----------------------------------------------- |\n| Statement of Principles concerning non-aneurysmal aortic atherosclerotic disease (Reasonable Hypothesis) (No. 52 of 2020)     | 28 August 2020F2020L01080 | 28 September 2020 |                                                 |\n| Veterans' Entitlements (Statements of Principles—definition of \"one pack-year\") Amendment Determination 2022 (No. 94 of 2022) | 26 August 2022F2022L01128 | 19 September 2022 |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected                             | How affected      |\n| ---------------------------------------------- | ----------------- |\n| Section 2……………….                               | rep LA s 48D      |\n| Section 4……………….                               | rep LA s 48C      |\n| Subsection 9(5) note.....                      | rs No. 94 of 2022 |\n| Subsection 9(6) note.....                      | rs No. 94 of 2022 |\n| Subsection 9(23) note...                       | rs No. 94 of 2022 |\n| Subsection 9(24) note...                       | rs No. 94 of 2022 |\n| Schedule 1 – Dictionary – one pack-year...…….. | rs No. 94 of 2022 |","sortOrder":0}],"analysis":{"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":7,"scope_assessment":{"changed":true,"description":"The instrument was amended by Veterans' Entitlements (Statements of Principles—definition of \"one pack-year\") Amendment Determination 2022 (No. 94 of 2022) (endnotes 3–4). The amendment revised the Schedule 1 definition of ‘one pack‑year’ and updated notes to subsections 9(5), 9(6), 9(23) and 9(24), thereby altering how tobacco exposure is measured for several smoking-related factors and potentially changing which claims meet those factors."},"complexity_factors":["Large number of discrete factors (37 listed in section 9) with duplicated ‘onset’ and ‘worsening’ branches increasing combinatorial outcomes","Multiple temporal conditions and look-back windows (eg. 5 years within 20 years; 20‑year smoking cessation window) in section 9","Technical medical thresholds and measurements defined in Schedule 1 (BMI, MET, lipid cutoffs, GFR, cumulative equivalent radiation dose)","Detailed smoking and second-hand smoke exposure metrics including pack‑year and hours of exposure (section 9 and Schedule 1)","Cross-reference to other Statements of Principles for overlapping injuries/diseases (section 11) creating dependency on external instruments","Requirement that each factor be ‘related to the relevant service’ shifts evidentiary burden to link factor to service (section 10(1))","Conditional application of factors 19–37 only where disease pre‑existed service or was suffered during but not arising out of service (section 10(2))","Reliance on administrative determinations by the Repatriation Medical Authority and statutory claim procedures under VEA/MRCA (sections 3, 5, 8)","Recent amendment activity focused on definition of ‘one pack‑year’ and related notes, producing interpretive change (endnotes 3–4)"],"plain_english_summary":"This instrument sets the medical criteria the Repatriation Medical Authority uses to decide whether non-aneurysmal aortic atherosclerotic disease (and death from it) can be reasonably connected to a veteran’s or service member’s eligible service for claims under the VEA or MRCA (section 5, 8). It lists specific medical, behavioural and exposure factors (with numeric thresholds and time windows) that, if related to the person’s relevant service, raise a reasonable hypothesis for entitlement."},"kimi_summary":{"content_quality":"ok","complexity_score":5,"scope_assessment":{"changed":false,"description":"The legislation remains focused on its original purpose: establishing criteria for linking non-aneurysmal aortic atherosclerotic disease to military service. The 2022 amendment (No. 94 of 2022) was a technical update to the definition of 'one pack-year' to clarify tobacco equivalency calculations, not an expansion of scope. The instrument maintains its narrow, disease-specific focus without mission creep."},"complexity_factors":["19 defined terms in Schedule 1 Dictionary, including nested definitions (e.g., 'chronic kidney disease' depends on 'abnormality of kidney structure or function')","37 separate factors with precise temporal requirements (e.g., 'at least five years within the 20 years before clinical onset')","Bifurcated structure: factors apply differently to 'clinical onset' vs 'clinical worsening' (subsections 9(1)-(18) vs 9(19)-(36))","Conditional logic for smoking and second-hand smoke exposure with alternative thresholds based on cessation status (current vs former smokers/exposure)","Cross-reference to external medical classification system (ICD-10-AM Tenth Edition)","Incorporation by reference to separate methodology guide for radiation dose calculations (ARPANSA guide dated 2 August 2017)","Mathematical formula required for BMI calculation and pack-year calculations with conversion rules for non-cigarette tobacco","Section 11 creates dynamic incorporation of other Statements of Principles by reference ('as in force from time to time')","Specific clinical thresholds with precise measurements (e.g., serum cholesterol >5.5 mmol/L, GFR <60 mL/min/1.73 m2, 3 METs exertion level)"],"plain_english_summary":"This Statement of Principles sets the medical criteria used to decide if non-aneurysmal aortic atherosclerotic disease can be linked to military service for veterans and current/former Australian Defence Force members claiming under the VEA or MRCA. It identifies established risk and exposure factors whose presence can create a “reasonable hypothesis” of service connection, guiding consistent decisions about compensation and treatment access."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-non-aneurysmal-aortic-atherosclerotic-disease-reasonable-hypothes","history":"/api/acts/statement-of-principles-concerning-non-aneurysmal-aortic-atherosclerotic-disease-reasonable-hypothes/history","analysis":"/api/acts/statement-of-principles-concerning-non-aneurysmal-aortic-atherosclerotic-disease-reasonable-hypothes/analysis","conflicts":"/api/acts/statement-of-principles-concerning-non-aneurysmal-aortic-atherosclerotic-disease-reasonable-hypothes/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-non-aneurysmal-aortic-atherosclerotic-disease-reasonable-hypothes/important-cases","documents":"/api/acts/statement-of-principles-concerning-non-aneurysmal-aortic-atherosclerotic-disease-reasonable-hypothes/documents"}}