{"id":"F2020L01403","name":"Statement of Principles concerning otitic barotrauma (Balance of Probabilities) (No. 87 of 2020)","slug":"statement-of-principles-concerning-otitic-barotrauma-balance-of-probabilities-no-87-of-2020","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440650,"registerId":"F2020L01403-fast-fetch-1775956214804","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning otitic barotrauma (Balance of Probabilities) (No. 87 of 2020)","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\nOTITIC BAROTRAUMA (Balance of Probabilities)\n\n(No. 87 of 2020)\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 30 October 2020\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 otitic barotrauma (Balance of Probabilities) (No. 87 of 2020).\n\n2 Commencement\n\n This instrument commences on 30 November 2020.\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 otitic barotrauma No. 36 of 2012 (Federal Register of Legislation No. F2012L00947) made under subsections 196B(3) and (8) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 otitic barotrauma and death from otitic barotrauma.\n\nMeaning of otitic barotrauma\n\n(2) For the purposes of this Statement of Principles, otitic barotrauma means an injury to the middle or inner ear arising from inequalities in the barometric pressure between the surrounding atmosphere and the air within the middle ear space.\n\nNote 1: Clinical manifestations of otitic barotrauma typically include:\n\n(a) disruption of the ossicle chain;\n\n(b) hearing loss;\n\n(c) otalgia;\n\n(d) perforation of the tympanic membrane;\n\n(e) rupture of the round or oval window membranes with vertigo or perilymphatic fistula; and\n\n(f) tinnitus.\n\nNote 2: Otitic barotrauma is also known as otic barotrauma.\n\n(3) While otitic barotrauma attracts ICD‑10‑AM code T70.0, in applying this Statement of Principles the meaning of otitic barotrauma 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 otitic barotrauma\n\n(5) For the purposes of this Statement of Principles, otitic barotrauma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's otitic barotrauma.\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 otitic barotrauma and death from otitic barotrauma 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, otitic barotrauma or death from otitic barotrauma is connected with the circumstances of a person's relevant service:\n\n(1) experiencing a change in ambient barometric pressure as specified within the 24 hours before the clinical onset of otitic barotrauma;\n\nNote: change in ambient barometric pressure as specified is defined in the Schedule 1 - Dictionary.\n\n(2) being exposed to blast pressure from an explosion or lightning strike within the 24 hours before the clinical onset of otitic barotrauma;\n\n(3) receiving mechanical ventilation involving a face mask within the 24 hours before the clinical onset of otitic barotrauma;\n\nNote: mechanical ventilation is defined in the Schedule 1 - Dictionary. \n\n(4) experiencing a change in ambient barometric pressure as specified within the 24 hours before the clinical worsening of otitic barotrauma;\n\nNote: change in ambient barometric pressure as specified is defined in the Schedule 1 - Dictionary.\n\n(5) being exposed to blast pressure from an explosion or lightning strike within the 24 hours before the clinical worsening of otitic barotrauma;\n\n(6) receiving mechanical ventilation involving a face mask within the 24 hours before the clinical worsening of otitic barotrauma;\n\nNote: mechanical ventilation is defined in the Schedule 1 - Dictionary. \n\n(7) inability to obtain appropriate clinical management for otitic barotrauma.\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(7) apply only to material contribution to, or aggravation of, otitic barotrauma where the person's otitic barotrauma 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 change in ambient barometric pressure as specified means a significant and rapid reduction or increase in the pressure surrounding the person, including in such circumstances as:\n\n(a) ascending from a submerged craft or device or a submarine escape training facility;\n\n(b) decompression or compression in a hypobaric or hyperbaric chamber;\n\n(c) flying;\n\n(d) sky diving;\n\n(e) underwater diving;\n\n(f) working in a pressurised chamber or tunnel; and\n\n(g) working in a submarine.\n\n mechanical ventilation means an artificial method of ventilation in which air is forced into the lungs of a person via mechanical means, and includes anaesthetic and continuous positive airway pressure (CPAP) use.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n otitic barotrauma—see subsection 7(2).\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":{"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the same narrow scope as its predecessor (SOP No. 36 of 2012). It is a standard Repatriation Medical Authority Statement of Principles, designed specifically to determine causation for a single medical condition (otitic barotrauma) within the veterans' compensation scheme. The 2020 version updates the medical evidence and ICD-10-AM reference but does not expand beyond the original purpose of establishing service connection for this specific ear injury."},"complexity_factors":["Short, focused instrument (approximately 1,500 words) dealing with a single medical condition","Only 7 defined terms in the Dictionary (Schedule 1)","Straightforward structure: definition of condition, causal factors, relationship to service, definitions","Simple conditional logic: 'at least one of the following factors must exist' with a clear 24-hour temporal requirement","Minimal cross-referencing—only refers to other Statements of Principles in section 11, and defines external references (ICD-10-AM, VEA, MRCA) clearly","No nested exceptions or complex deeming provisions; section 10(2) contains one simple limitation about pre-existing conditions"],"plain_english_summary":"This rulebook sets the medical criteria used to decide whether current and former Australian Defence Force members can get compensation for otitic barotrauma (middle/inner ear injury from sudden pressure change). It requires evidence that a relevant pressure event, blast, certain ventilatory procedures, or lack of timely treatment occurred within 24 hours of symptoms to link the injury to service.\n\nIt updates and replaces the 2012 version, reflecting current medical understanding."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2012 Statement of Principles (s.4) and reissues a new Statement applicable to claims under section 120B of the VEA or section 339 of the MRCA (s.5). The current instrument restates the definition of otitic barotrauma, sets specific causation factors and 24‑hour temporal rules (ss.7–11 and Schedule), updating the operative criteria used to assess service connection."},"complexity_factors":["Legal linkage to two statutes (VEA and MRCA) and repeal of an earlier Statement (ss.3–5)","Causation assessed on the balance of probabilities with reliance on medical‑scientific evidence (s.8)","Tight temporal windows for qualifying events (24 hours before onset or worsening) which require precise medical timelines (s.9)","Enumerated qualifying events and operational definitions in the Schedule (change in ambient barometric pressure, blast, mechanical ventilation, inability to obtain care) (s.9; Schedule)","Requirement that identified factors be related to the person's relevant service (s.10)","Cross‑reference to other Statements of Principles where overlap occurs, adding interdependence to determinations (s.11)","Technical medical and coding references (otitic barotrauma definition, ICD‑10‑AM code) that require clinical evidence for claims (s.7)"],"plain_english_summary":"This Statement of Principles sets when otitic barotrauma (ear injury from rapid pressure change) is treated as connected to a veteran's service for VEA/MRCA claims. It lists specific qualifying events—rapid ambient pressure change, blast exposure, face‑mask mechanical ventilation, or lack of appropriate clinical management—within 24 hours before onset or worsening, and includes death caused by the condition. Who pays: benefits under the VEA or MRCA may apply (ss.5,8). Who decides: the Repatriation Medical Authority issues the rules and cases are assessed on the balance of probabilities (ss.3,8)."},"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-otitic-barotrauma-balance-of-probabilities-no-87-of-2020","history":"/api/acts/statement-of-principles-concerning-otitic-barotrauma-balance-of-probabilities-no-87-of-2020/history","analysis":"/api/acts/statement-of-principles-concerning-otitic-barotrauma-balance-of-probabilities-no-87-of-2020/analysis","conflicts":"/api/acts/statement-of-principles-concerning-otitic-barotrauma-balance-of-probabilities-no-87-of-2020/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-otitic-barotrauma-balance-of-probabilities-no-87-of-2020/important-cases","documents":"/api/acts/statement-of-principles-concerning-otitic-barotrauma-balance-of-probabilities-no-87-of-2020/documents"}}