{"id":"F2025L00146","name":"Statement of Principles concerning otosclerosis (Balance of Probabilities) (No. 24 of 2025)","slug":"statement-of-principles-concerning-otosclerosis-balance-of-probabilities-no-24-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442730,"registerId":"F2025L00146-fast-fetch-1775957683719","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning otosclerosis (Balance of Probabilities) (No. 24 of 2025)","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![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nOTOSCLEROSIS  (Balance of Probabilities)\n\n(No. 24 of 2025)\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   18 February 2025.\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\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\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning otosclerosis (Balance of Probabilities) (No. 24 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 25 March 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning otosclerosis (Balance of Probabilities) (No. 62 of 2016) (Federal Register of Legislation No. F2016L01154) made under subsection 196B(3) of the VEA is repealed.\n\n1.                Application\n\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\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about otosclerosis and death from otosclerosis.\n\n\nMeaning of otosclerosis\n\n1.           For the purposes of this Statement of Principles, otosclerosis:\n  1.           means a disorder of the ear characterised by abnormal bone remodelling of the otic capsule which can progress towards the stapes resulting in conductive hearing loss, or less commonly towards the cochlea resulting in sensorineural hearing loss; and\n  2.           excludes familial otosclerosis.\n\n\nNote 1: otic capsule is defined in the Schedule 1 – Dictionary.\n\nNote 2: Mixed hearing loss, which includes both conductive and sensorineural hearing loss, can also occur.\n\n1.           While otosclerosis attracts ICD‑10‑AM code H80, in applying this Statement of Principles the meaning of otosclerosis is that given in subsection (2).\n2.           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\n\nDeath from otosclerosis\n\n1.           For the purposes of this Statement of Principles, otosclerosis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's otosclerosis.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that otosclerosis and death from otosclerosis 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\n1.                Factors that must exist\n\n\nAt least one of the following factor must exist before it can be said that, on the balance of probabilities, otosclerosis or death from otosclerosis is connected with the circumstances of a person's relevant service:\n\n1.           inability to obtain appropriate clinical management for otosclerosis before clinical worsening.\n\n\n1.            Relationship to service\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  2.           The factor set out in subsection 9(1) applies only to material contribution to, or aggravation of, otosclerosis where the person's otosclerosis was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 9 applies in relation to a person; and\n2.           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\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                             MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                             otic capsule (or bony labyrinth) means the bony cavities in the temporal bone of the inner ear and includes the cochlea, vestibule, and semicircular canals.\n\n                               otosclerosis—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":{"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument repeals the 2016 Statement and reissues criteria limited to otosclerosis (excluding familial forms), death from otosclerosis, a single qualifying factor (inability to obtain appropriate clinical management), and applicability to VEA s120B and MRCA s339 claims. On its face, the text does not expand or narrow scope beyond those elements; it restates definitions, the evidentiary standard (balance of probabilities), and cross-references to other Statements (sections 2, 4–11 and Schedule)."},"complexity_factors":["Single, narrow qualifying factor required (inability to obtain appropriate clinical management) but requires a causal link to relevant service and material contribution/aggravation (sections 9 and 10).","Precise definitional boundaries for the condition and exclusions (otosclerosis definition and exclusion of familial otosclerosis; section 7(2)).","Includes death from otosclerosis tied to terminal events defined in the Schedule, adding medico-legal causation complexity (section 7(4); Schedule).","Cross-references to other Statements of Principles where factors refer to other injuries or diseases, creating dependence on external instruments (section 11).","Legal framing and evidentiary standard set by the Repatriation Medical Authority under VEA s196B(3) and the balance-of-probabilities test, requiring documentary/clinical proof (sections 3 and 8).","Administrative interactions: repeal of prior Statement and application to claims under two different statutes (commencement, repeal, and application provisions: sections 2, 4, 5)."],"plain_english_summary":"This instrument (No. 24 of 2025) replaces the 2016 Statement and sets the medical rules the Repatriation Medical Authority uses to link otosclerosis (excluding familial otosclerosis) and death from otosclerosis to relevant service for claims under the VEA (s120B) or the MRCA (s339). It starts 25 March 2025. \n\nA claim is met on the balance of probabilities if at least one defined factor exists—principally an inability to obtain appropriate clinical management before clinical worsening—and that factor materially contributed to or aggravated otosclerosis suffered before or during (but not arising out of) relevant service."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the same narrow scope as its 2016 predecessor. It addresses only otosclerosis (excluding familial forms) and retains the single-factor test based on clinical management access. The repeal and replacement appears to be a routine update rather than an expansion of scope."},"complexity_factors":["Short document (approximately 2 pages of substantive content)","Only 6 defined terms in the Dictionary (MRCA, otic capsule, otosclerosis, relevant service, terminal event, VEA)","Single causal factor in section 9 (inability to obtain appropriate clinical management)","Minimal cross-referencing — only refers back to the Dictionary and standard veterans legislation definitions","Clear structure following the standard Repatriation Medical Authority template","No nested exceptions or conditional logic beyond the basic 'at least one factor' requirement"],"plain_english_summary":"This Statement of Principles updates the rules for claiming compensation for otosclerosis (abnormal ear bone remodelling causing hearing loss, excluding familial forms). It applies to veterans and defence members under the VEA and MRCA for non‑operational service and replaces the 2016 version.\n\nIt matters because it sets the narrow medical-legal test for causation: claimants must show, on the balance of probabilities, that their condition worsened due to lack of access to appropriate clinical treatment during 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-otosclerosis-balance-of-probabilities-no-24-of-2025","history":"/api/acts/statement-of-principles-concerning-otosclerosis-balance-of-probabilities-no-24-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-otosclerosis-balance-of-probabilities-no-24-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-otosclerosis-balance-of-probabilities-no-24-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-otosclerosis-balance-of-probabilities-no-24-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-otosclerosis-balance-of-probabilities-no-24-of-2025/documents"}}