{"id":"F2025L00145","name":"Statement of Principles concerning otosclerosis (Reasonable Hypothesis) (No. 23 of 2025)","slug":"statement-of-principles-concerning-otosclerosis-reasonable-hypothesis-no-23-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442731,"registerId":"F2025L00145-fast-fetch-1775957683746","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning otosclerosis (Reasonable Hypothesis) (No. 23 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  (Reasonable Hypothesis)\n\n(No. 23 of 2025)\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    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   \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 (Reasonable Hypothesis) (No. 23 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(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning otosclerosis (Reasonable Hypothesis) (No. 61 of 2016) (Federal Register of Legislation No. F2016L01152) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\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\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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that otosclerosis and death from otosclerosis 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\n1.                Factors that must exist\n\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 otosclerosis or death from otosclerosis with the circumstances of a person's relevant service:\n\n1.           having infection with measles virus before clinical onset;\n2.           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(2) 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(2) 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)          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":{"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"},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This is a straightforward reissue/replacement of the 2016 Statement of Principles concerning the same condition (otosclerosis). The scope remains identical: establishing medical factors for linking otosclerosis to veteran service under the reasonable hypothesis standard. No expansion beyond the original purpose."},"complexity_factors":["Short, focused instrument (approximately 2.5 pages)","Only 7 defined terms in the Dictionary","Simple binary structure: two alternative factors in section 9, with one conditional limitation in section 10(2)","Minimal cross-referencing — only refers to parent Acts (VEA and MRCA) and one repealed instrument","Clear medical definition with explicit exclusion (familial otosclerosis)","Single conditional limitation: subsection 10(2) restricts the 'inability to obtain appropriate clinical management' factor to aggravation cases only"],"plain_english_summary":"This instrument updates rules for when Australian veterans can claim compensation for otosclerosis — defined as abnormal inner‑ear bone remodelling causing hearing loss, excluding inherited/familial forms — replacing the 2016 version. It affects veterans and serving defence members claiming under the VEA or MRCA and for related deaths. As a “reasonable hypothesis” instrument, it lowers the proof standard, making it easier to link service (e.g. measles in service or lack of adequate treatment while serving) to the condition."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"The instrument repeals the 2016 Statement and restates medical criteria for otosclerosis claims (s.4–9). From the text alone there is no explicit broadening or narrowing of scope: it retains a focused clinical definition, excludes familial otosclerosis, and specifies two qualifying factors for a reasonable hypothesis (s.7–9). Any practical scope change compared with the prior instrument is not evident from this instrument alone."},"complexity_factors":["Technical medical definition and subcategories (conductive, sensorineural, mixed) requiring clinical interpretation (s.7(2)).","Limited, specific causal factors (measles infection; lack of appropriate clinical management) that create evidentiary challenges for claimants (s.9).","Interaction with entitlement law across two Acts (VEA and MRCA) and cross-references to other Statements of Principles (s.5, s.11).","Replaces a prior Statement (2016) but does not include transitional detail, requiring comparison by administrators (s.4).","Inclusion of death via contribution to a terminal event expands causal linkage questions and requires medical causation assessment (s.7(4); Schedule definition of terminal event).","Exclusion of familial otosclerosis narrows diagnostic scope and may require genetic/clinical distinction (s.7(2)(b)).","Authority discretion: RMA states the medical-scientific view and administers the factors; claimants must relate factors to relevant service (s.8, s.10)."],"plain_english_summary":"This instrument replaces the Repatriation Medical Authority's Statement of Principles for otosclerosis and applies to claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act (s.4–5). It defines otosclerosis (excluding familial forms), includes death from otosclerosis, and sets the medical test the Authority uses.\n\nTo raise a reasonable hypothesis linking otosclerosis to service a claimant must show at least one factor: measles infection before clinical onset, or inability to obtain appropriate clinical management before clinical worsening (s.7, s.9–10). The RMA prescribes the medical criteria (s.8)."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-otosclerosis-reasonable-hypothesis-no-23-of-2025","history":"/api/acts/statement-of-principles-concerning-otosclerosis-reasonable-hypothesis-no-23-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-otosclerosis-reasonable-hypothesis-no-23-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-otosclerosis-reasonable-hypothesis-no-23-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-otosclerosis-reasonable-hypothesis-no-23-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-otosclerosis-reasonable-hypothesis-no-23-of-2025/documents"}}