{"id":"F2024L01040","name":"Statement of Principles concerning pinguecula (Balance of Probabilities) (No. 61 of 2024)","slug":"statement-of-principles-concerning-pinguecula-balance-of-probabilities-no-61-of-2024","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442529,"registerId":"F2024L01040-fast-fetch-1775957507269","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning pinguecula (Balance of Probabilities) (No. 61 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![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nPINGUECULA  (Balance of Probabilities)\n\n(No. 61 of 2024)\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 20 August 2024.\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\n1               Name\n\nThis is the Statement of Principles concerning pinguecula (Balance of Probabilities) (No. 61 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(3) of the Veterans' Entitlements Act 1986.\n\n4               Repeal\n\nThe Statement of Principles concerning pinguecula (Balance of Probabilities) No. 119 of 2015 (Federal Register of Legislation No. F2015L01672) made under subsection 196B(3) of the VEA is repealed.\n\n5               Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and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 pinguecula and death from pinguecula.\n\nMeaning of pinguecula\n\n(2)          For the purposes of this Statement of Principles, pinguecula:\n\n(a)          means a small, raised benign elastoic conjunctival degeneration presenting as a fatty nodule near the temporal or nasal limbus (corneal-scleral junction) of the eye; and\n\n(b)          excludes pterygium.\n\n(3)          While pinguecula attracts ICD‑10‑AM code H11.1, in applying this Statement of Principles the meaning of pinguecula 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 pinguecula\n\n(5)          For the purposes of this Statement of Principles, pinguecula, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's pinguecula.\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 pinguecula and death from pinguecula 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, pinguecula or death from pinguecula is connected with the circumstances of a person's relevant service:\n\n(1)          having sunlight exposure to the unprotected eye for at least 4,500 hours while in a tropical area, or having equivalent sunlight exposure in other latitude zones, before clinical onset;\n\nNote: latitude equivalent hours of sun exposure are calculated as follows:\n\n(a)         hours of sun exposure in tropical latitudes (23.5° Sth to 23.5° Nth) multiplied by 1.0;\n\n(b)         hours of sun exposure in subtropical latitudes (23.6° - 35°) multiplied by 0.75;\n\n(c)         hours of sun exposure in warm temperate latitudes (35.1° - 45°) multiplied by 0.5;\n\n(d)         hours of sun exposure in cool temperate latitudes (45.1° - 65°) multiplied by 0.25;\n\nThe number of latitude equivalent hours of sun exposure in each region are then added together. This is done to account for differences in sunlight intensity at different latitudes.\n\n(2)          inability to obtain appropriate clinical management for pinguecula 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 factor set out in subsection 9(2) applies only to material contribution to, or aggravation of, pinguecula where the person's pinguecula 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                             MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                               pinguecula—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_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"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a straightforward replacement of a 2015 instrument with the same scope and purpose. It maintains the same structure, factors, and application framework. The update appears to reflect routine medical evidence review rather than expansion of scope."},"complexity_factors":["Mathematical conversion formula for latitude-based sun exposure calculations with four distinct zones and multipliers (0.25x to 1.0x)","Conditional logic distinguishing between 'clinical onset' (factor 1) and 'clinical worsening' (factor 2) with different applicability rules","Cross-referencing mechanism in section 11 allowing incorporation of other Statements of Principles by reference","Nested definitions: 'pinguecula' defined in section 7(2) then referenced in Dictionary; 'terminal event' defined with five specific examples","Exclusion clause explicitly ruling out pterygium (a similar but distinct eye condition)","Specific ICD-10-AM code reference with full bibliographic citation including ISBN","Dual statutory framework application (VEA and MRCA) with three distinct service categories defined"],"plain_english_summary":"This instrument updates the medical test for awarding compensation for pinguecula to Australian Defence Force members, replacing the 2015 guidance. It applies to claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act.\n\nIt matters because it narrows compensation to cases tied to heavy, prolonged unprotected sun exposure during service or where service prevented proper treatment of an existing pinguecula, affecting claimants and DVA decision-makers."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2015 Statement of Principles and replaces it with the current text. The replacement sets a specific sun‑exposure threshold (4,500 hours) and a latitude equivalent calculation, and adds inability to obtain appropriate clinical management as an alternative qualifying factor. Those formulaic and evidentiary elements clarify the measurable criteria decision‑makers must apply and thus alter the operational scope of how pinguecula is linked to relevant service for claims."},"complexity_factors":["Narrow clinical scope limited to a single ocular condition (pinguecula) and death from it.","Clear numeric exposure threshold (4,500 hours) plus a latitude‑weighting calculation for equivalence (adds administrative calculation).","Inclusion of an access‑to‑care factor (inability to obtain appropriate clinical management) introduces evidentiary and timing complexity.","Interplay with VEA and MRCA definitions of relevant service and the legal standard of proof ('balance of probabilities').","Explicit exclusion of pterygium and a specific ICD‑10‑AM code reference (clarifies diagnostic boundaries).","Repeal and replacement of a prior 2015 Statement (administrative transition for cases and decision‑makers).","Practical evidential burden on claimants to prove hours of exposure and/or lack of clinical access (records, statements, and calculations required)."],"plain_english_summary":"This instrument replaces the 2015 pinguecula Statement of Principles and sets the medical tests for linking pinguecula (a benign fatty conjunctival nodule) to a veteran’s or member’s relevant service under the VEA/MRCA. It defines pinguecula (excluding pterygium), includes death where pinguecula contributed, and requires either a quantified history of unprotected sunlight exposure (4,500 latitude‑equivalent hours) before clinical onset or inability to obtain appropriate clinical management. It determines who can qualify for service‑related compensation and treatment assessments."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-pinguecula-balance-of-probabilities-no-61-of-2024","history":"/api/acts/statement-of-principles-concerning-pinguecula-balance-of-probabilities-no-61-of-2024/history","analysis":"/api/acts/statement-of-principles-concerning-pinguecula-balance-of-probabilities-no-61-of-2024/analysis","conflicts":"/api/acts/statement-of-principles-concerning-pinguecula-balance-of-probabilities-no-61-of-2024/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-pinguecula-balance-of-probabilities-no-61-of-2024/important-cases","documents":"/api/acts/statement-of-principles-concerning-pinguecula-balance-of-probabilities-no-61-of-2024/documents"}}