{"id":"F2020L00825","name":"Statement of Principles concerning retinal vascular occlusion (Reasonable Hypothesis) (No. 50 of 2020)","slug":"statement-of-principles-concerning-retinal-vascular-occlusion-reasonable-hypothesis-no-50-of-2020","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":145426,"registerId":"commonwealth-F2020L00825-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning retinal vascular occlusion (Reasonable Hypothesis) (No. 50 of 2020)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning retinal vascular occlusion (Reasonable Hypothesis) (No. 50 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 retinal vascular occlusion (Reasonable Hypothesis) (No. 50 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 retinal vascular occlusion (Reasonable Hypothesis) (No. 50 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 retinal vascular occlusion and death from retinal vascular occlusion.\n\nMeaning of retinal vascular occlusion\n\n(2) For the purposes of this Statement of Principles, retinal vascular occlusion:\n\n(a) means obstruction to blood flow in either:\n\n(i) the retinal artery or its branches; or\n\n(ii) the retinal vein or its tributaries;\n\nleading to visual impairment; and\n\n(b) excludes ischaemic optic neuropathy and ophthalmic artery occlusion.\n\n> Note 1: Retinal vascular occlusion typically causes painless vision loss, ranging from mild to severe, and usually occurs suddenly. It may be accompanied by retinal ischaemia, macular oedema or retinal neovascularisation.\n\n> Note 2: Retinal vascular occlusion may manifest as transient monocular visual loss.\n\n(3) While retinal vascular occlusion attracts ICD‑10‑AM code H34, in applying this Statement of Principles the meaning of retinal vascular occlusion 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 retinal vascular occlusion\n\n(5) For the purposes of this Statement of Principles, retinal vascular occlusion, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's retinal vascular occlusion.\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 retinal vascular occlusion and death from retinal vascular occlusion 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 retinal vascular occlusion or death from retinal vascular occlusion with the circumstances of a person's relevant service:\n\n(1) having smoked at least ten pack-years of tobacco products before the clinical onset of retinal vascular occlusion, and where smoking has permanently ceased, the clinical onset of retinal vascular occlusion has occurred within ten years of cessation;\n\n> Note: one pack-year is defined in the Schedule 1 \\- Dictionary.\n\n(2) having hypertension before the clinical onset of retinal vascular occlusion;\n\n(3) having diabetes mellitus before the clinical onset of retinal vascular occlusion;\n\n(4) being obese for at least five years within the 15 years before the clinical onset of retinal vascular occlusion;\n\n> Note: being obese is defined in the Schedule 1 \\- Dictionary.\n\n(5) having dyslipidaemia before the clinical onset of retinal vascular occlusion;\n\n> Note: dyslipidaemia is defined in the Schedule 1 \\- Dictionary.\n\n(6) having hyperhomocysteinaemia before the clinical onset of retinal vascular occlusion;\n\n(7) having an arteritis from the specified list of systemic arteritides, at the time of the clinical onset of retinal vascular occlusion;\n\n> Note: specified list of systemic arteritides is defined in the Schedule 1 - Dictionary.\n\n(8) having retinal vasculitis at the time of the clinical onset of retinal vascular occlusion;\n\n> Note: retinal vasculitis is defined in the Schedule 1 - Dictionary.\n\n(9) having a non-inflammatory vasculopathy of the cerebral or retinal vessels from the specified list of vasculopathies at the time of the clinical onset of retinal vascular occlusion;\n\n> Note: specified list of vasculopathies is defined in the Schedule 1 - Dictionary.\n\n(10) having a disorder that is associated with a hypercoagulable state or hyperviscosity at the time of the clinical onset of retinal vascular occlusion;\n\n> Note: disorder that is associated with a hypercoagulable state or hyperviscosity is defined in the Schedule 1 - Dictionary.\n\n(11) having:\n\n(a) a benign or malignant neoplasm; or\n\n(b) a non-neoplastic mass lesion;\n\nwhich compresses or infiltrates the retinal vessels of the affected eye at the time of the clinical onset of retinal vascular occlusion;\n\n> Note 1: Examples of a benign or malignant neoplasm include astrocytoma, optic nerve meningioma, leukaemia and lymphoma.\n\n> Note: > Note 2: Examples of a non-neoplastic mass lesion include haematoma, sarcoidosis\n> \n> , neurofibromatosis and exophthalmos.\n\n(12) having a vascular abnormality of the retinal vessels of the affected eye at the time of the clinical onset of retinal vascular occlusion;\n\n> Note: Examples of a vascular abnormality include arterio-venous malformation and prepapillary vascular loop.\n\n(13) having migraine at the time of the clinical onset of retinal vascular occlusion;\n\n(14) having infection with human immunodeficiency virus before the clinical onset of retinal vascular occlusion;\n\n(15) having an ocular or orbital infection involving the affected eye within the 30 days before the clinical onset of retinal vascular occlusion;\n\n> Note 1: Examples of an ocular or orbital infection include:\n\n> Note: (a) cat scratch disease;\n\n> Note: (b) herpes zoster ophthalmicus;\n\n> Note: (c) ocular tuberculosis; and\n\n> Note: (d) orbital abscess or cellulitis.\n\n> Note 2: This excludes isolated conjunctivitis or blepharitis of the affected eye.\n\n(16) having direct external pressure to the eyeball of the affected eye for a continuous period of at least ten minutes, within the 24 hours before the clinical onset of retinal vascular occlusion;\n\n> Note: Examples of causes of direct external pressure to the eyeball include:\n\n> Note: (a) surgery in the prone position;\n\n> Note: (b) surgery involving the use of a device that compresses the eyes; and\n\n> Note: (c) positioning that places direct mechanical pressure on the eye.\n\n(17) having a blunt or penetrating injury involving the affected eye or the blood vessels supplying or draining the affected eye, including surgery or a therapeutic procedure, within the seven days before the clinical onset of retinal vascular occlusion;\n\n> Note 1: In the case of prolonged unconsciousness associated with trauma, the seven day period is taken to commence upon regaining consciousness.\n\n> Note 2: Examples of blunt or penetrating injury include:\n\n> Note: (a) blunt trauma to the orbit;\n\n> Note: (b) eyeball contusion; and\n\n> Note: (c) intraocular foreign body.\n\n> Note 3: Examples of surgery or a therapeutic procedure include:\n\n> Note: (a) cataract surgery;\n\n> Note: (b) filler injection to the forehead, or the glabellar, nasal or nasolabial fold regions;\n\n> Note: (c) intraocular or retrobulbar anaesthesia;\n\n> Note: (d) intravitreal bevacizumab injection; and\n\n> Note: (e) sclerotherapy of facial veins.\n\n(18) taking a drug from the specified list of drugs within the 72 hours before the clinical onset of retinal vascular occlusion;\n\n> Note: specified list of drugs is defined in the Schedule 1 \\- Dictionary.\n\n(19) taking a combined oral contraceptive pill for a continuous period of at least 21 days within the one year before the clinical onset of retinal vascular occlusion;\n\n(20) experiencing an acute hypotensive episode within the 24 hours before the clinical onset of retinal vascular occlusion;\n\n> Note: acute hypotensive episode is defined in the Schedule 1 \\- Dictionary.\n\n(21) for retinal venous occlusion only:\n\n(a) having open-angle glaucoma, angle-closure glaucoma or ocular hypertension, at the time of the clinical onset of retinal vascular occlusion;\n\n> Note: ocular hypertension is defined in the Schedule 1 - Dictionary.\n\n(b) having chronic renal failure at the time of the clinical onset of retinal vascular occlusion;\n\n> Note: chronic renal failure is defined in the Schedule 1 - Dictionary.\n\n(c) being severely dehydrated at the time of the clinical onset of retinal vascular occlusion; or\n\n> Note: being severely dehydrated is defined in the Schedule 1 - Dictionary.\n\n(d) having obstructive sleep apnoea at the time of the clinical onset of retinal vascular occlusion;\n\n(22) for retinal arterial occlusion only:\n\n(a) having carotid artery disease at the time of the clinical onset of retinal vascular occlusion;\n\n(b) having a cardiac disease with the potential to give rise to a retinal embolus at the time of the clinical onset of retinal vascular occlusion;\n\n> Note: Examples of a cardiac disease with the potential to give rise to a retinal embolus include:\n\n> Note: (a) acute myocardial infarction;\n\n> Note: (b) atrial fibrillation; and\n\n> Note: (c) mitral or aortic valve disease.\n\n(c) having a non-cardiac potential source of retinal embolus at the time of the clinical onset of retinal vascular occlusion; or\n\n> Note: Examples of a non-cardiac potential source of retinal embolus include:\n\n> Note: (a) aortic arch atherosclerosis;\n\n> Note: (b) atherosclerotic central retinal artery;\n\n> Note: (c) decompression sickness;\n\n> Note: (d) deep vein thrombosis in the presence of a potential route of paradoxical embolism;\n\n> Note: (e) pulmonary barotrauma; and\n\n> Note: (f) severe bone trauma.\n\n(d) undergoing a procedure to the heart or the carotid artery, or an intravascular procedure involving the vessels of the head or neck, within the seven days before the clinical onset of retinal vascular occlusion;\n\n> Note 1: Examples of a procedure to the heart include:\n\n> Note: (a) cardiac surgery or cardiac catheterisation;\n\n> Note: (b) coronary angiography; and\n\n> Note: (c) coronary artery bypass grafting.\n\n> Note 2: Examples of a procedure to the carotid artery include:\n\n> Note: (a) carotid angioplasty;\n\n> Note: (b) carotid endarterectomy; and\n\n> Note: (c) carotid stenting.\n\n> Note 3: Examples of an intravascular procedure involving the vessels of the head or neck include:\n\n> Note: (a) cosmetic vein sclerotherapy to the orbital adnexa, face, nose or sinuses;\n\n> Note: (b) transcatheter thyroid artery embolisation; and\n\n> Note: (c) transfemoral cerebral angiography.\n\n(23) having smoked at least ten pack-years of tobacco products before the clinical worsening of retinal vascular occlusion, and where smoking has permanently ceased, the clinical worsening of retinal vascular occlusion has occurred within ten years of cessation;\n\n> Note: one pack-year is defined in the Schedule 1 \\- Dictionary.\n\n(24) having hypertension before the clinical worsening of retinal vascular occlusion;\n\n(25) having diabetes mellitus before the clinical worsening of retinal vascular occlusion;\n\n(26) being obese for at least five years within the 15 years before the clinical worsening of retinal vascular occlusion;\n\n> Note: being obese is defined in the Schedule 1 \\- Dictionary.\n\n(27) having dyslipidaemia before the clinical worsening of retinal vascular occlusion;\n\n> Note: dyslipidaemia is defined in the Schedule 1 \\- Dictionary.\n\n(28) having hyperhomocysteinaemia before the clinical worsening of retinal vascular occlusion;\n\n(29) having an arteritis from the specified list of systemic arteritides, at the time of the clinical worsening of retinal vascular occlusion;\n\n> Note: specified list of systemic arteritides is defined in the Schedule 1 - Dictionary.\n\n(30) having retinal vasculitis at the time of the clinical worsening of retinal vascular occlusion;\n\n> Note: retinal vasculitis is defined in the Schedule 1 - Dictionary.\n\n(31) having a non-inflammatory vasculopathy of the cerebral or retinal vessels from the specified list of vasculopathies at the time of the clinical worsening of retinal vascular occlusion;\n\n> Note: specified list of vasculopathies is defined in the Schedule 1 - Dictionary.\n\n(32) having a disorder that is associated with a hypercoagulable state or hyperviscosity at the time of the clinical worsening of retinal vascular occlusion;\n\n> Note: disorder that is associated with a hypercoagulable state or hyperviscosity is defined in the Schedule 1 - Dictionary.\n\n(33) having:\n\n(a) a benign or malignant neoplasm; or\n\n(b) a non-neoplastic mass lesion;\n\nwhich compresses or infiltrates the retinal vessels of the affected eye at the time of the clinical worsening of retinal vascular occlusion;\n\n> Note 1: Examples of a benign or malignant neoplasm include astrocytoma, optic nerve meningioma, leukaemia and lymphoma.\n\n> Note: > Note 2: Examples of a non-neoplastic mass lesion include haematoma, sarcoidosis\n> \n> , neurofibromatosis and exophthalmos.\n\n(34) having a vascular abnormality of the retinal vessels of the affected eye at the time of the clinical worsening of retinal vascular occlusion;\n\n> Note: Examples of a vascular abnormality include arterio-venous malformation and prepapillary vascular loop.\n\n(35) having migraine at the time of the clinical worsening of retinal vascular occlusion;\n\n(36) having infection with human immunodeficiency virus before the clinical worsening of retinal vascular occlusion;\n\n(37) having an ocular or orbital infection involving the affected eye within the 30 days before the clinical worsening of retinal vascular occlusion;\n\n> Note 1: Examples of an ocular or orbital infection include:\n\n> Note: (a) cat scratch disease;\n\n> Note: (b) herpes zoster ophthalmicus;\n\n> Note: (c) ocular tuberculosis; and\n\n> Note: (d) orbital abscess or cellulitis.\n\n> Note 2: This excludes isolated conjunctivitis or blepharitis of the affected eye.\n\n(38) having direct external pressure to the eyeball of the affected eye for a continuous period of at least ten minutes, within the 24 hours before the clinical worsening of retinal vascular occlusion;\n\n> Note: Examples of causes of direct external pressure to the eyeball include:\n\n> Note: (a) surgery in the prone position;\n\n> Note: (b) surgery involving the use of a device that compresses the eyes; and\n\n> Note: (c) positioning that places direct mechanical pressure on the eye.\n\n(39) having a blunt or penetrating injury involving the affected eye or the blood vessels supplying or draining the affected eye, including surgery or a therapeutic procedure, within the seven days before the clinical worsening of retinal vascular occlusion;\n\n> Note 1: In the case of prolonged unconsciousness associated with trauma, the seven day period is taken to commence upon regaining consciousness.\n\n> Note 2: Examples of blunt or penetrating injury include:\n\n> Note: (a) blunt trauma to the orbit;\n\n> Note: (b) eyeball contusion; and\n\n> Note: (c) intraocular foreign body.\n\n> Note 3: Examples of surgery or a therapeutic procedure include:\n\n> Note: (a) cataract surgery;\n\n> Note: (b) filler injection to the forehead, or the glabellar, nasal or nasolabial fold regions;\n\n> Note: (c) intraocular or retrobulbar anaesthesia;\n\n> Note: (d) intravitreal bevacizumab injection; and\n\n> Note: (e) sclerotherapy of facial veins.\n\n(40) taking a drug from the specified list of drugs within the 72 hours before the clinical worsening of retinal vascular occlusion;\n\n> Note: specified list of drugs is defined in the Schedule 1 \\- Dictionary.\n\n(41) taking a combined oral contraceptive pill for a continuous period of at least 21 days within the one year before the clinical worsening of retinal vascular occlusion;\n\n(42) experiencing an acute hypotensive episode within the 24 hours before the clinical worsening of retinal vascular occlusion;\n\n> Note: acute hypotensive episode is defined in the Schedule 1 \\- Dictionary.\n\n(43) for retinal venous occlusion only:\n\n(a) having open-angle glaucoma, angle-closure glaucoma or ocular hypertension, at the time of the clinical worsening of retinal vascular occlusion;\n\n> Note: ocular hypertension is defined in the Schedule 1 - Dictionary.\n\n(b) having chronic renal failure at the time of the clinical worsening of retinal vascular occlusion;\n\n> Note: chronic renal failure is defined in the Schedule 1 - Dictionary.\n\n(c) being severely dehydrated at the time of the clinical worsening of retinal vascular occlusion; or\n\n> Note: being severely dehydrated is defined in the Schedule 1 - Dictionary.\n\n(d) having obstructive sleep apnoea at the time of the clinical worsening of retinal vascular occlusion;\n\n(44) for retinal arterial occlusion only:\n\n(a) having carotid artery disease at the time of the clinical worsening of retinal vascular occlusion;\n\n(b) having a cardiac disease with the potential to give rise to a retinal embolus at the time of the clinical worsening of retinal vascular occlusion;\n\n> Note: Examples of a cardiac disease with the potential to give rise to a retinal embolus include:\n\n> Note: (a) acute myocardial infarction;\n\n> Note: (b) atrial fibrillation; and\n\n> Note: (c) mitral or aortic valve disease.\n\n(c) having a non-cardiac potential source of retinal embolus at the time of the clinical worsening of retinal vascular occlusion; or\n\n> Note: Examples of a non-cardiac potential source of retinal embolus include:\n\n> Note: (a) aortic arch atherosclerosis;\n\n> Note: (b) atherosclerotic central retinal artery;\n\n> Note: (c) decompression sickness;\n\n> Note: (d) deep vein thrombosis in the presence of a potential route of paradoxical embolism;\n\n> Note: (e) pulmonary barotrauma; and\n\n> Note: (f) severe bone trauma.\n\n(d) undergoing a procedure to the heart or the carotid artery, or an intravascular procedure involving the vessels of the head or neck, within the seven days before the clinical worsening of retinal vascular occlusion;\n\n> Note 1: Examples of a procedure to the heart include:\n\n> Note: (a) cardiac surgery or cardiac catheterisation;\n\n> Note: (b) coronary angiography; and\n\n> Note: (c) coronary artery bypass grafting.\n\n> Note 2: Examples of a procedure to the carotid artery include:\n\n> Note: (a) carotid angioplasty;\n\n> Note: (b) carotid endarterectomy; and\n\n> Note: (c) carotid stenting.\n\n> Note 3: Examples of an intravascular procedure involving the vessels of the head or neck include:\n\n> Note: (a) cosmetic vein sclerotherapy to the orbital adnexa, face, nose or sinuses;\n\n> Note: (b) transcatheter thyroid artery embolisation; and\n\n> Note: (c) transfemoral cerebral angiography.\n\n(45) inability to obtain appropriate clinical management for retinal vascular occlusion.\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(23) to 9(45) apply only to material contribution to, or aggravation of, retinal vascular occlusion where the person's retinal vascular occlusion 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\nacute hypotensive episode means a sudden drop in blood pressure of a sufficient degree to cause cerebral hypoperfusion.\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\nbeing severely dehydrated means having clinical dysfunction due to inadequate body fluids, in which the loss of body fluids, mostly water, exceeds intake. Symptoms and signs of severe dehydration include limited or absent urine output, dizziness or lightheadedness, and orthostatic hypotension.\n\n> Note: Examples of causes of dehydration include strenuous physical activity, vomiting, diarrhoea and febrile illness.\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 renal failure means:\n\n(a) having a glomerular filtration rate of less than 15 mL/min/1.73 m2 for a period of at least three months; or\n\n(b) a need for renal replacement therapy (dialysis or transplantation) for treatment of complications of decreased glomerular filtration rate which would otherwise increase the risk of morbidity and mortality; or\n\n(c) undergoing chronic dialysis.\n\ndisorder that is associated with a hypercoagulable state or hyperviscosity means an acquired defect in blood components that alters blood viscosity or disrupts the coagulation cascade, characterised by an increased predisposition to form blood clots.\n\n> Note: Examples of a disorder that is associated with a hypercoagulable state or hyperviscosity include:\n\n> Note: (a) antiphospholipid antibody syndrome;\n\n> Note: (b) lymphoplasmacytic leukaemia;\n\n> Note: (c) lymphoplasmacytic lymphoma (Waldenstrom macroglobulinaemia);\n\n> Note: (d) myeloma;\n\n> Note: (e) myeloproliferative neoplasm;\n\n> Note: (f) nephrotic syndrome;\n\n> Note: (g) paroxysmal nocturnal haemoglobinuria; and\n\n> Note: (h) polycythaemia.\n\ndyslipidaemia means persistently abnormal blood lipid levels, diagnosed by a medical practitioner and evidenced by:\n\n(a) a total serum cholesterol level greater than 5.5 mmol/L; or\n\n(b) a serum low density lipoprotein level greater than 4.0 mmol/L; or\n\n(c) a serum high density lipoprotein level less than 1.0 mmol/L; or\n\n(d) a serum triglyceride level greater than or equal to 2.0 mmol/L; or\n\n(e) the regular administration of drug therapy to normalise blood lipid levels.\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\nocular hypertension means intra-ocular pressure greater than 21 mm Hg, without evidence of optic atrophy or visual field loss.\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\nretinal vascular occlusion—see subsection 7(2).\n\nretinal vasculitis means inflammation of the retinal artery or its branches, or the retinal vein or its tributaries. Retinal vasculitis can be due to autoimmune disease, infection, drugs, or may be idiopathic. It can be confined to the retinal vessels, or may be an element of a systemic vasculitis.\n\n> Note 1: Autoimmune diseases that can cause retinal vasculitis include:\n\n> Note: (a) Behcet disease;\n\n> Note: (b) eosinophilic granulomatosis with polyangiitis (EGPA);\n\n> Note: (c) granulomatosis with polyangiitis (Wegener granulomatosis);\n\n> Note: (d) microscopic polyangiitis;\n\n> Note: (e) polyarteritis nodosa;\n\n> Note: (f) Susac syndrome;\n\n> Note: (g) systemic lupus erythematosus; and\n\n> Note: (h) systemic sclerosis (scleroderma).\n\n> Note 2: Infections that can cause retinal vasculitis include:\n\n> Note: (a) cytomegalovirus;\n\n> Note: (b) herpes simplex virus;\n\n> Note: (c) human immunodeficiency virus;\n\n> Note: (d) syphilis;\n\n> Note: (e) toxoplasmosis;\n\n> Note: (f) tuberculosis;\n\n> Note: (g) varicella zoster virus; and\n\n> Note: (h) viral uveitis.\n\n> Note 3: Drug-induced causes of retinal vasculitis include intravitreal vancomycin and intraocular gentamycin.\n\nspecified list of drugs means:\n\n(a) amphetamines and amphetamine-like compounds;\n\n(b) cannabis;\n\n(c) intranasal cocaine;\n\n(d) intravenous heroin contaminated with talc;\n\n(e) phosphodiesterase type 5 (PDE5) inhibitors;\n\n(f) testosterone supplementation; or\n\n(g) tranexamic acid.\n\nspecified list of systemic arteritides means:\n\n(a) giant cell (temporal) arteritis;\n\n(b) polyarteritis nodosa;\n\n(c) Takayasu arteritis; or\n\n(d) thromboangiitis obliterans (Buerger's disease).\n\nspecified list of vasculopathies means:\n\n(a) fibromuscular dysplasia;\n\n(b) Moyamoya disease; or\n\n(c) Sneddon syndrome.\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 retinal vascular occlusion (Reasonable Hypothesis) (No. 50 of 2020)                        | 29 June 2020F2020L00825   | 27 July 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(1) note.....                      | rs No. 94 of 2022 |\n| Subsection 9(23) note...                       | rs No. 94 of 2022 |\n| Schedule 1 – Dictionary – one pack-year...…….. | rs No. 94 of 2022 |","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"The legislation remains focused on its original purpose: establishing the medical factors required to link retinal vascular occlusion to military service for compensation purposes. The 2022 amendment was minor — it simply updated the definition of 'one pack-year' to clarify calculation methods for tobacco consumption. The scope has not expanded beyond the specific eye condition and the veteran compensation framework."},"complexity_factors":["45 distinct factual factors spread across clinical onset and clinical worsening scenarios","Multiple sub-categories with conditional logic (factors 21-22 and 43-44 apply only to venous vs arterial occlusion respectively)","Extensive cross-referencing to defined terms in Schedule 1 Dictionary (approximately 15+ defined terms including 'one pack-year', 'being obese', 'dyslipidaemia', 'acute hypotensive episode', etc.)","Nested definitions (e.g., 'being obese' relies on BMI formula; 'BMI' is itself defined)","Temporal requirements with varying windows (72 hours, 7 days, 24 hours, 30 days, 1 year, 5 years within 15 years, 10 years post-cessation)","Specific exclusions in the definition (excludes ischaemic optic neuropathy and ophthalmic artery occlusion)","Reference to external classification systems (ICD-10-AM Tenth Edition)","Dual application structure — factors 1-22 for onset, factors 23-44 for worsening, plus factor 45 for both"],"plain_english_summary":"This Statement of Principles sets out the medical and factual factors needed to form a “reasonable hypothesis” that retinal vascular occlusion (sudden retinal blood‑vessel blockage causing vision loss) is related to military service. It guides compensation decisions under the Veterans’ Entitlements Act and the Military Rehabilitation and Compensation Act, affecting veterans, peacekeepers, and current/former defence members. Key links include smoking, hypertension/diabetes/obesity, certain infections/surgeries/drug use, cardiovascular or eye/renal disease, and lack of timely treatment."},"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"},"flash_summary":{"complexity_score":7,"scope_assessment":{"changed":true,"description":"The instrument has been amended since first made: notes to subsection 9(1) and 9(23) and the Schedule definition of 'one pack‑year' were revised (see Endnote 4). Those amendments adjust how tobacco exposure is measured and how related notes read, modifying application details without altering the core condition coverage (Endnote 3–4; sections noted)."},"complexity_factors":["Large enumerated list of discrete medical and exposure factors (45 subparagraphs) with separate items for onset and worsening (section 9).","Distinct branches for retinal arterial versus venous occlusion with different required factors and procedures (sections 9(21)–9(22), 9(43)–9(44)).","Multiple short, specific temporal windows for causative events (eg 72 hours, 7 days, 24 hours, 30 days, 1 year) requiring precise event dating (section 9).","Heavy reliance on technical clinical thresholds and tests defined in the Dictionary (eg BMI, ocular hypertension, chronic renal failure, dyslipidaemia, one pack‑year) increasing evidentiary burden (section 7, Schedule 1).","Cross-reference to ICD‑10‑AM code and external classification for disease identification (section 7(3)–(4)).","Interplay with other Statements of Principles where a listed factor points to another SOP, creating layered applicability and potential conflicts (section 11).","Requirement that factors be related to the person's relevant service, adding a legal causation layer on top of medical evidence (section 10)."],"plain_english_summary":"This Statement lists the medical criteria the Repatriation Medical Authority uses to decide whether retinal vascular occlusion (including death or later worsening) can reasonably be connected to a person's service for VEA/MRCA claims (s 5, 8–9).  A 'reasonable hypothesis' requires evidence of at least one listed factor (eg smoking pack‑years, vascular disease, recent procedures, drugs); detailed definitions, strict time windows and separate arterial/venous rules determine outcomes (s 9, Sch 1)."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-retinal-vascular-occlusion-reasonable-hypothesis-no-50-of-2020","history":"/api/acts/statement-of-principles-concerning-retinal-vascular-occlusion-reasonable-hypothesis-no-50-of-2020/history","analysis":"/api/acts/statement-of-principles-concerning-retinal-vascular-occlusion-reasonable-hypothesis-no-50-of-2020/analysis","conflicts":"/api/acts/statement-of-principles-concerning-retinal-vascular-occlusion-reasonable-hypothesis-no-50-of-2020/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-retinal-vascular-occlusion-reasonable-hypothesis-no-50-of-2020/important-cases","documents":"/api/acts/statement-of-principles-concerning-retinal-vascular-occlusion-reasonable-hypothesis-no-50-of-2020/documents"}}