{"id":"F2017L00464","name":"Statement of Principles concerning thromboangiitis obliterans (Balance of Probabilities) (No. 29 of 2017)","slug":"statement-of-principles-concerning-thromboangiitis-obliterans-balance-of-probabilities-no-29-of-2017","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439175,"registerId":"F2017L00464-fast-fetch-1775955289554","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning thromboangiitis obliterans (Balance of Probabilities) (No. 29 of 2017)","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\nTHROMBOANGIITIS OBLITERANS (Balance of Probabilities)\n\n(No. 29 of 2017)\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 21 April 2017\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 Revocation\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 thromboangiitis obliterans (Balance of Probabilities) (No. 29 of 2017).\n\n2 Commencement\n\n This instrument commences on 22 May 2017.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Revocation\n\nThe Statement of Principles concerning thromboangiitis obliterans No. 8 of 2009 made under subsection 196B(3) of the VEA is revoked.\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 thromboangiitis obliterans and death from thromboangiitis obliterans.\n\nMeaning of thromboangiitis obliterans\n\n(2) For the purposes of this Statement of Principles, thromboangiitis obliterans means a nonatherosclerotic, segmental, inflammatory, occlusive vascular disease affecting the small and medium-sized arteries and veins.\n\nNote: Thromboangiitis obliterans is also known as Buerger's disease.\n\n(3) While thromboangiitis obliterans attracts ICD‑10‑AM code I73.1, in applying this Statement of Principles the meaning of thromboangiitis obliterans 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), Ninth Edition, effective date of 1 July 2015, copyrighted by the Independent Hospital Pricing Authority, ISBN 978‑1‑76007‑020‑5.\n\nDeath from thromboangiitis obliterans\n\n(5) For the purposes of this Statement of Principles, thromboangiitis obliterans, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's thromboangiitis obliterans.\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 thromboangiitis obliterans and death from thromboangiitis obliterans can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\nNote: relevant service is 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, thromboangiitis obliterans or death from thromboangiitis obliterans is connected with the circumstances of a person's relevant service:\n\n(1) smoking at least three pack-years of cigarettes, or the equivalent thereof in other tobacco products, within the three years before the clinical onset of thromboangiitis obliterans;\n\nNote: pack-year of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary. \n\n(2) smoking at least half a pack-year of cigarettes, or the equivalent thereof in other tobacco products, within the one year before the clinical worsening of thromboangiitis obliterans;\n\nNote: pack-year of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary. \n\n(3) inability to obtain appropriate clinical management for thromboangiitis obliterans.\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(2) and 9(3) apply only to material contribution to, or aggravation of, thromboangiitis obliterans where the person's thromboangiitis obliterans 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 pack-year of cigarettes, or the equivalent thereof in other tobacco products means a calculation of consumption where one pack-year of cigarettes equals 20 tailor-made cigarettes per day for a period of one calendar year, or 7 300 cigarettes. One tailor-made cigarette approximates one gram of tobacco or one gram of cigar or pipe tobacco by weight. One pack-year of tailor-made cigarettes equates to 7.3 kilograms of smoking tobacco by weight. Tobacco products mean cigarettes, pipe tobacco or cigars, smoked alone or in any combination.\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 thromboangiitis obliterans—see subsection 7(2).\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"},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument revokes the 2009 Statement of Principles (s 4) and replaces it. It restates a precise medical meaning of thromboangiitis obliterans (s 7(2)), sets three qualifying factors (two numeric smoking thresholds and inability to obtain appropriate clinical management) for establishing a connection to service (s 9), and clarifies how those factors must relate to relevant service for VEA/MRCA claims (ss 5, 10)."},"complexity_factors":["Medical definition of the disease and inclusion of death via 'terminal event' (see s 7(2), Sch 1)","Quantified smoking thresholds and pack‑year calculation with conversion to grams/kilograms (see s 9(1)–(2), Sch 1)","Legal evidentiary standard: 'balance of probabilities' and requirement factors be 'related to relevant service' (see s 8, s 10)","Interplay with other Statements of Principles where factors overlap (see s 11)","Application limited to statutory claim schemes (VEA and MRCA) and revocation of prior instrument (see ss 3–5)","Cross-reference to ICD‑10‑AM for coding (s 7(3)–(4))"],"plain_english_summary":"This Statement of Principles says when thromboangiitis obliterans (Buerger's disease) or death from it can be treated as connected with a person’s relevant service for claims under the VEA or MRCA. It replaces the 2009 statement, gives a medical definition, and lists qualifying factors — two numeric smoking thresholds and inability to obtain appropriate clinical management — and requires those factors to be related to the person's relevant service."},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the original scope of Statements of Principles under the VEA and MRCA. It is a routine replacement of an expired 2009 instrument (revoked in section 4) with updated medical classification references. The scope remains tightly focused on establishing causation criteria for a single specific disease in the veterans' compensation context."},"complexity_factors":["Multiple defined terms in Schedule 1 (pack-year calculations, relevant service categories, terminal events)","Cross-references between the VEA and MRCA legislation requiring knowledge of two separate Acts","Conditional logic in section 9 requiring satisfaction of 'at least one' factor from a closed list","Nested limitation in section 10(2) restricting factors 9(2) and 9(3) to aggravation cases only","Incorporation by reference to ICD-10-AM Ninth Edition with specific ISBN and effective date","Circular definition structure (thromboangiitis obliterans defined in section 7(2), then referenced in Dictionary)","Requirement to connect factors to 'relevant service' creating a two-step factual analysis"],"plain_english_summary":"This rulebook determines when Australian veterans and defence members can get compensation for thromboangiitis obliterans (Buerger’s disease). It sets a medical causation test: claimants must show, on the balance of probabilities, that their disease was linked to service through tobacco exposure or through service-related inability to obtain appropriate care.\n\nBy tightening proof around smoking and service-connection, the instrument makes compensation unlikely unless the claimant’s tobacco use or lack of treatment can be tied to their military service."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-balance-of-probabilities-no-29-of-2017","history":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-balance-of-probabilities-no-29-of-2017/history","analysis":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-balance-of-probabilities-no-29-of-2017/analysis","conflicts":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-balance-of-probabilities-no-29-of-2017/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-balance-of-probabilities-no-29-of-2017/important-cases","documents":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-balance-of-probabilities-no-29-of-2017/documents"}}