{"id":"F2017L00462","name":"Statement of Principles concerning thromboangiitis obliterans (Reasonable Hypothesis) (No. 28 of 2017)","slug":"statement-of-principles-concerning-thromboangiitis-obliterans-reasonable-hypothesis-no-28-of-2017","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439170,"registerId":"F2017L00462-fast-fetch-1775955287415","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning thromboangiitis obliterans (Reasonable Hypothesis) (No. 28 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 (Reasonable Hypothesis)\n\n(No. 28 of 2017)\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 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 (Reasonable Hypothesis) (No. 28 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Revocation\n\nThe Statement of Principles concerning thromboangiitis obliterans No. 7 of 2009 made under subsection 196B(2) of the VEA is revoked.\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 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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that thromboangiitis obliterans and death from thromboangiitis obliterans 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: relevant service is 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 thromboangiitis obliterans or death from thromboangiitis obliterans 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 six 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) being exposed to second-hand smoke for at least 3 000 hours within the six years before the clinical onset of thromboangiitis obliterans;\n\nNote: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.\n\n(3) the oral use of smokeless tobacco on more days than not, for at least three years within the six years before the clinical onset of thromboangiitis obliterans;\n\nNote: smokeless tobacco is defined in the Schedule 1 - Dictionary.\n\n(4) 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(5) being exposed to second-hand smoke for at least 500 hours within the one year before the clinical worsening of thromboangiitis obliterans;\n\nNote: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.\n\n(6) the oral use of smokeless tobacco on more days than not, for at least six months within the one year before the clinical worsening of thromboangiitis obliterans;\n\nNote: smokeless tobacco is defined in the Schedule 1 - Dictionary.\n\n(7) 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(4) to 9(7) 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(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\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n being exposed to second-hand smoke means being in an enclosed space and inhaling smoke from burning tobacco products or smoke that has been exhaled by a person who is smoking.\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) 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 also defined in the Schedule 1 - Dictionary.\n\n smokeless tobacco means tobacco products without combustion or pyrolysis at the time of use, including chewing tobacco and tobacco snuff.\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":4,"scope_assessment":{"changed":true,"description":"The instrument expressly revokes the earlier Statement of Principles No. 7 of 2009 (s4) and replaces it with this new Statement. It restates the clinical meaning of thromboangiitis obliterans (s7), imposes specific numeric exposure and temporal thresholds for establishing a reasonable hypothesis (s9 and Schedule 1), and clarifies the Acts and service types to which it applies (s5, Schedule 1). These textual replacements alter the operative criteria claim‑handlers must apply."},"complexity_factors":["Medical definition and coding: provides a specific clinical definition separate from the ICD‑10‑AM code (s7(2)–(4)).","Quantified exposure thresholds and time windows: multiple numeric tests (pack‑years, hours, days/years) with different look‑back periods for onset and worsening (s9(1)–(6)).","Measurement conversions in the Dictionary: detailed pack‑year and tobacco‑weight conversions that require numeric calculation (Schedule 1).","Multiple exposure types: active smoking, second‑hand smoke, and smokeless tobacco are treated differently, increasing evidentiary permutations (s9, Schedule 1).","Service linkage rule: factors must be related to the person’s relevant service, requiring connection to VEA/MRCA service types (s10, Schedule 1).","Interaction with other Statements of Principles: cross‑references mean other SOPs may apply to the same exposures, creating dependency on other instruments (s11).","Discretionary or qualitative factor: ‘inability to obtain appropriate clinical management’ is open to interpretation and administrative fact‑finding (s9(7)).","Revocation of prior instrument: replacement of the 2009 Statement may change evidentiary expectations for ongoing or past claims (s4)."],"plain_english_summary":"This instrument replaces the 2009 Statement and sets the medical definition and specific exposure thresholds and time windows that must be met to raise a “reasonable hypothesis” linking thromboangiitis obliterans (Buerger’s disease) or death from it to a person’s relevant military service. It applies to claims under the Veterans’ Entitlements Act and the Military Rehabilitation and Compensation Act.\n\nIt matters because entitlement decisions turn on meeting the listed smoking, second‑hand smoke, smokeless‑tobacco and treatment‑access criteria; the instrument converts clinical and exposure histories into discrete legal thresholds."},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Statements of Principles under the VEA and MRCA. It replaces the 2009 version (No. 7 of 2009) with updated medical-scientific evidence but does not expand beyond the original purpose of determining service connection for thromboangiitis obliterans. The structure and approach remain consistent with the statutory framework established by subsection 196B(2) of the Veterans' Entitlements Act 1986."},"complexity_factors":["Multiple defined terms in Schedule 1 (8 definitions including technical calculations like 'pack-year')","Precise quantitative thresholds (3,000 hours, 500 hours, 3 pack-years, 0.5 pack-years, 3 years, 6 months)","Temporal requirements with multiple time windows (6 years before onset, 1 year before worsening)","Dual pathways for claims: clinical onset vs clinical worsening with different factor thresholds","Cross-references to other legislation (VEA, MRCA) and other Statements of Principles","Conditional logic in section 10(2) restricting certain factors to aggravation cases only","Technical medical definition requiring understanding of 'nonatherosclerotic, segmental, inflammatory, occlusive vascular disease'"],"plain_english_summary":"This Statement of Principles sets when Australian veterans and current/former defence members can claim compensation for thromboangiitis obliterans (Buerger's disease) if it is connected to their service. \n\nIt ties entitlement to specified tobacco-related exposures (active smoking, second‑hand smoke, or smokeless tobacco) at defined thresholds before disease onset or worsening, notes lack of access to treatment and death contribution can qualify, and replaces the 2009 version."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-reasonable-hypothesis-no-28-of-2017","history":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-reasonable-hypothesis-no-28-of-2017/history","analysis":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-reasonable-hypothesis-no-28-of-2017/analysis","conflicts":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-reasonable-hypothesis-no-28-of-2017/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-reasonable-hypothesis-no-28-of-2017/important-cases","documents":"/api/acts/statement-of-principles-concerning-thromboangiitis-obliterans-reasonable-hypothesis-no-28-of-2017/documents"}}