Statement of Principles concerning irritant contact dermatitis (Reasonable Hypothesis) (No. 3 of 2021)

The instrument sets out a small set of core legal‑medical concepts that govern how claims for irritant contact dermatitis are assessed:

• Definition of the disease: “Irritant contact dermatitis” is defined as inflammation of an area of skin from exposure to an irritant applied to the same area of skin, involving direct tissue injury, and including cutaneous exposure from airborne irritants (s 7(2)(a)-(c)). The definition expressly excludes allergic contact dermatitis, atopic dermatitis, dermatitis from extremes of weather, friction, solar or other radiation, photocontact dermatitis, systemic allergic dermatitis and urticaria (s 7(2)(d)-(e)). The instrument notes the typical clinical presentation in a non‑operative note, but the operative meaning is in s 7(2).
• Irritant: The Schedule defines “irritant” as a chemical substance or physical agent capable of producing direct tissue injury and inflammation when in contact with skin; the definition excludes heat, cold, friction, solar or other forms of radiation and provides a list of examples (Schedule 1). The list includes common workplace and personal agents such as cleansers, detergents, oils and coolants, fuels, solvents, food (including citrus fruits), alkalis (including wet cement or lime), pesticides, adhesives, tear gas or smokescreens, fibreglass, plant sap, bodily fluids of the rove beetle, and urine or faecal incontinence (Schedule 1).
• Temporal and causal factors to raise a reasonable hypothesis: Section 9 provides the minimum factors which, if present, raise a reasonable hypothesis linking ICD (or death from ICD) to relevant service. These are: (1) exposure of the affected area to an irritant within the three days before the clinical onset of ICD; (2) exposure of the affected area to an irritant within the three days before clinical worsening of ICD; and (3) inability to obtain appropriate clinical management for ICD. The instrument contains notes (non‑operative guidance) emphasising that “wet work” is a common cause (s 9 notes).
• Relationship to relevant service: Section 10 requires that any factor in s 9 must be related to the person’s relevant service (as defined in the Schedule). Subsection 10(2) limits application of s 9(2) and s 9(3) to situations where the person’s ICD was suffered or contracted before or during, but did not arise out of, the person’s relevant service,i.e. those factors are for material contribution or aggravation of pre‑existing disease.
• Interaction with other SoPs: Section 11 provides that if a factor in s 9 refers to an injury or disease covered by another SoP determined under s 196B(2) of the VEA, then the factors in that other SoP apply according to its terms.

Additional technical points: the instrument ties the condition to ICD‑10‑AM codes L22 or L24 (s 7(3)-(4)) but clarifies the operative meaning for claims is the statutory textual definition. The SoP explicitly includes death from ICD where the ICD contributed to a terminal event (s 7(5) and Schedule 1).

Taken together, the main practical concept is that raising a “reasonable hypothesis” for ICD related to relevant service requires showing at least one enumerated factor that is tied to relevant service, using the definitional boundaries supplied by the instrument.

This SoP affects persons lodging or defending claims under the VEA and the MRCA where irritant contact dermatitis or death from irritant contact dermatitis is in issue. The instrument applies to claims to which s 120A of the VEA or s 338 of the MRCA applies (s 5). Those statutory references identify the classes of claims within the VEA/MRCA framework; the SoP therefore functions as a determinative standard in those claims.

Directly affected parties include:

• Claimants presenting with, or asserting aggravation or death from, irritant contact dermatitis who assert a connection with relevant service. The claimant must establish that at least one factor in s 9 exists and that the factor is related to their relevant service (ss 9-10). If the ICD pre‑existed service, the claimant may seek material contribution or aggravation under s 9(2)-(3) subject to the limitation in s 10(2).
• Decision makers under the VEA/MRCA claims process who must assess whether a reasonable hypothesis has been raised. The SoP provides the fixed list of factors and the definitional boundaries they must apply (ss 5, 7-11). The RMA made the SoP under s 196B(2) VEA (s 3), so it is intended to be applied as part of the statutory decision framework for those claims.
• Medical practitioners and medico‑legal advisers preparing clinical reports for claims: the SoP provides the clinical and temporal markers that are decisive for raising a reasonable hypothesis (s 9). Medical reports will need to address the three‑day exposure windows, the nature of the irritant, clinical onset/worsening dates and any inability to obtain appropriate clinical management.
• Employers, unit commanders, supervisors, or records‑keepers whose personnel records or operational logs are used to establish exposures during relevant service. The Schedule’s list of irritants ties the SoP to specific substances and activities; therefore occupational records or operational histories identifying exposure to the listed irritants can be dispositive in meeting the factors in s 9.
• Where a factor in s 9 refers to another injury/disease covered by a different SoP, the holders of claims and decision makers must consult that other SoP, because s 11 makes that SoP’s factors applicable in accordance with its terms.

Indirectly affected groups include personnel in trades or roles that frequently involve the listed irritants (for example, cleaning, maintenance, handling fuels, solvents, wet work, or exposure to pesticides and adhesives), as those activities are the kinds of exposures the Schedule identifies. The SoP’s exclusions (for example, allergic contact dermatitis and atopic dermatitis in s 7(2)(d)-(e)) mean claims involving those conditions fall outside this instrument and must be assessed under different SoPs if any.

The instrument does not create new monetary entitlements itself, nor does it prescribe administrative procedures for payments; it functions as the medical‑legal standard for reasonable hypothesis determinations within specified claim types (s 5). The instrument contains no provision for penalties or sanctions; it is a determinative guidance instrument for claim assessment rather than enforcement.

The SoP imposes no direct duties on private parties in the sense of new criminal offences or civil liabilities. Its legal effect is to set the minimum factors that must exist to raise a reasonable hypothesis connecting ICD (or death from ICD) with relevant service, and to define relevant terms for that purpose. The operative legal obligations and rights flow from how decision makers under the VEA/MRCA must apply the SoP when assessing claims to which it applies.

Rights and entitlements in practical terms:

• Right of claimants to have their ICD claims assessed against the specified factors: claimants are entitled to have decision makers apply the SoP’s requirements,i.e. at least one of the factors in s 9 must exist and be related to relevant service (s 9 and s 10).
• Right to have death from ICD considered: the SoP explicitly includes death from a terminal event or condition that was contributed to by the person’s ICD (s 7(5) and Schedule 1 definition of terminal event).
• Right to have overlapping conditions adjudicated with reference to other SoPs: s 11 affords a claimant a mechanism where a factor in s 9 refers to an injury or disease covered by another SoP,those other SoP factors apply according to their terms.

Practical duties for claimants and advisers deriving from the SoP’s content:

• Duty to adduce facts that correspond to at least one factor in s 9 and to show that the factor is related to relevant service (s 9 and s 10). In practice, that will require medical records documenting onset/worsening and contemporaneous records or testimony establishing exposure within the three‑day windows or evidence that appropriate clinical management was unavailable.
• Where the claim concerns material contribution or aggravation of a pre‑existing ICD, the claimant must restrict reliance to s 9(2)-(3) and show the pre‑existing condition was suffered before or during, but did not arise out of, relevant service (s 10(2)).

Duties for decision makers:

• Apply this SoP as the medical‑scientific basis for assessing the reasonable hypothesis. The instrument is made under s 196B(2) VEA (s 3) and is therefore the RMA’s formal determination of the medical‑scientific factors that raise a reasonable hypothesis for the covered claims.
• Consult other SoPs where s 9 factors refer to injuries or diseases covered by those SoPs, and apply those SoPs’ factors in accordance with their terms (s 11).

Limitations and caveats as to legal effect:

• The instrument itself is not an entitlement statute; it operates within the VEA/MRCA claim frameworks (s 5). It provides medical‑legal criteria rather than prescribing payment mechanics.
• Notes in the instrument (for example, the explanatory notes about wet work in s 9) are guidance included in the text; the operative test remains the statutory wording of the SoP.

Overall, the SoP creates a legally relevant evidentiary threshold for claims assessment. Parties’ rights and the documentary or testimonial duties they face are shaped by the narrow, enumerated factors and the definitional boundaries in the instrument.

The Statement of Principles is not an enforcement instrument in the sense of creating criminal offences, civil sanctions, or administrative penalties. The instrument sets medical‑legal criteria for determining whether a “reasonable hypothesis” exists linking irritant contact dermatitis (or related death) to relevant service. It does not itself prescribe penalties for non‑compliance nor specify enforcement procedures.

Key points from the instrument relevant to enforcement and decision process:

• The SoP was made under s 196B(2) of the VEA (s 3), which is the statutory power under which the Repatriation Medical Authority issues Statements of Principles. The instrument’s legal force is as the RMA’s determination of the factors relevant to claim assessment; it is not framed as a punitive measure.
• The instrument applies to claims to which s 120A VEA or s 338 MRCA applies (s 5). Any sanctions, appeals, or enforcement mechanisms are those provided by the VEA or MRCA claim and review processes. This SoP merely provides the medical criteria those processes must apply when considering whether a reasonable hypothesis is raised.

Consequences in claim handling:

• If a claimant cannot establish at least one of the factors in s 9 and relate it to relevant service in the terms required by s 10, decision makers will not be able to conclude a reasonable hypothesis has been raised under this SoP. The practical consequence is that, within the VEA/MRCA claim machinery, the claim may fail at that threshold; the instrument itself does not describe appeal routes or penalties (those are matters for the underpinning statutes and administrative processes, which are not reproduced in this instrument).
• There is no provision in this SoP for monetary penalties, administrative fines, or criminal prosecution for failing to comply with the definitions or factors. The SoP is a determinative standard to be applied by authorised decision‑making bodies in VEA/MRCA claims.

Other enforcement considerations implicit in the document:

• The RMA’s assertion of “sound medical‑scientific evidence” (s 8) provides the evidential basis for the SoP. The instrument does not describe the standard of proof to be applied to the underlying factual issues in a claim (for example, whether clinical onset dates are established on a balance of probabilities), nor the procedural steps for adducing or contesting evidence,those procedural matters remain within the VEA/MRCA claim framework.
• Section 11 creates a cross‑reference enforcement mechanism: where a factor in s 9 refers to an injury/disease governed by another SoP, the factors in that other SoP apply according to its terms. That creates an enforcement pattern through statutory interlocking SoPs rather than through sanctions contained in this instrument.

In short, the SoP establishes evaluative criteria; it does not create or assign penalties. Enforcement in the sense of claim acceptance or rejection occurs through the statutory claim processes of the VEA and MRCA that invoke this SoP.

The instrument operates within the legal architecture of the VEA and the MRCA. The SoP was made under subsection 196B(2) of the VEA (s 3) and expressly applies to claims to which s 120A of the VEA or s 338 of the MRCA apply (s 5). Those cross‑references locate the instrument within the broader statutory scheme for veterans’ entitlements and military compensation.

Specific interactions set out in the instrument:

• Interaction with other Statements of Principles: Section 11 provides a direct cross‑instrument rule. If a factor in s 9 refers to an injury or disease for which another SoP has been determined under s 196B(2) of the VEA, then the factors in that other SoP apply in accordance with its terms. That mechanism ensures that where the factual issue touches multiple named conditions, the relevant SoP(s) are applied as appropriate. The interaction is framed by reference to other SoPs “as in force from time to time”, so the operative content of those SoPs at the time of the claim governs the interplay.
• Relationship to ICD coding standards: Section 7(3)-(4) ties the clinical coding of ICD to ICD‑10‑AM codes L22 or L24, while clarifying that the legal meaning for the SoP is the textually provided definition in s 7(2). The SoP therefore uses diagnostic coding as a reference point familiar to clinicians but displaces the coding as the determinative legal definition by stating the meaning is that given in subsection 7(2).
• Repeal of prior SoP: Section 4 repeals the earlier SoP (No. 110 of 2011) relating to irritant contact dermatitis, meaning the 2021 instrument replaces the previous RMA determination for claims rolled forward from that date. The repeal has immediate effect from commencement (s 2).
• Definition cross‑references within the instrument: The Schedule 1 dictionary defines terms such as “irritant”, “relevant service”, “MRCA”, “VEA”, and “terminal event”. The “relevant service” definition itself cross‑references particular classes of service under the VEA and MRCA (Schedule 1), linking the SoP’s substantive test back to statutory categories of service under those Acts.
• Limits to the SoP’s subject matter: The SoP excludes several dermatological conditions in s 7(2)(d)-(e) (for example, allergic contact dermatitis, atopic dermatitis). Those exclusions mean that claims involving those conditions are not to be decided against this SoP and must be assessed under a different SoP if applicable. Section 11 ensures that when factors refer to other conditions, the other SoPs govern.

Matters not altered by the instrument:

• The SoP does not purport to change the substantive entitlements or procedural rules in the VEA or MRCA; it supplies the RMA’s medical‑scientific determination of factors relevant to one specific condition for the purpose of assessing reasonable hypothesis in those claim streams (s 3 and s 5). The operation of appeal rights, administrative procedures and substantive compensation or rehabilitation entitlements remains governed by the VEA/MRCA frameworks, which are outside the text of this instrument.

In summary, the SoP is designed to be read and applied inside the statutory claim frameworks of the VEA and MRCA, interoperating with other RMA SoPs where necessary, and cross‑referenced to recognised diagnostic coding while preserving the textual legal definition.

The instrument itself records a short, discrete history. The principal items in the document that constitute the amendment record are:

• Identification and dating: The instrument is titled “Statement of Principles concerning irritant contact dermatitis (Reasonable Hypothesis) (No. 3 of 2021)” and is dated 24 December 2020 (s 1 and the front page text).
• Commencement: The instrument commenced on 25 January 2021 (s 2). That is the operative date from which the SoP applies to the relevant classes of claims.
• Authority and making provision: The RMA made the instrument under subsection 196B(2) of the VEA (s 3). That identifies the statutory power and place of the instrument within the legislative scheme.
• Repeal of prior SoP: The instrument expressly repeals the earlier Statement of Principles concerning irritant contact dermatitis No. 110 of 2011 (Federal Register of Legislation No. F2011L01746) made under subsection 196B(2) of the VEA (s 4). The repeal means that, as of commencement, the 2011 SoP no longer has effect and the 2021 SoP replaces it for relevant claims going forward.

No further amendments, revisions or historical versions are recorded in the text provided. The instrument’s s 11 reference to other SoPs “as in force from time to time” implies that future SoPs or amendments to existing SoPs will affect how cross‑referenced factors operate, but the instrument itself contains no later amendment trace within its text.

Because the instrument is a formal RMA determination under s 196B(2), its history of amendment would be recorded by the RMA and in the Federal Register of Legislation, but the present text only records the replacement of the 2011 SoP and its own commencement date. There are no transitional provisions, saving clauses, or explicit retrospective application statements in the text; the commencement clause (s 2) provides the date from which the new SoP is to be treated as in force.

If practitioners need to trace prior versions or confirm that a particular claim should be assessed under the 2011 or 2021 SoP (for example because the claim arose before commencement), they must consult the VEA/MRCA claim provisions and the administrative records of the RMA and the Federal Register. The instrument itself contains only the single repeal and commencement events described above.

The instrument contains no narrative or references to litigation, adjudicated cases, or judicial interpretations. It does not list any decisions, appeals, or Tribunal matters that have interpreted or applied this SoP. The text is a freestanding RMA determination setting out the medical‑scientific factors for this condition.

Consequences of that absence for legal research and litigation strategy:

• There is no case law referenced in the instrument that can be relied on to interpret its language or test application in contested environments. The instrument therefore requires decision makers, claimants and respondents to apply the text directly and to rely on general evidentiary and procedural law found in the VEA/MRCA frameworks when a dispute arises.
• Because s 11 cross‑references other SoPs “as in force from time to time”, litigation that raises overlapping conditions may involve interpretation and interaction of multiple SoPs. Any litigation will therefore likely turn on the textual interaction between this SoP and others that are relevant to the single claimant’s medical profile.
• The RMA’s statement in s 8 that “there is sound medical‑scientific evidence” is an administrative finding on which parties may base expert evidence in disputes, but the instrument does not identify or summarise the underlying studies, nor does it attach evidentiary exhibits. If the sufficiency of the medical‑scientific basis is litigated, that issue must be addressed through expert evidence and the appeal bodies under the VEA/MRCA processes, not by reference to cases cited in the instrument.

For practitioners preparing litigation or appeals where ICD is in issue, the practical route is:

• Apply the SoP text (ss 7-11) as the determinative RMA position on the factors constituting a reasonable hypothesis.
• If litigation ensues, draw on clinical records, contemporaneous exposure logs and expert medical testimony to establish whether the enumerated factors in s 9 and the relationship required in s 10 are satisfied.
• Consult other SoPs when a factor implicates another condition (s 11) and cross‑reference the operative wording of those SoPs.

Because the instrument records no litigation history, any precedent or interpretive guidance will need to be sourced from decisions under the VEA/MRCA that interpret similar RMA SoPs or general administrative law; those materials are not contained in this instrument and are outside its text.

The instrument contains several discrete features and drafting choices that can create practical pitfalls for claimants, decision makers and advisers. These are concrete, text‑based risks and traps for the unwary:

• Narrow temporal windows in s 9(1)-(2): The requirement that exposure to an irritant occur within the three days before the clinical onset of ICD, or within the three days before clinical worsening, is a tight, objective‑looking temporal threshold. If a claimant has documented exposure outside this three‑day window, the factor(s) in s 9(1)-(2) will not, on their face, be satisfied. Practitioners must pay attention to onset/worsening dates and to the dates of recorded exposures. The instrument’s notes mention “wet work” as a common cause, but the operative test remains the three‑day windows in s 9.
• Distinction between arising out of service and material contribution/aggravation: Section 10(2) restricts the applicability of s 9(2) and s 9(3) (worsening and inability to obtain appropriate clinical management) to situations where the ICD was “suffered or contracted before or during (but did not arise out of) the person’s relevant service”. This drafting creates a procedural difference between claims that arise out of service (for which other factors might apply) and claims of aggravation or material contribution to pre‑existing disease. Practitioners should ensure pleadings and evidence clearly state the temporal relationship of disease onset to service to determine which parts of s 9 are applicable.
• Exclusions in s 7(2)(d)-(e): The SoP explicitly excludes allergic contact dermatitis, atopic dermatitis, dermatitis due to extremes of weather, friction, solar radiation or other radiation, photocontact dermatitis, systemic allergic dermatitis, and urticaria. A claimant whose condition is primarily allergic or atopic will not fall within this SoP and must be assessed under any relevant SoP for those specific conditions. Misclassification risk is therefore material.
• The definition of “irritant” in Schedule 1 excludes heat, cold, friction, solar or other forms of radiation but includes a broad list of chemical and biological agents. Some items in the list may surprise practitioners (for example, bodily fluids of the rove beetle; urine or faecal incontinence). The inclusion of such items can be decisive for claims arising from certain exposures, but claimants and advisers must ensure the exposure falls within the Schedule definition and is linked to the affected area of skin as required by s 7(2)(a).
• ICD‑10‑AM code reference is not determinative: Section 7(3)-(4) states that while ICD typically attracts codes L22 or L24, for the purpose of the SoP the operative meaning is the textual definition in s 7(2). The ICD coding is a reference point but cannot be used to expand or contract the legal meaning beyond the s 7(2) definition.
• Inclusion of death via terminal event can broaden impact: Section 7(5) includes death from a terminal event or condition contributed to by the person’s ICD. The Schedule defines “terminal event” with items such as pneumonia, respiratory failure, cardiac arrest, circulatory failure and cessation of brain function. Practitioners should note that death need not be caused directly by dermatological pathology; a contributory role of ICD to a terminal event is sufficient to bring death within the SoP, provided the causal link is established in accordance with ss 9-10.
• Notes versus operative text: The instrument contains notes (for example, in s 9) stating that wet work is a common cause of ICD and defining examples of wet work. These notes are guidance; the operative legal tests are the sections themselves. Relying on notes as substitutes for satisfying the exact wording of s 9 risks misapplying the SoP.
• Cross‑SoP complexity under s 11: Where s 9 refers to another injury or disease covered by a different SoP, that other SoP’s factors apply. Practitioners must therefore be alert to whether a listed irritant or exposure scenario overlaps with other named conditions or SoPs and must apply the other SoPs “as in force from time to time”, which may involve checking for more recent RMA determinations.
• Repeal of 2011 SoP: The 2021 instrument repealed the 2011 SoP (s 4). For claims straddling the repeal date, practitioners should check whether an older claim should be assessed under the earlier SoP or under the current one; the instrument does not set out transitional rules and the applicable VEA/MRCA provisions must be consulted to resolve any temporal application questions.

These “gotchas” are concrete application traps grounded in the text. They affect evidentiary strategies and pleading choices, particularly around timing of exposure, clinical onset, the precise nature of the irritant, and the classification of the skin condition in question.

To have a claim for irritant contact dermatitis (or death from irritant contact dermatitis) assessed favourably under this SoP, the claimant and their medical advisers should focus on satisfying the textual requirements of ss 7-10 and ensuring documentary or testimonial evidence aligns with the enumerated factors.

Key compliance steps grounded in the instrument:

1. Establish the condition as irritant contact dermatitis under s 7(2).

   • Ensure clinical records demonstrate inflammation of the affected skin area, that the inflammation involves direct tissue injury, and that the exposure was to an irritant applied to the same area of skin. The SoP includes cutaneous exposure from airborne irritants (s 7(2)(c)).
   • Exclude other diagnoses listed in s 7(2)(d)-(e) (for example, allergic contact dermatitis, atopic dermatitis). Where diagnostic ambiguity exists, clinicians should document reasons for preferring an irritant aetiology over the excluded conditions.

2. Link the condition to an enumerated factor in s 9.

   • Satisfy at least one of the factors in s 9: a. Exposure of the affected area to an irritant within three days before the clinical onset of ICD (s 9(1)); or b. Exposure of the affected area to an irritant within three days before clinical worsening of ICD (s 9(2)); or c. Inability to obtain appropriate clinical management for ICD (s 9(3)).
   • Where relying on s 9(1) or s 9(2), document precise dates for exposure and for clinical onset/worsening so they fall within the three‑day window. Medical notes, incident reports, unit logs, cleaning rosters, operational diaries and contemporaneous witness statements can be relevant evidence.
   • Where relying on s 9(3), document attempts to obtain clinical management, barriers encountered, and the timing corresponding to the disease course.

3. Show the factor is related to relevant service as required by s 10(1).

   • The factor in s 9 must be related to the person’s relevant service. Use service records, duty logs, rostering records, deployment orders and contemporaneous operational notes to link the exposure or inability to obtain treatment to the period or circumstances of relevant service.
   • The Schedule defines “relevant service” across categories under the VEA and MRCA (Schedule 1). Confirm under which category the individual’s service falls (operational, peacekeeping, hazardous, British nuclear test defence, warlike or non‑warlike), and show the exposure or treatment barrier occurred in that service period.

4. If the disease pre‑existed service, apply s 10(2).

   • If the ICD was suffered or contracted before or during relevant service but did not arise out of it, then ss 9(2)-(3) apply only to material contribution or aggravation. Medical and occupational evidence must therefore demonstrate how service materially contributed to worsening or aggravated the pre‑existing disease.

5. Address ICD‑10‑AM coding with support but rely on statutory definition.

   • While ICD coding (L22 or L24) is referenced (ss 7(3)-(4)), ensure that clinical opinions explicitly address the statutory definition in s 7(2). Do not rely solely on coding.

6. Where a factor refers to another SoP, apply s 11.

   • If an exposure or injury in s 9 implicates another named disease that is the subject of a separate SoP, obtain and apply that SoP’s factors as required by s 11. This may require additional clinical linkage and cross‑referenced evidence.

7. Prepare medico‑legal reports to map facts onto the SoP.

   • Expert clinicians should explicitly state how the claimant’s history and clinical signs meet the SoP’s wording: identification of the irritant, precise dates of exposure and onset/worsening, explanation of why excluded diagnoses do not apply, and an opinion on whether service materially contributed to onset or aggravation where relevant.

8. Documentary evidence checklist (practical, consistent with instrument content):

   • Medical records with dates of clinical onset, worsening, and diagnosis.
   • Records of exposure: incident reports, exposure logs, cleaning/maintenance rosters, deployment or duty records showing presence where listed irritants were present.
   • Evidence of inability to obtain appropriate clinical management: appointment records, logs of medical facilities available during service, correspondence about treatment access, witness statements about treatment denial or absence of care.
   • Photographs or contemporaneous notes showing affected skin and timing.
   • Expert statement tying the exposure to the clinical onset/worsening within the required windows and explaining the biological plausibility consistent with the RMA’s definition.

9. Be alert to exclusions and alternative diagnoses.

   • If the claimant has features of allergic contact dermatitis, atopic dermatitis or other excluded conditions, the medical report should address differential diagnosis and, where appropriate, recommend referral to the relevant SoP for those conditions.

10. Anticipate cross‑SoP issues.

• If the exposure implicates, for example, an injury or disease that is the subject of another SoP, identify and comply with that SoP’s requirements as per s 11. Check the current phrasing “as in force from time to time” to ensure the correct version of the other SoP is used.

Following these steps aligns claim preparation and the medical evidence with the precise textual requirements of this SoP. The instrument defines a narrow set of legal‑medical predicates; compliance requires documentary precision on timing, exposure and service relationship, and clear clinical reasoning addressing the instrument’s definitions and exclusions.