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Statement of Principles

Bronchiolitis obliterans organising pneumonia — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Bronchiolitis obliterans organising pneumonia. DVA can only accept a claim for Bronchiolitis obliterans organising pneumonia if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

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Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

Bronchiolitis obliterans organising pneumonia

RH No. 79 of 2018 · BoP No. 80 of 201834 factors

Meaning of bronchiolitis obliterans organising pneumonia: For the purposes of this Statement of Principles, bronchiolitis obliterans organising pneumonia: (a) means a histological pattern of organising pneumonia consisting of the patchy filling of alveoli, alveolar ducts and bronchioles by loose plugs of granulation tissue consisting of fibroblasts embedded in connective tissue, arising in response to lung injury and resulting in excessive proliferation of healing tissue, with: (i) respiratory symptoms; or (ii) other clinical evidence of pulmonary dysfunction; and (b) excludes: (i) organising pneumonia secondary to infectious pneumonia or acute respiratory distress syndrome; (ii) organising pneumonia that occurs in the presence of another interstitial lung disease and is not the dominant histological finding; (iii) organising pneumonia that occurs as a pulmonary manifestation of a systemic disease; and (iv) pulmonary inflammation that is confined to the bronchioles (obliterative bronchiolitis, proliferative bronchiolitis).

Reasonable Hypothesis (RH) — Statement of Principles No. 79 of 2018

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting bronchiolitis obliterans organising pneumonia or death from bronchiolitis obliterans organising pneumonia with the circumstances of a person's relevant service:

  1. (1)
    taking a drug or a drug from a class of drugs from the specified list of drugs, at the time of the clinical onset of bronchiolitis obliterans organising pneumonia;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

  2. (2)
    being treated with a drug which is associated in the individual with the following: (a) the development of bronchiolitis obliterans organising pneumonia within six months of commencing drug therapy; and (b) the absence of bronchiolitis obliterans organising pneumonia prior to commencing drug therapy; and (c) clinical improvement within weeks of ceasing drug therapy; and (d) exclusion of other aetiologies for bronchiolitis obliterans organising pneumonia;
  3. (3)
    having a solid organ transplant, stem cell transplant or bone marrow transplant before the clinical onset of bronchiolitis obliterans organising pneumonia;
  4. (4)
    undergoing a course of therapeutic radiation for the treatment of malignant neoplasm of the breast or malignant neoplasm of the lung within the two years before the clinical onset of bronchiolitis obliterans organising pneumonia;
  5. (5)
    having bronchial obstruction immediately adjacent to a focus of pulmonary organisation, at the time of the clinical onset of bronchiolitis obliterans organising pneumonia;

    Note: bronchial obstruction is defined in the Schedule 1 - Dictionary.

  6. (6)
    inhaling high concentrations of a substance with irritant properties, where: (a) the inhalation has resulted in signs and symptoms of acute damage to the lower respiratory tract within the 48 hours after the inhalation; and (b) the clinical onset of bronchiolitis obliterans organising pneumonia occurs within the 30 days following the inhalation of the substance;
  7. (7)
    inhaling sulphur mustard (mustard gas) resulting in signs and symptoms of acute damage to the lower respiratory tract within the 30 days before the clinical onset of bronchiolitis obliterans organising pneumonia;
  8. (8)
    having gastro-oesophageal reflux disease at the time of the clinical onset of bronchiolitis obliterans organising pneumonia;
  9. (9)
    taking a drug or a drug from a class of drugs from the specified list of drugs, at the time of the clinical worsening of bronchiolitis obliterans organising pneumonia;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

  10. (10)
    being treated with a drug which is associated in the individual with the following: (a) the worsening of bronchiolitis obliterans organising pneumonia within six months of commencing drug therapy; and (b) clinical improvement within weeks of ceasing drug therapy;
  11. (11)
    having a solid organ transplant, stem cell transplant or bone marrow transplant before the clinical worsening of bronchiolitis obliterans organising pneumonia;
  12. (12)
    undergoing a course of therapeutic radiation for the treatment of malignant neoplasm of the breast or malignant neoplasm of the lung within the two years before the clinical worsening of bronchiolitis obliterans organising pneumonia;
  13. (13)
    having bronchial obstruction immediately adjacent to a focus of pulmonary organisation, at the time of the clinical worsening of bronchiolitis obliterans organising pneumonia;

    Note: bronchial obstruction is defined in the Schedule 1 - Dictionary.

  14. (14)
    inhaling high concentrations of a substance with irritant properties, where: (a) the inhalation has resulted in signs and symptoms of acute damage to the lower respiratory tract within the 48 hours after the inhalation; and (b) the clinical worsening of bronchiolitis obliterans organising pneumonia occurs within the 30 days following the inhalation of the substance;
  15. (15)
    inhaling sulphur mustard (mustard gas) resulting in signs and symptoms of acute damage to the lower respiratory tract within the 30 days before the clinical worsening of bronchiolitis obliterans organising pneumonia;
  16. (16)
    having gastro-oesophageal reflux disease at the time of the clinical worsening of bronchiolitis obliterans organising pneumonia;
  17. (17)
    inability to obtain appropriate clinical management for bronchiolitis obliterans organising pneumonia;

Aggravation-only factors: the factors in subsections 9(9) to 9(17) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 80 of 2018

17 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, bronchiolitis obliterans organising pneumonia or death from bronchiolitis obliterans organising pneumonia is connected with the circumstances of a person's relevant service:

  1. (1)
    taking a drug or a drug from a class of drugs from the specified list of drugs, at the time of the clinical onset of bronchiolitis obliterans organising pneumonia;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

  2. (2)
    being treated with a drug which is associated in the individual with the following: (a) the development of bronchiolitis obliterans organising pneumonia within six months of commencing drug therapy; and (b) the absence of bronchiolitis obliterans organising pneumonia prior to commencing drug therapy; and (c) clinical improvement within weeks of ceasing drug therapy; and (d) exclusion of other aetiologies for bronchiolitis obliterans organising pneumonia;
  3. (3)
    having a solid organ transplant, stem cell transplant or bone marrow transplant before the clinical onset of bronchiolitis obliterans organising pneumonia;
  4. (4)
    undergoing a course of therapeutic radiation for the treatment of malignant neoplasm of the breast within the two years before the clinical onset of bronchiolitis obliterans organising pneumonia;
  5. (5)
    having bronchial obstruction immediately adjacent to a focus of pulmonary organisation, at the time of the clinical onset of bronchiolitis obliterans organising pneumonia;

    Note: bronchial obstruction is defined in the Schedule 1 - Dictionary.

  6. (6)
    inhaling high concentrations of a substance with irritant properties, where: (a) the inhalation has resulted in signs and symptoms of acute damage to the lower respiratory tract within the 48 hours after the inhalation; and (b) the clinical onset of bronchiolitis obliterans organising pneumonia occurs within the 30 days following the inhalation of the substance;
  7. (7)
    inhaling sulphur mustard (mustard gas) resulting in signs and symptoms of acute damage to the lower respiratory tract within the 30 days before the clinical onset of bronchiolitis obliterans organising pneumonia;
  8. (8)
    having gastro-oesophageal reflux disease at the time of the clinical onset of bronchiolitis obliterans organising pneumonia;
  9. (9)
    taking a drug or a drug from a class of drugs from the specified list of drugs, at the time of the clinical worsening of bronchiolitis obliterans organising pneumonia;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

  10. (10)
    being treated with a drug which is associated in the individual with the following: (a) the worsening of bronchiolitis obliterans organising pneumonia within six months of commencing drug therapy; and (b) clinical improvement within weeks of ceasing drug therapy;
  11. (11)
    having a solid organ transplant, stem cell transplant or bone marrow transplant before the clinical worsening of bronchiolitis obliterans organising pneumonia;
  12. (12)
    undergoing a course of therapeutic radiation for the treatment of malignant neoplasm of the breast within the two years before the clinical worsening of bronchiolitis obliterans organising pneumonia;
  13. (13)
    having bronchial obstruction immediately adjacent to a focus of pulmonary organisation, at the time of the clinical worsening of bronchiolitis obliterans organising pneumonia;

    Note: bronchial obstruction is defined in the Schedule 1 - Dictionary.

  14. (14)
    inhaling high concentrations of a substance with irritant properties, where: (a) the inhalation has resulted in signs and symptoms of acute damage to the lower respiratory tract within the 48 hours after the inhalation; and (b) the clinical worsening of bronchiolitis obliterans organising pneumonia occurs within the 30 days following the inhalation of the substance;
  15. (15)
    inhaling sulphur mustard (mustard gas) resulting in signs and symptoms of acute damage to the lower respiratory tract within the 30 days before the clinical worsening of bronchiolitis obliterans organising pneumonia;
  16. (16)
    having gastro-oesophageal reflux disease at the time of the clinical worsening of bronchiolitis obliterans organising pneumonia;
  17. (17)
    inability to obtain appropriate clinical management for bronchiolitis obliterans organising pneumonia;

Aggravation-only factors: the factors in subsections 9(9) to 9(17) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

A VHC Diagnostic Assessment addresses each of these factors one by one against your service record and clinical history. See how a VHC DVA claim works, see all fees ($600 + GST per stage) or book an appointment.

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Dr Perkins has spent more than thirteen years working exclusively with current and former ADF members — treating their conditions, writing their reports and navigating the DVA system alongside them. With over 100,000 claims submitted and 2,000 Permanent Impairment Assessments completed, he has seen precisely what separates an accepted claim from a rejected one at every level, from initial liability to the Veterans' Review Board.

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