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Statement of Principles

Cholelithiasis — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Cholelithiasis. DVA can only accept a claim for Cholelithiasis 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.

Cholelithiasis

RH No. 51 of 2016 · BoP No. 52 of 201688 factors

Meaning of cholelithiasis: For the purposes of this Statement of Principles, cholelithiasis means the aggregation of bile constituents into a stone or calculus with a diameter exceeding two millimetres, in the gallbladder or in the intrahepatic or extrahepatic bile ducts; and which may present as biliary colic. (3) While cholelithiasis attracts ICD-10-AM code K80, in applying this Statement of Principles the meaning of cholelithiasis is that given in subsection (2). (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), Veterans' Entitlements Act 1986 Ninth Edition, effective date of 1 July 2015, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-020-5.

Reasonable Hypothesis (RH) — Statement of Principles No. 51 of 2016

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 cholelithiasis or death from cholelithiasis with the circumstances of a person's relevant service:

  1. (1)
    being obese for at least the two years before the clinical onset of cholelithiasis;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  2. (2)
    having rapid and extreme weight loss within the two years before the clinical onset of cholelithiasis;

    Note: rapid and extreme weight loss is defined in the Schedule 1 - Dictionary.

  3. (3)
    having a very low calorie diet for the six months before the clinical onset of cholelithiasis;

    Note: very low calorie diet is defined in the Schedule 1 - Dictionary.

  4. (4)
    undergoing bariatric surgery within the five years before the clinical onset of cholelithiasis;

    Note: bariatric surgery is defined in the Schedule 1 - Dictionary.

  5. (5)
    taking a drug or a drug from a class of drugs from the specified list of drugs, for a continuous period of at least three months before the clinical onset of cholelithiasis, and where treatment has ceased, the clinical onset of cholelithiasis has occurred within three months of cessation; Veterans' Entitlements Act 1986;

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

  6. (6)
    having cirrhosis of the liver at the time of the clinical onset of cholelithiasis;
  7. (7)
    having non-alcoholic fatty liver disease at the time of the clinical onset of cholelithiasis;

    Note: non-alcoholic fatty liver disease is defined in the Schedule 1 - Dictionary.

  8. (8)
    for males only, having hepatitis C virus infection at the time of the clinical onset of cholelithiasis;
  9. (9)
    having a haemolytic disease at the time of the clinical onset of cholelithiasis;

    Note: haemolytic disease is defined in the Schedule 1 - Dictionary.

  10. (10)
    having Crohn's disease at the time of the clinical onset of cholelithiasis;

    Note: Crohn's disease is defined in the Schedule 1 - Dictionary.

  11. (11)
    having an ileal resection or ileal bypass before the clinical onset of cholelithiasis;
  12. (12)
    having type 2 diabetes mellitus at the time of the clinical onset of cholelithiasis;

    Note: type 2 diabetes mellitus is defined in the Schedule 1 - Dictionary.

  13. (13)
    having total parenteral nutrition for a continuous period of at least three weeks before the clinical onset of cholelithiasis, and where total parenteral nutrition has ceased, the clinical onset of cholelithiasis has occurred within 30 days of cessation;

    Note: total parenteral nutrition is defined in the Schedule 1 - Dictionary.

  14. (14)
    being pregnant within the six months before the clinical onset of cholelithiasis;
  15. (15)
    having estrogen therapy for a continuous period of at least three months before the clinical onset of cholelithiasis, and where estrogen therapy has ceased, the clinical onset of cholelithiasis has occurred within six months of cessation;

    Note: estrogen therapy is defined in the Schedule 1 - Dictionary.

  16. (16)
    having a spinal cord injury at the time of the clinical onset of cholelithiasis;

    Note: spinal cord injury is defined in the Schedule 1 - Dictionary.

  17. (17)
    having a gastric or oesophageal resection, or another operation that included a vagotomy, before the clinical onset of cholelithiasis; Veterans' Entitlements Act 1986;
  18. (18)
    having a foreign body in the biliary tract, or a mechanical obstruction of the biliary tract, before the clinical onset of cholelithiasis;

    Note: foreign body and mechanical obstruction of the biliary tract are defined in the Schedule 1 - Dictionary.

  19. (19)
    having a parasitic disease from the specified list of parasitic diseases of the biliary tract, at the time of the clinical onset of cholelithiasis;

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

  20. (20)
    having bacterial infection of the biliary tract at the time of the clinical onset of cholelithiasis;
  21. (21)
    having cholangiohepatitis or recurrent pyogenic cholangitis at the time of the clinical onset of cholelithiasis;
  22. (22)
    having a somatostatinoma at the time of the clinical onset of cholelithiasis;

    Note: somatostatinoma is defined in the Schedule 1 - Dictionary.

  23. (23)
    an inability to undertake any physical activity greater than three METs for at least the five years before the clinical onset of cholelithiasis;

    Note: MET is defined in the Schedule 1 - Dictionary.

  24. (24)
    being obese for at least the two years before the clinical worsening of cholelithiasis;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  25. (25)
    having rapid and extreme weight loss within the two years before the clinical worsening of cholelithiasis;

    Note: rapid and extreme weight loss is defined in the Schedule 1 - Dictionary.

  26. (26)
    having a very low calorie diet for the six months before the clinical worsening of cholelithiasis;

    Note: very low calorie diet is defined in the Schedule 1 - Dictionary.

  27. (27)
    undergoing bariatric surgery within the five years before the clinical worsening of cholelithiasis;

    Note: bariatric surgery is defined in the Schedule 1 - Dictionary.

  28. (28)
    taking a drug or a drug from a class of drugs from the specified list of drugs, for a continuous period of at least three months before the clinical worsening of cholelithiasis, and where treatment has ceased, the clinical worsening of cholelithiasis has occurred within three months of cessation;

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

  29. (29)
    having cirrhosis of the liver at the time of the clinical worsening of cholelithiasis; Veterans' Entitlements Act 1986;
  30. (30)
    having non-alcoholic fatty liver disease at the time of the clinical worsening of cholelithiasis;

    Note: non-alcoholic fatty liver disease is defined in the Schedule 1 - Dictionary.

  31. (31)
    for males only, having hepatitis C virus infection at the time of the clinical worsening of cholelithiasis;
  32. (32)
    having a haemolytic disease at the time of the clinical worsening of cholelithiasis;

    Note: haemolytic disease is defined in the Schedule 1 - Dictionary.

  33. (33)
    having Crohn's disease at the time of the clinical worsening of cholelithiasis;

    Note: Crohn's disease is defined in the Schedule 1 - Dictionary.

  34. (34)
    having an ileal resection or ileal bypass before the clinical worsening of cholelithiasis;
  35. (35)
    having type 2 diabetes mellitus at the time of the clinical worsening of cholelithiasis;

    Note: type 2 diabetes mellitus is defined in the Schedule 1 - Dictionary.

  36. (36)
    having total parenteral nutrition for a continuous period of at least three weeks before the clinical worsening of cholelithiasis, and where total parenteral nutrition has ceased, the clinical worsening of cholelithiasis has occurred within 30 days of cessation;

    Note: total parenteral nutrition is defined in the Schedule 1 - Dictionary.

  37. (37)
    being pregnant within the six months before the clinical worsening of cholelithiasis;
  38. (38)
    having estrogen therapy for a continuous period of at least three months before the clinical worsening of cholelithiasis, and where estrogen therapy has ceased, the clinical worsening of cholelithiasis has occurred within six months of cessation;

    Note: estrogen therapy is defined in the Schedule 1 - Dictionary.

  39. (39)
    having a spinal cord injury at the time of the clinical worsening of cholelithiasis;

    Note: spinal cord injury is defined in the Schedule 1 - Dictionary.

  40. (40)
    having a gastric or oesophageal resection, or another operation that included a vagotomy, before the clinical worsening of cholelithiasis;
  41. (41)
    having a foreign body in the biliary tract, or a mechanical obstruction of the biliary tract, before the clinical worsening of cholelithiasis; Veterans' Entitlements Act 1986;

    Note: foreign body and mechanical obstruction of the biliary tract are defined in the Schedule 1 - Dictionary.

  42. (42)
    having a parasitic disease from the specified list of parasitic diseases of the biliary tract, at the time of the clinical worsening of cholelithiasis;

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

  43. (43)
    having bacterial infection of the biliary tract at the time of the clinical worsening of cholelithiasis;
  44. (44)
    having cholangiohepatitis or recurrent pyogenic cholangitis at the time of the clinical worsening of cholelithiasis;
  45. (45)
    having a somatostatinoma at the time of the clinical worsening of cholelithiasis;

    Note: somatostatinoma is defined in the Schedule 1 - Dictionary.

  46. (46)
    an inability to undertake any physical activity greater than three METs for at least the five years before the clinical worsening of cholelithiasis;

    Note: MET is defined in the Schedule 1 - Dictionary.

  47. (47)
    inability to obtain appropriate clinical management for cholelithiasis;

Aggravation-only factors: the factors in subsections 9(24) to 9(47) 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. 52 of 2016

41 factors

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

  1. (1)
    being obese for at least the five years before the clinical onset of cholelithiasis;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  2. (2)
    having rapid and extreme weight loss within the one year before the clinical onset of cholelithiasis;

    Note: rapid and extreme weight loss is defined in the Schedule 1 - Dictionary.

  3. (3)
    having a very low calorie diet for the one year before the clinical onset of cholelithiasis;

    Note: very low calorie diet is defined in the Schedule 1 - Dictionary.

  4. (4)
    undergoing bariatric surgery within the two years before the clinical onset of cholelithiasis;

    Note: bariatric surgery is defined in the Schedule 1 - Dictionary.

  5. (5)
    taking a drug or a drug from a class of drugs from the specified list of drugs, for a continuous period of at least six months before the clinical onset of cholelithiasis, and where treatment has ceased, the clinical onset of cholelithiasis has occurred within three months of cessation;

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

  6. (6)
    having cirrhosis of the liver at the time of the clinical onset of cholelithiasis; Veterans' Entitlements Act 1986;
  7. (7)
    having a haemolytic disease at the time of the clinical onset of cholelithiasis;

    Note: haemolytic disease is defined in the Schedule 1 - Dictionary.

  8. (8)
    having Crohn's disease at the time of the clinical onset of cholelithiasis;

    Note: Crohn's disease is defined in the Schedule 1 - Dictionary.

  9. (9)
    having an ileal resection or ileal bypass before the clinical onset of cholelithiasis;
  10. (10)
    having type 2 diabetes mellitus at the time of the clinical onset of cholelithiasis;

    Note: type 2 diabetes mellitus is defined in the Schedule 1 - Dictionary.

  11. (11)
    having total parenteral nutrition for a continuous period of at least three weeks before the clinical onset of cholelithiasis, and where total parenteral nutrition has ceased, the clinical onset of cholelithiasis has occurred within 30 days of cessation;

    Note: total parenteral nutrition is defined in the Schedule 1 - Dictionary.

  12. (12)
    being pregnant within the three months before the clinical onset of cholelithiasis;
  13. (13)
    having estrogen therapy for a continuous period of at least six months before the clinical onset of cholelithiasis, and where estrogen therapy has ceased, the clinical onset of cholelithiasis has occurred within three months of cessation;

    Note: estrogen therapy is defined in the Schedule 1 - Dictionary.

  14. (14)
    having a spinal cord injury at the time of the clinical onset of cholelithiasis;

    Note: spinal cord injury is defined in the Schedule 1 - Dictionary.

  15. (15)
    having a gastric or oesophageal resection, or another operation that included a vagotomy, before the clinical onset of cholelithiasis;
  16. (16)
    having a foreign body in the biliary tract, or a mechanical obstruction of the biliary tract, before the clinical onset of cholelithiasis;

    Note: foreign body and mechanical obstruction of the biliary tract are defined in the Schedule 1 - Dictionary.

  17. (17)
    having a parasitic disease from the specified list of parasitic diseases of the biliary tract, at the time of the clinical onset of cholelithiasis;

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

  18. (18)
    having cholangiohepatitis or recurrent pyogenic cholangitis at the time of the clinical onset of cholelithiasis; Veterans' Entitlements Act 1986;
  19. (19)
    having a somatostatinoma at the time of the clinical onset of cholelithiasis;

    Note: somatostatinoma is defined in the Schedule 1 - Dictionary.

  20. (20)
    an inability to undertake any physical activity greater than three METs for at least the five years before the clinical onset of cholelithiasis;

    Note: MET is defined in the Schedule 1 - Dictionary.

  21. (21)
    being obese for at least the five years before the clinical worsening of cholelithiasis;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  22. (22)
    having rapid and extreme weight loss within the one year before the clinical worsening of cholelithiasis;

    Note: rapid and extreme weight loss is defined in the Schedule 1 - Dictionary.

  23. (23)
    having a very low calorie diet for a continuous period of the one year before the clinical worsening of cholelithiasis;

    Note: very low calorie diet is defined in the Schedule 1 - Dictionary.

  24. (24)
    undergoing bariatric surgery within the two years before the clinical worsening of cholelithiasis;

    Note: bariatric surgery is defined in the Schedule 1 - Dictionary.

  25. (25)
    taking a drug or a drug from a class of drugs from the specified list of drugs, for a continuous period of at least six months before the clinical worsening of cholelithiasis, and where treatment has ceased, the clinical worsening of cholelithiasis has occurred within three months of cessation;

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

  26. (26)
    having cirrhosis of the liver at the time of the clinical worsening of cholelithiasis;
  27. (27)
    having a haemolytic disease at the time of the clinical worsening of cholelithiasis;

    Note: haemolytic disease is defined in the Schedule 1 - Dictionary.

  28. (28)
    having Crohn's disease at the time of the clinical worsening of cholelithiasis;

    Note: Crohn's disease is defined in the Schedule 1 - Dictionary.

  29. (29)
    having an ileal resection or ileal bypass before the clinical worsening of cholelithiasis;
  30. (30)
    having type 2 diabetes mellitus at the time of the clinical worsening of cholelithiasis; Veterans' Entitlements Act 1986;

    Note: type 2 diabetes mellitus is defined in the Schedule 1 - Dictionary.

  31. (31)
    having total parenteral nutrition for a continuous period of at least three weeks before the clinical worsening of cholelithiasis, and where total parenteral nutrition has ceased, the clinical worsening of cholelithiasis has occurred within 30 days of cessation;

    Note: total parenteral nutrition is defined in the Schedule 1 - Dictionary.

  32. (32)
    being pregnant within the three months before the clinical worsening of cholelithiasis;
  33. (33)
    having estrogen therapy for a continuous period of at least six months before the clinical worsening of cholelithiasis, and where estrogen therapy has ceased, the clinical worsening of cholelithiasis has occurred within three months of cessation;

    Note: estrogen therapy is defined in the Schedule 1 - Dictionary.

  34. (34)
    having a spinal cord injury at the time of the clinical worsening of cholelithiasis;

    Note: spinal cord injury is defined in the Schedule 1 - Dictionary.

  35. (35)
    having a gastric or oesophageal resection, or another operation that included a vagotomy, before the clinical worsening of cholelithiasis;
  36. (36)
    having a foreign body in the biliary tract, or a mechanical obstruction of the biliary tract, before the clinical worsening of cholelithiasis;

    Note: foreign body and mechanical obstruction of the biliary tract are defined in the Schedule 1 - Dictionary.

  37. (37)
    having a parasitic disease from the specified list of parasitic diseases of the biliary tract, at the time of the clinical worsening of cholelithiasis;

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

  38. (38)
    having cholangiohepatitis or recurrent pyogenic cholangitis at the time of the clinical worsening of cholelithiasis;
  39. (39)
    having a somatostatinoma at the time of the clinical worsening of cholelithiasis;

    Note: somatostatinoma is defined in the Schedule 1 - Dictionary.

  40. (40)
    an inability to undertake any physical activity greater than three METs for at least the five years before the clinical worsening of cholelithiasis;

    Note: MET is defined in the Schedule 1 - Dictionary.

  41. (41)
    inability to obtain appropriate clinical management for cholelithiasis;

Aggravation-only factors: the factors in subsections 9(21) to 9(41) 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.

About Dr Thomas Perkins

One doctor. Every report.

Founding doctor of the Veterans Health Centre in Ipswich, Queensland, and one of Australia's most experienced practitioners in veterans' medicolegal medicine.

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.

Every chart review, diagnostic assessment, impairment rating and appeal that leaves this clinic is personally overseen by Dr Perkins. No template, no locum, no hand-off.

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