Diaphragmatic hernia
Meaning of diaphragmatic hernia: For the purposes of this Statement of Principles, diaphragmatic hernia: (a) means an acquired protrusion of intra-abdominal tissue through the diaphragm into the thoracic cavity; and (b) excludes: (i) congenital diaphragmatic hernia; (ii) eventration of the diaphragm; and (iii) hiatus hernia.
Reasonable Hypothesis (RH) — Statement of Principles No. 99 of 2022
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 diaphragmatic hernia or death from diaphragmatic hernia with the circumstances of a person's relevant service:
- (1)having a surgical procedure that involves the affected region of the diaphragm, excluding the oesophageal hiatus, within the 10 years before the clinical onset of diaphragmatic hernia;
Note: Examples of surgical procedures that can involve the affected region of the diaphragm include liver resection, debulking surgery in ovarian cancer, nephrectomy, biopsy of a lesion on the diaphragmatic peritoneum and coronary artery bypass grafting.
- (2)having acute trauma to the affected region of the diaphragm before the clinical onset of diaphragmatic hernia;
Note: Examples of acute trauma include falling from a height, motor vehicle accidents and gunshot or stab wounds.
- (3)having acute elevation of pressure within the abdominal cavity due to any one of the following: (a) Heimlich manoeuvre; (b) significant coughing; (c) significant physical effort; or (d) underwater diving with compressed air; within the 7 days before the clinical onset of diaphragmatic hernia;
- (4)having endometriosis involving the affected region of the diaphragm before the clinical onset of diaphragmatic hernia;
- (5)having a surgical procedure that involves the affected region of the diaphragm, excluding the oesophageal hiatus, within the 10 years before the clinical worsening of diaphragmatic hernia;
Note: Examples of surgical procedures that can involve the affected region of the diaphragm include liver resection, debulking surgery in ovarian cancer, nephrectomy, biopsy of a lesion on the diaphragmatic peritoneum and coronary artery bypass grafting.
- (6)having acute trauma to the affected region of the diaphragm before the clinical worsening of diaphragmatic hernia;
Note: Examples of acute trauma include falling from a height, motor vehicle accidents and gunshot or stab wounds.
- (7)having acute elevation of pressure within the abdominal cavity due to any one of the following: (a) Heimlich manoeuvre; (b) significant coughing; (c) significant physical effort; or (d) underwater diving with compressed air; within the 7 days before the clinical worsening of diaphragmatic hernia;
- (8)having endometriosis involving the affected region of the diaphragm before the clinical worsening of diaphragmatic hernia;
- (9)being obese for at least the 2 years before the clinical worsening of diaphragmatic hernia;
Note: being obese is defined in the Schedule 1 - Dictionary.
- (10)being pregnant within the 6 weeks before the clinical worsening of diaphragmatic hernia;
- (11)inability to obtain appropriate clinical management for diaphragmatic hernia;
Aggravation-only factors: the factors in subsections 8(5) to (11) 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. 100 of 2022
8 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, diaphragmatic hernia or death from diaphragmatic hernia is connected with the circumstances of a person's relevant service:
- (1)having a surgical procedure that involves the affected region of the diaphragm, excluding the oesophageal hiatus, within the 10 years before the clinical onset of diaphragmatic hernia;
Note: Examples of surgical procedures that can involve the affected region of the diaphragm include liver resection, debulking surgery in ovarian cancer, nephrectomy, biopsy of a lesion on the diaphragmatic peritoneum and coronary artery bypass grafting.
- (2)having acute trauma to the affected region of the diaphragm before the clinical onset of diaphragmatic hernia;
Note: Examples of acute trauma include falling from a height, motor vehicle accidents and gunshot or stab wounds.
- (3)having endometriosis involving the affected region of the diaphragm before the clinical onset of diaphragmatic hernia;
- (4)having a surgical procedure that involves the affected region of the diaphragm, excluding the oesophageal hiatus, within the 10 years before the clinical worsening of diaphragmatic hernia;
Note: Examples of surgical procedures that can involve the affected region of the diaphragm include liver resection, debulking surgery in ovarian cancer, nephrectomy, biopsy of a lesion on the diaphragmatic peritoneum and coronary artery bypass grafting.
- (5)having acute trauma to the affected region of the diaphragm before the clinical worsening of diaphragmatic hernia;
Note: Examples of acute trauma include falling from a height, motor vehicle accidents and gunshot or stab wounds.
- (6)having endometriosis involving the affected region of the diaphragm before the clinical worsening of diaphragmatic hernia;
- (7)being pregnant within the 6 weeks before the clinical worsening of diaphragmatic hernia;
- (8)inability to obtain appropriate clinical management for diaphragmatic hernia;
Aggravation-only factors: the factors in subsections 8(4) to (8) 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.
