Pinguecula

Pinguecula — DVA SoP factors

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

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.

RH No. 60 of 2024 · BoP No. 61 of 20247 factors

Meaning of pinguecula: For the purposes of this Statement of Principles, pinguecula: (a) Means a small, raised benign elastoic conjunctival degeneration presenting as a fatty nodule near the temporal or nasal limbus (corneal-scleral junction) of the eye; and (b) excludes pterygium. (3) While pinguecula attracts ICD-10-AM code H11.1, in applying this Statement of Principles the meaning of pinguecula 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), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.

Reasonable Hypothesis (RH) — Statement of Principles No. 60 of 2024

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

(1)
having sunlight exposure to the unprotected eye for at least 2,250 hours while in a tropical area, or having equivalent sunlight exposure in other latitude zones, before clinical onset; (a) hours of sun exposure in tropical latitudes (23.5° Sth to 23.5° Nth) multiplied by 1.0; (b) hours of sun exposure in subtropical latitudes (23.6° - 35°) multiplied by 0.75; (c) hours of sun exposure in warm temperate latitudes (35.1° - 45°) multiplied by 0.5; (d) hours of sun exposure in cool temperate latitudes (45.1° - 65°) multiplied by 0.25; The number of latitude equivalent hours of sun exposure in each region are then added together. This is done to account for differences in sunlight intensity at different latitudes;
Note: latitude equivalent hours of sun exposure are calculated as follows:.
(2)
having heavy exposure of the unprotected affected eye to dust, where the upper body is mostly covered in dust, for an average of at least 20 hours per week for two years, before clinical onset;
(3)
having exposure of the affected eye to arc welding radiation and fumes, while welding without eye protection, for an average of at least 20 hours per week for at least the 2 years, before clinical onset;
(4)
having Meibomian gland dysfunction at the time of clinical onset;
(5)
inability to obtain appropriate clinical management for pinguecula before clinical worsening;

Aggravation-only factors: the factors in subsection 9(5) 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. 61 of 2024

2 factors

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

(1)
having sunlight exposure to the unprotected eye for at least 4,500 hours while in a tropical area, or having equivalent sunlight exposure in other latitude zones, before clinical onset; (a) hours of sun exposure in tropical latitudes (23.5° Sth to 23.5° Nth) multiplied by 1.0; (b) hours of sun exposure in subtropical latitudes (23.6° - 35°) multiplied by 0.75; (c) hours of sun exposure in warm temperate latitudes (35.1° - 45°) multiplied by 0.5; (d) hours of sun exposure in cool temperate latitudes (45.1° - 65°) multiplied by 0.25; The number of latitude equivalent hours of sun exposure in each region are then added together. This is done to account for differences in sunlight intensity at different latitudes;
Note: latitude equivalent hours of sun exposure are calculated as follows:.
(2)
inability to obtain appropriate clinical management for pinguecula before clinical worsening;

Aggravation-only factors: the factors in subsection 9(2) 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.

Accepted — what is it worth?

A Statement of Principles decides one thing only: whether DVA accepts liability for pinguecula. It says nothing about how much you are paid. Compensation is worked out separately, from impairment points under the GARP — so a condition can be accepted and still rate few points, or rate more than you expect once it is combined with everything else on your file.

Pinguecula (conjunctival degeneration) may be accepted without proving the link to service

Pinguecula (conjunctival degeneration) is listed in Part 2 of the determination as attributable to defence service, provided the criteria below are met.

Qualifying service: peacetime service for at least 56 weeks; or warlike service or non-warlike service for at least 29 weeks.

A diagnosis is still required, and the presumption may not apply where there is clear evidence of a cause other than service. "Onset" means when an injury was sustained, or when all the signs and symptoms of a disease were first present — not the date of diagnosis. Applies to claims made on or after 1 July 2026.