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SoP Library › Renal artery atherosclerotic disease

Statement of Principles

Renal artery atherosclerotic disease — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Renal artery atherosclerotic disease. DVA can only accept a claim for Renal artery atherosclerotic disease 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.

Renal artery atherosclerotic disease

RH No. 56 of 2020 · BoP No. 57 of 202054 factors

Meaning of renal artery atherosclerotic disease: For the purposes of this Statement of Principles, renal artery atherosclerotic disease means atherosclerosis of the renal arteries which causes a partial or complete occlusion of a renal artery and either: (a) warrants medical treatment; or (b) results in at least one of the following clinical manifestations: (i) moderate to severe hypertension; (ii) poorly controlled hypertension; (iii) persistent renal impairment; (iv) acute pulmonary oedema; or (v) chronic heart failure. (3) While renal artery atherosclerotic disease attracts ICD-10-AM code I70.1, in applying this Statement of Principles the meaning of renal artery atherosclerotic disease 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. 56 of 2020

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 renal artery atherosclerotic disease or death from renal artery atherosclerotic disease with the circumstances of a person's relevant service:

  1. (1)
    having hypertension for a period of at least five years before the clinical onset of renal artery atherosclerotic disease;
  2. (2)
    having diabetes mellitus before the clinical onset of renal artery atherosclerotic disease;
  3. (3)
    being obese for at least five years within the 20 years before the clinical onset of renal artery atherosclerotic disease;

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

  4. (4)
    having dyslipidaemia before the clinical onset of renal artery atherosclerotic disease;

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

  5. (5)
    where smoking has not permanently ceased, having smoked at least one pack-year of tobacco products before the clinical onset of renal artery atherosclerotic disease;

    Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

  6. (6)
    where smoking has permanently ceased before the clinical onset of renal artery atherosclerotic disease: (a) having smoked at least five pack-years of tobacco products; or (b) having smoked at least one pack-year but less than five pack- years of tobacco products, and the clinical onset of renal artery atherosclerotic disease has occurred within 20 years of smoking cessation;

    Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

  7. (7)
    where exposure to second-hand smoke has not permanently ceased, being exposed to second-hand smoke for at least 1,000 hours before the clinical onset of renal artery atherosclerotic disease;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

  8. (8)
    where exposure to second-hand smoke has permanently ceased before the clinical onset of renal artery atherosclerotic disease: (a) being exposed to second-hand smoke for at least 5,000 hours; or (b) being exposed to second-hand smoke for at least 1,000 hours but less than 5,000 hours, and the clinical onset of renal artery atherosclerotic disease has occurred within five years of the last exposure to second-hand smoke;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

  9. (9)
    having hyperhomocysteinaemia before the clinical onset of renal artery atherosclerotic disease;
  10. (10)
    an inability to undertake any physical activity greater than three METs for at least five years within the 20 years before the clinical onset of renal artery atherosclerotic disease;

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

  11. (11)
    having chronic kidney disease for a period of at least five years before the clinical onset of renal artery atherosclerotic disease;

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

  12. (12)
    undergoing a course of therapeutic radiation for cancer, where the renal artery was in the field of radiation, before the clinical onset of renal artery atherosclerotic disease;
  13. (13)
    having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the renal artery before the clinical onset of renal artery atherosclerotic disease;

    Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.

  14. (14)
    an inability to consume an average of at least 100 grams per day of any combination of fruit and vegetables, for at least five consecutive years within the 20 years before the clinical onset of renal artery atherosclerotic disease;
  15. (15)
    having periodontitis for at least the two years before the clinical onset of renal artery atherosclerotic disease;
  16. (16)
    having hypertension for a period of at least five years before the clinical worsening of renal artery atherosclerotic disease;
  17. (17)
    having diabetes mellitus before the clinical worsening of renal artery atherosclerotic disease;
  18. (18)
    being obese for at least five years within the 20 years before the clinical worsening of renal artery atherosclerotic disease;

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

  19. (19)
    having dyslipidaemia before the clinical worsening of renal artery atherosclerotic disease;

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

  20. (20)
    where smoking has not permanently ceased, having smoked at least one pack-year of tobacco products before the clinical worsening of renal artery atherosclerotic disease;

    Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

  21. (21)
    where smoking has permanently ceased before the clinical worsening of renal artery atherosclerotic disease: (a) having smoked at least five pack-years of tobacco products; or (b) having smoked at least one pack-year but less than five pack- years of tobacco products, and the clinical worsening of renal artery atherosclerotic disease has occurred within 20 years of smoking cessation;

    Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

  22. (22)
    where exposure to second-hand smoke has not permanently ceased, being exposed to second-hand smoke for at least 1,000 hours before the clinical worsening of renal artery atherosclerotic disease;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

  23. (23)
    where exposure to second-hand smoke has permanently ceased before the clinical worsening of renal artery atherosclerotic disease: (a) being exposed to second-hand smoke for at least 5,000 hours; or (b) being exposed to second-hand smoke for at least 1,000 hours but less than 5,000 hours, and the clinical worsening of renal artery atherosclerotic disease has occurred within five years of the last exposure to second-hand smoke;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

  24. (24)
    having hyperhomocysteinaemia before the clinical worsening of renal artery atherosclerotic disease;
  25. (25)
    an inability to undertake any physical activity greater than three METs for at least five years within the 20 years before the clinical worsening of renal artery atherosclerotic disease;

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

  26. (26)
    having chronic kidney disease for a period of at least five years before the clinical worsening of renal artery atherosclerotic disease;

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

  27. (27)
    undergoing a course of therapeutic radiation for cancer, where the renal artery was in the field of radiation, before the clinical worsening of renal artery atherosclerotic disease;
  28. (28)
    having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the renal artery before the clinical worsening of renal artery atherosclerotic disease;

    Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.

  29. (29)
    an inability to consume an average of at least 100 grams per day of any combination of fruit and vegetables, for at least five consecutive years within the 20 years before the clinical worsening of renal artery atherosclerotic disease;
  30. (30)
    having periodontitis for at least the two years before the clinical worsening of renal artery atherosclerotic disease;
  31. (31)
    being treated with an angiotensin converting enzyme inhibitor or an angiotensin receptor blocker, within the three months before the clinical worsening of renal artery atherosclerotic disease;
  32. (32)
    inability to obtain appropriate clinical management for renal artery atherosclerotic disease;

Aggravation-only factors: the factors in subsections 9(16) to 9(32) 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. 57 of 2020

22 factors

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

  1. (1)
    having hypertension for a period of at least ten years before the clinical onset of renal artery atherosclerotic disease;
  2. (2)
    having diabetes mellitus before the clinical onset of renal artery atherosclerotic disease;
  3. (3)
    having dyslipidaemia before the clinical onset of renal artery atherosclerotic disease;

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

  4. (4)
    where smoking has not permanently ceased, having smoked at least one pack-year of tobacco products before the clinical onset of renal artery atherosclerotic disease;

    Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

  5. (5)
    where smoking has permanently ceased before the clinical onset of renal artery atherosclerotic disease: (a) having smoked at least five pack-years of tobacco products; or (b) having smoked at least one pack-year but less than five pack- years of tobacco products, and the clinical onset of renal artery atherosclerotic disease has occurred within 20 years of smoking cessation;

    Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

  6. (6)
    where exposure to second-hand smoke has not permanently ceased, being exposed to second-hand smoke for at least 1,000 hours before the clinical onset of renal artery atherosclerotic disease;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

  7. (7)
    where exposure to second-hand smoke has permanently ceased before the clinical onset of renal artery atherosclerotic disease: (a) being exposed to second-hand smoke for at least 5,000 hours; or (b) being exposed to second-hand smoke for at least 1,000 hours but less than 5,000 hours, and the clinical onset of renal artery atherosclerotic disease has occurred within five years of the last exposure to second-hand smoke;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

  8. (8)
    having hyperhomocysteinaemia before the clinical onset of renal artery atherosclerotic disease;
  9. (9)
    undergoing a course of therapeutic radiation for cancer, where the renal artery was in the field of radiation, before the clinical onset of renal artery atherosclerotic disease;
  10. (10)
    having received a cumulative equivalent dose of at least 1.0 sievert of ionising radiation to the renal artery before the clinical onset of renal artery atherosclerotic disease;

    Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.

  11. (11)
    having hypertension for a period of at least ten years before the clinical worsening of renal artery atherosclerotic disease;
  12. (12)
    having diabetes mellitus before the clinical worsening of renal artery atherosclerotic disease;
  13. (13)
    having dyslipidaemia before the clinical worsening of renal artery atherosclerotic disease;

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

  14. (14)
    where smoking has not permanently ceased, having smoked at least one pack-year of tobacco products before the clinical worsening of renal artery atherosclerotic disease;

    Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

  15. (15)
    where smoking has permanently ceased before the clinical worsening of renal artery atherosclerotic disease: (a) having smoked at least five pack-years of tobacco products; or (b) having smoked at least one pack-year but less than five pack- years of tobacco products, and the clinical worsening of renal artery atherosclerotic disease has occurred within 20 years of smoking cessation;

    Note: pack-year of tobacco products is defined in the Schedule 1 - Dictionary.

  16. (16)
    where exposure to second-hand smoke has not permanently ceased, being exposed to second-hand smoke for at least 1,000 hours before the clinical worsening of renal artery atherosclerotic disease;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

  17. (17)
    where exposure to second-hand smoke has permanently ceased before the clinical worsening of renal artery atherosclerotic disease: (a) being exposed to second-hand smoke for at least 5,000 hours; or (b) being exposed to second-hand smoke for at least 1,000 hours but less than 5,000 hours, and the clinical worsening of renal artery atherosclerotic disease has occurred within five years of the last exposure to second-hand smoke;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

  18. (18)
    having hyperhomocysteinaemia before the clinical worsening of renal artery atherosclerotic disease;
  19. (19)
    undergoing a course of therapeutic radiation for cancer, where the renal artery was in the field of radiation, before the clinical worsening of renal artery atherosclerotic disease;
  20. (20)
    having received a cumulative equivalent dose of at least 1.0 sievert of ionising radiation to the renal artery before the clinical worsening of renal artery atherosclerotic disease;

    Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.

  21. (21)
    being treated with an angiotensin converting enzyme inhibitor or an angiotensin receptor blocker, within the three months before the clinical worsening of renal artery atherosclerotic disease;
  22. (22)
    inability to obtain appropriate clinical management for renal artery atherosclerotic disease;

Aggravation-only factors: the factors in subsections 9(11) to 9(22) 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.

Accepted — what is it worth?

A Statement of Principles decides one thing only: whether DVA accepts liability for renal artery atherosclerotic disease. 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.

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Presumptive liability · from 1 July 2026

Renal artery atherosclerotic disease may be accepted without proving the link to service

Renal artery atherosclerotic disease is listed in Part 3 as a sequela attributable to any defence service, provided a specified condition has already been accepted:

  • diabetes mellitus is an accepted condition that is present before onset.

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.

How presumptive liability works →

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Dr Thomas Perkins, Veterans Health Centre

Reviewed by Dr Thomas Perkins

Founding doctor, Veterans Health Centre · former RAAF aviation medical officer · 13 years working exclusively with ADF members and veterans. Full profile →