SoP LibraryToxic vestibulopathy

Statement of Principles

Toxic vestibulopathy — DVA SoP factors

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

Toxic vestibulopathy

RH No. 88 of 2020 · BoP No. 89 of 202016 factors

Meaning of toxic vestibulopathy: For the purposes of this Statement of Principles, toxic vestibulopathy: (a) means damage to the vestibular organs of the inner ear or the vestibular nerve as a result of exposure to a chemical agent, resulting in symptoms or signs of vestibular loss; and (b) excludes impairment of balance due to damage to the brain or brainstem.

Reasonable Hypothesis (RH) — Statement of Principles No. 88 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 toxic vestibulopathy or death from toxic vestibulopathy with the circumstances of a person's relevant service:

  1. (1)
    taking a drug from the specified list of drugs within the 30 days before the clinical onset of toxic vestibulopathy;

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

  2. (2)
    taking a drug which is associated in the individual with: (a) the development of toxic vestibulopathy within 30 days of commencing drug therapy; and (b) a decrease in the symptoms and signs of toxic vestibulopathy within three months of discontinuing or tapering drug therapy; and where treatment with the drug continued for at least the three days before the clinical onset of toxic vestibulopathy;
  3. (3)
    having inner ear exposure to a chemical agent from the specified list of chemical agents within the 30 days before the clinical onset of toxic vestibulopathy;

    Note: Inner ear exposure to a chemical agent will only occur in the presence of a defect in the tympanic membrane.

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

  4. (4)
    inhaling fumes from jet fuel or having cutaneous contact with jet fuel: (a) for a cumulative period of at least 2,000 hours before the clinical onset of toxic vestibulopathy; and (b) where that exposure has ceased, the clinical onset of toxic vestibulopathy has occurred within one year of cessation;

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

  5. (5)
    taking a drug from the specified list of drugs within the 30 days before the clinical worsening of toxic vestibulopathy;

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

  6. (6)
    taking a drug which is associated in the individual with: (a) an increase in the symptoms or signs of toxic vestibulopathy during drug therapy; and (b) a decrease in the symptoms or signs of toxic vestibulopathy within three months of discontinuing or tapering drug therapy; and where treatment with the drug continued for at least the three days before the clinical worsening of toxic vestibulopathy;
  7. (7)
    having inner ear exposure to a chemical agent from the specified list of chemical agents within the 30 days before the clinical worsening of toxic vestibulopathy;

    Note: Inner ear exposure to a chemical agent will only occur in the presence of a defect in the tympanic membrane.

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

  8. (8)
    inhaling fumes from jet fuel or having cutaneous contact with jet fuel: (a) for a cumulative period of at least 2,000 hours before the clinical worsening of toxic vestibulopathy; (b) and where that exposure has ceased, the clinical worsening of toxic vestibulopathy has occurred within one year of cessation;

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

  9. (9)
    inability to obtain appropriate clinical management for toxic vestibulopathy;

Aggravation-only factors: the factors in subsections 8(5) to 8(9) 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. 89 of 2020

7 factors

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

  1. (1)
    taking a drug from the specified list of drugs within the 30 days before the clinical onset of toxic vestibulopathy;

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

  2. (2)
    taking a drug which is associated in the individual with: (a) the development of toxic vestibulopathy within 30 days of commencing drug therapy; and (b) a decrease in the symptoms and signs of toxic vestibulopathy within three months of discontinuing or tapering drug therapy; and where treatment with the drug continued for at least the three days before the clinical onset of toxic vestibulopathy;
  3. (3)
    having inner ear exposure to a chemical agent from the specified list of chemical agents within the 30 days before the clinical onset of toxic vestibulopathy;

    Note: Inner ear exposure to a chemical agent will only occur in the presence of a defect in the tympanic membrane.

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

  4. (4)
    taking a drug from the specified list of drugs within the 30 days before the clinical worsening of toxic vestibulopathy;

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

  5. (5)
    taking a drug which is associated in the individual with: (a) an increase in the symptoms or signs of toxic vestibulopathy during drug therapy; and (b) a decrease in the symptoms or signs of toxic vestibulopathy within three months of discontinuing or tapering drug therapy; and where treatment with the drug continued for at least the three days before the clinical worsening of toxic vestibulopathy;
  6. (6)
    having inner ear exposure to a chemical agent from the specified list of chemical agents within the 30 days before the clinical worsening of toxic vestibulopathy;

    Note: Inner ear exposure to a chemical agent will only occur in the presence of a defect in the tympanic membrane.

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

  7. (7)
    inability to obtain appropriate clinical management for toxic vestibulopathy;

Aggravation-only factors: the factors in subsections 8(4) to 8(7) 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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