{"id":"F2013L00017","name":"Statement of Principles concerning malignant neoplasm of the oral cavity, oropharynx and hypopharynx No. 2 of 2013","slug":"f2013l00017","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"repealed","isInForce":false,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":351557,"registerId":"commonwealth-F2013L00017-current","compilationNumber":null,"startDate":"2026-04-09","status":"Repealed","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning malignant neoplasm of the oral cavity, oropharynx and hypopharynx No. 2 of 2013","content":"![](image.001.jpeg)\n\nStatement of Principles\n\nconcerning\n\nMALIGNANT NEOPLASM OF THE ORAL CAVITY, OROPHARYNX AND HYPOPHARYNX\n\nNo. 2 of 2013\n\nfor the purposes of the\n\nVeterans’ Entitlements Act 1986\n\nand\n\nMilitary Rehabilitation and Compensation Act 2004\n\nTitle\n\n1. This Instrument may be cited as Statement of Principles concerning malignant neoplasm of the oral cavity, oropharynx and hypopharynx No. 2 of 2013.\n\nDetermination\n\n2. The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):\n\n(a) revokes Instrument No. 20 of 2005 concerning malignant neoplasm of the oral cavity, oropharynx and hypopharynx; and\n\n(b) determines in its place this Statement of Principles.\n\nKind of injury, disease or death\n\n3. (a) This Statement of Principles is about malignant neoplasm of the oral cavity, oropharynx and hypopharynx and death from malignant neoplasm of the oral cavity, oropharynx and hypopharynx.\n\n(b) For the purposes of this Statement of Principles, \"malignant neoplasm of the oral cavity, oropharynx and hypopharynx\" means a primary malignancy of the mucosa of the oral cavity, oropharynx or hypopharynx, which is the region that extends posteriorly from the lips (excluding the vermilion border and the skin of the lips) to the upper borders of the larynx and oesophagus, and includes the gums, the floor of the mouth, the buccal mucosa, the alveolar ridge, the hard and soft palate, and the tongue. This definition excludes malignant neoplasm of the major or minor salivary glands or salivary gland ducts, soft tissue sarcoma, carcinoid tumour, non-Hodgkin’s lymphoma and Hodgkin’s lymphoma.\n\nBasis for determining the factors\n\n4. On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that malignant neoplasm of the oral cavity, oropharynx or hypopharynx and death from malignant neoplasm of the oral cavity, oropharynx or hypopharynx can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).\n\nFactors that must be related to service\n\n5. Subject to clause 7, at least one of the factors set out in clause 6 must be related to the relevant service rendered by the person.\n\nFactors\n\n6. The factor that must exist before it can be said that, on the balance of probabilities, malignant neoplasm of the oral cavity, oropharynx or hypopharynx or death from malignant neoplasm of the oral cavity, oropharynx or hypopharynx is connected with the circumstances of a person’s relevant service is:\n\n(a) smoking at least five pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx, and\n\n(i) smoking commenced at least ten years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; and\n\n(ii) where smoking has ceased, the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx has occurred within ten years of cessation; or\n\n(b) the oral use of smokeless tobacco on more days than not, for at least ten years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx, and where the oral use of smokeless tobacco has ceased, the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx has occurred within ten years of cessation; or\n\n(c) chewing betel quid or areca nut on more days than not, for at least ten years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx, and where chewing of betel quid or areca nut has ceased, the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx has occurred within ten years of cessation; or\n\n(d) drinking maté on more days than not, for at least ten years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx, and where drinking maté has ceased, the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx has occurred within ten years of cessation; or\n\n(e) drinking at least 150 kilograms of alcohol before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; or\n\n(f) undergoing stem cell or solid organ transplantation before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; or\n\n(g) acquiring persistent infection of the oropharyngeal epithelium with human papilloma virus type 16 or 18 before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; or\n\n(h) being exposed to mustard gas at least ten years before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; or\n\n(i) being infected with the human immunodeficiency virus before the clinical onset of malignant neoplasm of the oral cavity, oropharynx or hypopharynx; or\n\n(j) for malignant neoplasm of the oral cavity only, having leukoplakia or erythroplakia at the affected site for at least the one year before the clinical onset of malignant neoplasm of the oral cavity; or\n\n(k) inability to obtain appropriate clinical management for malignant neoplasm of the oral cavity, oropharynx or hypopharynx.\n\nFactors that apply only to material contribution or aggravation\n\n7. Paragraph 6(k) applies only to material contribution to, or aggravation of, malignant neoplasm of the oral cavity, oropharynx or hypopharynx where the person’s malignant neoplasm of the oral cavity, oropharynx or hypopharynx was suffered or contracted before or during (but not arising out of) the person’s relevant service.\n\nInclusion of Statements of Principles\n\n8. In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\nOther definitions\n\n9. For the purposes of this Statement of Principles:\n\n\"alcohol\" is measured by the alcohol consumption calculations utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink;\n\n\"death from malignant neoplasm of the oral cavity, oropharynx or hypopharynx \" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s malignant neoplasm of the oral cavity, oropharynx or hypopharynx;\n\n\"pack-years of cigarettes, or the equivalent thereof in other tobacco products\" means a calculation of consumption where one pack-year of cigarettes equals twenty tailor-made cigarettes per day for a period of one calendar year, or 7300 cigarettes. One tailor-made cigarette approximates one gram of tobacco or one gram of cigar or pipe tobacco by weight. One pack-year of tailor-made cigarettes equates to 7.3 kilograms of smoking tobacco by weight. Tobacco products means either cigarettes, pipe tobacco or cigars, smoked alone or in any combination;\n\n\"relevant service\" means:\n\n(a) eligible war service (other than operational service) under the VEA;\n\n(b) defence service (other than hazardous service and British nuclear test defence service) under the VEA; or\n\n(c) peacetime service under the MRCA;\n\n\"smokeless tobacco\" means tobacco products without combustion or pyrolysis at the time of use, including chewing tobacco and tobacco snuff;\n\n\"terminal event\" means the proximate or ultimate cause of death and includes:\n\n(a) pneumonia;\n\n(b) respiratory failure;\n\n(c) cardiac arrest;\n\n(d) circulatory failure; or\n\n(e) cessation of brain function.\n\nApplication\n\n10. This Instrument applies to all matters to which section 120B of the VEA or section 339 of the MRCA applies.\n\nDate of effect\n\n11. This Instrument takes effect from 9 January 2013.\n\nDated this fourteenth day of December 2012\n\nThe Common Seal of the )\n\nRepatriation Medical Authority )\n\nwas affixed to this instrument )\n\nin the presence of: )\n\nPROFESSOR NICHOLAS SAUNDERS AO\n\nCHAIRPERSON","sortOrder":0}],"analysis":{"summary":{"complexity_score":5,"scope_assessment":{"changed":false,"description":"This instrument is a direct replacement of the 2005 predecessor SoP (Instrument No. 20 of 2005) covering the same disease category. The core structure and purpose remain identical: to define the accepted causal factors linking this specific cancer to military service for compensation purposes. The 2013 update reflects an expansion or refinement of the recognised risk factors based on updated medical-scientific evidence (notably the inclusion of HPV types 16/18, HIV, stem cell/solid organ transplantation, and maté), but this is consistent with the SoP framework's intended function of keeping risk factors current with medical science. The scope has not materially changed — it remains a targeted instrument about one disease category for one defined class of people (veterans and military members)."},"complexity_factors":["Multiple defined terms requiring precise interpretation, including 'pack-years', 'smokeless tobacco', 'terminal event', 'relevant service', and 'alcohol' (measured by a specific calculation)","Conditional logic in the smoking factor (clause 6(a)) with nested sub-conditions covering duration, commencement timing, and cessation windows","Temporal conditions attached to nearly every risk factor (e.g. 10-year exposure minimums, 10-year cessation windows), requiring careful factual analysis","Clause 7 creates a carve-out restricting factor 6(k) solely to aggravation/material contribution claims, introducing a two-track claims structure","Cross-references to two separate parent Acts (VEA and MRCA) and their specific subsections (s.120B VEA, s.339 MRCA, s.196B(3) and (8) VEA)","Clause 8 creates a cascading incorporation mechanism — where a factor involves another injury covered by its own SoP, that SoP's factors are also imported by reference","Precise anatomical definition of the disease in clause 3(b) with multiple inclusions and explicit exclusions, requiring medical knowledge to apply correctly","Revocation of a prior instrument (No. 20 of 2005) adds a temporal layer requiring awareness of what the previous rules were for transitional matters"],"plain_english_summary":"This Statement of Principles is a legally binding rule that accepts certain cancers of the mouth and throat as caused or worsened by Australian military service when linked to specified service-related risk factors. It applies to veterans and current/former ADF members covered by the VEA and MRCA.\n\nIt replaces the 2005 instrument and matters because it shifts the evidential burden: if a recognised service-linked risk factor is present, compensation claims are accepted without veterans proving causation anew."}},"importantCases":[],"_links":{"self":"/api/acts/f2013l00017","history":"/api/acts/f2013l00017/history","analysis":"/api/acts/f2013l00017/analysis","conflicts":"/api/acts/f2013l00017/conflicts","importantCases":"/api/acts/f2013l00017/important-cases","documents":"/api/acts/f2013l00017/documents"}}