{"id":"F2019L01363","name":"Statement of Principles concerning acoustic neuroma (Reasonable Hypothesis) (No. 96 of 2019)","slug":"statement-of-principles-concerning-acoustic-neuroma-reasonable-hypothesis-no-96-of-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440279,"registerId":"F2019L01363-fast-fetch-1775955964805","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning acoustic neuroma (Reasonable Hypothesis) (No. 96 of 2019)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nACOUSTIC NEUROMA (Reasonable Hypothesis)\n\n(No. 96 of 2019)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 18 October 2019\n\n \n\n \n\n \n\n \n\n \n\n| The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:
|\n| --- |\n| 
Professor Nicholas Saunders AO
Chairperson
|\n\n\n \n\n \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n\n\n\n1 Name\n\nThis is the Statement of Principles concerning acoustic neuroma (Reasonable Hypothesis) (No. 96 of 2019).\n\n2 Commencement\n\n This instrument commences on 18 November 2019.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning acoustic neuroma No. 29 of 2011 (Federal Register of Legislation No. F2011L00735) made under subsections 196B(2) and (8) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n6 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about acoustic neuroma and death from acoustic neuroma.\n\nMeaning of acoustic neuroma\n\n(2) For the purposes of this Statement of Principles, acoustic neuroma:\n\n(a) means a benign neoplasm arising from Schwann cells of the vestibular or cochlear nerve; and\n\n(b) excludes acoustic neuroma associated with a tumour predisposition syndrome, such as neurofibromatosis or schwannomatosis.\n\nNote 1: Acoustic neuroma is also known as vestibular schwannoma.\n\nNote 2: Typical presenting symptoms are progressive hearing loss and tinnitus. Imbalance, dizziness, vertigo, facial paraesthesia, and headache can also occur.\n\n(3) While acoustic neuroma attracts ICD‑10‑AM code D33.3, in applying this Statement of Principles the meaning of acoustic neuroma is that given in subsection (2).\n\n(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.\n\nDeath from acoustic neuroma\n\n(5) For the purposes of this Statement of Principles, acoustic neuroma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's acoustic neuroma.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that acoustic neuroma and death from acoustic neuroma can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.\n\n9 Factors that must exist\n\nAt least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting acoustic neuroma or death from acoustic neuroma with the circumstances of a person's relevant service:\n\n(1) having received a cumulative equivalent dose of at least 0.1 sievert of ionising radiation to the affected vestibular or cochlear nerve at least five years before the clinical onset of acoustic neuroma;\n\nNote: cumulative equivalent dose is defined in the Schedule 1 - Dictionary. \n\n(2) inability to obtain appropriate clinical management for acoustic neuroma.\n\n10 Relationship to service\n\n(1) The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.\n\n(2) The factor set out in subsection 9(2) applies only to material contribution to, or aggravation of, acoustic neuroma where the person's acoustic neuroma was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nIn this Statement of Principles:\n\n(1) if a factor referred to in section 9 applies in relation to a person; and\n\n(2) that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(2) of the VEA;\n\nthen the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n acoustic neuroma—see subsection 7(2).\n\n cumulative equivalent dose means the total dose of ionising radiation received by the particular organ or tissue from external exposure, internal exposure or both, apart from normal background radiation exposure in Australia, calculated in accordance with the methodology set out in the Guide to calculation of 'cumulative equivalent dose' for the purpose of applying ionising radiation factors contained in Statements of Principles determined under Part XIA of the Veterans' Entitlements Act 1986 (Cth), Australian Radiation Protection and Nuclear Safety Agency, as in force on 2 August 2017.\n\nNote 1: Examples of circumstances that might lead to exposure to ionising radiation include being present during or subsequent to the testing or use of nuclear weapons, undergoing diagnostic or therapeutic medical procedures involving ionising radiation, and being a member of an aircrew, leading to increased levels of exposure to cosmic radiation.\n\nNote 2: For the purpose of dose reconstruction, dose is calculated as an average over the mass of a specific tissue or organ. If a tissue is exposed to multiple sources of ionising radiation, the various dose estimates for each type of radiation must be combined.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n relevant service means:\n\n(a) operational service under the VEA;\n\n(b) peacekeeping service under the VEA;\n\n(c) hazardous service under the VEA;\n\n(d) British nuclear test defence service under the VEA;\n\n(e) warlike service under the MRCA; or\n\n(f) non-warlike service under the MRCA.\n\nNote: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\n terminal event means the proximate or ultimate cause of death and includes the following:\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\n VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Repatriation Medical Authority Statements of Principles. It replaces the 2011 version (No. 29 of 2011) with updated medical evidence and revised radiation dose thresholds, but does not expand beyond the original purpose of determining service connection for acoustic neuroma in veterans' compensation claims."},"complexity_factors":["Moderate cross-referencing: Links to two separate Acts (Veterans' Entitlements Act 1986 and Military Rehabilitation and Compensation Act 2004)","Technical medical definitions: Requires understanding of 'cumulative equivalent dose', 'sievert' units, and specific ICD-10-AM coding","External methodology reference: Radiation dose calculation depends on a separate ARPANSA guide document dated August 2017","Conditional logic in section 9(2): Contains a nested limitation applying only to aggravation cases where condition pre-existed service","Dual applicability: Must be read alongside companion 'Statement of Principles' instruments for related conditions","Defined terms: 6 explicit definitions in Schedule 1, plus implicit definitions within substantive sections"],"plain_english_summary":"This rulebook sets the medical test for whether current or former Australian Defence Force members, veterans, peacekeepers (and their families, for death cases) can get compensation for acoustic neuroma. It accepts a “reasonable hypothesis” linking service and tumour—principally significant ionising radiation exposure (≥0.1 Sv, with symptoms ≥5 years later) or service-related lack of access to care worsening a pre-existing tumour. Genetic causes and normal background radiation are excluded."},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2011 Statement of Principles (No. 29 of 2011) and substitutes the 2019 Statement (s.4). It applies to claims under VEA s.120A and MRCA s.338 (s.5). The text therefore replaces the previous governing Statement; the source does not provide a clause‑by‑clause comparison, so whether substantive coverage has been broadened or narrowed cannot be determined from this instrument alone."},"complexity_factors":["Legal causation standard: use of the 'reasonable hypothesis' threshold rather than balance of probabilities (s.8, s.9).","Technical medical definition and exclusions: specific definition of acoustic neuroma and exclusion of tumour predisposition syndromes (s.7(2)).","Numeric radiation threshold and latency: cumulative equivalent dose ≥0.1 sievert and at least 5 years before clinical onset (s.9(1)).","Dose reconstruction methodology: cumulative equivalent dose defined by ARPANSA guide, invoking technical calculation and averaging rules (Schedule 1 definition).","Alternative non‑exposure factor: 'inability to obtain appropriate clinical management' as a separate path to a reasonable hypothesis (s.9(2)), with a timing restriction for contribution/aggravation (s.10(2)).","Interplay with other Statements of Principles: cross‑application if a factor refers to an injury/disease covered elsewhere (s.11).","Application limited to statutory claim contexts: only applies to claims under VEA s.120A or MRCA s.338 (s.5).","Repeal and replacement: the 2011 Statement is repealed, raising potential transitional and interpretive questions (s.4).","Use of ICD‑10‑AM coding as an aid but not as sole definitional source (s.7(3)–(4)).","Evidentiary and administrative burden: requires medical and dose‑reconstruction evidence to establish factors, which may demand specialised records and expert analysis (s.9; Schedule 1)."],"plain_english_summary":"Sets the medical criteria the Repatriation Medical Authority uses to decide when acoustic neuroma (vestibular schwannoma) can be reasonably hypothesised as connected to military or peacekeeping service. It affects veterans and service members lodging claims under the VEA or MRCA by defining two paths to a service link (a radiation‑dose threshold with a 5‑year latency and inability to obtain appropriate clinical management) and by excluding tumours caused by genetic predisposition syndromes. It determines who may qualify for statutory entitlements."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-acoustic-neuroma-reasonable-hypothesis-no-96-of-2019","history":"/api/acts/statement-of-principles-concerning-acoustic-neuroma-reasonable-hypothesis-no-96-of-2019/history","analysis":"/api/acts/statement-of-principles-concerning-acoustic-neuroma-reasonable-hypothesis-no-96-of-2019/analysis","conflicts":"/api/acts/statement-of-principles-concerning-acoustic-neuroma-reasonable-hypothesis-no-96-of-2019/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-acoustic-neuroma-reasonable-hypothesis-no-96-of-2019/important-cases","documents":"/api/acts/statement-of-principles-concerning-acoustic-neuroma-reasonable-hypothesis-no-96-of-2019/documents"}}