{"id":"F2024L01708","name":"Statement of Principles concerning benign prostatic hyperplasia (Balance of Probabilities) (No. 14 of 2025)","slug":"statement-of-principles-concerning-benign-prostatic-hyperplasia-balance-of-probabilities-no-14-of-20","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442687,"registerId":"F2024L01708-fast-fetch-1775957635954","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning benign prostatic hyperplasia (Balance of Probabilities) (No. 14 of 2025)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nBENIGN PROSTATIC HYPERPLASIA  (Balance of Probabilities)\n\n(No. 14 of 2025)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 17 December 2024.\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\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\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning benign prostatic hyperplasia (Balance of Probabilities) (No. 14 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 28 January 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning benign prostatic hyperplasia (Balance of Probabilities) (No. 18 of 2016) (Federal Register of Legislation No. F2016L00242) made under subsection 196B(3) of the VEA is repealed.\n\n1.                Application\n\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about benign prostatic hyperplasia and death from benign prostatic hyperplasia.\n\n\nMeaning of benign prostatic hyperplasia\n\n1.           For the purposes of this Statement of Principles, benign prostatic hyperplasia:\n  1.           means a benign hyperplasia of the prostate glandular and stromal tissue which can cause obstruction of urine outflow; and\n  2.           excludes:\n    1.             malignant neoplasm of the prostate;\n    2.          overactive bladder; and\n    3.        prostatitis.\n\n\nNote: Obstruction of urine outflow may present as increased urgency, increased urinary frequency, poor flow or dribbling.\n\n1.           While benign prostatic hyperplasia attracts ICD‑10‑AM code N40, in applying this Statement of Principles the meaning of benign prostatic hyperplasia is that given in subsection (2).\n2.           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\n\nDeath from benign prostatic hyperplasia\n\n1.           For the purposes of this Statement of Principles, benign prostatic hyperplasia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's benign prostatic hyperplasia.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that benign prostatic hyperplasia and death from benign prostatic hyperplasia can be related to relevant service rendered by veterans 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\n1.                Factors that must exist\n\n\nThe following factor must exist before it can be said that, on the balance of probabilities, benign prostatic hyperplasia or death from benign prostatic hyperplasia is connected with the circumstances of a person's relevant service:\n\n1.           inability to obtain appropriate clinical management for benign prostatic hyperplasia before clinical worsening.\n\n\n1.            Relationship to service\n  1.           The existence in a person of the factor referred to in section 9, must be related to the relevant service rendered by the person.\n  2.           The factor set out in subsection 9(1) applies only to material contribution to, or aggravation of, benign prostatic hyperplasia where the person's benign prostatic hyperplasia was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 9 applies in relation to a person; and\n2.           that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;\n\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                               benign prostatic hyperplasia—see subsection 7(2).\n\n                             MRCA means the Military Rehabilitation and Compensation Act 2004.\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\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":3,"scope_assessment":{"changed":false,"description":"The legislation maintains its original narrow purpose: establishing the specific medical factor required to connect benign prostatic hyperplasia to military service. It replaces the 2016 version without expanding the scope — the single factor (inability to obtain appropriate clinical management) remains the sole pathway for claims, and the exclusion of de novo cases (those arising directly from service) is preserved."},"complexity_factors":["Short instrument: approximately 1,200 words across 11 sections plus a brief dictionary","Only 5 defined terms in Schedule 1 (benign prostatic hyperplasia, MRCA, relevant service, terminal event, VEA)","Single operative factor in section 9 with limited conditional logic","Minimal cross-referencing: only refers to the parent Veterans' Entitlements Act and Military Rehabilitation and Compensation Act","Clear structure following standard Repatriation Medical Authority template","Medical definition in section 7 includes specific exclusions (malignant neoplasm, overactive bladder, prostatitis) but these are straightforward carve-outs"],"plain_english_summary":"This rulebook sets the medical test used to decide if benign prostatic hyperplasia (BPH) is linked to military service under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. It replaces the 2016 version and guides the Repatriation Medical Authority.\n\nIt affects veterans and current/former defence members claiming for BPH or BPH‑related death. To succeed, claimants must show service prevented appropriate medical treatment for pre‑existing BPH and that this lack of care worsened the condition — a narrow gateway that will exclude most claims."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2016 Statement and replaces it (section 4). It narrows the operational test for service connection to a single mandatory factor — inability to obtain appropriate clinical management before clinical worsening — judged on the balance of probabilities (sections 9 and 8) and limits application to claims under specific VEA/MRCA provisions (section 5). It also clarifies temporal constraints on when the factor can establish material contribution or aggravation (section 10(2))."},"complexity_factors":["Single required causal factor — inability to obtain appropriate clinical management before clinical worsening (section 9). Concentrates evidentiary burden on proof of access/timing of care.","Standard of proof set as 'balance of probabilities' (section 8), a civil standard applied to medical causation.","Specific medical definition and explicit exclusions for BPH (malignant neoplasm, overactive bladder, prostatitis) which constrains scope (section 7(2)).","Inclusion of death via contribution to a terminal event, with terminal event defined in the Dictionary (section 7(4); Schedule 1).","Repeal and replacement of the 2016 Statement — procedural/legal change that may alter claim outcomes (section 4).","Application tied to specific claim provisions of the VEA and MRCA, so effect limited to claims covered by those sections (section 5; Schedule 1 definitions).","Cross-reference mechanism to other Statements of Principles creates layered dependency where other SOPs’ factors may also apply (section 11).","Temporal and causal limitation: the factor applies only to material contribution/aggravation where BPH was suffered or contracted before or during (but did not arise out of) relevant service, imposing a temporal proof requirement (section 10(2)).","Authority and evidentiary basis are medical-scientific judgments made by the Repatriation Medical Authority under the VEA (section 3; section 8).","Commencement date and repeal timing may affect pending or future claims (section 2; section 4)."],"plain_english_summary":"In place of the 2016 Statement (repealed), this instrument sets the medical test for linking benign prostatic hyperplasia (BPH) to a person's relevant service for claims under section 120B of the VEA or section 339 of the MRCA. It requires, on the balance of probabilities, that the claimant lacked appropriate clinical management before clinical worsening. It affects veterans and service members claiming BPH or death from BPH and changes what evidence is necessary to establish service connection."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-benign-prostatic-hyperplasia-balance-of-probabilities-no-14-of-20","history":"/api/acts/statement-of-principles-concerning-benign-prostatic-hyperplasia-balance-of-probabilities-no-14-of-20/history","analysis":"/api/acts/statement-of-principles-concerning-benign-prostatic-hyperplasia-balance-of-probabilities-no-14-of-20/analysis","conflicts":"/api/acts/statement-of-principles-concerning-benign-prostatic-hyperplasia-balance-of-probabilities-no-14-of-20/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-benign-prostatic-hyperplasia-balance-of-probabilities-no-14-of-20/important-cases","documents":"/api/acts/statement-of-principles-concerning-benign-prostatic-hyperplasia-balance-of-probabilities-no-14-of-20/documents"}}