{"id":"F2025L01286","name":"Statement of Principles concerning cardiac myxoma (Balance of Probabilities) (No. 84 of 2025)","slug":"statement-of-principles-concerning-cardiac-myxoma-balance-of-probabilities-no-84-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443006,"registerId":"F2025L01286-fast-fetch-1775957926093","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning cardiac myxoma (Balance of Probabilities) (No. 84 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\nCARDIAC MYXOMA  (Balance of Probabilities)\n\n(No. 84 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 24 October 2025\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 cardiac myxoma (Balance of Probabilities) (No. 84 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 24 November 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 cardiac myxoma (Balance of Probabilities) (No. 33 of 2017) (Federal Register of Legislation No. F2017L00465) made under subsection 196B(3) of the VEA is repealed.\n\n1.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 cardiac myxoma and death from cardiac myxoma.\n\n\nMeaning of cardiac myxoma\n\n1.           For the purposes of this Statement of Principles, cardiac myxoma means:\n  1.           a benign neoplasm of the heart composed of primitive connective tissue cells and stroma resembling mesenchyme.\n\n\nNote: Cardiac myxomas usually occur in the atria, but can also occur in the ventricles.\n\n1.           While cardiac myxoma attracts ICD‑10‑AM code D15.1, in applying this Statement of Principles the meaning of cardiac myxoma 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 cardiac myxoma\n\n1.           For the purposes of this Statement of Principles, cardiac myxoma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's cardiac myxoma.\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 cardiac myxoma and death from cardiac myxoma 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\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, cardiac myxoma or death from cardiac myxoma is connected with the circumstances of a person's relevant service:\n\n1.           having a heart transplant before clinical onset;\n2.           having blunt force trauma to the chest immediately preceding clinical worsening;\n\n\nNote: Blunt force trauma to the chest can cause a cardiac myxoma to break up and embolise to multiple places throughout the body. The emboli can lodge in the major blood vessels, and the vessels of the brain, organs, and the limbs, causing life-threatening ischaemia and infarction.\n\n1.           inability to obtain appropriate clinical management for cardiac myxoma before clinical worsening.\n\n\n1.            Relationship to service\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  2.           The clinical worsening aspect of factors set out in section 9 apply to material contribution to, or aggravation of, cardiac myxoma where the person's cardiac myxoma 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                               cardiac myxoma—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":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This is a straightforward reissue/replacement of the 2017 Statement of Principles concerning the same condition. The scope remains tightly focused on establishing the causal factors for cardiac myxoma in the veterans' compensation context. No expansion of scope is evident — it maintains the same limited purpose of defining when this specific rare heart tumour can be service-connected."},"complexity_factors":["Short, single-purpose instrument (approximately 1,500 words)","Only 5 defined terms in the Dictionary (cardiac myxoma, MRCA, relevant service, terminal event, VEA)","Simple conditional structure: three alternative factors in section 9, only one needs to be satisfied","Minimal cross-referencing — primarily internal references to the Dictionary and parent Acts","No nested exceptions or complex temporal calculations","Straightforward repeal and commencement provisions","Medical definition provided in plain language with ICD-10-AM code reference for administrative clarity only"],"plain_english_summary":"This instrument sets when Australian veterans and current/former defence members can claim compensation for cardiac myxoma (a rare benign heart tumour) under the VEA and MRCA. It replaces the 2017 rules and limits recognition to three service-linked pathways: prior heart transplant, blunt chest trauma causing tumour fragmentation/embolism, or inability to access appropriate treatment before worsening.\n\nIt matters because compensation requires proving one of these narrow links to service on the balance of probabilities; cardiac myxoma is otherwise considered spontaneous."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"The instrument expressly repeals the 2017 Statement of Principles (s4) and replaces it with updated definitions and qualifying factors for cardiac myxoma and death from cardiac myxoma (s7, s9). It therefore changes the governing medical criteria that decision‑makers must apply to claims under the VEA and MRCA (s5), including explicit inclusion of death by terminal events and inability to obtain appropriate clinical management as a qualifying circumstance."},"complexity_factors":["Use of the legal causation standard 'balance of probabilities' (Basis for determining the factors, s8) — requires probabilistic medical-juridical assessment.","Technical medical definition of cardiac myxoma and ICD‑10‑AM cross-reference (Meaning of cardiac myxoma, s7(2) & s7(4)) — needs clinical interpretation.","Qualifying factors listed (prior heart transplant; blunt chest trauma immediately preceding clinical worsening; inability to obtain appropriate clinical management) (s9) — factual, temporal and medical proof required.","Requirement that any qualifying factor be related to the person's 'relevant service' (Relationship to service, s10(1)) — necessitates service-history and nexus analysis.","Treatment of clinical 'worsening' and material contribution/aggravation where condition pre-existed service (s10(2)) — complicates causation for pre-existing conditions.","Interplay with other Statements of Principles (Factors referring to an injury or disease covered by another Statement, s11) — cross-references can shift evidentiary pathways.","Inclusion of death from cardiac myxoma via 'terminal event' definitions in the Schedule — requires linking proximate/ultimate cause of death to the condition.","Repeal of the 2017 Statement (Repeal, s4) — administrative transition and potential differences in accepted evidence or qualifying criteria."],"plain_english_summary":"This instrument replaces the 2017 Statement of Principles and sets the medical criteria the Repatriation Medical Authority will use to decide whether cardiac myxoma, or death to which it contributed, is connected to a person’s service under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. It defines the condition, clarifies the causation standard and qualifying clinical circumstances, and so changes what veterans, their families and decision-makers must prove for service‑connection claims."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-balance-of-probabilities-no-84-of-2025","history":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-balance-of-probabilities-no-84-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-balance-of-probabilities-no-84-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-balance-of-probabilities-no-84-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-balance-of-probabilities-no-84-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-balance-of-probabilities-no-84-of-2025/documents"}}