{"id":"F2025L01285","name":"Statement of Principles concerning cardiac myxoma (Reasonable Hypothesis) (No. 83 of 2025)","slug":"statement-of-principles-concerning-cardiac-myxoma-reasonable-hypothesis-no-83-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443005,"registerId":"F2025L01285-fast-fetch-1775957926092","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning cardiac myxoma (Reasonable Hypothesis) (No. 83 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  (Reasonable Hypothesis)\n\n(No. 83 of 2025)\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    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   \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 (Reasonable Hypothesis) (No. 83 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(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning cardiac myxoma (Reasonable Hypothesis) (No. 32 of 2017) (Federal Register of Legislation No. F2017L00463) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\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\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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that cardiac myxoma and death from cardiac myxoma 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\n1.                Factors that must exist\n\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 cardiac myxoma or death from cardiac myxoma 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 only 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(2) 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)          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 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":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2017 Statement and re‑issues the Statement of Principles for cardiac myxoma, maintaining the same statutory purpose of guiding VEA/MRCA claims but updating definitions, listed qualifying factors and references. The text does not set out a detailed comparison to the repealed instrument, so the replacement indicates a renewed authoritative Statement rather than an explicit broadening beyond VEA/MRCA coverage."},"complexity_factors":["Legal threshold of a 'reasonable hypothesis' requires interpretation in individual claims (Basis for determining the factors / sections 8–9).","Narrow, technical medical definition of cardiac myxoma and reliance on ICD‑10‑AM coding (Meaning of cardiac myxoma / section 7(2) and note).","Small enumerated list of qualifying factors (heart transplant before clinical onset; blunt chest trauma immediately preceding clinical worsening; inability to obtain appropriate clinical management) creates tight but clinically nuanced tests (Factors that must exist / section 9).","Temporal and causal language—phrases like 'before clinical onset' and 'immediately preceding clinical worsening'—require clinical judgment and may be fact‑specific (section 9).","Requirement that any qualifying factor be related to 'relevant service' adds an administrative link to service types under the VEA and MRCA (Relationship to service / section 10; Schedule 1 definitions).","Interaction with other Statements of Principles where a factor refers to another injury/disease adds cross‑instrument dependency (Factors referring to another Statement / section 11).","Replaces a prior 2017 Statement and sets a specific commencement date, creating transition/interpretation issues for ongoing claims (Repeal / Commencement sections).","Definition of 'death from cardiac myxoma' uses 'terminal event' with an enumerated list, complicating proximate cause analysis in mortality cases (Death from cardiac myxoma / Schedule 1).","External reliance on a specific edition of ICD‑10‑AM (Tenth Edition, effective 1 July 2017) imports an external publication into legal interpretation (section 7 note).","Applies directly to administrative claim processes under two Acts (application to VEA/MRCA claims), so changes the evidentiary standards decision makers must apply (Application / section 5)."],"plain_english_summary":"This instrument (Statement of Principles No. 83 of 2025) updates the medical rules the Repatriation Medical Authority uses to decide whether cardiac myxoma (a benign heart tumour) can be linked to a person’s military or peacekeeping service. It applies to claims under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. The Statement lists three specific qualifying factors which, if linked to relevant service, raise a reasonable hypothesis that the condition or death was related to service and so affect entitlement decisions."},"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":"This instrument maintains the standard scope of a Repatriation Medical Authority Statement of Principles. It covers one specific medical condition (cardiac myxoma) under the 'reasonable hypothesis' standard, consistent with the original legislative framework established by the Veterans' Entitlements Act 1986. The 2025 version simply updates and repeals the 2017 version without expanding into new policy areas or altering the fundamental eligibility structure."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 7 defined terms in the Dictionary (Schedule 1)","Simple conditional structure: three specific factors in section 9, any one of which satisfies the test","Minimal cross-referencing — only refers to parent Acts (VEA and MRCA) for service definitions","Single medical condition covered (cardiac myxoma) with straightforward clinical definition","No nested exceptions or complex temporal calculations beyond 'before clinical onset' and 'before clinical worsening'","Standard boilerplate provisions for commencement, repeal, and application common to all Statements of Principles"],"plain_english_summary":"This instrument replaces the 2017 rules and sets how the DVA decides if a veteran’s cardiac myxoma (or death from it) is linked to service, using a generous \"reasonable hypothesis\" test rather than the stricter balance of probabilities.  \n\nIt affects veterans, peacekeepers and current/former defence members who served in operations or hazardous settings, and identifies three medical pathways—prior heart transplant, blunt chest trauma worsening a tumour, or inability to obtain treatment—that, if tied to service, support a compensation claim."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-reasonable-hypothesis-no-83-of-2025","history":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-reasonable-hypothesis-no-83-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-reasonable-hypothesis-no-83-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-reasonable-hypothesis-no-83-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-reasonable-hypothesis-no-83-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-cardiac-myxoma-reasonable-hypothesis-no-83-of-2025/documents"}}