{"id":"F2021L01914","name":"Statement of Principles concerning colorectal adenoma (Reasonable Hypothesis) (No. 15 of 2022)","slug":"statement-of-principles-concerning-colorectal-adenoma-reasonable-hypothesis-no-15-of-2022","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441155,"registerId":"F2021L01914-fast-fetch-1775956529198","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning colorectal adenoma (Reasonable Hypothesis) (No. 15 of 2022)","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\nCOLORECTAL ADENOMA (Reasonable Hypothesis)\n\n(No. 15 of 2022)\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 December 2021\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 Terence Campbell AM
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\n\n\n1 Name\n\nThis is the Statement of Principles concerning colorectal adenoma (Reasonable Hypothesis) (No. 15 of 2022).\n\n2 Commencement\n\n This instrument commences on 31 January 2022.\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 colorectal adenoma No. 35 of 2013 (Federal Register of Legislation No. F2013L01138) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 colorectal adenoma and death from colorectal adenoma.\n\nMeaning of colorectal adenoma\n\n(2) For the purposes of this Statement of Principles, colorectal adenoma:\n\n(a) means a benign neoplasm arising from the epithelial cells of the colorectum; and\n\n(b) includes:\n\n(i) adenomatous polyp;\n\n(ii) sessile serrated adenoma; and\n\n(iii) traditional serrated adenoma; and\n\n(c) excludes:\n\n(i) benign neoplasms of the anus and anal canal;\n\n(ii) familial adenomatous polyposis;\n\n(iii) non-neoplastic polyps of the colon;\n\n(iv) nonepithelial neoplasms of the colon; and\n\n(v) non-polypoid dysplasia.\n\n(3) While colorectal adenoma attracts ICD‑10‑AM code D12.0, D12.1, D12.2, D12.3, D12.4, D12.5, D12.7 or D12.8, in applying this Statement of Principles the meaning of colorectal adenoma 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 colorectal adenoma\n\n(5) For the purposes of this Statement of Principles, colorectal adenoma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's colorectal adenoma.\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 colorectal adenoma and death from colorectal adenoma 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 colorectal adenoma or death from colorectal adenoma with the circumstances of a person's relevant service:\n\n(1) having smoked tobacco products:\n\n(a) in an amount of at least 10 pack-years before the clinical onset of colorectal adenoma; and\n\n(b) commencing at least 5 years before the clinical onset of colorectal adenoma; and\n\nif smoking has ceased before the clinical onset of colorectal adenoma, then that onset occurred within 30 years of cessation;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(2) consuming at least 250 kilograms of alcohol before the clinical onset of colorectal adenoma;\n\nNote: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.\n\n(3) being overweight or obese for at least 5 years within the 30 years before the clinical onset of colorectal adenoma;\n\nNote: being overweight or obese is defined in the Schedule 1 - Dictionary.\n\n(4) having diabetes mellitus for at least 5 years before the clinical onset of colorectal adenoma;\n\n(5) inability to consume an average of at least 20 grams per day of fibre in food, for at least 5 consecutive years within the 10 years before the clinical onset of colorectal adenoma;\n\nNote: fibre in food is defined in the Schedule 1 - Dictionary.\n\n(6) having a solid organ transplant at least 5 years before the clinical onset of colorectal adenoma;\n\n(7) having a ureterosigmoidostomy involving the affected part of the colorectum at least 5 years before the clinical onset of colorectal adenoma;\n\n(8) for adenoma of the colon only:\n\n(a) inability to undertake any physical activity greater than 3 METs for at least 10 consecutive years within the 30 years before the clinical onset of adenoma of the colon;\n\nNote: adenoma of the colon and MET are defined in the Schedule 1 - Dictionary.\n\n(b) having acromegaly before the clinical onset of adenoma of the colon;\n\nNote: acromegaly and adenoma of the colon are defined in the Schedule 1 - Dictionary.\n\n(c) consuming an average of at least 100 grams per day of red meat, for at least 5 years within the 10 years before the clinical onset of adenoma of the colon;\n\nNote: adenoma of the colon and red meat are defined in the Schedule 1 - Dictionary.\n\n(d) consuming an average of at least 25 grams per day of processed meat product, for at least 5 years within the 10 years before the clinical onset of adenoma of the colon;\n\nNote: adenoma of the colon and processed meat product are defined in the Schedule 1 - Dictionary.\n\n(e) inability to consume an average of at least 100 grams per day of any combination of fruit and vegetables, for at least the 5 years before the clinical onset of adenoma of the colon;\n\nNote: adenoma of the colon is defined in the Schedule 1 - Dictionary.\n\n(9) inability to obtain appropriate clinical management for colorectal adenoma.\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(9) applies only to material contribution to, or aggravation of, colorectal adenoma where the person's colorectal adenoma 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 acromegaly means a chronic disease of adults resulting from excessive production of growth hormone after closure of the epiphyses.\n\n adenoma of the colon means a benign epithelial neoplasm of the colon. Anatomically the colon is defined as extending from the caecum, including the ileocaecal junction and the vermiform appendix, to the sigmoid colon, not including the rectosigmoid junction.\n\n being overweight or obese means:\n\n(a) having a Body Mass Index (BMI) of 25 or greater; or\n\n(b) for males, having a waist circumference exceeding 94 centimetres; or\n\n(c) for females, having a waist circumference exceeding 80 centimetres.\n\nNote: BMI is also defined in the Schedule 1 - Dictionary.\n\n BMI means W/H2 where:\n\n(a) W is the person's weight in kilograms; and\n\n(b) H is the person's height in metres.\n\n colorectal adenoma—see subsection 7(2).\n\n fibre in food means complex carbohydrates of plant origin consumed as vegetables, fruits or cereals which resist digestion by gastrointestinal enzymes in the gastrointestinal tract, and include plant cell walls and non-starch polysaccharides from sources other than cell walls, including cellulose and pectins.\n\n MET means a unit of measurement of the level of physical exertion. 1 MET = 3.5 ml of oxygen/kg of body weight per minute, or 1.0 kcal/kg of body weight per hour, or resting metabolic rate.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n one pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.\n\nNote 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.\n\nNote 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.\n\n processed meat product means preserved or cured meats, including ham, frankfurters, salami and bacon.\n\n red meat means all types of mammalian meat, including beef, veal, pork, lamb, mutton, horse and goat.\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":6,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Repatriation Medical Authority Statements of Principles. It replaces the 2013 version (No. 35 of 2013) with updated medical evidence but does not expand beyond the traditional function of determining service-related causation for specific conditions. The structure, application to VEA/MRCA claims, and use of the 'reasonable hypothesis' standard remain consistent with the original legislative scheme established under the Veterans' Entitlements Act 1986."},"complexity_factors":["Multiple nested temporal conditions (e.g., 'at least 5 years within the 10 years before the clinical onset') requiring careful date calculations","14 defined terms in Schedule 1, several with their own sub-definitions and mathematical formulas (BMI calculation, pack-year calculation with worked examples)","Differential application: factors 8(a)-(e) apply only to 'adenoma of the colon' not rectal adenomas, creating a bifurcated scheme","Cross-referencing between the main instrument and Schedule 1, plus external references to ICD-10-AM medical coding system (10th Edition, specific ISBN)","Conditional logic in section 9(1) with three cumulative requirements for smoking plus a conditional fourth (cessation within 30 years)","Specific quantitative thresholds requiring precise measurement (250kg alcohol, 20g fibre, 3 METs, 100g red meat, 25g processed meat, 94cm/80cm waist circumference)","Interaction with other Statements of Principles via section 11, creating a dynamic referencing system where definitions can change over time","Dual statutory framework application (VEA and MRCA) with different service definitions"],"plain_english_summary":"This instrument updates medical guidance for deciding veterans’ compensation claims for colorectal adenoma, replacing the 2013 version and applying to claims under the Veterans’ Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. It identifies specific service‑connected risk factors and measurable thresholds that satisfy the law’s “reasonable hypothesis” test. The change matters because it translates medical evidence into precise legal criteria that affect which current and former ADF members can qualify for compensation."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"The instrument repeals the 2013 Statement (section 4) and replaces it with updated, numerically specified factors, but the text does not state an explicit expansion or contraction of the kinds of claims covered. From the instrument alone, scope in terms of who may claim (claims under s120A VEA or s338 MRCA) remains the same (section 5); whether substantive coverage changed relative to the 2013 Statement cannot be determined from this text alone."},"complexity_factors":["Multiple numeric exposure thresholds and timing windows (e.g. at least 10 pack‑years smoking, 250 kg total alcohol, ≥5 or ≥10 year minimum durations, 30‑year cessation window) increasing evidential precision.","Technical medical definitions and exclusions (types of colorectal adenoma included/excluded; ICD‑10‑AM code reference) requiring clinical interpretation.","Specific biometric and behavioural metrics (BMI, waist circumference, METs, grams/day of fibre, red meat, processed meat) that demand quantified historical or clinical data.","Cross‑references to Veterans' Entitlements Act and MRCA claim provisions (application scope: s120A VEA, s338 MRCA) and to other Statements of Principles (section 11), creating interdependence between instruments.","Requirement that each factor be related to 'relevant service' (section 10), shifting the evidentiary burden onto claimants to connect exposures to service.","Limited application of some factors (e.g. subsection 9(9) on management only applies where adenoma pre‑existed service), adding conditional rules to determinations.","Repeal of the prior 2013 Statement (section 4) means practitioners and decision‑makers must apply the new thresholds from commencement, with administrative transition implications."],"plain_english_summary":"This Statement of Principles, made by the Repatriation Medical Authority under subsection 196B(2) of the Veterans' Entitlements Act 1986, sets the medical criteria that raise a “reasonable hypothesis” linking colorectal adenoma (and death from it) to relevant service for claims under section 120A VEA or section 338 MRCA. It replaces the 2013 Statement and commences 31 January 2022. It lists specific, measurable risk‑factor thresholds (see ss9–10) whose timing and duration must be demonstrated, so claimants must produce clinical and historical evidence to meet those thresholds."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-reasonable-hypothesis-no-15-of-2022","history":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-reasonable-hypothesis-no-15-of-2022/history","analysis":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-reasonable-hypothesis-no-15-of-2022/analysis","conflicts":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-reasonable-hypothesis-no-15-of-2022/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-reasonable-hypothesis-no-15-of-2022/important-cases","documents":"/api/acts/statement-of-principles-concerning-colorectal-adenoma-reasonable-hypothesis-no-15-of-2022/documents"}}