{"id":"F2024L01702","name":"Statement of Principles concerning ganglion (Balance of Probabilities) (No. 8 of 2025)","slug":"statement-of-principles-concerning-ganglion-balance-of-probabilities-no-8-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442680,"registerId":"F2024L01702-fast-fetch-1775957631598","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning ganglion (Balance of Probabilities) (No. 8 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\nGANGLION  (Balance of Probabilities)\n\n(No. 8 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 ganglion (Balance of Probabilities) (No. 8 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 ganglion (Balance of Probabilities) (No. 72 of 2016) (Federal Register of Legislation No. F2016L01353) made under subsection 196B(3) of the VEA is repealed.\n\n1.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 ganglion and death from ganglion.\n\n\nMeaning of ganglion\n\n1.           For the purposes of this Statement of Principles, ganglion:\n  1.           means a benign, cystic lesion overlying a joint or tendon, consisting of a thin fibrous capsule with no epithelial lining enclosing clear mucinous fluid, which may be accompanied by pain, weakness and loss of function; and\n  2.           excludes:\n    1.             cyst of bursa;\n    2.          epidermoid cyst;\n    3.        ganglion in yaws;\n    4.         synovial cyst; and\n    5.           Tarlov cyst.\n\n\nNote: Ganglion cysts occur most commonly in the wrist, hand, or foot, but can also form in the elbow, shoulder, hip, knee, ankle, or spine.\n\n1.           While ganglion attracts ICD‑10‑AM code M67.4, in applying this Statement of Principles the meaning of ganglion 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 ganglion\n\n1.           For the purposes of this Statement of Principles, ganglion, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's ganglion.\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 ganglion and death from ganglion 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 factors must exist before it can be said that, on the balance of probabilities, ganglion or death from ganglion is connected with the circumstances of a person's relevant service:\n\n1.           inability to obtain appropriate clinical management for ganglion 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 factor set out in subsection 9(1) applies only to material contribution to, or aggravation of, ganglion where the person's ganglion 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                               ganglion—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":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2016 Statement of Principles (section 4) and reissues criteria for ganglion and death from ganglion (sections 7 and Schedule 1). Its operative scope is defined to apply to VEA and MRCA claims (section 5) and is concentrated on a single qualifying factor (section 9). Decision‑makers must apply these definitions and the temporal/causal constraints set out (section 10)."},"complexity_factors":["Single medical condition defined with exclusions (definition of ganglion — subsection 7(2))","Legal cross‑references to two statutes and specific claim provisions (applies to claims under s120B VEA or s339 MRCA — section 5)","One qualifying factor framed in clinical terms that invite medical interpretation ('inability to obtain appropriate clinical management' and 'clinical worsening' — section 9(1))","Temporal and causal constraint on application (factor applies where ganglion was suffered or contracted before or during, but did not arise out of, relevant service — section 10(2))","Repeal and replacement of an earlier Statement (repeal of No. 72 of 2016 — section 4) requiring practitioners and decision‑makers to apply the new text from commencement (section 2)","Definitions that draw on clinical coding and mortality concepts (ICD‑10‑AM reference — subsection 7(4); 'terminal event' in Schedule 1) ","Cross‑application mechanism to other Statements of Principles when factors refer to other injuries or diseases (section 11), creating potential dependency on other instruments"],"plain_english_summary":"This instrument replaces the earlier Statement of Principles and sets the medical criteria the Repatriation Medical Authority uses to link ganglion (and death from ganglion) to service for claims under the Veterans' Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004. It defines what counts as a ganglion and treats death from ganglion as death from a terminal event contributed to by ganglion. The only prescribed qualifying factor is inability to obtain appropriate clinical management before clinical worsening; that factor must be related to the person’s relevant service."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This is a straightforward reissue/replacement of the 2016 Statement of Principles concerning ganglion. It maintains the same narrow scope — focusing solely on the inability to obtain clinical management as the connecting factor. There is no evidence of scope creep; it remains tightly focused on the specific medical condition and the specific causal pathway (access to care) for the defined veteran population."},"complexity_factors":["Short document (approximately 1,500 words)","Only 5 defined terms in the Dictionary (ganglion, MRCA, relevant service, terminal event, VEA)","Single causal factor in section 9 (inability to obtain appropriate clinical management)","Minimal cross-referencing — only refers to the parent Acts (VEA and MRCA) and the previous 2016 instrument being repealed","Straightforward structure with standard Statement of Principles format (name, commencement, definitions, factors, relationship to service)","No nested exceptions or conditional logic beyond the basic exclusion list in section 7(2)(b) and the limitation in section 10(2) regarding pre-existing conditions"],"plain_english_summary":"This instrument updates the 2016 rules for compensation for ganglion cysts, narrowly defining the condition (excluding bursa or epidermoid cysts) and applying to veterans and current/former defence members claiming under the VEA or MRCA for non‑operational service. It permits a claim only on the balance of probabilities and only where the cyst worsened because the person was unable to obtain proper medical treatment during service. The effect is a highly restrictive, access‑to‑care–focused test for entitlement."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-ganglion-balance-of-probabilities-no-8-of-2025","history":"/api/acts/statement-of-principles-concerning-ganglion-balance-of-probabilities-no-8-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-ganglion-balance-of-probabilities-no-8-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-ganglion-balance-of-probabilities-no-8-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-ganglion-balance-of-probabilities-no-8-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-ganglion-balance-of-probabilities-no-8-of-2025/documents"}}