{"id":"F2024L01700","name":"Statement of Principles concerning ganglion (Reasonable Hypothesis) (No. 7 of 2025)","slug":"statement-of-principles-concerning-ganglion-reasonable-hypothesis-no-7-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442678,"registerId":"F2024L01700-fast-fetch-1775957631567","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning ganglion (Reasonable Hypothesis) (No. 7 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  (Reasonable Hypothesis)\n\n(No. 7 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    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   \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 (Reasonable Hypothesis) (No. 7 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(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning ganglion (Reasonable Hypothesis) (No. 71 of 2016) (Federal Register of Legislation No. F2016L01356) made under subsections 196B(2) and (8) of the VEA is repealed.\n\n1.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 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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that ganglion and death from ganglion 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 ganglion or death from ganglion with the circumstances of a person's relevant service:\n\n1.           having acute trauma due to a significant physical force applied to the affected joint or tendon within the 1 year before clinical onset;\n2.           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(2) 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(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                               ganglion—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":{"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 the same condition (ganglion). It maintains the same narrow scope: establishing the causal factors required to link ganglion to military service for compensation purposes. There is no evidence of scope creep — it does not expand to cover new conditions, new claimant groups, or new types of benefits."},"complexity_factors":["Short, single-purpose instrument (approximately 1,500 words)","Only 5 defined terms in the Dictionary (ganglion, MRCA, relevant service, terminal event, VEA)","Simple binary structure: two alternative factors in section 9, with one restricted to aggravation cases only","Minimal cross-referencing — only refers to parent Acts (VEA and MRCA) and the repealed 2016 instrument","Clear medical definition with explicit exclusions (5 specific exclusions listed)","No nested exceptions or conditional logic beyond the basic 'at least one factor' requirement and the single limitation in section 10(2)"],"plain_english_summary":"This instrument replaces the 2016 rules and sets when Australian veterans and defence members can claim compensation for a ganglion (a benign fluid-filled joint/tendon cyst). It applies to claims under the VEA and MRCA and requires a \"reasonable hypothesis\" linking the ganglion to service.\n\nCompensation is only likely where service-related factors—notably acute trauma to the affected joint/tendon within a year before the cyst or lack of medical care that worsened an existing ganglion—can plausibly explain the condition."},"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"},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2016 Statement of Principles (s4) and reissues a Statement with defined medical meaning of ganglion, inclusion of death from ganglion (s7(2), s7(4)), and two specified causation factors (acute trauma within 1 year and inability to obtain appropriate clinical management, s9). That repeal plus the specific new/clarified factors indicates the instrument updates the operative criteria used to raise a reasonable hypothesis for claims under s120A VEA or s338 MRCA (s5). The text itself does not provide the prior instrument’s wording, so whether the change materially broadens or narrows coverage compared with the 2016 instrument cannot be determined from this document alone."},"complexity_factors":["Narrow clinical definition with explicit exclusions (definition of ganglion, s7(2)); requires medical interpretation of pathology versus excluded cyst types.","Small number of discrete causation factors (two listed in s9) but one factor—'inability to obtain appropriate clinical management'—is open to factual and evidentiary interpretation, increasing decision-maker discretion (s9(2)).","Temporal limitation for trauma (acute trauma within 1 year before clinical onset) imposes a strict timing rule that can be contested in evidentiary assessments (s9(1)).","Applies only to claims under specific statutory provisions (s120A VEA or s338 MRCA), so claim scope is bounded by those Acts and their eligibility rules (s5).","Includes death from ganglion via contribution to a terminal event, requiring causal linkage between the ganglion and proximate/ultimate cause of death (definition of death from ganglion and 'terminal event', s7(4), Schedule 1).","Cross-reference mechanism: if a factor refers to another injury/disease covered by a different Statement of Principles, that other Statement’s factors apply, creating interdependence across instruments (s11).","The instrument repeals a prior 2016 Statement (s4) and replaces it with updated wording, so administrators must reconcile prior decisions and transition issues (s4)."],"plain_english_summary":"This Statement of Principles sets the medical criteria used to link a ganglion (a benign cyst over a joint or tendon) — and death from a related terminal event — to a person’s military or relevant service for claims under the VEA or MRCA (applies to s120A VEA and s338 MRCA). It defines what counts as a ganglion and requires at least one of two specific factors to be present to raise a reasonable hypothesis: significant acute trauma within 1 year, or inability to obtain appropriate clinical management."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-ganglion-reasonable-hypothesis-no-7-of-2025","history":"/api/acts/statement-of-principles-concerning-ganglion-reasonable-hypothesis-no-7-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-ganglion-reasonable-hypothesis-no-7-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-ganglion-reasonable-hypothesis-no-7-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-ganglion-reasonable-hypothesis-no-7-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-ganglion-reasonable-hypothesis-no-7-of-2025/documents"}}