{"id":"F2021L00620","name":"Statement of Principles concerning hypogonadism (Balance of Probabilities) (No. 74 of 2021)","slug":"statement-of-principles-concerning-hypogonadism-balance-of-probabilities-no-74-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":101802,"registerId":"commonwealth-F2021L00620-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning hypogonadism (Balance of Probabilities) (No. 74 of 2021)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning hypogonadism (Balance of Probabilities) (No. 74 of 2021)\n\nmade under subsection 196B(3) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 30 May 2022\n\nIncludes amendments up to: Amendment Statement of Principles concerning hypogonadism (Balance of Probabilities) (No. 52 of 2022) (F2022L00668)\n\nThe day of commencement of this Amendment Statement of Principles concerning hypogonadism is 30 May 2022.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning hypogonadism (Balance of Probabilities) (No. 74 of 2021) that shows the text of the law as amended and in force on 30 May 2022.\n\nThe notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.\n\nUncommenced amendments\n\nThe effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.\n\nApplication, saving and transitional provisions for provisions and amendments\n\nIf the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.\n\nModifications\n\nIf the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.\n\nSelf‑repealing provisions\n\nIf a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.\n\nContents\n\n1 Name\n\n3 Authority\n\n4 Application\n\n5 Definitions\n\n6 Kind of injury, disease or death to which this Statement of Principles relates\n\n7 Basis for determining the factors\n\n8 Factors that must exist\n\n9 Relationship to service\n\n10 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\nEndnotes\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\n  \n\n1 Name\n\nThis is the Statement of Principles concerning hypogonadism (Balance of Probabilities) (No. 74 of 2021).\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Application\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\n5 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n6 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about hypogonadism and death from hypogonadism.\n\nMeaning of hypogonadism\n\n(2) For the purposes of this Statement of Principles, hypogonadism:\n\n(a) means deficient production of testosterone from the testis or estrogen from the ovary, or deficient production of ova (eggs) or sperm, where any such deficiency is associated with clinical symptoms and signs or a requirement for treatment; and\n\n(b) includes:\n\n(i) primary hypogonadism;\n\n(ii) secondary hypogonadism (also known as central hypogonadism and hypogonadotropic hypogonadism); and\n\n(iii) infertility due to endocrine or gonadal pathology; and\n\n(c) excludes heritable and congenital forms of hypogonadism, compensated hypogonadism, diminished ovarian reserve, naturally occurring menopause and abnormal semen analysis.\n\n> Note 1: Associated clinical symptoms and signs of hypogonadism may include loss of secondary sexual characteristics, loss of sexual function and loss of reproductive function (endocrine or gonadal infertility).\n\n> Note 2: infertility is defined in the Schedule 1 - Dictionary.\n\nDeath from hypogonadism\n\n(3) For the purposes of this Statement of Principles, hypogonadism, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's hypogonadism.\n\n> Note: terminal event is defined in the Schedule 1 - Dictionary.\n\n7 Basis for determining the factors\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that hypogonadism and death from hypogonadism can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\n> Note: MRCA, relevant service and VEA are defined in the Schedule 1 - Dictionary.\n\n8 Factors that must exist\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, hypogonadism or death from hypogonadism is connected with the circumstances of a person's relevant service:\n\n(1) having hypopituitarism involving deficiency of follicle stimulating hormone or luteinising hormone at the time of the clinical onset of hypogonadism;\n\n(2) having hyperprolactinaemia at the time of the clinical onset of hypogonadism;\n\n(3) for males only, having a spinal cord injury resulting in paraplegia or tetraplegia before the clinical onset of hypogonadism;\n\n(4) having blunt or penetrating trauma to:\n\n(a) both ovaries or testes; or\n\n(b) a single functional ovary or testis, where there is only one functional ovary or testis;\n\nsufficient to cause gonadal atrophy before the clinical onset of hypogonadism;\n\n(5) having surgical excision of:\n\n(a) both ovaries or testes; or\n\n(b) a single functional ovary or testis, where there is only one functional ovary or testis;\n\nbefore the clinical onset of hypogonadism;\n\n(6) undergoing a course of therapeutic radiation for cancer, where:\n\n(a) both ovaries or testes; or\n\n(b) a single functional ovary or testis, where there is only one functional ovary or testis;\n\nwere in the field of radiation before the clinical onset of hypogonadism;\n\n(7) having infection with human immunodeficiency virus before the clinical onset of hypogonadism;\n\n(8) for males only, having infection with Mycobacterium leprae before the clinical onset of hypogonadism;\n\n> Note: Mycobacterium leprae is the organism that causes leprosy.\n\n(9) having infection with Trypanosoma brucei before the clinical onset of hypogonadism;\n\n> Note: Trypanosoma brucei is the organism that causes African sleeping sickness (trypanosomiasis).\n\n(10) having mumps orchitis as an adult affecting:\n\n(a) both testes; or\n\n(b) a single functional testis, where there is only one functional testis;\n\nbefore the clinical onset of hypogonadism;\n\n(11) having an infiltrative disease from the specified list of infiltrative diseases of:\n\n(a) both ovaries or testes; or\n\n(b) a single functional ovary or testis, where there is only one functional ovary or testis;\n\nbefore the clinical onset of hypogonadism;\n\n> Note: specified list of infiltrative diseases is defined in the Schedule 1 - Dictionary.\n\n(12) for males only, having a testicular varicocoele before the clinical onset of hypogonadism;\n\n(13) having infarction of:\n\n(a) both ovaries or testes; or\n\n(b) a single functional ovary or testis, where there is only one functional ovary or testis;\n\nwithin the 1 year before the clinical onset of hypogonadism;\n\n(14) having sickle-cell disorder before the clinical onset of hypogonadism;\n\n(15) having a bone marrow or stem cell transplant before the clinical onset of hypogonadism;\n\n(16) having cirrhosis of the liver at time of the clinical onset of hypogonadism;\n\n(17) having chronic kidney disease at time of the clinical onset of hypogonadism;\n\n> Note: chronic kidney disease is defined in the Schedule 1 - Dictionary.\n\n(18) having anorexia nervosa at the time of the clinical onset of hypogonadism;\n\n(19) taking a course of systemic cytotoxic drugs for treatment of a malignant neoplasm before the clinical onset of hypogonadism;\n\n(20) taking gonadotrophin releasing hormone agonists or antagonists as androgen or estrogen deprivation therapy for at least 1 year within the 2 years before the clinical onset of hypogonadism;\n\n(21) having active epilepsy before the clinical onset of hypogonadism;\n\n> Note: active epilepsy is defined in the Schedule 1 - Dictionary.\n\n(22) taking a drug from the Specified List 1 of drugs before the clinical onset of hypogonadism;\n\n> Note: Specified List 1 of drugs is defined in the Schedule 1 - Dictionary.\n\n(23) taking an immune checkpoint inhibitor within the 1 year before the clinical onset of hypogonadism;\n\n> Note: immune checkpoint inhibitor is defined in the Schedule 1 - Dictionary.\n\n(24) taking a drug from the Specified List 2 of drugs, which cannot be ceased or substituted, at the time of the clinical onset of hypogonadism;\n\n> Note: Specified List 2 of drugs is defined in the Schedule 1 - Dictionary.\n\n(25) taking a drug which cannot be ceased or substituted and which is associated in the individual with the clinical onset of hypogonadism during drug therapy and either:\n\n(a) the improvement of hypogonadism within 2 months of discontinuing or tapering drug therapy; or\n\n(b) the redevelopment of hypogonadism on rechallenge with the same drug; and\n\nwhere taking the drug continued for at least the 30 days before the clinical onset of hypogonadism;\n\n(26) inhaling fumes from a metal from the specified list of metals or a compound containing a metal from the specified list of metals:\n\n(a) for a cumulative period of at least 2,000 hours before the clinical onset of hypogonadism; and\n\n(b) if that exposure has ceased before the clinical onset of hypogonadism, then that onset occurred within 2 years of cessation;\n\n> Note: fumes and specified list of metals are defined in the Schedule 1 - Dictionary.\n\n(27) inhaling, ingesting or having cutaneous contact with a chemical agent from the specified list of chemical agents:\n\n(a) for a cumulative period of at least 2,000 hours before the clinical onset of hypogonadism; and\n\n(b) if that exposure has ceased before the clinical onset of hypogonadism, then that onset occurred within 2 years of cessation;\n\n> Note: specified list of chemical agents is defined in the Schedule 1 - Dictionary.\n\n(28) for females only, having smoked tobacco products:\n\n(a) in an amount of at least 5 pack-years before the clinical onset of hypogonadism; and\n\n(b) if smoking has ceased before the clinical onset of hypogonadism, then that onset occurred within 10 years of cessation;\n\n> Note: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(29) for males only, having alcohol use disorder before the clinical onset of hypogonadism;\n\n(30) for females only, being underweight for at least the 5 years before the clinical onset of hypogonadism;\n\n> Note: being underweight is defined in the Schedule 1 - Dictionary.\n\n(31) having hypopituitarism involving deficiency of follicle stimulating hormone or luteinising hormone at the time of the clinical worsening of hypogonadism;\n\n(32) having hyperprolactinaemia at the time of the clinical worsening of hypogonadism;\n\n(33) for males only, having a spinal cord injury resulting in paraplegia or tetraplegia before the clinical worsening of hypogonadism;\n\n(34) having blunt or penetrating trauma to:\n\n(a) both ovaries or testes; or\n\n(b) a single functional ovary or testis, where there is only one functional ovary or testis;\n\nsufficient to cause gonadal atrophy before the clinical worsening of hypogonadism;\n\n(35) having surgical excision of:\n\n(a) both ovaries or testes; or\n\n(b) a single functional ovary or testis, where there is only one functional ovary or testis;\n\nbefore the clinical worsening of hypogonadism;\n\n(36) undergoing a course of therapeutic radiation for cancer, where:\n\n(a) both ovaries or testes; or\n\n(b) a single functional ovary or testis, where there is only one functional ovary or testis;\n\nwere in the field of radiation before the clinical worsening of hypogonadism;\n\n(37) having infection with human immunodeficiency virus before the clinical worsening of hypogonadism;\n\n(38) for males only, having infection with Mycobacterium leprae before the clinical worsening of hypogonadism;\n\n> Note: Mycobacterium leprae is the organism that causes leprosy.\n\n(39) having infection with Trypanosoma brucei before the clinical worsening of hypogonadism;\n\n> Note: Trypanosoma brucei is the organism that causes African sleeping sickness (trypanosomiasis).\n\n(40) having mumps orchitis as an adult affecting:\n\n(a) both testes; or\n\n(b) a single functional testis, where there is only one functional testis;\n\nbefore the clinical worsening of hypogonadism;\n\n(41) having an infiltrative disease from the specified list of infiltrative diseases of:\n\n(a) both ovaries or testes; or\n\n(b) a single functional ovary or testis, where there is only one functional ovary or testis;\n\nbefore the clinical worsening of hypogonadism;\n\n> Note: specified list of infiltrative diseases is defined in the Schedule 1 - Dictionary.\n\n(42) for males only, having a testicular varicocoele before the clinical worsening of hypogonadism;\n\n(43) having infarction of:\n\n(a) both ovaries or testes; or\n\n(b) a single functional ovary or testis, where there is only one functional ovary or testis;\n\nwithin the 1 year before the clinical worsening of hypogonadism;\n\n(44) having sickle-cell disorder before the clinical worsening of hypogonadism;\n\n(45) having a bone marrow or stem cell transplant before the clinical worsening of hypogonadism;\n\n(46) having cirrhosis of the liver at time of the clinical worsening of hypogonadism;\n\n(47) having chronic kidney disease at time of the clinical worsening of hypogonadism;\n\n> Note: chronic kidney disease is defined in the Schedule 1 - Dictionary.\n\n(48) having anorexia nervosa at the time of the clinical worsening of hypogonadism;\n\n(49) taking a course of systemic cytotoxic drugs for treatment of a malignant neoplasm before the clinical worsening of hypogonadism;\n\n(50) taking gonadotrophin releasing hormone agonists or antagonists as androgen or estrogen deprivation therapy for at least 1 year within the 2 years before the clinical worsening of hypogonadism;\n\n(51) having active epilepsy before the clinical worsening of hypogonadism;\n\n> Note: active epilepsy is defined in the Schedule 1 - Dictionary.\n\n(52) taking a drug from the Specified List 1 of drugs before the clinical worsening of hypogonadism;\n\n> Note: Specified List 1 of drugs is defined in the Schedule 1 - Dictionary.\n\n(53) taking an immune checkpoint inhibitor within the 1 year before the clinical worsening of hypogonadism;\n\n> Note: immune checkpoint inhibitor is defined in the Schedule 1 - Dictionary.\n\n(54) taking a drug from the Specified List 2 of drugs, which cannot be ceased or substituted, at the time of the clinical worsening of hypogonadism;\n\n> Note: Specified List 2 of drugs is defined in the Schedule 1 - Dictionary.\n\n(55) taking a drug which cannot be ceased or substituted and which is associated in the individual with the clinical worsening of hypogonadism during drug therapy and either:\n\n(a) the improvement of hypogonadism within 2 months of discontinuing or tapering drug therapy; or\n\n(b) the clinical worsening of hypogonadism on rechallenge with the same drug; and\n\nwhere taking the drug continued for at least the 30 days before the clinical worsening of hypogonadism;\n\n(56) inhaling fumes from a metal from the specified list of metals or a compound containing a metal from the specified list of metals:\n\n(a) for a cumulative period of at least 2,000 hours before the clinical worsening of hypogonadism; and\n\n(b) if that exposure has ceased before the clinical worsening of hypogonadism, then that worsening occurred within 2 years of cessation;\n\n> Note: fumes and specified list of metals are defined in the Schedule 1 - Dictionary.\n\n(57) inhaling, ingesting or having cutaneous contact with a chemical agent from the specified list of chemical agents:\n\n(a) for a cumulative period of at least 2,000 hours before the clinical worsening of hypogonadism; and\n\n(b) if that exposure has ceased before the clinical worsening of hypogonadism, then that worsening occurred within 2 years of cessation;\n\n> Note: specified list of chemical agents is defined in the Schedule 1 - Dictionary.\n\n(58) for females only, having smoked tobacco products:\n\n(a) in an amount of at least 5 pack-years before the clinical worsening of hypogonadism; and\n\n(b) if smoking has ceased before the clinical worsening of hypogonadism, then that worsening occurred within 10 years of cessation;\n\n> Note: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(59) for males only, having alcohol use disorder before the clinical worsening of hypogonadism;\n\n(60) for females only, being underweight for at least the 5 years before the clinical worsening of hypogonadism;\n\n> Note: being underweight is defined in the Schedule 1 - Dictionary.\n\n(61) inability to obtain appropriate clinical management for hypogonadism.\n\n9 Relationship to service\n\n(1) The existence in a person of any factor referred to in section 8, must be related to the relevant service rendered by the person.\n\n(2) The factors set out in subsections 8(31) to 8(61) apply only to material contribution to, or aggravation of, hypogonadism where the person's hypogonadism was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n10 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 8 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(3) 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 5\n\n1 Definitions\n\nIn this instrument:\n\nabnormality of kidney structure or function means:\n\n(a) having a glomerular filtration rate of less than 60 mL/min/1.73 m2; or\n\n(b) having kidney damage, as evidenced by renal biopsy, imaging studies, albuminuria, urinary sediment abnormalities or other markers of abnormal renal function; or\n\n(c) having had a kidney transplant.\n\nactive epilepsy means having at least one epileptic seizure per year.\n\nbeing underweight means having a Body Mass Index (BMI) of 18.5 or less.\n\n> Note: BMI is also defined in the Schedule 1 - Dictionary.\n\nBMI 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\nchronic kidney disease means an abnormality of kidney structure or function that has been present for at least 3 months.\n\n> Note: abnormality of kidney structure or function is also defined in the Schedule 1 - Dictionary.\n\nfumes means combustion products, aerosols, vapours or dust arising through industrial processes or from workplace practices that involve the refining, manufacture or use of the stated material.\n\nhypogonadism—see subsection 6(2).\n\nimmune checkpoint inhibitor means a form of cancer immunotherapy that uses monoclonal antibodies targeting the immune checkpoint proteins. Examples include ipilimumab, tremelimumab, nivolumab and pembrolizumab.\n\ninfertility means inability to conceive a pregnancy after 12 months of unprotected sexual intercourse, use of assisted reproductive technology or azoospermia in males.\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\none 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\n> Note 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\n> Note 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\nrelevant 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\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\nSpecified List 1 of drugs means:\n\n(a) alkylating agents including busulphan, carmustine, chlorambucil, cyclophosphamide, dacarbazine, lomustine, melphalan (phenylalanine mustard), nitrogen mustard (mechlorethamine), procarbazine and ifosfamide (isophosphamide);\n\n(b) anthracycline antibiotics including daunorubicin, doxorubicin, epirubicin and idarubicin;\n\n(c) ibiraterone;\n\n(d) platinum compounds including cisplatin and carboplatin.\n\nSpecified List 2 of drugs means:\n\n(a) androgens;\n\n(b) antipsychotics;\n\n(c) ketoconazole for males only;\n\n(d) opioids;\n\n(e) progestins for males only;\n\n(f) sirolimus for males only; or\n\n(g) steroidal antiandrogens (including cyproterone acetate) for males only.\n\nspecified list of chemical agents means:\n\n(a) 2-bromopropane; or\n\n(b) dibromochloropropane for males only.\n\nspecified list of infiltrative diseases means:\n\n(a) amyloidosis;\n\n(b) endometriosis;\n\n(c) haemochromatosis;\n\n(d) a primary or secondary malignant neoplasm; or\n\n(e) sarcoidosis.\n\nspecified list of metals means:\n\n(a) cadmium;\n\n(b) lead; or\n\n(c) mercury.\n\nterminal 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\nVEA means the Veterans' Entitlements Act 1986.\n\n> Note: Endnotes\n\n> Note: Endnote 1—About the endnotes\n\nThe endnotes provide information about this compilation and the compiled law.\n\nThe following endnotes are included in every compilation:\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\nAbbreviation key—Endnote 2\n\nThe abbreviation key sets out abbreviations that may be used in the endnotes.\n\nLegislation history and amendment history—Endnotes 3 and 4\n\nAmending laws are annotated in the legislation history and amendment history.\n\nThe legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.\n\nThe amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.\n\nMisdescribed amendments\n\nA misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.\n\nIf a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.\n\n> Note: Endnote 2—Abbreviation key\n\n|                                                | o = order(s)                        |\n| ---------------------------------------------- | ----------------------------------- |\n| ad = added or inserted                         | Ord = Ordinance                     |\n| am = amended                                   | orig = original                     |\n| amdt = amendment                               | par = paragraph(s)/subparagraph(s)  |\n| c = clause(s)                                  | /sub‑subparagraph(s)                |\n| C[x] = Compilation No. x                       | pres = present                      |\n| Ch = Chapter(s)                                | prev = previous                     |\n| def = definition(s)                            | (prev…) = previously                |\n| Dict = Dictionary                              | Pt = Part(s)                        |\n| disallowed = disallowed by Parliament          | r = regulation(s)/rule(s)           |\n| Div = Division(s)                              |                                     |\n| exp = expires/expired or ceases/ceased to have | reloc = relocated                   |\n| effect                                         | renum = renumbered                  |\n| F = Federal Register of Legislation            | rep = repealed                      |\n| gaz = gazette                                  | rs = repealed and substituted       |\n| LA = Legislation Act 2003                      | s = section(s)/subsection(s)        |\n| LIA = Legislative Instruments Act 2003         | Sch = Schedule(s)                   |\n| (md) = misdescribed amendment can be given     | Sdiv = Subdivision(s)               |\n| effect                                         | SLI = Select Legislative Instrument |\n| (md not incorp) = misdescribed amendment       | SR = Statutory Rules                |\n| cannot be given effect                         | Sub‑Ch = Sub‑Chapter(s)             |\n| mod = modified/modification                    | SubPt = Subpart(s)                  |\n| No. = Number(s)                                | underlining = whole or part not     |\n|                                                | commenced or to be commenced        |\n\n> Note: Endnote 3—Legislation history\n\n| Name                                                                                                  | Registration           | Commencement | Application, saving and transitional provisions |\n| ----------------------------------------------------------------------------------------------------- | ---------------------- | ------------ | ----------------------------------------------- |\n| Statement of Principles concerning hypogonadism (Balance of Probabilities) (No. 74 of 2021)           | 24 May 2021F2021L00620 | 21 June 2021 |                                                 |\n| Amendment Statement of Principles concerning hypogonadism (Balance of Probabilities) (No. 52 of 2022) | 2 May 2022F2022L00668  | 30 May 2022  |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected                                              | How affected      |\n| --------------------------------------------------------------- | ----------------- |\n| Section 2……………….                                                | rep LA s 48D      |\n| Schedule 1 – Dictionary – immune checkpoint inhibitor……………...…. | rs No. 52 of 2022 |","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 is a standard Repatriation Medical Authority Statement of Principles instrument. It remains tightly scoped to its original purpose: establishing the medical-scientific basis for linking hypogonadism to military service for compensation purposes. The 2022 amendment added 'immune checkpoint inhibitors' as a defined term and factor, which is a standard medical-scientific update rather than scope creep."},"complexity_factors":["61 distinct factors with specific temporal requirements (e.g., 'within 1 year before', 'for at least 5 years before')","Gender-specific factors (factors 3, 8, 12, 28, 29, 30, 33, 38, 42, 58, 59, 60 specify 'for males only' or 'for females only')","Multiple defined terms requiring cross-reference to Schedule 1 (e.g., 'specified list of infiltrative diseases', 'Specified List 1 of drugs', 'chronic kidney disease')","Nested definitions (e.g., 'chronic kidney disease' depends on 'abnormality of kidney structure or function')","Complex exposure calculations (e.g., '2,000 hours' cumulative exposure, '5 pack-years' of smoking with 10-year cessation windows)","Dual structure with parallel factors for 'clinical onset' (factors 1-30) and 'clinical worsening' (factors 31-60), plus a catch-all factor 61","Specific anatomical conditions (e.g., 'single functional ovary or testis, where there is only one functional ovary or testis')","Drug-related factors with multiple conditions (factors 25 and 55 require cessation/rechallenge protocols)"],"plain_english_summary":"This law establishes a Statement of Principles to decide when hypogonadism (and death from it) is service‑related for compensation claims under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. It affects current and former ADF members and the Repatriation Medical Authority by listing 61 possible service‑linked factors (exposures, injuries, treatments) that, on the balance of probabilities, can establish a service connection and determine taxpayer-funded compensation."},"flash_summary":{"complexity_score":7,"scope_assessment":{"changed":true,"description":"The compilation records an amendment to the Schedule 1 definition of 'immune checkpoint inhibitor' (see Endnote 4 and Schedule 1 definition). That amendment (Amendment No. 52 of 2022) clarifies examples of included immunotherapies (e.g. ipilimumab, nivolumab, pembrolizumab). The change narrows ambiguity about which agents qualify under subsection references to immune checkpoint inhibitors (sections 8(23), 8(53)) but does not add new classes of factors or otherwise expand the list of causal factors in section 8."},"complexity_factors":["Detailed medical definitions and subtypes (see section 6(2): primary, secondary, infertility) increase clinical complexity.","Long lists of discrete causal factors and exposures (section 8) including sex‑specific items (male/female only) and both onset and worsening criteria (subsections 8(1)–8(61)).","Quantitative exposure thresholds and timing windows (e.g. 2,000 cumulative hours for fumes/chemicals, 1 year for radiation/infarction, pack‑year and cessation windows) create evidentiary precision and burden (see subsections 8(26)–8(29), 8(13), 8(58)).","Multiple specified lists in the Schedule (Specified List 1 and 2 drugs, metals, chemical agents, infiltrative diseases) require cross‑referencing to the Dictionary (Schedule 1) to interpret factors.","Cross‑instrument interaction: factors that refer to injuries/diseases covered by other Statements of Principles must adopt those SOPs (section 10), adding legal and evidentiary layering.","Requirement that any factor be related to the person's relevant service (section 9(1)) imposes a legal nexus test beyond medical causation.","Some broadly phrased factors (e.g. inability to obtain appropriate clinical management, subsection 8(61)) leave room for administrative judgment and potential discretionary decision‑making by assessing authorities.","Sex‑ and condition‑specific exclusions (section 6(2)(c)) and nuanced definitions in the Dictionary (e.g. active epilepsy, being underweight) increase the need for precise clinical documentation."],"plain_english_summary":"This instrument sets out the medical, treatment and exposure factors that, if present on the balance of probabilities, link hypogonadism (and death from it) to a person’s relevant service for claims under the Veterans' Entitlements Act or the Military Rehabilitation and Compensation Act. It affects veterans and current/former members making compensation or rehabilitation claims because it lists the specific clinical conditions, drug/chemical/metal exposures, infections and timing rules claimants must show to establish a service connection."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hypogonadism-balance-of-probabilities-no-74-of-2021","history":"/api/acts/statement-of-principles-concerning-hypogonadism-balance-of-probabilities-no-74-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-hypogonadism-balance-of-probabilities-no-74-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hypogonadism-balance-of-probabilities-no-74-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hypogonadism-balance-of-probabilities-no-74-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-hypogonadism-balance-of-probabilities-no-74-of-2021/documents"}}