{"id":"F2019L01691","name":"Statement of Principles concerning Kaposi sarcoma (Balance of Probabilities) (No. 2 of 2020)","slug":"statement-of-principles-concerning-kaposi-sarcoma-balance-of-probabilities-no-2-of-2020","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440350,"registerId":"F2019L01691-fast-fetch-1775956013957","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning Kaposi sarcoma (Balance of Probabilities) (No. 2 of 2020)","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\nKAPOSI SARCOMA (Balance of Probabilities)\n\n(No. 2 of 2020)\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 20 December 2019\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 Nicholas Saunders AO
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\n1 Name\n\nThis is the Statement of Principles concerning Kaposi sarcoma (Balance of Probabilities) (No. 2 of 2020).\n\n2 Commencement\n\n This instrument commences on 27 January 2020.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning Kaposi's sarcoma No. 10 of 2011 (Federal Register of Legislation No. F2010L03267) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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\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 Kaposi sarcoma and death from Kaposi sarcoma.\n\nMeaning of Kaposi sarcoma\n\n(2) For the purposes of this Statement of Principles, Kaposi sarcoma:\n\n(a) means a multicentric vascular neoplasm arising from endothelial cells and characterised by the proliferation of spindle cells, formation of new blood vessels and inflammation; and\n\n(b) excludes soft tissue sarcoma.\n\nNote: Typical clinical manifestations are coloured patches, plaques or nodules on the skin, although lesions may also involve the mucous membranes, lymph nodes and viscera.\n\n(3) While Kaposi sarcoma attracts ICD‑10‑AM code C46, in applying this Statement of Principles the meaning of Kaposi sarcoma 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 Kaposi sarcoma\n\n(5) For the purposes of this Statement of Principles, Kaposi sarcoma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's Kaposi sarcoma.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 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 Kaposi sarcoma and death from Kaposi sarcoma 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\n9 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, Kaposi sarcoma or death from Kaposi sarcoma is connected with the circumstances of a person's relevant service:\n\n(1) having infection with human herpesvirus type 8 before the clinical onset of Kaposi sarcoma;\n\n(2) having infection with human immunodeficiency virus before the clinical onset of Kaposi sarcoma;\n\n(3) having non-Hodgkin lymphoma or chronic lymphocytic leukaemia/small lymphocytic lymphoma before the clinical onset of Kaposi sarcoma;\n\n(4) undergoing solid organ, stem cell or bone marrow transplantation before the clinical onset of Kaposi sarcoma;\n\n(5) being treated with an immunosuppressive drug:\n\n(a) for a continuous period of at least three months before the clinical onset of Kaposi sarcoma; and\n\n(b) where that exposure has ceased, the clinical onset of Kaposi sarcoma has occurred within ten years of cessation;\n\nNote: immunosuppressive drug is defined in the Schedule 1 - Dictionary. \n\n(6) being treated with an angiotensin converting enzyme inhibitor:\n\n(a) for at least three months before the clinical onset of Kaposi sarcoma; and\n\n(b) where that exposure has ceased, the clinical onset of Kaposi sarcoma has occurred within ten years of cessation;\n\n(7) inability to obtain appropriate clinical management for Kaposi sarcoma.\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(7) applies only to material contribution to, or aggravation of, Kaposi sarcoma where the person's Kaposi sarcoma 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(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\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n immunosuppressive drug means a drug or an agent which results in substantial suppression of immune responses.\n\n Note: Examples of an immunosuppressive drug include, but are not limited to:\n\n(a) chemotherapeutic agents used for the treatment of cancer;\n\n(b) corticosteroids, other than inhaled or topical corticosteroids;\n\n(c) drugs used to prevent transplant rejection; and\n\n(d) tumour necrosis factor-α inhibitors.\n\n Kaposi sarcoma—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":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier Kaposi sarcoma Statement (No. 10 of 2011) and substitutes the 2020 Statement. It continues to apply to claims under section 120B of the VEA and section 339 of the MRCA and updates the medical definition and the list and timing conditions of qualifying factors (see sections 4, 5, 7 and 9)."},"complexity_factors":["Medical‑scientific criteria: reliance on clinical infections, cancers, transplantation and medication exposures to establish causation.","Evidentiary threshold: 'balance of probabilities' with requirement that a listed factor be related to relevant service.","Temporal conditions: minimum exposure periods (eg. ≥3 months) and post‑cessation windows (eg. onset within 10 years).","Broad/technical definitions: wide definition of 'immunosuppressive drug' and specific exclusion of soft tissue sarcoma (section 7(2)).","Cross‑references: interplay with other Statements of Principles and statutory regimes (VEA, MRCA, other SOPs).","Application to death: includes death via terminal events contributed to by Kaposi sarcoma, requiring proximate/ultimate cause analysis."],"plain_english_summary":"Effective 27 January 2020, this instrument replaces the 2011 Statement and sets a Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986 for Kaposi sarcoma and related deaths. It specifies medical factors which—if present and shown to be related to a person's relevant service—establish on the balance of probabilities that Kaposi sarcoma is connected to VEA or MRCA service claims. Examples include HHV‑8 or HIV infection, certain lymphoid cancers, organ/stem‑cell transplantation, prolonged immunosuppression or ACE‑inhibitor use (with timing limits), and lack of appropriate clinical management."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Repatriation Medical Authority Statements of Principles. It replaces the 2011 version (No. 10 of 2011) with updated medical evidence, but does not expand beyond the original purpose of determining service connection for Kaposi sarcoma in veterans' compensation claims. The inclusion of ACE inhibitors reflects updated medical knowledge rather than scope creep."},"complexity_factors":["Moderate cross-referencing between the main instrument and Schedule 1 (Dictionary)","Conditional time limits in factors 5 and 6 (3-month minimum exposure + 10-year post-cessation window)","Nested definitions requiring lookup (e.g., 'terminal event' defined in Dictionary, used in section 7(5))","Exclusion clause in section 7(2)(b) excluding soft tissue sarcoma","Specific reference to ICD-10-AM coding system (Tenth Edition, 1 July 2017) with full bibliographic details","Dual statutory framework application (VEA and MRCA with different service definitions)","Section 11 creates dynamic incorporation of other Statements of Principles by reference ('as in force from time to time')","Factor 7 has restricted application to aggravation/pre-existing cases only (section 10(2))"],"plain_english_summary":"This rulebook sets the medical criteria used to decide whether Kaposi sarcoma in Australian veterans and current/former defence members is service-related for compensation under the Veterans' Entitlements Act and Military Rehabilitation and Compensation Act. It applies to peacetime, eligible war, and defence service (excluding hazardous and British nuclear test service).\n\nIt lists medical links—like HHV‑8, HIV, prior lymphoid cancers, transplant or prolonged immunosuppression, and prolonged ACE‑inhibitor use—and matters because it determines entitlement to benefits."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-kaposi-sarcoma-balance-of-probabilities-no-2-of-2020","history":"/api/acts/statement-of-principles-concerning-kaposi-sarcoma-balance-of-probabilities-no-2-of-2020/history","analysis":"/api/acts/statement-of-principles-concerning-kaposi-sarcoma-balance-of-probabilities-no-2-of-2020/analysis","conflicts":"/api/acts/statement-of-principles-concerning-kaposi-sarcoma-balance-of-probabilities-no-2-of-2020/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-kaposi-sarcoma-balance-of-probabilities-no-2-of-2020/important-cases","documents":"/api/acts/statement-of-principles-concerning-kaposi-sarcoma-balance-of-probabilities-no-2-of-2020/documents"}}