{"id":"F2024L00485","name":"Statement of Principles concerning malignant melanoma of the skin (Reasonable Hypothesis) (No. 34 of 2024)","slug":"statement-of-principles-concerning-malignant-melanoma-of-the-skin-reasonable-hypothesis-no-34-of-202","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442374,"registerId":"F2024L00485-fast-fetch-1775957393916","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning malignant melanoma of the skin (Reasonable Hypothesis) (No. 34 of 2024)","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\nMALIGNANT MELANOMA OF THE SKIN  (Reasonable Hypothesis)\n\n(No. 34 of 2024)\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                                           26 April 2024.\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\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 malignant melanoma of the skin (Reasonable Hypothesis) (No. 34 of 2024).\n\n2               Commencement\n\n              This instrument commences on 28 May 2024.\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 malignant melanoma of the skin (reasonable hypothesis) No. 102 of 2015 (Federal Register of Legislation No. F2015L01317) 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 malignant melanoma of the skin and death from malignant melanoma of the skin.\n\nMeaning of malignant melanoma of the skin\n\n(2)          For the purposes of this Statement of Principles, malignant melanoma of the skin:\n\n(a)          means a primary malignant neoplasm arising from the melanocytes; and\n\n(b)          includes:\n\n(i)            melanoma in situ including Hutchinson melanotic freckle/lentigo maligna;\n\n(ii)         superficial spreading melanoma;\n\n(iii)       lentigo maligna melanoma;\n\n(iv)        nodular melanoma;\n\n(v)          desmoplastic melanoma;\n\n(vi)        amelanotic melanoma; and\n\n(vii)     malignant melanoma of the skin of the lip, anogenital region, and acral regions (palms of the hands, soles of the feet, and skin underlying the nails); and\n\n(c)          excludes:\n\n(i)            malignant melanoma of the eye;\n\n(ii)         malignant melanoma of the mucosa; and\n\n(iii)       melanocytic naevi.\n\n(3)          While malignant melanoma of the skin attracts ICD‑10‑AM codes C43 and D03, in applying this Statement of Principles the meaning of malignant melanoma of the skin 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 malignant melanoma of the skin\n\n(5)          For the purposes of this Statement of Principles, malignant melanoma of the skin, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's malignant melanoma of the skin.\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 malignant melanoma of the skin and death from malignant melanoma of the skin 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 malignant melanoma of the skin or death from malignant melanoma of the skin with the circumstances of a person's relevant service:\n\n(1)          having at least 5 sunburns at the affected site at least 2 years before  clinical onset;\n\nNote: sunburn and clinical onset are defined in the Schedule 1 - Dictionary.\n\n(2)          having a burn scar involving the affected site at least 5 years before clinical onset;\n\n(3)          having sunlight exposure to unprotected skin for a cumulative period of at least 2,250 latitude equivalent hours before clinical onset;\n\nNote: latitude equivalent hours and unprotected skin are defined in the Schedule 1 - Dictionary.\n\n(4)          having ultraviolet radiation exposure from an ultraviolet-emitting tanning device on at least 5 occasions before the clinical onset of malignant melanoma of the skin, where the first exposure occurred more than 2 years before clinical onset;\n\n(5)          having PUVA therapy, where:\n\n(a)          the first PUVA treatment commenced at least 10 years before clinical onset; and\n\n(b)          at least 200 PUVA treatments were administered, before clinical onset;\n\nNote: PUVA therapy is defined in the Schedule 1 - Dictionary.\n\n(6)          undergoing solid organ (excluding corneal transplant) or bone marrow transplantation before clinical onset;\n\n(7)          being treated with methotrexate or azathioprine within the 5 years before clinical;\n\n(8)          being infected with human immunodeficiency virus before clinical onset;\n\n(9)          having non-Hodgkin lymphoma at least one year before clinical onset;\n\n(10)      having chronic lymphocytic leukaemia/small cell lymphoma at least one year before clinical onset;\n\nNote: Chronic lymphocytic leukaemia/small cell lymphoma is also known as mature B-cell lymphoid leukaemia and small lymphocytic lymphoma.\n\n(11)      having Parkinson’s disease for at least 2 years before clinical onset;\n\n(12)      for superficial spreading melanoma only, taking oral estradiol menopausal hormone therapy continuously for at least 6 months, more than 2 years before clinical onset;\n\n(13)      taking voriconazole continuously for at least 1 year, more than 3 years before clinical onset;\n\n(14)      being obese for at least 5 years within the 20 years before clinical onset;\n\nNote: being obese is defined in the Schedule 1 – Dictionary.\n\n(15)      consuming at least 30 grams of alcohol per day for at least one year, more than 5 years before clinical onset;\n\n(16)      being employed as a firefighter for a cumulative period of at least 10 years, more than 5 years before clinical onset;\n\n(17)      inhaling, ingesting or having cutaneous contact with dielectric (insulating) liquids containing polychlorinated biphenyls during the production or repair of capacitors, transformers, or electrical switches, for a cumulative period of at least 2,000 hours, completed at least 20 years before clinical onset;\n\n(18)      inability to obtain appropriate clinical management for malignant neoplasm of the skin before clinical worsening.\n\nNote: clinical worsening is defined in the Schedule 1 – Dictionary.\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(18) applies only to material contribution to, or aggravation of, malignant melanoma of the skin where it 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                                                                         being obese means having a Body Mass Index (BMI) of 30 or greater.\n\nNote: BMI is 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                               latitude equivalent hours means hours of sunlight exposure multiplied by the appropriate latitude weighting factor as follows:\n\n(a)          For tropical latitudes (23.5° South to 23.5° North) multiply by 1.0;\n\n(b)          For subtropical latitudes (23.6° - 35°) multiply by 0.75;\n\n(c)          For warm temperate latitudes (35.1° - 45°) multiply by 0.5;\n\n(d)          For cool temperate latitudes (45.1° - 65°) multiply by 0.25.\n\nNote: sunlight exposure is calculated as the sum of sunlight exposure in each separate latitude, accounting for the different sunlight intensity in each latitude (weighting factor).\n\nSum of sunlight exposure = (hours spent in tropical latitude x tropical latitude weighting factor) + (hours spent in subtropical latitude x subtropical latitude weighting factor) + (hours spent in warm temperate latitude x warm temperate latitude weighting factor) + (hours spent in cool temperate latitude x cool temperate latitude weighting factor)\n\n                               malignant melanoma of the skin—see subsection 7(2).\n\n                               MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                               PUVA therapy means a combination treatment consisting of taking oral psoralen (P) (also known as Methoxsalen) and exposing the skin to long-wave ultra-violet light (UVA).\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                               sunburn means painful erythema of the skin of at least 48 hours duration, resulting from exposure to solar ultraviolet radiation.\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                               unprotected skin means skin that is directly exposed to the sun and is not protected by sunscreen, clothing or other physical barrier.\n\n                               VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"This is a standard periodic update of a Repatriation Medical Authority Statement of Principles. It replaces the 2015 version (No. 102 of 2015) with the same fundamental purpose: establishing medical criteria for veterans' compensation claims. The scope remains tightly focused on malignant melanoma of the skin and its relationship to military service. While specific factors have been updated based on new medical evidence (reflecting 9 years of research), the instrument has not expanded beyond its original purpose of determining service-related liability for this specific cancer."},"complexity_factors":["Mathematical formula for 'latitude equivalent hours' requiring geographic calculations and weighted multipliers (tropical=1.0, cool temperate=0.25)","17 distinct factors with varying temporal requirements (ranging from 'at least 2 years before' to 'at least 20 years before' clinical onset)","Specific quantitative thresholds throughout (5 sunburns, 2,250 hours, 200 PUVA treatments, 30g alcohol/day, BMI 30+)","Nested definitions requiring cross-referencing (BMI defined in terms of weight/height, then referenced by 'being obese')","Conditional logic for specific melanoma subtypes (factor 12 applies only to 'superficial spreading melanoma')","Interaction with other Statements of Principles via section 11 (incorporation by reference of other instruments)","Dual statutory framework application (VEA and MRCA with different service definitions)","Exclusion clauses in the disease definition (specifically excludes ocular and mucosal melanomas)"],"plain_english_summary":"This instrument updates medical rules for when Australian Defence Force members and veterans can claim malignant melanoma under the “reasonable hypothesis” test, replacing the 2015 version. It lists 17 risk factors that, if tied to service, create a legal presumption service caused or contributed to the cancer — e.g. heavy sun exposure measured by a “latitude equivalent hours” formula, certain occupational exposures (firefighting, PCBs), medical treatments and some health/lifestyle conditions. The factor must be shown to have occurred during or because of service."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier 2015 Statement (s4) and replaces it with the current list of qualifying factors and definitions (notably in s9 and Schedule 1). It maintains application to claims under section 120A of the VEA and section 338 of the MRCA (s5) but makes the listed exposures, timing thresholds and technical definitions the operative criteria for service connection, thereby altering the authoritative scope of qualifying evidence."},"complexity_factors":["Detailed, quantitative exposure thresholds (e.g. ≥5 sunburns, 2,250 latitude‑equivalent hours, ≥5 tanning sessions) create precise evidentiary tests (s9(1),(3),(4)).","Multiple medical/time latency conditions and dose/occurrence requirements (PUVA ≥200 treatments, transplants, medication durations) increase factual complexity (s9(5)-(7),(13)).","Technical definition and calculation of 'latitude equivalent hours' requires geographic weighting and summation across locations (Schedule 1).","Interplay with other Statements of Principles: factors that refer to other conditions defer to those separate SOPs, creating cross-references to update over time (s11).","Requirement that any qualifying factor be related to the person's relevant service introduces causation and proof issues (s10(1)).","Exclusions and scope-limiting definitions (excludes ocular and mucosal melanoma; defines terminal event, unprotected skin, BMI) require careful medical classification (s7(2)(c); Schedule 1).","Relevance windows and minimum latency periods (varied lookback periods: 2, 5, 10, 20 years) complicate documentary proof and timelines (s9 generally).","Administrative discretion: the Authority asserts a medical‑scientific basis for connection but application depends on evidence supplied in each claim (s8).","Proving certain exposures (e.g. cumulative hours, dielectric liquid contact for 2,000 hours) likely imposes substantial evidentiary burden on claimants (s9(3),(17)).","Overlap between lifestyle, occupational, therapeutic and immunological risk factors (eg. obesity, alcohol, HIV, immunosuppression) requires multidisciplinary medical assessment (s9(6)-(16))."],"plain_english_summary":"This Statement of Principles tells the Repatriation Medical Authority what medical facts will reasonably link malignant melanoma of the skin (and deaths from it) to a person’s relevant military service. It lists specific exposures, treatments, health conditions and timing thresholds and supplies technical definitions (for example, latitude‑equivalent sunlight hours). It applies to veterans and members covered by the VEA and MRCA and determines whether a claim meets the legal threshold for a service connection."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-malignant-melanoma-of-the-skin-reasonable-hypothesis-no-34-of-202","history":"/api/acts/statement-of-principles-concerning-malignant-melanoma-of-the-skin-reasonable-hypothesis-no-34-of-202/history","analysis":"/api/acts/statement-of-principles-concerning-malignant-melanoma-of-the-skin-reasonable-hypothesis-no-34-of-202/analysis","conflicts":"/api/acts/statement-of-principles-concerning-malignant-melanoma-of-the-skin-reasonable-hypothesis-no-34-of-202/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-malignant-melanoma-of-the-skin-reasonable-hypothesis-no-34-of-202/important-cases","documents":"/api/acts/statement-of-principles-concerning-malignant-melanoma-of-the-skin-reasonable-hypothesis-no-34-of-202/documents"}}