{"id":"F2026L00142","name":"Statement of Principles concerning malignant neoplasm of the brain (Balance of Probabilities) (No. 18 of 2026)","slug":"statement-of-principles-concerning-malignant-neoplasm-of-the-brain-balance-of-probabilities-no-18-of","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443152,"registerId":"F2026L00142-fast-fetch-1775958064002","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning malignant neoplasm of the brain (Balance of Probabilities) (No. 18 of 2026)","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 NEOPLASM OF THE BRAIN  (Balance of Probabilities)\n\n(No. 18 of 2026)\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 February 2026\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 malignant neoplasm of the brain (Balance of Probabilities) (No. 18 of 2026).\n\n1.                Commencement\n\n\n              This instrument commences on 23 March 2026.\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 malignant neoplasm of the brain (Balance of Probabilities) (No. 86 of 2016) (Federal Register of Legislation F2016L01693) 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 malignant neoplasm of the brain and death from malignant neoplasm of the brain.\n\n\nMeaning of malignant neoplasm of the brain\n\n1.           For the purposes of this Statement of Principles, malignant neoplasm of the brain means:\n  1.           a primary malignant neoplasm arising from the cells of the brain; and\n  2.           includes malignant neuroepithelial tumour and germ cell tumour; and\n  3.           excludes nerve sheath tumour, soft tissue sarcoma, any central nervous system lymphoma (Hodgkin's lymphoma or non-Hodgkin's lymphoma), carcinoid tumour, neoplasm of the pituitary gland, cerebral meningioma, acoustic neuroma, choroid plexus papilloma, craniopharyngioma, dysembryoplastic neuroepithelial tumour, gangliocytoma, hemangioblastoma, hemangiopericytoma, meningioma, neurofibroma, pituitary adenoma, schwannoma, soft tissue sarcoma of the brain.\n\n\nNote: neuroepithelial tumour is defined in the Schedule 1 – Dictionary.\n\n1.           While malignant neoplasm of the brain attracts ICD‑10‑AM code C71, in applying this Statement of Principles the meaning of malignant neoplasm of the brain 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 malignant neoplasm of the brain\n\n1.           For the purposes of this Statement of Principles, malignant neoplasm of the brain, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's malignant neoplasm of the brain.\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 malignant neoplasm of the brain and death from malignant neoplasm of the brain 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\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, malignant neoplasm of the brain or death from malignant neoplasm of the brain is connected with the circumstances of a person's relevant service:\n\n1.           having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the brain at least 2 years before the clinical onset of malignant neoplasm of the brain;\n\n\nNote: cumulative equivalent dose is defined in the Schedule 1 - Dictionary\n\n1.           inability to obtain appropriate clinical management for malignant neoplasm of the brain 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, malignant neoplasm of the brain where the person's malignant neoplasm of the brain 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                             cumulative equivalent dose means the total dose of ionising radiation received by the particular organ or tissue from external exposure, internal exposure or both, apart from normal background radiation exposure in Australia, calculated in accordance with the methodology set out in Guide to calculation of 'cumulative equivalent dose' for the purpose of applying ionising radiation factors contained in Statements of Principles determined under Part XIA of the Veterans' Entitlements Act 1986 (Cth), Australian Radiation Protection and Nuclear Safety Agency, as in force on 2 August 2017.\n\nNote 1: examples of circumstances that might lead to exposure to ionising radiation include being present during or subsequent to the testing or use of nuclear weapons, undergoing diagnostic or therapeutic medical procedures involving ionising radiation, and being a member of an aircrew, leading to increased levels of exposure to cosmic radiation.\n\nNote 2: for the purpose of dose reconstruction, dose is calculated as an average over the mass of a specific tissue or organ. If a tissue is exposed to multiple sources of ionising radiation, the various dose estimates for each type of radiation must be combined.\n\n                             malignant neoplasm of the brain—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                             neuroepithelial tumour means a tumour originating from neuroepithelial tissue and includes any of the following:\n\n(a)          choroid plexus tumours;\n\n(b)          diffuse astrocytic and oligodendroglial tumours (including astrocytoma, glioblastoma multiforme);\n\n(c)          embryonal tumours;\n\n(d)          ependymal tumours;\n\n(e)          neuronal and mixed neuronal-glial tumours;\n\n(f)           other astrocytic tumours;\n\n(g)          other gliomas; or\n\n(h)          tumours of the pineal region.\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":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the same scope as its predecessor and the legislative framework established by Part XIA of the Veterans' Entitlements Act 1986. It is a routine reissue of a Statement of Principles with updated medical evidence, not an expansion beyond the original purpose of determining service connection for specific diseases."},"complexity_factors":["Multiple defined terms (8 defined terms in Schedule 1, plus inline definitions)","Extensive exclusions list in section 7(2) specifying 13 excluded tumour types","Cross-references to external documents: ICD-10-AM Tenth Edition, and ARPANSA Guide to calculation of cumulative equivalent dose (2017)","Nested definitions: 'malignant neoplasm of the brain' refers to 'neuroepithelial tumour' which has its own 8-subcategory definition","Conditional logic in section 10 distinguishing between causation of onset vs. aggravation of pre-existing condition","Reference to other Statements of Principles in section 11 creating potential circular dependencies","Technical medical terminology requiring specialist knowledge (sieverts, ICD-10-AM codes, specific tumour classifications)"],"plain_english_summary":"This Statement of Principles sets the medical rules for when malignant brain cancer is considered connected to military service under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004. It affects veterans, current and former defence members, and their families seeking compensation. It requires evidence of service-related causes (notably significant ionising radiation exposure or lack of timely medical care) to establish a service connection, and thus gates entitlement to benefits."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2016 Statement (s4) and replaces it (commencement on 23 March 2026). It explicitly frames compensable connections by (a) setting a radiation threshold and latency (0.5 sievert, ≥2 years) and tying dose reconstruction to the ARPANSA guide (section 9(1); Schedule 1), and (b) adding a clinical‑management factor with a limiting application to pre‑existing cases (section 9(2); section 10(2)). It also clarifies tumour inclusions and exclusions (section 7(2); Schedule 1). These changes alter the instrument's operational scope for deciding service connection and introduce technical and evidentiary requirements for claim assessment."},"complexity_factors":["Technical radiation threshold and dose reconstruction requirement (0.5 sievert; 2‑year latency) — section 9(1) and Schedule 1 definition of cumulative equivalent dose referencing the ARPANSA guide","Medical definitions and exclusions for what counts as a malignant neoplasm of the brain (inclusions like neuroepithelial tumours; long exclusion list) — section 7(2) and Schedule 1","Legal standard and medical‑scientific basis: 'balance of probabilities' and RMA's reliance on available medical‑scientific evidence — section 8","Conditional application of the clinical management factor to pre‑existing or pre‑service disease (material contribution/aggravation only) — section 10(2)","Interaction with other Statements of Principles where factors refer to other injuries/diseases — section 11","Application scope across two Acts (VEA and MRCA) and defined categories of relevant service — section 5 and Schedule 1","Citation to an external methodological guide (ARPANSA) for dose calculation introduces technical dependency and implementation burden — Schedule 1","Repeal and replacement of an earlier instrument, requiring comparison for claim processing continuity — section 4"],"plain_english_summary":"This Statement of Principles, made under s196B(3) of the Veterans' Entitlements Act and commencing 23 March 2026, replaces the 2016 instrument and sets the legal test used to decide whether a veteran's malignant brain tumour (or death from it) is connected to service. It applies to claims under s120B of the VEA and s339 of the MRCA.\n\nA service connection is found on the balance of probabilities if specified medical criteria are met—most notably a cumulative brain radiation dose of at least 0.5 sievert received at least two years before clinical onset, or inability to obtain appropriate clinical management—using defined ICD and dose‑calculation methods."},"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-malignant-neoplasm-of-the-brain-balance-of-probabilities-no-18-of","history":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-brain-balance-of-probabilities-no-18-of/history","analysis":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-brain-balance-of-probabilities-no-18-of/analysis","conflicts":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-brain-balance-of-probabilities-no-18-of/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-brain-balance-of-probabilities-no-18-of/important-cases","documents":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-brain-balance-of-probabilities-no-18-of/documents"}}