{"id":"F2018L00197","name":"Statement of Principles concerning malignant neoplasm of the eye (Balance of Probabilities) (No. 28 of 2018)","slug":"statement-of-principles-concerning-malignant-neoplasm-of-the-eye-balance-of-probabilities-no-28-of-2","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":96821,"registerId":"commonwealth-F2018L00197-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning malignant neoplasm of the eye (Balance of Probabilities) (No. 28 of 2018)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning malignant neoplasm of the eye (Balance of Probabilities) (No. 28 of 2018)\n\nmade under subsection 196B(3) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 23 March 2020\n\nIncludes amendments up to: Amendment Statement of Principles concerning malignant neoplasm of the eye (Balance of Probabilities) (No. 20 of 2020) (F2020L00200)\n\nThe day of commencement of this Amendment Statement of Principles concerning malignant neoplasm of the eye is 23 March 2020.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning malignant neoplasm of the eye (Balance of Probabilities) (No. 28 of 2018) that shows the text of the law as amended and in force on 23 March 2020.\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\n![RMA-Red](image.002.jpeg)\n\nStatement of Principles\n\nconcerning\n\nMALIGNANT NEOPLASM OF THE EYE  \n(Balance of Probabilities)\n\n(No. 28 of 2018)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\nDated 2 March 2018\n\n|     |\n| --- |\n|     |\n\n  \n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Revocation\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\n1 Name\n\nThis is the Statement of Principles concerning malignant neoplasm of the eye (Balance of Probabilities) (No. 28 of 2018).\n\n2 Commencement\n\nThis instrument commences on 2 April 2018.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Revocation\n\nThe Statement of Principles concerning malignant neoplasm of the eye No. 16 of 2010 made under subsection 196B(3) of the VEA is revoked.\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 malignant neoplasm of the eye and death from malignant neoplasm of the eye.\n\nMeaning of malignant neoplasm of the eye\n\n(2) For the purposes of this Statement of Principles, malignant neoplasm of the eye:\n\n(a) means a primary malignant neoplasm arising from the tissue of the eyeball and conjunctiva; and\n\n(b) includes:\n\n(i) malignant melanoma of the uveal tract (iris, ciliary body and choroid); and\n\n(ii) malignant melanoma of the conjunctiva, including melanoma in situ; and\n\n(iii) squamous cell carcinoma of the cornea or the conjunctiva, including carcinoma in situ; and\n\n(c) excludes eye retinoblastoma, connective tissue and bone tumours (sarcomas), vascular tumours (sarcoma), non-Hodgkin's lymphoma, Hodgkin's lymphoma and carcinoid tumour.\n\n> Note: The eye means the eyeball with conjunctival covering but excluding extraocular muscles, connecting nerves (optic nerve, autonomic sympathetic and parasympathetic nerves), arteries, veins and lymphatics, other orbital contents such as orbital fat and orbital bone, eyelid skin, Meibomian glands, the caruncle and the lacrimal apparatus.\n\n(3) While malignant neoplasm of the eye attracts ICD‑10‑AM code C69.0, C69.1, C69.2, C69.3, C69.4, C69.8, C69.9 or D09.2, in applying this Statement of Principles the meaning of malignant neoplasm of the eye 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 neoplasm of the eye\n\n(5) For the purposes of this Statement of Principles, malignant neoplasm of the eye, 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 eye.\n\n> Note: 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 malignant neoplasm of the eye and death from malignant neoplasm of the eye 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\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, malignant neoplasm of the eye or death from malignant neoplasm of the eye is connected with the circumstances of a person's relevant service:\n\n(1) having sunlight or ultraviolet light exposure to the eye for a cumulative period of at least 4 500 hours while in a tropical area, or having equivalent sunlight exposure in other latitude zones, before the clinical onset of malignant neoplasm of the eye;\n\n> Note: equivalent sunlight exposure in other latitude zones and tropical area are defined in the Schedule 1 - Dictionary.\n\n(2) having ultraviolet radiation exposure from an ultraviolet-emitting tanning device to the unprotected eye on at least 20 occasions, at least five years before the clinical onset of malignant neoplasm of the eye;\n\n> Note: unprotected eye is defined in the Schedule 1 - Dictionary.\n\n(3) being infected with human immunodeficiency virus before the clinical onset of malignant neoplasm of the eye;\n\n(4) being treated with an immunosuppressive drug:\n\n    (a) for a cumulative period of at least three months before the clinical onset of malignant neoplasm of the eye; and\n    (b) where the first treatment occurred at least five years before the clinical onset of malignant neoplasm of the eye; and\n    (c) where that exposure has ceased, the clinical onset of malignant neoplasm of the eye has occurred within ten years of cessation;\n\n> Note: immunosuppressive drug is defined in the Schedule 1 - Dictionary.\n\n(5) having a solid organ or stem cell transplantation before the clinical onset of malignant neoplasm of the eye;\n\n(6) for uveal melanoma of the eye only, using manual welding equipment for welding metal, for a cumulative period of at least ten years before the clinical onset of malignant neoplasm of the eye;\n\n(7) for melanoma of the eye only, having at least four episodes of photokeratitis of the affected eye, where the first exposure occurred at least five years before the clinical onset of malignant neoplasm of the eye;\n\n> Note: photokeratitis is defined in the Schedule 1 - Dictionary.\n\n(8) for conjunctival melanoma of the eye only, receiving a conjunctival transplant to the affected eye before the clinical onset of malignant neoplasm of the eye;\n\n(9) for squamous cell carcinoma of the cornea or the conjunctiva only:\n\n(a) having ultraviolet radiation exposure from whole body PUVA therapy to the unprotected eye, where:\n\n(i) the first PUVA treatment commenced at least five years before the clinical onset of malignant neoplasm of the eye; and\n\n(ii) at least 50 PUVA treatments were administered before the clinical onset of malignant neoplasm of the eye; or\n\n> Note: unprotected eye and whole body PUVA are defined in the Schedule 1 \\- Dictionary.\n\n(b) being treated with voriconazole for a continuous period of at least the two months before the clinical onset of malignant neoplasm of the eye;\n\n(10) for squamous cell carcinoma of the conjunctiva only, having an ocular prosthesis in an anophthalmic socket of the affected eye for more than ten years before the clinical onset of malignant neoplasm of the eye;\n\n(11) inability to obtain appropriate clinical management for malignant neoplasm of the eye.\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(11) applies only to material contribution to, or aggravation of, malignant neoplasm of the eye where the person's malignant neoplasm of the eye 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\nequivalent sunlight exposure in other latitude zones means the cumulative hours of sunlight exposure equivalent to that specified for a tropical area, calculated by multiplying the hours of exposure in each latitude zone by the latitude weighting factor for the zone as per the latitude weighting factor schedule and adding together the result for each zone:\n\nLatitude weighting factor schedule\n\nLatitude zone Latitude weighting factor\n\na latitude between 23° 27' South and 23° 27' North 1.0\n\na latitude from > 23° 27' to 35° 0.75\n\na latitude from > 35° to 45° 0.5\n\na latitude from > 45° to 65° 0.25.\n\n> Note: tropical area is also defined in the Schedule 1 - Dictionary.\n\nimmunosuppressive drug means a drug or an agent which results in substantial suppression of immune responses.\n\nNote: 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\nmalignant neoplasm of the eye—see subsection 7(2).\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\nphotokeratitis means a clinical illness manifesting from radiation damage to the cornea and conjunctiva by exposure of the eye to ultraviolet light rays from natural sources including snowblindness or artificial sources including electrical arc welding.\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\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\ntropical area means any area between the Tropic of Capricorn (23º 27' South) and the Tropic of Cancer (23º 27' North).\n\nunprotected eye means an eye not protected by ultraviolet radiation screening devices such as goggles.\n\nVEA means the Veterans' Entitlements Act 1986.\n\nwhole body PUVA means photochemotherapy with oral methoxsalen (psoralen) and ultraviolet A radiation. It does not include localised PUVA therapy.\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 malignant neoplasm of the eye (Balance of Probabilities) (No. 28 of 2018)           | 5 March 2018F2018L00197 | 2 April 2018 |                                                 |\n| Amendment Statement of Principles concerning malignant neoplasm of the eye (Balance of Probabilities) (No. 20 of 2020) | 2 March 2020F2020L00200 | 23 March2020 |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected                                        | How affected       |\n| --------------------------------------------------------- | ------------------ |\n| Clause 9(4)…………….                                         | rs. No. 20 of 2020 |\n| Schedule 1 – Dictionary – immunosuppressive drug……………..…… | rs. No. 20 of 2020 |","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument revokes the earlier 2010 Statement (No.16 of 2010) and replaces it with updated criteria. Amendments up to March 2020 alter clause 9(4) (immunosuppression timing/conditions) and expand or clarify definitions (Schedule 1), changing the evidentiary thresholds and the medical terms that determine which exposures and treatments can link eye cancer to relevant service."},"complexity_factors":["Quantitative exposure thresholds requiring calculations (sunlight hours, latitude weighting) (Schedule 1; s.9(1))","Multiple, specific medical and exposure pathways with distinct latency and count thresholds (s.9(1)–(11))","Detailed definitions and categorical exclusions that affect scope (s.7(2)–(4); Schedule 1)","Interplay with other Statements of Principles and cross-referenced diseases (s.11)","Legal cross-references to VEA and MRCA eligibility and application rules (ss.3,5,9,10)","Evidentiary and proof burdens on claimants to show exposure, timing and relation to relevant service (s.9; s.10)","Administrative judgment about ‘appropriate clinical management’ and causation timing (s.9(11); s.10)","Amendments updating medical terms (immunosuppressive drug) and factor formulations (Endnotes/Amendment history)"],"plain_english_summary":"This Statement of Principles replaces the 2010 version and sets the medical and exposure rules used to decide whether malignant neoplasm of the eye (and death from it) is connected to veterans' or Defence service for VEA/MRCA claims. It lists specific qualifying factors — quantified sunlight/UV exposure (with latitude weighting), tanning devices, PUVA, immunosuppression or transplantation, welding, photokeratitis, ocular prosthesis, HIV, or inadequate clinical management — and defines latency windows, exclusions and required evidence that determine entitlement."},"kimi_summary":{"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"This legislation maintains its original scope as a specific medical determination for eye cancer under the Veterans' Entitlements Act framework. The 2020 amendment (No. 20 of 2020) made targeted changes to clause 9(4) (immunosuppressive drug timing requirements) and the definition of immunosuppressive drugs, but did not expand the scope beyond the original purpose of determining service connection for malignant neoplasms of the eye. The instrument remains tightly focused on its original medical-legal function."},"complexity_factors":["Multiple condition-specific factors: 11 distinct factors in section 9, with 4 factors restricted to specific cancer subtypes (uveal melanoma, melanoma, conjunctival melanoma, squamous cell carcinoma)","Nested temporal requirements: Several factors contain multi-layered time conditions (e.g., factor 9(4) requires cumulative period of 3 months AND first treatment at least 5 years before onset AND onset within 10 years of cessation)","Geographic/latitude calculation system: Factor 9(1) requires understanding of the 'latitude weighting factor schedule' with four distinct zones and multipliers (1.0, 0.75, 0.5, 0.25) to calculate equivalent exposure","Cross-referencing architecture: Section 11 creates a recursive system where factors referring to other diseases trigger the application of separate Statements of Principles","Exclusionary definitions: Section 7(2)(c) excludes 6 specific tumour types, and the Note to section 7(2) anatomically excludes extraocular muscles, nerves, arteries, orbital contents, eyelids, and lacrimal apparatus","Dual statutory framework: Applies to both VEA and MRCA with different service definitions (eligible war service, defence service, peacetime service) defined in the Dictionary","Medical terminology density: 47 defined terms or concepts including ICD-10-AM coding references, specific drug classes, and clinical conditions (photokeratitis, PUVA therapy, immunosuppressive drugs)","Cumulative exposure calculations: Three factors require tracking cumulative hours (4,500 hours sun, 10 years welding, 10 years prosthesis) or discrete episodes (4 episodes of photokeratitis, 20 tanning occasions, 50 PUVA treatments)"],"plain_english_summary":"This Statement of Principles sets medical rules for deciding when eye cancers (malignant tumours of the eyeball and conjunctiva) are presumed service-related for veterans and current/former defence personnel claiming under veterans’ compensation laws. It lists 11 specified risk factors—if at least one is present and linked to service, the cancer is presumed service-related—affecting RMA decisions and DVA claim outcomes and determining access to pensions, treatment and benefits."},"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-eye-balance-of-probabilities-no-28-of-2","history":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-eye-balance-of-probabilities-no-28-of-2/history","analysis":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-eye-balance-of-probabilities-no-28-of-2/analysis","conflicts":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-eye-balance-of-probabilities-no-28-of-2/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-eye-balance-of-probabilities-no-28-of-2/important-cases","documents":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-eye-balance-of-probabilities-no-28-of-2/documents"}}