{"id":"F2021L01402","name":"Statement of Principles concerning malignant neoplasm of the pancreas (Balance of Probabilities) (No. 104 of 2021)","slug":"statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-balance-of-probabilities-no-10","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441036,"registerId":"F2021L01402-fast-fetch-1775956465937","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 pancreas (Balance of Probabilities) (No. 104 of 2021)","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\nMALIGNANT NEOPLASM OF THE PANCREAS (Balance of Probabilities)\n\n(No. 104 of 2021)\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 1 October 2021\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 Terence Campbell AM
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 malignant neoplasm of the pancreas (Balance of Probabilities) (No. 104 of 2021).\n\n2 Commencement\n\n This instrument commences on 1 November 2021.\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 malignant neoplasm of the pancreas No. 74 of 2013 (Federal Register of Legislation No. F2013L01893) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 malignant neoplasm of the pancreas and death from malignant neoplasm of the pancreas.\n\nMeaning of malignant neoplasm of the pancreas\n\n(2) For the purposes of this Statement of Principles, malignant neoplasm of the pancreas:\n\n(a) means a primary malignant neoplasm arising from the cells of the exocrine pancreas; and\n\n(b) excludes soft tissue sarcoma, carcinoid tumour, endocrine tumours, non-Hodgkin lymphoma and Hodgkin's lymphoma.\n\n(3) While malignant neoplasm of the pancreas attracts ICD‑10‑AM code C25.0, C25.1, C25.2, C25.3, C25.7 or C25.8, in applying this Statement of Principles the meaning of malignant neoplasm of the pancreas 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 pancreas\n\n(5) For the purposes of this Statement of Principles, malignant neoplasm of the pancreas, 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 pancreas.\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 malignant neoplasm of the pancreas and death from malignant neoplasm of the pancreas 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, malignant neoplasm of the pancreas or death from malignant neoplasm of the pancreas is connected with the circumstances of a person's relevant service:\n\n(1) having smoked tobacco products:\n\n(a) in an amount of at least 20 pack-years before the clinical onset of malignant neoplasm of the pancreas; and\n\n(b) commencing at least 10 years before the clinical onset of malignant neoplasm of the pancreas; and\n\nif smoking has ceased before the clinical onset of malignant neoplasm of the pancreas, then that onset occurred within 15 years of cessation;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary. \n\n(2) the oral use of smokeless tobacco:\n\n(a) on more days than not; and\n\n(b) for at least 40 years before the clinical onset of malignant neoplasm of the pancreas; and\n\nif the oral use of smokeless tobacco has ceased before the clinical onset of malignant neoplasm of the pancreas, then that onset occurred within 15 years of cessation;\n\nNote: smokeless tobacco is defined in the Schedule 1 - Dictionary. \n\n(3) being overweight or obese for at least 10 years within the 30 years before the clinical onset of malignant neoplasm of the pancreas;\n\nNote: being overweight or obese is defined in the Schedule 1 - Dictionary. \n\n(4) having diabetes mellitus for at least 10 years before the clinical onset of malignant neoplasm of the pancreas;\n\n(5) having chronic pancreatitis for at least 5 years before the clinical onset of malignant neoplasm of the pancreas;\n\n(6) inability to obtain appropriate clinical management for malignant neoplasm of the pancreas.\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(6) applies only to material contribution to, or aggravation of, malignant neoplasm of the pancreas where the person's malignant neoplasm of the pancreas 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 being overweight or obese means:\n\n(a) having a Body Mass Index (BMI) of 25 or greater; or\n\n(b) for males, having a waist circumference exceeding 94 centimetres; or\n\n(c) for females, having a waist circumference exceeding 80 centimetres.\n\nNote: BMI is also 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 malignant neoplasm of the pancreas—see subsection 7(2).\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n one pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of one year, or an equivalent amount of tobacco products.\n\nNote 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\nNote 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\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 smokeless tobacco means tobacco products without combustion or pyrolysis at the time of use, including chewing tobacco and tobacco snuff.\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","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":4,"scope_assessment":{"changed":false,"description":"This is a standard Statement of Principles instrument that operates within its established statutory framework under the Veterans' Entitlements Act 1986. It updates the 2013 version but maintains the same scope: establishing medical criteria for service connection of pancreatic cancer. No scope creep is evident."},"complexity_factors":["Multiple nested conditions within each factor (e.g., factor 9(1) has three sub-conditions: quantity threshold, timing threshold, and cessation window)","Cross-references to other legislation (VEA and MRCA) for definitions of service types","Technical medical definitions requiring precise measurement (BMI calculations, pack-year calculations with conversion formulas for pipe tobacco/cigars)","Conditional logic in section 9(6) limiting its application to pre-existing conditions aggravated by service","Recursive definition structure where Schedule 1 definitions refer back to substantive sections (e.g., malignant neoplasm definition)","Specific ICD-10-AM coding references with edition and ISBN specificity"],"plain_english_summary":"This instrument sets medical rules that create a legal presumption linking pancreatic cancer (or death from it) to military service for veterans and defence members, using the lower \"balance of probabilities\" standard. It identifies six qualifying risk factors — including heavy smoking, long‑term smokeless tobacco use, overweight/obesity, long‑standing diabetes, chronic pancreatitis, and inability to obtain medical care — so proving one factor tied to service substantially lowers the burden for compensation claims."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the earlier Statement of Principles No.74 of 2013 (s4) and supplies updated definitions, quantitative thresholds and temporal tests for factors linking pancreatic cancer to relevant service (see s7, s9 and Schedule definitions). It applies to claims under section 120B of the VEA or section 339 of the MRCA (s5). The text itself indicates a revision of criteria and thresholds but the prior instrument’s full provisions are not reproduced here, so precise point‑by‑point differences cannot be listed from this source alone."},"complexity_factors":["Multiple quantitative exposure and timing thresholds to establish a factor (eg. 20 pack‑years, ≥10 years before onset, cessation within 15 years) (s9(1)(a)-(b); Schedule definition of one pack‑year)","Long duration requirements for smokeless tobacco (on more days than not for ≥40 years) and cessation window (s9(2))","Clinical-duration windows for metabolic and inflammatory conditions (overweight/obese for ≥10 years within prior 30 years; diabetes ≥10 years; chronic pancreatitis ≥5 years) (s9(3)-(5))","A non‑exhaustive, technical disease definition that excludes specified tumour types and ties to ICD‑10‑AM codes (s7(2)-(4))","Requirement that any listed factor be related to the person’s relevant service — legal causation element separate from medical presence of the factor (s10(1))","Special rule for inability to obtain appropriate clinical management applying only where disease pre‑existed or was suffered/contracted before or during service but did not arise out of service (s10(2))","Cross‑reference to other Statements of Principles when a listed factor is itself an injury/disease covered elsewhere (s11)","Repeal of the earlier 2013 Statement creates a single current source but requires practitioners and decision‑makers to note changed thresholds/definitions where they differ from prior guidance (s4)"],"plain_english_summary":"This Statement of Principles (No.104 of 2021) replaces the 2013 instrument and sets the medical rules the Repatriation Medical Authority uses to link malignant neoplasm of the exocrine pancreas to a veteran’s “relevant service” for claims under the VEA or MRCA. It lists discrete risk factors and timing thresholds (eg. smoking pack‑years and latency, long‑term smokeless tobacco use, prolonged overweight/obesity, diabetes, chronic pancreatitis, or lack of appropriate clinical management) that, when shown and related to service, support a service‑connection finding. The RMA issues the criteria; claim outcomes determine access to entitlements. (ss3,5,7,9,10)"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-balance-of-probabilities-no-10","history":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-balance-of-probabilities-no-10/history","analysis":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-balance-of-probabilities-no-10/analysis","conflicts":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-balance-of-probabilities-no-10/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-balance-of-probabilities-no-10/important-cases","documents":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-pancreas-balance-of-probabilities-no-10/documents"}}