{"id":"F2023L01431","name":"Statement of Principles concerning malignant neoplasm of the salivary gland (Balance of Probabilities) (No. 103 of 2023)","slug":"statement-of-principles-concerning-malignant-neoplasm-of-the-salivary-gland-balance-of-probabilities","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442146,"registerId":"F2023L01431-fast-fetch-1775957231799","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 salivary gland (Balance of Probabilities) (No. 103 of 2023)","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\n\n \n\nStatement of Principles\n\nconcerning\n\nMALIGNANT NEOPLASM OF THE SALIVARY GLAND (Balance of Probabilities)\n\n(No. 103 of 2023)\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 25 October 2023.\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 salivary gland (Balance of Probabilities) (No. 103 of 2023).\n\n2 Commencement\n\n This instrument commences on 28 November 2023.\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 salivary gland No. 58 of 2015 (Federal Register of Legislation No. F2015L00261) made under subsections 196B(3) and (8) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 salivary gland and death from malignant neoplasm of the salivary gland.\n\nMeaning of malignant neoplasm of the salivary gland\n\n(2) For the purposes of this Statement of Principles, malignant neoplasm of the salivary gland:\n\n(a) means a primary malignant neoplasm arising from the epithelial cells of the major salivary glands (parotid, submandibular and sublingual glands), minor salivary glands or salivary gland ducts; and\n\n(b) excludes:\n\n(i) carcinoid tumour;\n\n(ii) haematolymphoid tumours including non-Hodgkin lymphoma and Hodgkin lymphoma; and\n\n(iii) soft tissue sarcoma.\n\nDeath from malignant neoplasm of the salivary gland\n\n(3) For the purposes of this Statement of Principles, malignant neoplasm of the salivary gland, 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 salivary gland.\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 salivary gland and death from malignant neoplasm of the salivary gland 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 salivary gland or death from malignant neoplasm of the salivary gland is connected with the circumstances of a person's relevant service:\n\n(1) having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the salivary gland at least 10 years before the clinical onset of malignant neoplasm of the salivary gland;\n\nNote: cumulative equivalent dose is defined in the Schedule 1 – Dictionary.\n\n(2) for individuals aged 20 years or less, having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the salivary gland at least 5 years before the clinical onset of malignant neoplasm of the salivary gland;\n\nNote: cumulative equivalent dose is defined in the Schedule 1 – Dictionary.\n\n(3) undergoing ablative treatment with radioactive iodine for thyroid cancer before the clinical onset of malignant neoplasm of the salivary gland, where the first exposure occurred at least 10 years before the clinical onset of malignant neoplasm of the salivary gland;\n\n(4) having infection with human immunodeficiency virus before the clinical onset of malignant neoplasm of the salivary gland;\n\n(5) inability to obtain appropriate clinical management for malignant neoplasm of the salivary gland before the clinical worsening of malignant neoplasm of the salivary gland.\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(5) applies only to material contribution to, or aggravation of, malignant neoplasm of the salivary gland where the person's malignant neoplasm of the salivary gland 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 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 salivary gland—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":5,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2015 Statement (s4) and replaces it with updated qualifying factors (s9). New or clarified elements include an explicit age‑specific latency for radiation exposure (s9(2)), inclusion of ablative radioactive iodine for thyroid cancer as a qualifying exposure (s9(3)), listing HIV infection (s9(4)), and inability to obtain appropriate clinical management as a ground for material contribution or aggravation (s9(5), s10(2)). It also ties dose assessment to the ARPANSA cumulative equivalent dose methodology (Schedule 1), which alters evidentiary and dose‑reconstruction requirements compared with the prior instrument."},"complexity_factors":["Technical medical and dosimetric thresholds (cumulative equivalent dose ≥ 0.5 sievert) involving latency periods and age‑specific rules (s9(1)–(2); Schedule 1 definition).","Interaction with external technical guidance for dose reconstruction (ARPANSA Guide referenced in Schedule 1).","Multiple causal pathways listed (external/internal radiation, radioactive iodine therapy, HIV infection, and access to clinical management) requiring different evidentiary approaches (s9(1)–(5)).","Requirement that any listed factor be tied to a person’s relevant service, invoking VEA/MRCA categories and timing constraints (s10(1)–(2); Schedule 1 relevant service).","Repeal and replacement of the prior Statement of Principles, creating potential interpretive differences from earlier guidance (s4).","Cross‑references to other Statements of Principles where factors overlap, introducing dependency on changing external instruments (s11).","Precise definitional exclusions and inclusions for the disease (e.g. excludes carcinoid, haematolymphoid tumours, soft tissue sarcoma) which affect claim scope (s7(2))."],"plain_english_summary":"This instrument sets the legal test for when malignant salivary gland cancer (or death from it) is presumed to be related to a veteran’s or service member’s military service for claims under the VEA or MRCA. It lists specific medical and exposure factors — principally certain ionising radiation doses, radioactive‑iodine therapy, HIV infection, or failure to obtain appropriate clinical care — which, if present, make it more probable than not that the cancer is connected to service and so may support entitlement to benefits."},"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 updates the 2015 version with current medical evidence but does not expand beyond the traditional function of determining service-connection for a specific condition. The structure, application provisions, and relationship to the veterans' compensation framework remain consistent with the original legislative intent of Part XIA of the VEA."},"complexity_factors":["Moderate cross-referencing: requires understanding of the Veterans' Entitlements Act 1986 and Military Rehabilitation and Compensation Act 2004 frameworks","Technical medical definitions: includes precise radiation measurement terminology (sieverts, cumulative equivalent dose) with reference to external calculation methodology","Conditional logic with temporal requirements: multiple factors include specific time lags (10 years, 5 years) and age thresholds (20 years or less)","Nested definitions: 'malignary neoplasm' definition excludes three specific tumour types, requiring knowledge of what is NOT covered","Dual statutory framework: operates across two different compensation schemes (VEA and MRCA) with different service categories","Section 11 creates dynamic incorporation: factors referring to other diseases automatically import the rules from other Statements of Principles as they update over time"],"plain_english_summary":"This instrument updates the medical rules for deciding when salivary gland cancer is treated as service-related for compensation, replacing the 2015 guidance with newer evidence. It applies to veterans and current/former defence members claiming under the Veterans' Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004.\n\nIt requires at least one specified causal factor (for example, substantial ionising radiation, ablative radioactive‑iodine therapy, prior HIV infection, or lack of medical care) to link the cancer to service."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-salivary-gland-balance-of-probabilities","history":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-salivary-gland-balance-of-probabilities/history","analysis":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-salivary-gland-balance-of-probabilities/analysis","conflicts":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-salivary-gland-balance-of-probabilities/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-salivary-gland-balance-of-probabilities/important-cases","documents":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-salivary-gland-balance-of-probabilities/documents"}}