{"id":"F2024L00038","name":"Statement of Principles concerning malignant neoplasm of the testis and epididymis (Reasonable Hypothesis) (No. 7 of 2024)","slug":"statement-of-principles-concerning-malignant-neoplasm-of-the-testis-and-epididymis-reasonable-hypoth","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442245,"registerId":"F2024L00038-fast-fetch-1775957292999","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 testis and epididymis (Reasonable Hypothesis) (No. 7 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\n\n \n\nStatement of Principles\n\nconcerning\n\nMALIGNANT NEOPLASM OF THE TESTIS AND EPIDIDYMIS (Reasonable Hypothesis)\n\n(No. 7 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 22 December 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 testis and epididymis (Reasonable Hypothesis) (No. 7 of 2024).\n\n2 Commencement\n\n This instrument commences on 22 January 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 neoplasm of the testis and paratesticular tissues No. 3 of 2015 (Federal Register of Legislation No. F2014L01813) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 neoplasm of the testis and epididymis and death from malignant neoplasm of the testis and epididymis.\n\nMeaning of malignant neoplasm of the testis and epididymis\n\n(2) For the purposes of this Statement of Principles, malignant neoplasm of the testis and epididymis:\n\n(a) means a primary malignant neoplasm arising from cells of the testis and/or epididymis; and\n\n(b) includes the following:\n\n(i) germ cell tumour in situ;\n\n(ii) germ cell tumour;\n\n(iii) seminoma and non-seminoma;\n\n(iv) sex cord stromal carcinomas;\n\n(v) epididymis carcinomas; and\n\n(vi) rete testis carcinomas; and\n\n(c) excludes the following:\n\n(i) vas deferens tumours;\n\n(ii) soft tissue sarcoma;\n\n(iii) non-Hodgkin lymphoma;\n\n(iv) Hodgkin lymphoma;\n\n(v) leukaemic infiltrates.\n\n(3) While malignant neoplasm of the testis and epididymis attracts ICD‑10‑AM codes C62 and C63.0, in applying this Statement of Principles the meaning of malignant neoplasm of the testis and epididymis 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 testis and epididymis\n\n(5) For the purposes of this Statement of Principles, malignant neoplasm of the testis and epididymis, 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 testis and epididymis.\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 neoplasm of the testis and epididymis and death from malignant neoplasm of the testis and epididymis 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 neoplasm of the testis and epididymis or death from malignant neoplasm of the testis and epididymis with the circumstances of a person's relevant service:\n\n(1) being infected with human immunodeficiency virus before the clinical onset of malignant neoplasm of the testis and epididymis;\n\n(2) smoking at least ten joint-years of cannabis, or the equivalent in other cannabis products, before the clinical onset of malignant neoplasm of the testis and epididymis, where smoking commenced at least five years before the clinical onset of malignant neoplasm of the testis and epididymis;\n\nNote: joint-years of cannabis is defined is the schedule 1 dictionary.\n\n(3) having at least 3 years continuous exposure to dimethylformamide at a concentration of at least 10 ppm for 8 hours per day, at least 2 years before the clinical onset of malignant neoplasm of the testis and epididymis;\n\n(4) being employed as a firefighter for a cumulative period of at least 1,000 hours before the clinical onset of malignant neoplasm of the testis and epididymis, where the employment commenced at least 10 years before the clinical onset of malignant neoplasm of the testis and epididymis;\n\n(5) being employed for at least 3 years in aircraft maintenance work at least 2 years before the clinical onset of malignant neoplasm of the testis and epididymis;\n\n(6) inability to obtain appropriate clinical management for malignant neoplasm of the testis and epididymis before the clinical worsening of malignant neoplasm of the testis and epididymis.\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 testis and epididymis where the person's malignant neoplasm of the testis and epididymis 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\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n joint-years of cannabis means a calculation of consumption where one joint-year of cannabis equals one joint per day for a period of one year.\n\n malignant neoplasm of the testis and epididymis—see subsection 7(2).\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\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 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":true,"description":"The legislation narrows scope compared to the repealed 2015 instrument. The previous version covered 'malignant neoplasm of the testis and paratesticular tissues' — a broader anatomical category. This 2024 version specifically targets 'testis and epididymis' only, explicitly excluding vas deferens tumours, soft tissue sarcomas, lymphomas and leukaemic infiltrates that were potentially covered under the broader 'paratesticular tissues' definition. This represents a tightening of scope to focus on specific cell origins rather than anatomical proximity."},"complexity_factors":["Moderate cross-referencing between the VEA and MRCA schemes","Specific quantitative thresholds requiring precise calculation (10 joint-years, 1,000 hours firefighting, 3 years exposure, 10 ppm concentration)","Temporal requirements (time lags between exposure and onset: 2 years, 5 years, 10 years)","Nested definitions requiring consultation of Schedule 1 (joint-years calculation, terminal event definition)","Exclusion clauses in the disease definition (subsection 7(2)(c)) that require careful parsing","Conditional application of factor 9(6) restricted to pre-existing conditions under section 10(2)","Incorporation by reference of ICD-10-AM Tenth Edition coding system"],"plain_english_summary":"This instrument replaces the 2015 policy with a narrower medical rule focused on testis and epididymis cancer and specifies six qualifying service-related risk factors. It applies to veterans, peacekeepers and current/former defence members claiming under the VEA or MRCA.\n\nIf a claimant proves any listed factor linked to their service, the law presumes the cancer is service-related, easing the burden of proof for compensation."},"flash_summary":{"complexity_score":7,"scope_assessment":{"changed":true,"description":"Section 4 repeals the 2015 Statement concerning \"malignant neoplasm of the testis and paratesticular tissues\" and replaces it with this instrument focused on \"testis and epididymis\" (s7(2)). The new statement expressly lists included and excluded tumour types (s7(2)(b)–(c)) and introduces specific, quantified exposure and occupational factors (s9). It therefore narrows and reframes scope relative to the repealed instrument by specifying anatomical focus and precise exposure thresholds; it continues to apply to VEA and MRCA claims (s5)."},"complexity_factors":["Technical medical definitions and ICD coding linkage (s7(2)–(4)): distinguishing included tumours (germ cell, seminoma, sex‑cord stromal, etc.) from excluded entities (lymphoma, sarcoma, vas deferens tumours).","Quantified, exposure‑based thresholds (s9(2)–(5)): precise metrics such as \"ten joint‑years\" of cannabis, dimethylformamide exposure ≥10 ppm for 3 years, 1,000 firefighter hours, and 3 years in aircraft maintenance introduce measurement and evidentiary complexity.","Temporal conditions and latency rules (s9(2)–(5)): many factors require exposures to have commenced or ended a specific number of years before clinical onset, adding timing burdens for claimants and administrators.","Causation standard and legal interface (title, s8–s9): the instrument is constructed to establish a \"reasonable hypothesis\" of service connection rather than definitive causation, requiring interpretive judgment by decision‑makers.","Relationship to service requirement (s10(1)–(2)): every listed factor must be related to the person's relevant service, imposing factual inquiries about when and where exposures occurred and whether aggravation versus origin applies.","Interaction with other Statements of Principles (s11): factors that overlap with other SOPs defer to those instruments, creating cross‑instrument dependency and potential inconsistency.","Proof and verification burdens: demonstrating concentrations (ppm), cumulative hours, or joint‑years can be difficult (reliance on employment records, industrial hygiene data, or self‑report).","Administrative change (s4): repeal of the 2015 instrument and replacement with a differently framed list raises transitional and precedent issues for pending claims.","Clinical management factor (s9(6)): a non‑exposure factor—\"inability to obtain appropriate clinical management\"—applies only to material contribution or aggravation and only where disease pre‑existed or was contracted before/during service, adding nuanced legal/medical assessment."],"plain_english_summary":"This Repatriation Medical Authority Statement sets out medical definitions and a short list of specific exposure and clinical factors that, if present, raise a \"reasonable hypothesis\" that malignant neoplasm of the testis and epididymis is connected to Australian military or peacekeeping service. It applies to claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. It names quantified thresholds — e.g. HIV infection, cannabis joint‑years, dimethylformamide exposure, firefighter‑hours, aircraft‑maintenance years, and lack of appropriate clinical management — used to decide service connection and entitlement to 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-testis-and-epididymis-reasonable-hypoth","history":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-testis-and-epididymis-reasonable-hypoth/history","analysis":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-testis-and-epididymis-reasonable-hypoth/analysis","conflicts":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-testis-and-epididymis-reasonable-hypoth/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-testis-and-epididymis-reasonable-hypoth/important-cases","documents":"/api/acts/statement-of-principles-concerning-malignant-neoplasm-of-the-testis-and-epididymis-reasonable-hypoth/documents"}}