{"id":"F2018L00529","name":"Statement of Principles concerning mesenteric panniculitis (Balance of Probabilities) (No. 50 of 2018)","slug":"statement-of-principles-concerning-mesenteric-panniculitis-balance-of-probabilities-no-50-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439595,"registerId":"F2018L00529-fast-fetch-1775955561457","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning mesenteric panniculitis (Balance of Probabilities) (No. 50 of 2018)","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\nMESENTERIC PANNICULITIS (Balance of Probabilities)\n\n(No. 50 of 2018)\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 27 April 2018\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 Nicholas Saunders AO
Chairperson
|\n\n\n \n\n \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Application\n\n5 Definitions\n\n6 Kind of injury, disease or death to which this Statement of Principles relates\n\n7 Basis for determining the factors\n\n8 Factor that must exist\n\n9 Relationship to service\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n\n\n\n1 Name\n\nThis is the Statement of Principles concerning mesenteric panniculitis (Balance of Probabilities) (No. 50 of 2018).\n\n2 Commencement\n\n This instrument commences on 28 May 2018.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 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\n5 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n6 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about mesenteric panniculitis and death from mesenteric panniculitis.\n\nMeaning of mesenteric panniculitis\n\n(2) For the purposes of this Statement of Principles, mesenteric panniculitis:\n\n(a) means an inflammatory condition of the fatty layer (panniculus) that underlies the mesentery, omentum and peritoneum in the abdominal cavity, and which is clinically symptomatic or requires treatment; and\n\n(b) excludes sclerosing encapsulating peritonitis, retroperitoneal fibrosis (Ormond disease), peritoneal adhesions, acute peritonitis, infectious peritonitis, and the radiological phenomenon of \"misty mesentery\" not diagnosed specifically as mesenteric panniculitis.\n\nNote 1: Clinical symptoms commonly include acute or chronic abdominal pain, an abdominal mass or abdominal swelling, fever, weight loss, diarrhoea or vomiting. The symptoms are often due to obstruction of the bowel or mesenteric vessels.\n\nNote 2: The inflammation is histologically characterised by chronic inflammatory infiltration by lymphocytes and macrophages, fat necrosis and fibrosis. Mesenteric panniculitis is diagnosed by histology or by abdominal imaging using established radiological criteria.\n\nNote 3: Mesenteric panniculitis may also be known as mesenteric lipodystrophy or sclerosing mesenteritis.\n\n(3) While mesenteric panniculitis attracts ICD‑10‑AM code K65.8, in applying this Statement of Principles the meaning of mesenteric panniculitis 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 mesenteric panniculitis\n\n(5) For the purposes of this Statement of Principles, mesenteric panniculitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's mesenteric panniculitis.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n7 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 mesenteric panniculitis and death from mesenteric panniculitis 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\n8 Factor that must exist\n\nThe factor that must exist before it can be said that, on the balance of probabilities, mesenteric panniculitis or death from mesenteric panniculitis is connected with the circumstances of a person's relevant service is inability to obtain appropriate clinical management for mesenteric panniculitis.\n\n9 Relationship to service\n\nThe existence in a person of the factor referred to in section 8, applies only to material contribution to, or aggravation of, mesenteric panniculitis where the person's mesenteric panniculitis was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 5\n\n1 Definitions\n\nIn this instrument:\n\n mesenteric panniculitis—see subsection 6(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":3,"scope_assessment":{"changed":false,"description":"The instrument defines the scope of application: it applies to claims under section 120B of the VEA or section 339 of the MRCA, specifies what mesenteric panniculitis means (and excludes related conditions), and sets the causal and temporal conditions for service connection. The instrument itself does not state that it alters or replaces any prior scope; it simply establishes these definitions and criteria for mesenteric panniculitis and related death."},"complexity_factors":["Narrow medical definition with explicit exclusions (mesenteric panniculitis defined and certain similar conditions excluded) — section 6(2)(a)-(b) and notes.","Single required causal factor: inability to obtain appropriate clinical management must be established before service connection can be found — section 8.","Temporal limitation restricting application to conditions suffered or contracted before or during, but not arising out of, relevant service (affects when material contribution/aggravation can be accepted) — section 9.","Death included only where mesenteric panniculitis contributed to a terminal event; proving contribution to death adds evidentiary complexity — section 6(5) and Schedule 1 (terminal event).","Diagnostic standard references histology or established radiological criteria and notes use of ICD‑10‑AM code but the instrument’s definition controls, which can complicate record assessment — section 6(2), 6(3)-(4) and Note 2.","Legal/evidentiary standard is the balance of probabilities; RMA’s view rests on ‘sound medical‑scientific evidence’ which frames administrative discretion — title and section 7.","Application is limited to claims under specified VEA/MRCA provisions, so claim type and legislative gateway must be established — section 4.","Compliance burden on claimants to produce clinical records showing inability to obtain appropriate management (access/treatment history, imaging, histology) — implied by sections 8 and 6(2) Note 2.","Potential diagnostic overlap with excluded conditions (e.g. Ormond disease, acute/infectious peritonitis, 'misty mesentery') which may require differential diagnosis and specialist evidence — section 6(2)(b) and Note 2."],"plain_english_summary":"This instrument sets out the Repatriation Medical Authority’s Statement of Principles that links mesenteric panniculitis (a specified inflammatory condition of abdominal fat) to veterans’ or service members’ relevant service for VEA/MRCA claims. Mechanically, it makes ‘inability to obtain appropriate clinical management’ the single required causal factor for service connection. It applies where the condition was suffered or contracted before or during (but did not arise out of) relevant service and includes deaths to which the condition contributed, so it defines what medical proof and causal pathway will support entitlement."},"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":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the standard scope for Repatriation Medical Authority Statements of Principles. It addresses a single specific condition (mesenteric panniculitis) under the standard 'balance of probabilities' framework, with the typical limitation that it only applies to aggravation of pre-existing conditions due to inability to obtain clinical management. This reflects the original intent of the statutory framework under section 196B(3) of the Veterans' Entitlements Act 1986."},"complexity_factors":["Short document (approximately 1,500 words)","Only 6 defined terms in the Dictionary (mesenteric panniculitis, MRCA, relevant service, terminal event, VEA)","Single causal factor (section 8) with no exceptions or nested conditions","Clear structural separation between definition (section 6), causal factor (section 8), and limitation (section 9)","Minimal cross-referencing — only internal references to the Dictionary and explicit citations of parent Acts","Straightforward exclusion list in subsection 6(2)(b) without conditional logic"],"plain_english_summary":"This Statement of Principles sets the legal test for linking mesenteric panniculitis to military service for VEA and MRCA claims. A successful claim requires the disease to have existed before or during service and that service involved an inability to obtain appropriate clinical management.\n\nIt applies to non‑operational service and creates a narrow pathway — most claims will fail because it ties compensation to lack of access to care, not service as the cause."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-balance-of-probabilities-no-50-of-2018","history":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-balance-of-probabilities-no-50-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-balance-of-probabilities-no-50-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-balance-of-probabilities-no-50-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-balance-of-probabilities-no-50-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-balance-of-probabilities-no-50-of-2018/documents"}}