{"id":"F2018L00528","name":"Statement of Principles concerning mesenteric panniculitis (Reasonable Hypothesis) (No. 49 of 2018)","slug":"statement-of-principles-concerning-mesenteric-panniculitis-reasonable-hypothesis-no-49-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439596,"registerId":"F2018L00528-fast-fetch-1775955561485","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning mesenteric panniculitis (Reasonable Hypothesis) (No. 49 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 (Reasonable Hypothesis)\n\n(No. 49 of 2018)\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 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 Factors that must exist\n\n9 Relationship to service\n\n10 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 mesenteric panniculitis (Reasonable Hypothesis) (No. 49 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(2) of the Veterans' Entitlements Act 1986.\n\n4 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\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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that mesenteric panniculitis and death from mesenteric panniculitis 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\n8 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 mesenteric panniculitis or death from mesenteric panniculitis with the circumstances of a person's relevant service:\n\n(1) having an abdominal infection with tuberculosis or atypical mycobacteria at the time of clinical onset of mesenteric panniculitis;\n\n(2) having an abdominal infection with tuberculosis or atypical mycobacteria at the time of clinical worsening of mesenteric panniculitis;\n\n(3) for mesenteric panniculitis of the colon only, having undergone colonoscopy within the 48 hours before the clinical worsening of mesenteric panniculitis;\n\n(4) inability to obtain appropriate clinical management for mesenteric panniculitis.\n\n9 Relationship to service\n\n(1) The existence in a person of any factor referred to in section 8, must be related to the relevant service rendered by the person.\n\n(2) The factors set out in subsections 8(2) to 8(4) apply 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\n10 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 8 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\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) 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 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":{"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains its original narrow scope. It addresses a single rare medical condition (mesenteric panniculitis) and establishes specific causal factors for veterans' compensation purposes. The scope has not expanded beyond its intended purpose of determining liability for this specific disease under the reasonable hypothesis standard."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 6 defined terms in the Dictionary (Schedule 1)","Simple conditional structure: one of four factors must exist (section 8)","Single cross-reference to other Statements of Principles (section 10)","Clear exclusion list in the definition (subsection 6(2)(b)) — 6 specific conditions excluded","Limited temporal conditions: 'within 48 hours' and 'at the time of clinical onset/worsening'","One nested limitation in section 9(2) restricting application of three factors to pre-existing conditions"],"plain_english_summary":"This instrument sets when Australian Defence Force members and veterans can get compensation for mesenteric panniculitis by applying a \"reasonable hypothesis\" test—making it easier to link the abdominal inflammatory disease to service. If certain risk factors (infectious triggers, a recent colonoscopy for colon cases, or inability to access treatment) are present the law may presume a service connection, though those three factors only help if the condition existed before or during service. It determines access to pensions and treatment."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument does not expand statutory coverage; it applies to claims under the VEA and MRCA (s4) and confines assessment to a specific medical condition and listed factors (s6, s8). It sets evidentiary criteria for linking the condition to 'relevant service' (s9) and defers to other Statements where overlap occurs (s10), rather than altering who is eligible under the underlying Acts."},"complexity_factors":["Specialised medical definition and diagnostic standards for mesenteric panniculitis, including histology and radiology criteria (s6(2), notes 2–3).","Precise temporal and causal link requirements between listed factors and 'relevant service' (s8, s9(1)).","Narrow, specific qualifying factors (infection at onset/worsening; colonoscopy within 48 hours for colon cases; inability to obtain care) that require medical evidence and chronology (s8(1)–(4)).","Interaction with other Statements of Principles where a factor refers to another disease—cross‑application and dependence on other instruments (s10).","Exclusions of related conditions (e.g. sclerosing encapsulating peritonitis, retroperitoneal fibrosis) which require correct diagnostic differentiation (s6(2)(b)).","Potential evidentiary ambiguity around 'inability to obtain appropriate clinical management' that may create administrative discretion and proof burden (s8(4))."],"plain_english_summary":"This Statement of Principles sets the medical criteria the Repatriation Medical Authority uses to decide whether mesenteric panniculitis (including death from it) can be linked to a veteran’s relevant service for VEA/MRCA claims. It defines the condition, excludes similar disorders, and lists four qualifying factors (for example, abdominal tuberculosis/atypical mycobacterial infection at onset or worsening, colonoscopy within 48 hours for colonic cases, or inability to obtain appropriate care) that must be related to the person’s service to raise a reasonable hypothesis."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-reasonable-hypothesis-no-49-of-2018","history":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-reasonable-hypothesis-no-49-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-reasonable-hypothesis-no-49-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-reasonable-hypothesis-no-49-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-reasonable-hypothesis-no-49-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-mesenteric-panniculitis-reasonable-hypothesis-no-49-of-2018/documents"}}