{"id":"F2021L01183","name":"Statement of Principles concerning myeloma (Balance of Probabilities) (No. 96 of 2021)","slug":"statement-of-principles-concerning-myeloma-balance-of-probabilities-no-96-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440974,"registerId":"F2021L01183-fast-fetch-1775956410944","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning myeloma (Balance of Probabilities) (No. 96 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\nMYELOMA (Balance of Probabilities)\n\n(No. 96 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 20 August 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 myeloma (Balance of Probabilities) (No. 96 of 2021).\n\n2 Commencement\n\n This instrument commences on 20 September 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 myeloma No. 70 of 2012 (Federal Register of Legislation No. F2012L02080) made under subsections 196B(3) and (8) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 myeloma and death from myeloma.\n\nMeaning of myeloma\n\n(2) For the purposes of this Statement of Principles, myeloma:\n\n(a) means a malignant disease of plasma cells, in which a single line of plasma cells accumulates and produces a monoclonal immunoglobulin; and\n\n(b) includes:\n\n(i) extramedullary plasmacytoma;\n\n(ii) multiple myeloma;\n\n(iii) plasma cell leukaemia; and\n\n(iv) solitary plasmacytoma of bone.\n\n(3) While myeloma attracts ICD‑10‑AM code C90, in applying this Statement of Principles the meaning of myeloma 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 myeloma\n\n(5) For the purposes of this Statement of Principles, myeloma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's myeloma.\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 myeloma and death from myeloma 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, myeloma or death from myeloma is connected with the circumstances of a person's relevant service:\n\n(1) undergoing organ or tissue transplantation, excluding corneal transplant and autologous stem cell transplantation, before the clinical onset of myeloma;\n\nNote: organ or tissue transplantation is defined in the Schedule 1 - Dictionary.\n\n(2) being obese for a continuous period of at least 5 years before the clinical onset of myeloma;\n\nNote: being obese is defined in the Schedule 1 - Dictionary.\n\n(3) inability to obtain appropriate clinical management for myeloma.\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(3) applies only to material contribution to, or aggravation of, myeloma where the person's myeloma 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 obese means having a Body Mass Index (BMI) of 30 or greater.\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 MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n myeloma—see subsection 7(2).\n\n organ or tissue transplantation means the transplantation of:\n\n(a) all or part of an organ or tissue; or\n\n(b) a substance obtained from an organ or tissue.\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_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":"The legislation maintains its original narrow purpose: establishing specific medical criteria for linking myeloma to military service. The 2021 revision updates the predecessor instrument (No. 70 of 2012) without expanding beyond the established framework of determining liability for veterans' compensation claims. The scope remains tightly confined to the single disease (myeloma) and its variants, with no policy drift into broader oncological or veterans' affairs matters."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 8 defined terms in the Dictionary (BMI, being obese, MRCA, myeloma, organ or tissue transplantation, relevant service, terminal event, VEA)","Simple conditional structure: three alternative factors in section 9, only one required","Single cross-reference mechanism in section 11 allowing incorporation of other Statements of Principles","Minimal nested logic — only one conditional limitation in section 10(2) restricting the application of the medical treatment factor","Clear medical definitions with ICD-10-AM code reference for precision"],"plain_english_summary":"This instrument updates the 2012 medical rules for when current or former ADF members and veterans can claim compensation under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act for myeloma or death from it. \n\nA claim succeeds if, on balance of probabilities, one of three medical factors is present (certain organ transplants, long‑term obesity, or inability to obtain proper treatment); treatment-related claims require pre‑existing myeloma worsened by service."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier Statement of Principles No. 70 of 2012 (s4) and replaces it with updated definitions, qualifying factors and application wording. It redefines myeloma for this purpose (s7), adds specific qualifying factors and exclusions (s9; Schedule 1), clarifies the causation test and limits on contribution/aggravation (s10), and confirms applicability to VEA and MRCA claims (s5). These changes alter the operative criteria claimants must meet compared with the repealed instrument."},"complexity_factors":["Legal cross‑references and application to two statutory claims schemes (authority under s3; application to VEA s120B and MRCA s339 in s5).","Medical definition and taxonomy: adopts a statutory definition of myeloma and cites ICD‑10‑AM while setting its own meaning (s7(2)–(4)).","Three discrete qualifying factors with precise inclusions/exclusions (organ/tissue transplantation excluding corneal and autologous stem cell transplantation; obesity for continuous 5 years; inability to obtain appropriate clinical management) (s9; Schedule 1).","Quantitative evidentiary requirement for obesity (BMI formula in Schedule 1) creating measurable proof obligations for claimants (Schedule 1).","Standard of proof and evidentiary framing: connection assessed as 'more probable than not' on the basis of 'sound medical‑scientific evidence' (s8), which shapes medical expert evidence and adjudicator discretion.","Causation linkage requirement: any listed factor must be related to the person's relevant service (s10(1)); s10(2) limits s9(3) to material contribution/aggravation where myeloma pre‑existed service.","Interaction with other Statements of Principles: where a listed factor refers to another injury/disease covered by a different Statement, that Statement’s factors apply (s11), creating cross‑instrument dependencies.","Instrument replacement: repeal of the 2012 Statement (s4) means entitlement criteria and definitions may have changed, requiring comparison for transitional or evidentiary effects."],"plain_english_summary":"This Statement of Principles sets the medical rules the Repatriation Medical Authority uses to decide, on the balance of probabilities, whether myeloma (including multiple myeloma and related plasma‑cell cancers) or death from myeloma is connected with a veteran’s or service member’s relevant service. It lists specific qualifying factors (certain organ/tissue transplants, obesity sustained ≥5 years defined as BMI≥30, or inability to obtain appropriate clinical management), defines key terms and repeals the 2012 statement. It applies to claims under the VEA or the MRCA."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-myeloma-balance-of-probabilities-no-96-of-2021","history":"/api/acts/statement-of-principles-concerning-myeloma-balance-of-probabilities-no-96-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-myeloma-balance-of-probabilities-no-96-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-myeloma-balance-of-probabilities-no-96-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-myeloma-balance-of-probabilities-no-96-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-myeloma-balance-of-probabilities-no-96-of-2021/documents"}}