{"id":"F2018L01490","name":"Statement of Principles concerning non-Hodgkin lymphoma (Balance of Probabilities) (No. 91 of 2018)","slug":"statement-of-principles-concerning-non-hodgkin-lymphoma-balance-of-probabilities-no-91-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":98161,"registerId":"commonwealth-F2018L01490-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning non-Hodgkin lymphoma (Balance of Probabilities) (No. 91 of 2018)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning non-Hodgkin lymphoma (Balance of Probabilities) (No. 91 of 2018)\n\nmade under subsection 196B(3) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 21 June 2021\n\nIncludes amendments up to: Amendment Statement of Principles concerning non-Hodgkin lymphoma (Balance of Probabilities) (No. 76 of 2021) (F2021L00612)\n\nThe day of commencement of this Amendment Statement of Principles concerning non-Hodgkin lymphoma is 21 June 2021.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning non-Hodgkin lymphoma (Balance of Probabilities) (No. 91 of 2018) that shows the text of the law as amended and in force on 21 June 2021.\n\nThe notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.\n\nUncommenced amendments\n\nThe effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.\n\nApplication, saving and transitional provisions for provisions and amendments\n\nIf the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.\n\nModifications\n\nIf the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.\n\nSelf‑repealing provisions\n\nIf a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.\n\n![RMA-Red](image.002.jpeg)\n\nStatement of Principles\n\nconcerning\n\nNON-HODGKIN LYMPHOMA  \n(Balance of Probabilities)\n\n(No. 91 of 2018)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\nDated 26 October 2018\n\n  \n\nContents\n\n1 Name\n\n3 Authority\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\n1 Name\n\nThis is the Statement of Principles concerning non-Hodgkin lymphoma (Balance of Probabilities) (No. 91 of 2018).\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\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 non-Hodgkin lymphoma and death from non-Hodgkin lymphoma.\n\nMeaning of non-Hodgkin lymphoma\n\n(2) For the purposes of this Statement of Principles, non-Hodgkin lymphoma:\n\n(a) means a heterogeneous group of malignant lymphoproliferative diseases that originate from T and B lymphocytes, and present as solid tumours of the immune system that lack Reed-Sternberg cells; and\n\n(b) includes Burkitt lymphoma, mycosis fungoides, adult T cell lymphoma/leukaemia and non-Hodgkin lymphoma arising within parenchymal organs; and\n\n(c) excludes myeloma, hairy cell leukaemia, Waldenström macroglobulinaemia, acute lymphoblastic leukaemia and chronic lymphocytic leukaemia/small lymphocytic lymphoma.\n\nDeath from non-Hodgkin lymphoma\n\n(3) For the purposes of this Statement of Principles, non-Hodgkin lymphoma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's non-Hodgkin lymphoma.\n\n> Note: 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 non-Hodgkin lymphoma and death from non-Hodgkin lymphoma can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\n> Note: 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, non-Hodgkin lymphoma or death from non-Hodgkin lymphoma is connected with the circumstances of a person's relevant service:\n\n(1) having infection with human immunodeficiency virus at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(2) undergoing solid organ, stem cell or bone marrow transplantation before the clinical onset of non-Hodgkin lymphoma;\n\n(3) having an autoimmune disease from the specified list of autoimmune diseases before the clinical onset of non-Hodgkin lymphoma;\n\n> Note: specified list of autoimmune diseases is defined in the Schedule 1 \\- Dictionary.\n\n(4) for cutaneous T-cell lymphoma only, having psoriasis at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(5) being treated with a drug from the specified list of systemic immunosuppressive drugs for a continuous period of at least three months before the clinical onset of non-Hodgkin lymphoma, and where that exposure has ceased, the clinical onset of non-Hodgkin lymphoma has occurred within ten years of cessation;\n\n> Note: specified list of systemic immunosuppressive drugs is defined in the Schedule 1 \\- Dictionary.\n\n(6) for Richter syndrome only, having chronic lymphoid leukaemia/small lymphocytic lymphoma at the time of the clinical onset of non‑Hodgkin lymphoma;\n\n> Note: Richter syndrome is defined in the Schedule 1 \\- Dictionary.\n\n(7) for adult T-cell leukaemia-lymphoma only, having infection with human T-cell lymphotropic virus type-1 at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(8) for gastric lymphoma only, having infection with Helicobacter pylori at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(9) having infection with Epstein-Barr virus before the clinical onset of non-Hodgkin lymphoma;\n\n(10) for primary effusion lymphoma and Kaposi's sarcoma herpesvirus-positive diffuse large B-cell lymphoma not otherwise specified only, having infection with Kaposi's sarcoma herpesvirus at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(11) for small intestinal mucosa-associated lymphoid tissue lymphoma only, having infection with Campylobacter jejuni at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(12) for ocular adnexal mucosa-associated lymphoid tissue lymphoma only, having infection with Chlamydia psittaci at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(13) for cutaneous mucosa-associated lymphoid tissue lymphoma only, having infection with specified bacteria belonging to the Borrelia burgdorferi sensu lato complex at the time of the clinical onset of non‑Hodgkin lymphoma;\n\n> Note: specified bacteria belonging to the Borrelia burgdorferi sensu lato complex is defined in the Schedule 1 \\- Dictionary.\n\n(14) having infection with hepatitis C virus at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(15) for B-cell lymphoma only, having infection with hepatitis B virus at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(16) for Burkitt lymphoma only, having infection with Plasmodium falciparum at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(17) having Hodgkin's lymphoma before the clinical onset of non-Hodgkin lymphoma;\n\n(18) being obese for at least ten years within the 20 years before the clinical onset of non-Hodgkin lymphoma;\n\n> Note: being obese is defined in the Schedule 1 – Dictionary.\n\n(19) for diffuse large B-cell lymphoma only, having chronic inflammation as specified at the affected site for at least ten years before the clinical onset of non-Hodgkin lymphoma;\n\n> Note: chronic inflammation as specified is defined in the Schedule 1 – Dictionary.\n\n(20) for anaplastic large cell lymphoma of the breast only, having a breast implant at the time of the clinical onset of non-Hodgkin lymphoma;\n\n(21) inhaling, ingesting or having cutaneous contact with lindane on more days than not for a cumulative period of at least one year, at least five years before the clinical onset of non-Hodgkin lymphoma;\n\n> Note: lindane is defined in the Schedule 1 – Dictionary.\n\n(22) inhaling, ingesting or having cutaneous contact with pentachlorophenol:\n\n(a) for a cumulative period of at least 2 000 hours, within a consecutive period of ten years, before the clinical onset of non‑Hodgkin lymphoma; and\n\n(b) where the first exposure occurred at least five years before the clinical onset of non-Hodgkin lymphoma;\n\n(23) inability to obtain appropriate clinical management for non-Hodgkin lymphoma.\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(23) applies only to material contribution to, or aggravation of, non-Hodgkin lymphoma where the person's non-Hodgkin lymphoma 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\nbeing obese means having a Body Mass Index (BMI) of 30 or greater.\n\n> Note: BMI is also defined in the Schedule 1 - Dictionary.\n\nBMI means W/H2 where:\n\nW is the person's weight in kilograms; and\n\nH is the person's height in metres.\n\nchronic inflammation as specified means chronic suppuration or inflammation arising in settings such as pyothorax resulting from artificial pneumothorax for treatment of pulmonary or pleural tuberculosis, chronic osteomyelitis, metallic implant insertion, surgical mesh implantation and chronic skin venous ulcer.\n\nlindane means a complex synthetic mixture in which the gamma-isomer of hexachlorocyclohexane is present.\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\nnon-Hodgkin lymphoma—see subsection 7(2).\n\nrelevant 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\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\nRichter syndrome means a form of high-grade large cell lymphoma, characterised by systemic symptoms, rapid tumour growth and extra-nodal involvement, which develops in patients with chronic lymphocytic leukaemia.\n\nspecified bacteria belonging to the Borrelia burgdorferi sensu lato complex means Borrelia burgdorferi sensu stricto, Borrelia afzelii, Borrelia garinii, Borrelia spielmanii, Borrelia bavariensis, Borrelia bissettii, Borrelia lusitaniae, Borrelia valaisiana or Borrelia mayonii.\n\nspecified list of autoimmune diseases means:\n\n(a) autoimmune haemolytic anaemia;\n\n(b) biliary cirrhosis;\n\n(c) coeliac disease;\n\n(d) dermatitis herpetiformis;\n\n(e) dermatomyositis;\n\n(f) Hashimoto's thyroiditis or chronic lymphocytic thyroiditis;\n\n(g) immune thrombocytopaenia;\n\n(h) inflammatory bowel disease;\n\n(i) myasthenia gravis;\n\n(j) polyarteritis nodosa;\n\n(k) polymyositis;\n\n(l) rheumatoid arthritis;\n\n(m) sarcoidosis;\n\n(n) Sjogren syndrome;\n\n(o) systemic lupus erythematosus; or\n\n(p) systemic sclerosis or localised sclerosis.\n\nspecified list of systemic immunosuppressive drugs means:\n\n(a) azathioprine;\n\n(b) methotrexate; or\n\n(c) 6-mercaptopurine.\n\nterminal 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\nVEA means the Veterans' Entitlements Act 1986.\n\n> Note: Endnotes\n\n> Note: Endnote 1—About the endnotes\n\nThe endnotes provide information about this compilation and the compiled law.\n\nThe following endnotes are included in every compilation:\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\nAbbreviation key—Endnote 2\n\nThe abbreviation key sets out abbreviations that may be used in the endnotes.\n\nLegislation history and amendment history—Endnotes 3 and 4\n\nAmending laws are annotated in the legislation history and amendment history.\n\nThe legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.\n\nThe amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.\n\nMisdescribed amendments\n\nA misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.\n\nIf a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.\n\n> Note: Endnote 2—Abbreviation key\n\n|                                                | o = order(s)                        |\n| ---------------------------------------------- | ----------------------------------- |\n| ad = added or inserted                         | Ord = Ordinance                     |\n| am = amended                                   | orig = original                     |\n| amdt = amendment                               | par = paragraph(s)/subparagraph(s)  |\n| c = clause(s)                                  | /sub‑subparagraph(s)                |\n| C[x] = Compilation No. x                       | pres = present                      |\n| Ch = Chapter(s)                                | prev = previous                     |\n| def = definition(s)                            | (prev…) = previously                |\n| Dict = Dictionary                              | Pt = Part(s)                        |\n| disallowed = disallowed by Parliament          | r = regulation(s)/rule(s)           |\n| Div = Division(s)                              |                                     |\n| exp = expires/expired or ceases/ceased to have | reloc = relocated                   |\n| effect                                         | renum = renumbered                  |\n| F = Federal Register of Legislation            | rep = repealed                      |\n| gaz = gazette                                  | rs = repealed and substituted       |\n| LA = Legislation Act 2003                      | s = section(s)/subsection(s)        |\n| LIA = Legislative Instruments Act 2003         | Sch = Schedule(s)                   |\n| (md) = misdescribed amendment can be given     | Sdiv = Subdivision(s)               |\n| effect                                         | SLI = Select Legislative Instrument |\n| (md not incorp) = misdescribed amendment       | SR = Statutory Rules                |\n| cannot be given effect                         | Sub‑Ch = Sub‑Chapter(s)             |\n| mod = modified/modification                    | SubPt = Subpart(s)                  |\n| No. = Number(s)                                | underlining = whole or part not     |\n|                                                | commenced or to be commenced        |\n\n> Note: Endnote 3—Legislation history\n\n| Name                                                                                                          | Registration               | Commencement     | Application, saving and transitional provisions |\n| ------------------------------------------------------------------------------------------------------------- | -------------------------- | ---------------- | ----------------------------------------------- |\n| Statement of Principles concerning non-Hodgkin lymphoma (Balance of Probabilities) (No. 91 of 2018)           | 29 October 2018F2018L01490 | 26 November 2018 |                                                 |\n| Amendment Statement of Principles concerning non-Hodgkin lymphoma (Balance of Probabilities) (No. 76 of 2021) | 24 May 2021F2021L00612     | 21 June 2021     |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected | How affected      |\n| ------------------ | ----------------- |\n| Section 2……………….   | rep LA s 48D      |\n| Section 4……………….   | rep LA s 48C      |\n| Section 9(9)………….  | am No. 76 of 2021 |","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":4,"scope_assessment":{"changed":false,"description":"This instrument remains focused on its original purpose: establishing the medical criteria for linking non-Hodgkin lymphoma to veterans' service. The 2021 amendment (No. 76 of 2021) was a minor technical amendment to section 9(9) regarding Epstein-Barr virus, not an expansion of scope. The instrument maintains its narrow, technical medical-legal function without significant mission creep."},"complexity_factors":["22 defined terms in Schedule 1 Dictionary, including nested definitions (e.g., 'being obese' refers to BMI, which has its own formula)","Multiple condition-specific factors that apply only to particular subtypes of non-Hodgkin lymphoma (e.g., factors 4, 6-8, 10-13, 15-16, 19-20 are limited to specific variants)","Temporal requirements with varying windows (e.g., 'at least 10 years within the 20 years before', 'within ten years of cessation', 'at least five years before')","Cross-references to other Statements of Principles via section 11","Dual legislative framework application (VEA and MRCA with different service definitions)","Specific exclusion list in section 7(2)(c) distinguishing non-Hodgkin lymphoma from related conditions like myeloma and leukaemia"],"plain_english_summary":"This Statement of Principles sets the medical rules the Repatriation Medical Authority must use to decide whether non‑Hodgkin lymphoma is “more likely than not” connected to military service, affecting veterans and current/former defence members claiming under veterans’ laws.\n\nIt lists 23 medical factors (infections, certain treatments and immunosuppression, autoimmune disease, long‑term obesity, some chemical exposures, implants, chronic inflammation), explains legal concepts like “balance of probabilities” and “clinical onset,” and determines eligibility for disability pensions and benefits."},"flash_summary":{"complexity_score":7,"scope_assessment":{"changed":false,"description":"This instrument remains narrowly focused on setting the medical causation rules linking non‑Hodgkin lymphoma (and death from it) to relevant service for veteran/military claims. The only recorded amendment up to the compilation date (Amendment No. 76 of 2021) modifies one sub‑factor (section 9(9)), which is a technical adjustment to the list of causation factors rather than a substantive broadening of the instrument’s purpose. In other words, the Statement’s scope — to enumerate medical and exposure factors that, if proved and related to relevant service, suffice to support a finding of service connection — has not been expanded beyond its original intent (see Endnote 3 and Endnote 4 referencing the 2021 amendment)."},"complexity_factors":["Relatively large list of discrete causation factors (23 listed in section 9) including subtype‑specific items (many factors apply only to particular NHL subtypes).","Multiple defined term lists in Schedule 1: specified list of autoimmune diseases (16 entries), specified bacteria list (9 entries), specified list of systemic immunosuppressive drugs (3 entries).","Quantitative and temporal conditions attached to exposures: e.g. continuous systemic immunosuppressive drug use for ≥3 months with a 10‑year post‑cessation window (s9(5)); lindane exposure on \"more days than not\" for a cumulative ≥1 year occurring ≥5 years before onset (s9(21)); pentachlorophenol cumulative 2,000 hours within 10 years and first exposure ≥5 years before onset (s9(22)).","Multiple cross‑references: the instrument ties into the VEA and MRCA claim provisions (s5) and other Statements of Principles where a factor refers to a disease covered elsewhere (s11).","Precision requirements for medical classification: subtype‑specific infections and syndromes (e.g. Richter syndrome definition in Schedule 1), increasing demand for specialist pathology/infectious disease evidence. ","Conditional limitation on factor 23 (inability to obtain appropriate clinical management) — its operation is restricted by s10(2), adding an exception layer. ","Numerical definitions and formulae in the Schedule (BMI = W/H2) and legal thresholds (BMI ≥ 30).","Amendment history and incremental changes: at least one post‑2018 amendment affecting a factor (section 9(9) amended in 2021), which requires readers to check current compiled text and history for small but material textual changes. "],"plain_english_summary":"**What this instrument does (mechanics first)**\n\n- This is a \"Statement of Principles\" made by the Repatriation Medical Authority under subsection 196B(3) of the Veterans' Entitlements Act 1986 (see section 3).  Mechanically, it sets the medical‑causation rules the Department uses when deciding whether non‑Hodgkin lymphoma (NHL) — or death from NHL — is connected with a person’s relevant military service for the purposes of claims under section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 (see section 5).\n\n- It does not itself pay benefits; it provides the legal/medical test that decision‑makers apply when assessing entitlement to service‑related compensation or treatment. The Repatriation Medical Authority makes the Statement (s3); decision makers in the veterans’ compensation system apply it to individual claims. (See sections 3 and 5.)\n\n**Who this affects**\n\n- Veterans and current/former members of the Forces who lodge claims for NHL or death from NHL under the VEA or MRCA (s5).  \n- Clinicians and medical experts who provide evidence for those claims, because the instrument specifies particular medical conditions, infections and exposures that count as causal factors (section 9 and Schedule 1).  \n- Administrators and adjudicators in the veterans’ compensation system, who must test claim facts against the listed factors and the requirement that any factor be related to the person's relevant service (section 10).\n\n**Plain description of the legal test**\n\n- The Authority states that, based on the available medical‑scientific evidence, it is \"more probable than not\" that NHL can be related to relevant service (section 8).  \n- The Statement lists specific factors (section 9). A claimant needs at least one listed factor to be present in the person’s medical/history record before NHL (or death from NHL) can be accepted, on the balance of probabilities, as connected with their service.  \n- Examples of listed factors include infection with certain viruses or bacteria (e.g. Epstein‑Barr virus (s9(9)), hepatitis C (s9(14)), Helicobacter pylori for gastric lymphoma (s9(8))), prior autoimmune diseases (s9(3)), prior cancers (s9(17)), organ transplantation (s9(2)), long‑term obesity (s9(18)) and specific occupational/chemical exposures such as lindane or pentachlorophenol under defined exposure thresholds (s9(21)–(22)). Some factors apply only to specific NHL subtypes (e.g. anaplastic large cell lymphoma of the breast and breast implants, s9(20)).  \n- The Schedule (Schedule 1) defines key terms used in the test — for example, what counts as \"being obese\" (BMI ≥ 30), what counts as \"lindane\", the list of autoimmune diseases, and the precise bacterial or viral agents referenced.\n\n**How the relationship to service is treated**\n\n- Any factor that is cited under section 9 must be related to the person’s relevant service as defined in the Schedule (section 10(1)).  \n- One listed factor (inability to obtain appropriate clinical management, s9(23)) is limited to situations where the person already had NHL before or during service and the inability to obtain management materially contributed to or aggravated their condition (section 10(2)).\n\n**Why this matters (official purpose and practical effects)**\n\n- Official purpose: the Authority says the Statement reflects the medical‑scientific view that NHL can be linked to relevant service on the balance of probabilities (section 8). That is, the Statement gives a pre‑specified set of clinical and exposure circumstances in which causation for claims may be accepted more readily.\n\n- Practical effects and incentives: \n  - Claimants with one or more listed factors potentially face an easier path to establishing service connection than if every case required fresh, case‑by‑case medical proof of causal linkage. The presence of a listed factor functions as a legal/medical trigger the decision maker may rely on. (See section 9.)\n  - Claimants bear the evidentiary burden of proving the presence of listed factors and showing those factors were related to relevant service (sections 9 and 10). This creates demand for medical records, laboratory tests, occupational histories, and expert reports. Examples of potentially burdensome proof: cumulative exposure hours for pentachlorophenol (s9(22)); multi‑year exposure windows for lindane (s9(21)); proof of prior infections or specific bacterial/viral agents as defined in the Schedule.\n  - The Statement narrows eligibility to the enumerated factors and defined conditions. If a claimant’s potential cause is not on the list, the Statement does not help establish service connection; the decision maker must then consider other evidence according to the usual law and policy.\n\n**Costs, trade‑offs and implementation risks**\n\n- Administrative and compliance costs: decision makers and claimants will need to collect, review and judge extra‑medical evidence (occupational histories, chemical exposure logs, implant records, BMI records, infection tests). Some items require specific laboratory confirmation (e.g. HTLV‑1, H. pylori, hepatitis viruses) or long historical documentation (exposure durations).  \n- Medical uncertainty and interpretation: several factors are subtype‑specific (e.g. Burkitt lymphoma and Plasmodium falciparum, s9(16); Richter syndrome and CLL/SLL, s9(6)). Adjudicators and experts must apply histological or subtype definitions in evidence, creating scope for medical interpretation and dispute.  \n- Potential for substitution effects: claimants without listed factors may seek different legal avenues or newer expert opinions to prove causation; conversely, those with listed factors may rely heavily on the Statement to establish causation.  \n- Concentrated benefits and diffuse costs: the benefits (accepted claims) will be concentrated on claimants who can document the listed infections/exposures; costs (administration, testing) are spread across the compensation system.  \n- Bureaucratic discretion: although the Statement prescribes factors, adjudicators still apply it to individual records (connection to relevant service, timing, and proof), which leaves room for case‑by‑case judgment (sections 9–11).\n\n**Key text pointers for practitioners**\n\n- Which claims it covers: section 5.  \n- The causation test and requirement of at least one factor: section 9.  \n- Relationship of any found factor to relevant service: section 10.  \n- Definitions that control meaning (obesity, infections, specified drugs, exposure agents): Schedule 1.\n\n(Reference: Statement of Principles concerning non‑Hodgkin lymphoma (Balance of Probabilities) (No. 91 of 2018), sections 3, 5, 8–11 and Schedule 1.)"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-non-hodgkin-lymphoma-balance-of-probabilities-no-91-of-2018","history":"/api/acts/statement-of-principles-concerning-non-hodgkin-lymphoma-balance-of-probabilities-no-91-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-non-hodgkin-lymphoma-balance-of-probabilities-no-91-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-non-hodgkin-lymphoma-balance-of-probabilities-no-91-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-non-hodgkin-lymphoma-balance-of-probabilities-no-91-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-non-hodgkin-lymphoma-balance-of-probabilities-no-91-of-2018/documents"}}