{"id":"F2024L01704","name":"Statement of Principles concerning peritoneal adhesions (Balance of Probabilities) (No. 10 of 2025)","slug":"statement-of-principles-concerning-peritoneal-adhesions-balance-of-probabilities-no-10-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442682,"registerId":"F2024L01704-fast-fetch-1775957633711","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning peritoneal adhesions (Balance of Probabilities) (No. 10 of 2025)","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![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nPERITONEAL ADHESIONS  (Balance of Probabilities)\n\n(No. 10 of 2025)\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 17 December 2024.\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\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\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning peritoneal adhesions (Balance of Probabilities) (No. 10 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 28 January 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning peritoneal adhesions (Balance of Probabilities) (No. 4 of 2016) (Federal Register of Legislation No. F2016L00006) made under subsections 196B(3) and (8) of the VEA is repealed.\n\n1.                Application\n\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\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about peritoneal adhesions and death from peritoneal adhesions.\n\n\nMeaning of peritoneal adhesions\n\n1.           For the purposes of this Statement of Principles, peritoneal adhesions:\n  1.           means acquired permanent abnormal fibrous connections between abdominal organs or between abdominal organs and the parietal peritoneum, resulting from an abnormal inflammatory reaction of the peritoneum; and\n  2.           includes encapsulating peritoneal sclerosis (sclerosing encapsulating peritonitis); and\n  3.           excludes congenital peritoneal adhesions.\n\n\nNote: Peritoneal adhesions can be asymptomatic, or can cause bowel obstructions, dyspareunia, female infertility, obstetric complications, abdominal pain, and difficulty performing subsequent abdominal surgery.\n\n1.           While peritoneal adhesions attracts ICD‑10‑AM codes K66.0, N73.6, and N99.4, in applying this Statement of Principles the meaning of peritoneal adhesions is that given in subsection (2).\n2.           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\n\nDeath from peritoneal adhesions\n\n1.           For the purposes of this Statement of Principles, peritoneal adhesions, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's peritoneal adhesions.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that peritoneal adhesions and death from peritoneal adhesions 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\n1.                Factors that must exist\n\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, peritoneal adhesions or death from peritoneal adhesions is connected with the circumstances of a person's relevant service:\n\n1.           having peritonitis at least 3 days before clinical onset;\n2.           having one of the following diseases at least 3 days before clinical onset:\n  1.           appendicitis;\n  2.           cholecystitis;\n  3.           diverticulitis;\n  4.           endometriosis;\n  5.           inflammatory bowel disease;\n  6.            pancreatitis;\n  7.           pelvic inflammatory disease.\n3.           having intra-abdominal or pelvic surgery at least 3 days before clinical onset;\n4.           having penetrating trauma to the abdomen that enters the peritoneal cavity at least 3 days before clinical onset;\n5.           undergoing a course of ablative radiotherapy for cancer, where the abdominopelvic region was in the field of radiation, at least 3 days before clinical onset;\n6.           having a bacterial, fungal or Echinococcus granulosus infection involving the peritoneal cavity at least 3 days before clinical onset;\n7.           having a perforation of the hollow viscus into the peritoneal cavity at least 3 days before clinical onset;\n\n\nNote: A perforated hollow viscus could include a perforated stomach, gallbladder, intestine, appendix, renal pelvis, ureter, bladder, or uterus.\n\n1.           undergoing peritoneal dialysis for at least 6 months duration before  clinical onset;\n2.           undergoing intraperitoneal chemotherapy with cisplatin, oxaliplatin, carboplatin, 5-fluorouracil, mitoxantrone (mitozantrone), or mitomycin C at least 3 days before clinical onset;\n3.       having a primary or secondary malignant neoplasm involving the peritoneum at least 3 days before clinical onset;\n4.       having an ovarian dermoid cyst rupturing into the peritoneum at least 3 days before clinical onset;\n5.       having a ventriculoperitoneal shunt at least 3 days before clinical onset;\n6.       having hernia mesh inserted in the abdomen at the site of the subsequent peritoneal adhesions at least 3 days before clinical onset;\n7.       having a retained surgical sponge at least 3 days before clinical onset;\n8.       taking practolol for at least 1 year before clinical onset.\n\n\n1.            Relationship to service\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.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 9 applies in relation to a person; and\n2.           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\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                             MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                               peritoneal adhesions—see subsection 7(2).\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":4,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the Statement of Principles concerning peritoneal adhesions (No. 4 of 2016) and replaces it with No. 10 of 2025. The new instrument defines peritoneal adhesions, includes death from peritoneal adhesions, lists specific antecedent medical events/interventions and timing thresholds, requires those factors to be related to the person's relevant service, and applies to claims under section 120B of the VEA and section 339 of the MRCA. The source text does not provide a comparative analysis of how individual factors differ from the 2016 version."},"complexity_factors":["Medical and technical content: clinical definition of peritoneal adhesions, inclusion of encapsulating peritoneal sclerosis and ICD‑10‑AM references.","Enumerated causation factors with varied timing thresholds (e.g. ≥3 days, ≥6 months, ≥1 year) and diverse clinical antecedents.","Legal causation standard: 'balance of probabilities' and requirement that a listed factor be related to 'relevant service'.","Cross‑reference mechanism: factors that overlap with other Statements of Principles defer to those Statements as in force.","Statutory framing and administrative effect: instrument made under subsection 196B(3) VEA and repeals the 2016 Statement, affecting claim assessment practice.","Application scope tied to two statutes (VEA and MRCA) with defined classes of 'relevant service'.","Practical evidentiary burden on claimants to show antecedent events and service connection (medical records, surgical notes, radiotherapy records, drug histories)."],"plain_english_summary":"Updates the Repatriation Medical Authority’s Statement of Principles for peritoneal adhesions, defining the condition and listing medical events or interventions that, if present and linked to a person’s relevant service, make it more likely than not the condition is service‑related. It applies to claims under the VEA and MRCA.\n\nThe RMA issues the determination (authority: subsection 196B(3)); entitlement decisions and payments under the VEA/MRCA flow from claim assessments. Claimants must establish an antecedent factor and that it related to their relevant service; proof depends on medical records and clinical evidence."},"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 maintains the established scope of Repatriation Medical Authority Statements of Principles. It replaces the 2016 version without expanding beyond the original purpose of determining service connection for peritoneal adhesions. The 16 factors represent a standard enumeration of medical causation pathways consistent with similar instruments."},"complexity_factors":["16 distinct causal factors in section 9 with varying time thresholds (mostly 'at least 3 days before clinical onset', but one requires 'at least 6 months' and another 'at least 1 year')","Cross-referencing mechanism in section 11 allowing other Statements of Principles to be incorporated by reference","Nested definitions: 'peritoneal adhesions' defined in section 7(2) with three sub-paragraphs including inclusions/exclusions, then referenced in Schedule 1","Multiple overlapping legislative frameworks (VEA and MRCA) with distinct service categories defined in Schedule 1","Technical medical terminology throughout (peritoneum, hollow viscus, encapsulating peritoneal sclerosis, Echinococcus granulosus) requiring specialist knowledge","ICD-10-AM coding reference with specific edition citation (Tenth Edition, 1 July 2017) creating version-locking complexity"],"plain_english_summary":"This instrument sets when peritoneal adhesions (scar tissue in the abdomen) and deaths from them can be treated as caused by Australian military service for compensation purposes. It applies to veterans and current/former defence members claiming under the VEA or MRCA for non-operational peacetime and non-operational war/defence service. Claimants must show, on the balance of probabilities, that at least one qualifying medical factor related to their service preceded the condition — a decision that affects entitlement to taxpayer-funded compensation."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-peritoneal-adhesions-balance-of-probabilities-no-10-of-2025","history":"/api/acts/statement-of-principles-concerning-peritoneal-adhesions-balance-of-probabilities-no-10-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-peritoneal-adhesions-balance-of-probabilities-no-10-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-peritoneal-adhesions-balance-of-probabilities-no-10-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-peritoneal-adhesions-balance-of-probabilities-no-10-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-peritoneal-adhesions-balance-of-probabilities-no-10-of-2025/documents"}}