{"id":"F2019L00248","name":"Statement of Principles concerning pilonidal sinus (Reasonable Hypothesis) (No. 27 of 2019)","slug":"statement-of-principles-concerning-pilonidal-sinus-reasonable-hypothesis-no-27-of-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":98859,"registerId":"commonwealth-F2019L00248-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning pilonidal sinus (Reasonable Hypothesis) (No. 27 of 2019)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning pilonidal sinus (Reasonable Hypothesis) (No. 27 of 2019)\n\nmade under subsection 196B(2) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 20 December 2021\n\nIncludes amendments up to: Amendment Statement of Principles concerning pilonidal sinus (Reasonable Hypothesis) (No. 115 of 2021) (F2021L01633)\n\nThe day of commencement of this Amendment Statement of Principles concerning pilonidal sinus is 20 December 2021.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning pilonidal sinus (Reasonable Hypothesis) (No. 27 of 2019) that shows the text of the law as amended and in force on 20 December 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\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\nEndnotes\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\n  \n\n1 Name\n\nThis is the Statement of Principles concerning pilonidal sinus (Reasonable Hypothesis) (No. 27 of 2019).\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n5 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\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 pilonidal sinus and death from pilonidal sinus.\n\nMeaning of pilonidal sinus\n\n(2) For the purposes of this Statement of Principles, pilonidal sinus:\n\n(a) means an inflammatory tissue reaction of the skin to an embedded hair which is manifested by the development of a sinus or fistula; and\n\n(b) includes pilonidal cyst and pilonidal fistula; and\n\n(c) excludes ingrown hair.\n\n> Note: Pilonidal sinus principally occurs in the sacrococcygeal region, but can also occur in the interdigital webs of the hands and in other regions of the body.\n\n(3) While pilonidal sinus attracts ICD‑10‑AM code L05, in applying this Statement of Principles the meaning of pilonidal sinus 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 pilonidal sinus\n\n(5) For the purposes of this Statement of Principles, pilonidal sinus, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's pilonidal sinus.\n\n> Note: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that pilonidal sinus and death from pilonidal sinus 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\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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting pilonidal sinus or death from pilonidal sinus with the circumstances of a person's relevant service:\n\n(1) for pilonidal sinus of the hand or foot only:\n\n(a) working as a hairdresser or barber within the six months before the clinical onset of pilonidal sinus; or\n\n(b) having cutaneous exposure to animal hair within the six months before the clinical onset of pilonidal sinus;\n\n> Note: having cutaneous exposure to animal hair is defined in the Schedule 1 \\- Dictionary.\n\n(2) for pilonidal sinus of the sacrococcygeal region only:\n\n(a) driving or being a seated passenger in a motorised vehicle for an average of at least 20 hours per week for a period of at least three months, within the six months before the clinical onset of pilonidal sinus; or\n\n(aa) sitting on a hard or vibrating surface for an average of at least 20 hours per week for a period of at least three months, within the six months before the clinical onset of pilonidal sinus; or\n\n(b) being overweight or obese within the six months before the clinical onset of pilonidal sinus;\n\n> Note: being overweight or obese is defined in the Schedule 1 \\- Dictionary.\n\n(3) for pilonidal sinus of the sacrococcygeal and umbilical regions only, inability to shower or bathe more than two times per week for a period of at least four weeks, within the six months before the clinical onset of pilonidal sinus;\n\n(4) for pilonidal sinus of the hand or foot only:\n\n(a) working as a hairdresser or barber within the six months before the clinical worsening of pilonidal sinus; or\n\n(b) having cutaneous exposure to animal hair within the six months before the clinical worsening of pilonidal sinus;\n\n> Note: having cutaneous exposure to animal hair is defined in the Schedule 1 \\- Dictionary.\n\n(5) for pilonidal sinus of the sacrococcygeal region only:\n\n(a) driving or being a seated passenger in a motorised vehicle for an average of at least 20 hours per week for a period of at least three months, within the six months before the clinical worsening of pilonidal sinus; or\n\n(aa) sitting on a hard or vibrating surface for an average of at least 20 hours per week for a period of at least three months, within the six months before the clinical worsening of pilonidal sinus; or\n\n(b) being overweight or obese within the six months before the clinical worsening of pilonidal sinus;\n\n> Note: being overweight or obese is defined in the Schedule 1 \\- Dictionary.\n\n(6) for pilonidal sinus of the sacrococcygeal and umbilical regions only, inability to shower or bathe more than two times per week for a period of at least four weeks, within the six months before the clinical worsening of pilonidal sinus;\n\n(7) inability to obtain appropriate clinical management for pilonidal sinus.\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 factors set out in subsections 9(4) to 9(7) apply only to material contribution to, or aggravation of, pilonidal sinus where the person's pilonidal sinus 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(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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\nbeing overweight or obese means having a Body Mass Index (BMI) of 25 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\nhaving cutaneous exposure to animal hair means milking, shearing, grooming, clipping or slaughtering animals.\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\npilonidal sinus—see subsection 7(2).\n\nrelevant 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\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\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 pilonidal sinus (Reasonable Hypothesis) (No. 27 of 2019)            | 5 March 2019F2019L00248     | 25 March 2019    |                                                 |\n| Amendment Statement of Principles concerning pilonidal sinus (Reasonable Hypothesis) (No. 115 of 2021) | 29 November 2021F2021L01633 | 20 December 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| Subsection 9(2)(aa)….. | ad No. 115 of 2021 |\n| Subsection 9(5)(aa)….. | ad No. 115 of 2021 |","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"The Statement's substantive scope was expanded by Amendment No.115 of 2021 to add 'sitting on a hard or vibrating surface' as an exposure factor for sacrococcygeal pilonidal sinus (added to subsections 9(2)(aa) and 9(5)(aa)), thereby broadening the circumstances that can raise a reasonable hypothesis linking the condition to service. Other core elements (definitions, time windows, BMI threshold, hygiene and hair‑exposure factors) remain as set in the instrument."},"complexity_factors":["Multiple, body‑region specific criteria (s9) distinguishing sacrococcygeal, umbilical, hand and foot presentations.","Temporal and quantitative qualifiers: time windows (within six months), minimum durations (eg. ≥3 months, ≥20 hours/week), and short periods (eg. 4 weeks).","Overlap between onset and clinical worsening rules (s9(1)–(6)) and separate factor for inability to obtain appropriate clinical management (s9(7)).","Definitions and measurements in the Schedule (BMI calculation and threshold of 25; definition of 'having cutaneous exposure to animal hair') affect applying factors.","Cross‑references to other Statements of Principles (s11) create dependency where factors refer to other covered injuries/diseases.","Service linkage requirement and limits on aggravation/material contribution (s10(1)–(2)) require fact‑specific causal inquiry.","Recent amendment adding 'sitting on a hard or vibrating surface' for sacrococcygeal onset/worsening (subsecs 9(2)(aa) and 9(5)(aa); Amdt No.115 of 2021)."],"plain_english_summary":"**What this instrument does:** This Statement of Principles sets the medical criteria used to decide whether pilonidal sinus (including death from it) can be reasonably connected to a person’s relevant service. It specifies time‑bounded exposure and clinical factors (for example: prolonged seated driving, exposure to animal or human hair, BMI ≥25, restricted hygiene, or lack of appropriate clinical care) that, when related to service, raise a ‘reasonable hypothesis’ for entitlement claims under the VEA or the MRCA."},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This legislation remains tightly focused on its original purpose: establishing the medical criteria for linking pilonidal sinus to military service. The 2021 amendment added one factor (sitting on hard/vibrating surfaces) to both onset and worsening sections, but this represents a modest expansion within the existing framework rather than scope creep. The instrument maintains its narrow, condition-specific focus typical of Repatriation Medical Authority Statements of Principles."},"complexity_factors":["Multiple anatomical location-specific factor sets (hand/foot vs sacrococcygeal vs sacrococcygeal and umbilical) creating parallel but distinct tests","Temporal requirements embedded throughout (\"within the six months before\", \"for a period of at least three months\", \"for a period of at least four weeks\")","Dual structure for onset vs worsening (subsections 9(1)-(3) for onset, 9(4)-(6) for worsening) with nearly identical but slightly varied language","Cross-references to external legislation (VEA, MRCA) and other Statements of Principles via section 11","Mathematical formula for BMI definition (W/H²) in the Dictionary","Specific exclusion (ingrown hair) and inclusion (pilonidal cyst, pilonidal fistula) definitions in section 7","Reference to specific medical classification system (ICD-10-AM Tenth Edition, 1 July 2017) with ISBN and copyright holder"],"plain_english_summary":"This Statement of Principles sets the medical rules for linking pilonidal sinus to military service for compensation decisions. It applies to veterans and current/former Defence members and the DVA decision-makers who assess their claims.\n\nIt adopts a “reasonable hypothesis” test favoring claimants: certain service-related exposures (e.g., occupational contact with hair/animal hair, prolonged driving/sitting, elevated BMI, poor access to hygiene, or lack of treatment) can establish a service connection unless disproven. Factors must be tied to the person’s service."},"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-pilonidal-sinus-reasonable-hypothesis-no-27-of-2019","history":"/api/acts/statement-of-principles-concerning-pilonidal-sinus-reasonable-hypothesis-no-27-of-2019/history","analysis":"/api/acts/statement-of-principles-concerning-pilonidal-sinus-reasonable-hypothesis-no-27-of-2019/analysis","conflicts":"/api/acts/statement-of-principles-concerning-pilonidal-sinus-reasonable-hypothesis-no-27-of-2019/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-pilonidal-sinus-reasonable-hypothesis-no-27-of-2019/important-cases","documents":"/api/acts/statement-of-principles-concerning-pilonidal-sinus-reasonable-hypothesis-no-27-of-2019/documents"}}