{"id":"F2024L01334","name":"Statement of Principles concerning subcutaneous lipoma (Balance of Probabilities) (No. 83 of 2024)","slug":"statement-of-principles-concerning-subcutaneous-lipoma-balance-of-probabilities-no-83-of-2024","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442618,"registerId":"F2024L01334-fast-fetch-1775957587801","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning subcutaneous lipoma (Balance of Probabilities) (No. 83 of 2024)","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\n\n \n\nStatement of Principles\n\nconcerning\n\nSUBCUTANEOUS LIPOMA (Balance of Probabilities)\n\n(No. 83 of 2024)\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 18 October 2024.\n\n \n\n \n\n \n\n \n\n \n\n|
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Professor Terence Campbell AM
Chairperson
by and on behalf of
The Repatriation Medical Authority |\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\n\n\n1. Name\n\n\nThis is the Statement of Principles concerning subcutaneous lipoma (Balance of Probabilities) (No. 83 of 2024).\n\n1. Commencement\n\n\n This instrument commences on 19 November 2024.\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 lipoma (Balance of Probabilities) (No. 101 of 2015) (Federal Register of Legislation No. F2015L01316) made under subsection 196B(3) of the VEA is repealed.\n\n1.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 subcutaneous lipoma and death from subcutaneous lipoma.\n\n\nMeaning of subcutaneous lipoma\n\n1. For the purposes of this Statement of Principles, subcutaneous lipoma:\n 1. means a benign neoplasm of mature adipose cells occurring in subcutaneous tissues, which is usually surrounded by a capsule; and\n 2. excludes:\n 1. breast lipoma;\n 2. fat hyperplasia;\n 3. liposarcoma; and\n 4. prolapse of adipose tissue.\n2. While subcutaneous lipoma attracts ICD‑10‑AM code D17, in applying this Statement of Principles the meaning of subcutaneous lipoma is that given in subsection (2).\n3. 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 subcutaneous lipoma\n\n1. For the purposes of this Statement of Principles, subcutaneous lipoma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's subcutaneous lipoma.\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 subcutaneous lipoma and death from subcutaneous lipoma 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, subcutaneous lipoma or death from subcutaneous lipoma is connected with the circumstances of a person's relevant service:\n\n1. having alcohol use disorder at the time of the clinical onset of benign symmetrical lipomatosis;\n\n\nNote: Benign symmetrical lipomatosis is also known as multiple symmetrical lipomatosis or Madelung disease, which usually manifests as multiple symmetrical fat deposits in the head, neck and shoulder area.\n\n1. inability to obtain appropriate clinical management for subcutaneous lipoma before clinical worsening.\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.\n 2. The factor set out in subsection 9(2) applies only to material contribution to, or aggravation of, subcutaneous lipoma where the person's subcutaneous lipoma was suffered or contracted before or during (but did not arise out of) the person's relevant service.\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 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 subcutaneous lipoma—see subsection 7(2).\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":"The legislation maintains its original narrow purpose. It replaces the 2015 lipoma Statement of Principles with a more specific focus on subcutaneous lipoma (excluding other types), but does not expand the scope beyond determining service connection for this specific benign condition. The two-factor test remains tightly constrained."},"complexity_factors":["Short document (approximately 1,500 words)","Only 5 defined terms in the Dictionary","Simple binary structure: definition section, two-factor test, relationship-to-service rule","Minimal cross-referencing (only to other Statements of Principles in section 11, and standard references to VEA/MRCA)","No nested exceptions or conditional logic beyond the basic 'at least one factor must exist' requirement","Straightforward exclusion list (4 items) in the definition of subcutaneous lipoma"],"plain_english_summary":"This instrument updates the medical rules for when Australian veterans and defence members can claim compensation for subcutaneous lipoma, replacing the 2015 policy. It narrowly defines the condition (excluding breast lipomas, malignant fatty tumours, and similar lesions) and limits service connection to only two exceptional situations: a specific alcohol-related form (benign symmetrical lipomatosis/Madelung disease) or worsening caused by inability to obtain appropriate treatment.\n\nIt matters because ordinary, common lipomas are generally not considered caused by service, sharply restricting eligibility."},"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"},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":false,"description":"This instrument repeals the 2015 Statement and reissues a Statement defining subcutaneous lipoma, death from it, the evidentiary basis and the qualifying factors for connection to service. Based solely on the text provided, the core scope—deciding service connection for subcutaneous lipoma and related death for VEA/MRCA claims—remains the same; the instrument specifies the particular factors and limits that must be established (see ss.5, 7–11)."},"complexity_factors":["Technical medical definitions and narrow exclusions for subcutaneous lipoma (Schedule 1; s.7(2)–(3)): requires application of clinical diagnostic criteria versus ICD‑10‑AM coding.","Definition of death linked via a ‘‘terminal event’’ with enumerated causes (Schedule 1), requiring causal chaining in medico‑legal assessments (s.7(4); Schedule 1).","Explicit evidentiary standard ‘‘balance of probabilities’’ and statement of RMA view as basis for factors (s.8), imposing a civil standard on medical connection.","Qualifying factors are limited and specific (s.9): alcohol use disorder at clinical onset of benign symmetrical lipomatosis (s.9(1)) and inability to obtain appropriate clinical management before worsening (s.9(2)), the latter potentially requiring factual proof of access or system failure.","Relationship‑to‑service rules add nuance: factors must be related to relevant service and s.10(2) limits s.9(2) to material contribution or aggravation of pre‑existing conditions, creating distinct causal pathways (s.10).","Cross‑reference to other Statements of Principles (s.11) creates dependency on other instruments where factors refer to other injuries/diseases, increasing interpretive complexity.","Application and repeal mechanics: applies to VEA/MRCA claims (s.5) and expressly repeals the 2015 Statement (s.4), so decision‑makers must map prior and current instruments when handling legacy claims.","Reference to external classification (ICD‑10‑AM) requires concordance between statutory wording and clinical coding systems (s.7(3)).","Some assessments (e.g. ‘‘inability to obtain appropriate clinical management’’) involve non‑medical evidence (access, timing, service records), increasing evidentiary and administrative burden (s.9(2))."],"plain_english_summary":"This instrument replaces an earlier Statement and sets the medical criteria used to decide whether subcutaneous lipoma (a benign fat tumour in subcutaneous tissue, excluding breast lipoma, liposarcoma, fat hyperplasia and adipose prolapse) is connected to a veteran’s or member’s service for VEA/MRCA claims. It records the Repatriation Medical Authority’s view that, on the balance of probabilities, such a connection can exist and identifies two qualifying factors: alcohol use disorder at onset of benign symmetrical lipomatosis, or inability to obtain appropriate clinical management before clinical worsening."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-subcutaneous-lipoma-balance-of-probabilities-no-83-of-2024","history":"/api/acts/statement-of-principles-concerning-subcutaneous-lipoma-balance-of-probabilities-no-83-of-2024/history","analysis":"/api/acts/statement-of-principles-concerning-subcutaneous-lipoma-balance-of-probabilities-no-83-of-2024/analysis","conflicts":"/api/acts/statement-of-principles-concerning-subcutaneous-lipoma-balance-of-probabilities-no-83-of-2024/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-subcutaneous-lipoma-balance-of-probabilities-no-83-of-2024/important-cases","documents":"/api/acts/statement-of-principles-concerning-subcutaneous-lipoma-balance-of-probabilities-no-83-of-2024/documents"}}