{"id":"F2024L00742","name":"Statement of Principles concerning traumatic contusion or haematoma (Balance of Probabilities) (No. 44 of 2024)","slug":"statement-of-principles-concerning-traumatic-contusion-or-haematoma-balance-of-probabilities-no-44-o","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442441,"registerId":"F2024L00742-fast-fetch-1775957449201","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning traumatic contusion or haematoma (Balance of Probabilities) (No. 44 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![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nTRAUMATIC CONTUSION OR HAEMATOMA  (Balance of Probabilities)\n\n(No. 44 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 21 June 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\n1               Name\n\nThis is the Statement of Principles concerning traumatic contusion or haematoma (Balance of Probabilities) (No. 44 of 2024).\n\n2               Commencement\n\n              This instrument commences on 23 July 2024.\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 external bruise No. 6 of 2016 (Federal Register of Legislation No. F2016L00005) made under subsection 196B(3) 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 traumatic contusion or haematoma and death from traumatic contusion or haematoma.\n\nMeaning of traumatic contusion or haematoma\n\n(2)          For the purposes of this Statement of Principles, traumatic contusion or haematoma:\n\n(a)          means a blood collection in the skin, tissue or organ as a result of application of physical force causing tissue damage and internal bleeding; and\n\n(b)          includes traumatic contusion of organs including the heart, pericardium, lung, pleura, liver, spleen, and kidneys, bone, joint, eye, orbit; and\n\n(c)          excludes:\n\n(i)            blood collections associated with a fracture; and\n\n(ii)         blood collections associated with subarachnoid haemorrhage, subdural haemorrhage, extradural haemorrhage or cerebrovascular accident;\n\nNote 1: If traumatic haematoma is only affecting the brain, then the moderate to severe traumatic brain injury SoP would be preferred.\n\nNote 2: Some traumatic contusions or haemorrhage can continue to enlarge due to persistent bleeding.\n\nNote 3: Some haematomas can compress surrounding structures such as nerves, and vessels. An acute compartment syndrome due to the blood collection is considered an integral manifestation of the contusion. \n\nDeath from traumatic contusion or haematoma\n\n(3)          For the purposes of this Statement of Principles, traumatic contusion or haematoma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's traumatic contusion or haematoma.\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 traumatic contusion or haematoma and death from traumatic contusion or haematoma 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, traumatic contusion or haematoma or death from traumatic contusion or haematoma is connected with the circumstances of a person's relevant service:\n\n(1)          having trauma involving the affected site within the 24 hours before clinical onset;\n\n(2)          inability to obtain appropriate clinical management for traumatic contusion or haematoma before clinical worsening.\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(2) applies only to material contribution to, or aggravation of, traumatic contusion or haematoma where the person's traumatic contusion or haematoma 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                             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 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                             traumatic contusion or haematoma—see subsection 7(2).\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":"This is a straightforward replacement of the 2016 'external bruise' Statement of Principles with updated medical terminology and evidence. The scope remains tightly focused on determining service connection for traumatic bruising and haematomas. The change from 'external bruise' to 'traumatic contusion or haematoma' reflects medical precision rather than scope creep."},"complexity_factors":["Short document (approximately 1,500 words)","Only 5 defined terms in the Dictionary","Simple binary structure: definition + two factors","Minimal cross-referencing (only to other Statements of Principles in section 11)","Clear exclusion clauses (subsection 7(2)(c)) with helpful notes explaining boundary cases","Single conditional limitation in section 10(2) restricting when the 'inability to obtain treatment' factor applies"],"plain_english_summary":"This instrument updates the medical test for compensation for \"traumatic contusion or haematoma\" — bruising or internal bleeding of skin, tissue or listed organs (heart, lungs, liver, spleen, kidneys, bones, joints, eyes) — for veterans and current/former Defence members. It excludes brain bleeds and bruises linked to fractures.\n\nA claim succeeds only if there was physical trauma to the site within 24 hours of onset, or inadequate treatment worsened a pre‑existing service‑related condition. It functions as a Statement of Principles medical gatekeeper for claims."},"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":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the prior ‘external bruise’ Statement (s4) and replaces it with a broader definition covering internal contusions and haematomas of organs and tissues (s7(2)(b)), while expressly excluding blood collections tied to fractures and certain intracranial haemorrhages (s7(2)(c)). It also adds an express death linkage (s7(3)) and sets specific causation factors (s9), thereby expanding and refining the range and legal tests for covered injuries."},"complexity_factors":["Technical medical definitions and exclusions (definition of traumatic contusion or haematoma; exclusions for fractures and certain intracranial haemorrhages) — s7(2)(a)–(c).","Short, specific temporal causation window (trauma within 24 hours before clinical onset) — s9(1).","Vague terms that require medical judgment: “appropriate clinical management”, “clinical worsening”, and “material contribution or aggravation” — s9(2), s10(2).","Interaction with other Statements of Principles where an identified factor refers to another injury/disease — s11.","Statutory cross‑references and application to entitlement schemes (applies to VEA s120B and MRCA s339 claims) — s5; authority under s196B(3) of the VEA — s3.","Inclusion of death via a terminal event (definition in Schedule 1) creates causal linkage questions in fatal cases — s7(3); Schedule 1."],"plain_english_summary":"This instrument, determined by the Repatriation Medical Authority, replaces the earlier “external bruise” statement and defines “traumatic contusion or haematoma” (including internal organ contusions) for claims under the Veterans’ Entitlements Act and the MRCA. It sets the legal criteria for causation: either trauma at the affected site within 24 hours of clinical onset, or inability to obtain appropriate clinical management before clinical worsening, and requires that the factor be related to the person’s relevant service."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-balance-of-probabilities-no-44-o","history":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-balance-of-probabilities-no-44-o/history","analysis":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-balance-of-probabilities-no-44-o/analysis","conflicts":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-balance-of-probabilities-no-44-o/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-balance-of-probabilities-no-44-o/important-cases","documents":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-balance-of-probabilities-no-44-o/documents"}}