{"id":"F2024L00741","name":"Statement of Principles concerning traumatic contusion or haematoma (Reasonable Hypothesis) (No. 43 of 2024)","slug":"statement-of-principles-concerning-traumatic-contusion-or-haematoma-reasonable-hypothesis-no-43-of-2","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442440,"registerId":"F2024L00741-fast-fetch-1775957449196","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 (Reasonable Hypothesis) (No. 43 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  (Reasonable Hypothesis)\n\n(No. 43 of 2024)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) 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\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of      \n\nThe Repatriation Medical Authority\n\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\n1               Name\n\nThis is the Statement of Principles concerning traumatic contusion or haematoma (Reasonable Hypothesis) (No. 43 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(2) of the Veterans' Entitlements Act 1986.\n\n4               Repeal\n\nThe Statement of Principles concerning external bruise No. 5 of 2016 (Federal Register of Legislation No. F2016L00008) made under subsection 196B(2) of the VEA is repealed.\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 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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that traumatic contusion or haematoma and death from traumatic contusion or haematoma 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\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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting traumatic contusion or haematoma or death from traumatic contusion or haematoma 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(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\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)          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\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":{"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"},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the standard SoP format and scope. It replaces a 2016 instrument concerning 'external bruise' with updated medical terminology ('traumatic contusion or haematoma'), but this appears to be a technical update rather than scope expansion. The coverage remains consistent with the Repatriation Medical Authority's statutory function under section 196B(2) of the VEA."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 5 defined terms in the Dictionary (MRCA, relevant service, terminal event, traumatic contusion or haematoma, VEA)","Simple binary structure: two alternative factors in section 9, with one limitation in section 10(2)","Minimal cross-referencing — only refers to parent legislation (VEA and MRCA) and other SoPs in general terms","Clear delineation of scope through inclusion/exclusion criteria in section 7(2)","Single conditional limitation (section 10(2) restricts factor 9(2) to pre-existing conditions aggravated by service)"],"plain_english_summary":"This Statement of Principles sets the medical test for when traumatic contusion or haematoma (bruising or pooled blood, including internal organs) is accepted as service-related for VEA/MRCA claims. It allows compensation where the injury plausibly arose from service trauma (symptoms within 24 hours) or where service prevented treatment and thereby materially worsened a pre‑existing condition. It excludes bone‑associated bruising and intracranial bleeds, covers death from complications, and uses the lower \"reasonable hypothesis\" standard of proof."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier \"external bruise\" Statement (section 4) and replaces it with a Statement expressly covering traumatic contusion or haematoma, including internal organ contusions and death from those conditions (section 7(2)(b), 7(3)). It narrows certain matters by excluding blood collections tied to fractures and specific intracranial haemorrhages (section 7(2)(c)), and it sets a short temporal link (24 hours) plus a separate factor for failure to obtain appropriate clinical management (section 9). The instrument also directs that, where a linking factor refers to an injury/disease covered by another SoP, the other SoP applies (section 11), changing how overlapping conditions are treated compared with the repealed instrument."},"complexity_factors":["Technical medical definitions and exclusions (definition of traumatic contusion or haematoma; exclusions for fractures and certain intracranial haemorrhages) — section 7(2)(a)-(c).","Temporal causation requirement (trauma within 24 hours before clinical onset) — section 9(1).","Non-clinical management linking factor (inability to obtain appropriate clinical management before clinical worsening) and its limited application — sections 9(2) and 10(2).","Interaction with other Statements of Principles when a factor refers to an injury/disease covered elsewhere — section 11.","Application to two different statutory claim streams (VEA and MRCA) and reliance on statutory definitions of relevant service and terminal event — sections 3, 5 and Schedule 1.","Replacement of an earlier instrument (repeal of external bruise No.5 of 2016), creating transitional or comparative interpretive issues — section 4.","Inclusion of death from the condition via terminal events (definition and scope for proximate/ultimate cause of death) — section 7(3) and Schedule 1.","Limited factual thresholds (\"at least one\" factor) which can create evidentiary disputes about timing, clinical management access, and causal link to service — section 9."],"plain_english_summary":"This instrument, made by the Repatriation Medical Authority under the Veterans' Entitlements Act, sets the medical criteria used to decide whether a traumatic contusion or haematoma (including internal organ contusions and death caused by them) is linked to a veteran's relevant service for claims under the VEA or MRCA. It requires at least one linking factor — trauma at the affected site within 24 hours or inability to obtain appropriate clinical management — and replaces the earlier \"external bruise\" Statement of Principles."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-reasonable-hypothesis-no-43-of-2","history":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-reasonable-hypothesis-no-43-of-2/history","analysis":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-reasonable-hypothesis-no-43-of-2/analysis","conflicts":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-reasonable-hypothesis-no-43-of-2/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-reasonable-hypothesis-no-43-of-2/important-cases","documents":"/api/acts/statement-of-principles-concerning-traumatic-contusion-or-haematoma-reasonable-hypothesis-no-43-of-2/documents"}}