{"id":"F2025L01293","name":"Statement of Principles concerning umbilical hernia, peri-umbilical hernia and para-umbilical hernia (Reasonable Hypothesis) (No. 91 of 2025)","slug":"statement-of-principles-concerning-umbilical-hernia-peri-umbilical-hernia-and-para-umbilical-hernia-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443016,"registerId":"F2025L01293-fast-fetch-1775957930570","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning umbilical hernia, peri-umbilical hernia and para-umbilical hernia (Reasonable Hypothesis) (No. 91 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\nUMBILICAL HERNIA, PERI-UMBILICAL HERNIA AND PARA-UMBILICAL HERNIA  (Reasonable Hypothesis)\n\n(No. 91 of 2025)\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    24 October 2025\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   \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 umbilical hernia, peri-umbilical hernia and para-umbilical hernia (Reasonable Hypothesis) (No. 91 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 24 November 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning umbilical hernia (Reasonable Hypothesis) (No. 93 of 2016) (Federal Register of Legislation No. F2016L01673) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\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\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 umbilical hernia, peri-umbilical hernia and para-umbilical hernia and death from umbilical hernia, peri-umbilical hernia and para-umbilical hernia.\n\n\nMeaning of umbilical hernia, peri-umbilical hernia and para-umbilical hernia\n\n1.           For the purposes of this Statement of Principles, umbilical hernia, peri-umbilical hernia and para-umbilical hernia:\n  1.           means a protrusion of intra-abdominal tissue through a defect in the abdominal wall in the region of the umbilicus; and\n  2.           excludes incisional hernia located at the umbilicus.\n\n\nNote: Clinical worsening can include umbilical hernia, peri-umbilical hernia or para-umbilical hernia enlargement, obstruction, incarceration, strangulation or rupture.\n\n1.           While umbilical hernia, peri-umbilical hernia and para-umbilical hernia attracts ICD‑10‑AM code K42.0, K42.1 or K42.9, in applying this Statement of Principles the meaning of umbilical hernia, peri-umbilical hernia and para-umbilical hernia 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 umbilical hernia, peri-umbilical hernia and para-umbilical hernia\n\n1.           For the purposes of this Statement of Principles, umbilical hernia, peri-umbilical hernia and para-umbilical hernia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's umbilical hernia, peri-umbilical hernia and para-umbilical hernia.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that umbilical hernia, peri-umbilical hernia or para-umbilical hernia and death from umbilical hernia, peri-umbilical hernia or para-umbilical hernia 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\n1.                Factors that must exist\n\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 umbilical hernia, peri-umbilical hernia or para-umbilical hernia or death from umbilical hernia, peri-umbilical hernia or para-umbilical hernia with the circumstances of a person's relevant service:\n\n1.           having a Body Mass Index (BMI) of 30 or greater at the time of clinical onset or clinical worsening;\n\n\nNote: Body Mass Index (BMI) is calculated as W/H2 where:\n\n1.      W is the person's weight in kilograms; and\n2.      H is the person's height in metres.\n  1.           having chronic (intermittent or continuous) elevation of pressure within the abdominal cavity at the time of clinical onset;\n\n\nNote: Examples of conditions or settings which can cause chronic elevation of pressure within the abdominal cavity include, but are not limited to, ascites, chronic ambulatory or automated peritoneal dialysis, extensive intra-abdominal neoplastic disease or mass, and pregnancy.\n\n1.           having elevation of pressure within the abdominal cavity due to lifting heavy loads for at least 1 hour per day, on more days than not, over a period of at least 12 months before clinical onset;\n2.           having acute or chronic (intermittent or continuous) elevation of pressure within the abdominal cavity at the time of clinical worsening;\n\n\nNote: Examples of conditions or settings which can cause acute or chronic elevation of pressure within the abdominal cavity include, but are not limited to, ascites, significant coughing, significant vomiting, heavy lifting, chronic ambulatory peritoneal dialysis, pregnancy and straining at stool due to constipation.\n\n1.           inability to obtain appropriate clinical management for umbilical hernia, peri-umbilical hernia or para-umbilical hernia 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 clinical worsening aspect of factors set out in section 9 apply only to material contribution to, or aggravation of, umbilical hernia, peri-umbilical hernia or para-umbilical hernia where the person's umbilical hernia, peri-umbilical hernia or para-umbilical hernia 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(2) 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)          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                               umbilical hernia, peri-umbilical hernia and para-umbilical hernia—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":"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":true,"description":"This instrument expressly repeals the 2016 Statement of Principles (s4) and reissues an SOP covering umbilical, peri‑umbilical and para‑umbilical hernias with updated definitions and lists of connective factors (ss7–11). The source document does not provide a clause‑by‑clause comparison, so while the instrument clearly replaces the prior instrument, the extent and direction of substantive changes versus the 2016 text cannot be determined from this instrument alone."},"complexity_factors":["Legal cross‑references and authority: instrument made under s196B(2) of VEA and repeals the 2016 Statement (see sections 3 and 4) — requires attention to statutory context.","Medical definition and coding: defines umbilical/peri‑/para‑umbilical hernia and cites ICD‑10‑AM codes (s7(2), s7(4)) — requires clinical interpretation.","Multiple, alternative connective factors: several distinct medical/occupational pathways can establish a reasonable hypothesis (BMI ≥30; chronic/acute raised intra‑abdominal pressure; sustained heavy lifting; inability to obtain management) (s9) — creates evidentiary permutations.","Temporal and causation limits: factors must relate to 'relevant service' and clinical worsening rules apply only where condition pre‑existed service (s10) — timing/causation analysis needed.","Interaction with other Statements of Principles: factors referring to other injuries/diseases defer to those other Statements (s11) — requires cross‑instrument coordination.","Measurement and proof burdens: requires BMI at time of clinical onset, duration/intensity of lifting (1 hour/day, >12 months), and proof of inability to obtain management — evidentiary and record‑keeping demands (s9).","Defined technical terms in Dictionary/Schedule: 'relevant service', 'terminal event', MRCA/VEA definitions affect scope and application (Schedule 1).","Exclusions and notes: explicit exclusion of incisional hernia and notes on clinical worsening/terminal events demand precise clinical classification (s7)."],"plain_english_summary":"Replaces the prior Statement and sets the medical criteria the Repatriation Medical Authority uses to decide if an umbilical, peri‑umbilical or para‑umbilical hernia (or death from one) can be linked to a person's relevant service. It defines the condition, excludes incisional hernia, and lists minimum connective factors — e.g. BMI ≥30 at onset, chronic or acute raised abdominal pressure (including heavy lifting), or inability to obtain appropriate clinical management — and requires the factor to be related to the person's relevant service."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":true,"description":"The original 2016 instrument covered only 'umbilical hernia'. This 2025 version expands the scope to explicitly include 'peri-umbilical hernia and para-umbilical hernia'—related but distinct conditions involving abdominal wall defects near the navel. While medically related, this represents a deliberate broadening of coverage beyond the original single-condition focus."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 5 defined terms in the Dictionary (MRCA, relevant service, terminal event, umbilical hernia/peri-umbilical/para-umbilical, VEA)","Clear, numbered list of 5 factors in section 9 with minimal cross-referencing","Single layer of conditional logic (section 10: factors must be related to service; clinical worsening only applies to pre-existing conditions)","Straightforward repeal and replacement structure (repeals 2016 instrument, no complex transitional provisions)","Limited medical terminology, mostly explained in plain language or through examples in notes"],"plain_english_summary":"This instrument updates the medical test for compensation for umbilical-area hernias and related deaths for veterans and current/former defence members claiming under the VEA or MRCA. It broadens coverage from just “umbilical hernia” to also include peri‑umbilical and para‑umbilical hernias and sets service‑connection criteria (e.g., obesity, chronic/acute abdominal pressure, heavy lifting, or lack of proper care).\n\nIt matters because it determines when these belly‑button hernias are treated as service‑related injuries eligible for compensation, including pre‑existing conditions made materially worse by service."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-umbilical-hernia-peri-umbilical-hernia-and-para-umbilical-hernia-","history":"/api/acts/statement-of-principles-concerning-umbilical-hernia-peri-umbilical-hernia-and-para-umbilical-hernia-/history","analysis":"/api/acts/statement-of-principles-concerning-umbilical-hernia-peri-umbilical-hernia-and-para-umbilical-hernia-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-umbilical-hernia-peri-umbilical-hernia-and-para-umbilical-hernia-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-umbilical-hernia-peri-umbilical-hernia-and-para-umbilical-hernia-/important-cases","documents":"/api/acts/statement-of-principles-concerning-umbilical-hernia-peri-umbilical-hernia-and-para-umbilical-hernia-/documents"}}