Statement of Principles concerning cut, stab, abrasion and laceration (Balance of Probabilities) (No. 38 of 2025)

This instrument is a Statement of Principles (No. 38 of 2025) issued by the Repatriation Medical Authority (RMA) under subsection 196B(3) of the Veterans' Entitlements Act 1986 (the VEA) (s 3). It defines, for the purposes of claims under specified provisions of the VEA and the Military Rehabilitation and Compensation Act 2004 (MRCA), the medical and temporal factors that the RMA considers make it more probable than not that cut, stab, abrasion and laceration, and death from such injury, can be related to a person's relevant service (ss 7, 8). The instrument commences on 19 May 2025 (s 2) and expressly repeals the earlier Statement of Principles concerning cut, stab, abrasion and laceration No. 54 of 2016 (s 4).

Mechanically, the instrument:

• Specifies the kind of injury covered, by definition and by listed inclusions and exclusions (s 7(2));
• States that death caused by a terminal event or condition contributed to by the injury is included (s 7(3));
• Identifies the evidentiary basis the RMA used to set the factors, namely the RMA's view on the sound medical‑scientific evidence that a connection to relevant service is more probable than not (s 8);
• Prescribes the factors that must exist, on the balance of probabilities, to connect the injury or death with relevant service: (a) direct physical trauma to the affected site at the time of the injury; or (b) inability to obtain appropriate clinical management for the injury before clinical worsening (s 9);
• Sets temporal and causal limits on the application of the factors to service, including an express limitation on the operation of s 9(2) to injuries suffered or contracted before or during (but did not arise out of) relevant service, where the issue is material contribution or aggravation (s 10);
• Provides that where a factor refers to an injury or disease already covered by another Statement of Principles, the factors in that other instrument apply as in force (s 11);
• Supplies defined terms relevant to interpretation, including the scope of "relevant service" and what counts as a terminal event (Schedule 1).

The instrument is not framed as primary legislation but as a statutory medical determination that will be used in adjudicating entitlement claims under the VEA and MRCA. It does not itself create entitlement, payments, offences or enforcement mechanisms; it sets conditions for linking cut, stab, abrasion and laceration to relevant service for claims within the statutory schemes (ss 3, 5). The RMA records examples and notes intended to assist interpretation (for example, examples of friction burns and needlestick injuries, and examples of "other external or exposed tissue") within the instrument text (s 7(2) notes).

The instrument centres on a small set of legal-medical concepts and a narrow causal test applied "on the balance of probabilities".

Definitions and scope

• Cut, stab, abrasion and laceration is defined as an injury that interrupts the continuity of the epidermis or other external or exposed tissue and causes a wound; the wound may or may not penetrate to subcutaneous tissues and underlying structures (s 7(2)(a)). The definition expressly includes friction burns and needlestick injuries (s 7(2)(b)) and expressly excludes certain categories of wounds: burns other than friction burns, dental abrasion, injuries from explosive devices or fragments, gunshot, missile, and traumatic contusion or haematoma (s 7(2)(c)(i)-(vi)). The instrument notes examples of "other external or exposed tissue" such as cornea, sclera, mouth, fingernails and toenails (s 7(2) note).
• Death from the injury is included where the death results from a terminal event or condition that was contributed to by the person's cut, stab, abrasion and laceration (s 7(3)). The Schedule defines "terminal event" and lists illustrative causes such as pneumonia, respiratory failure, cardiac arrest, circulatory failure and cessation of brain function (Schedule 1).

Causal and evidentiary test

• The RMA frames the basis of the Statement as its view, founded on available sound medical‑scientific evidence, that it is "more probable than not" that the injury and resulting death can be related to relevant service (s 8). This is the RMA's medico‑scientific threshold for the Statement as a whole.
• For an individual claim, at least one of the two specified factors in section 9 must exist before it can be said, on the balance of probabilities, that the injury or death is connected with the circumstances of a person's relevant service (s 9). The two factors are:
  1. direct physical trauma to the affected site at the time of the injury (s 9(1)); or
  2. inability to obtain appropriate clinical management for the injury before clinical worsening (s 9(2)).

Temporal and relationship constraints

• Section 10(1) requires that any factor in s 9 be related to the relevant service rendered by the person; the factor must have a service nexus.
• Section 10(2) constrains the operation of s 9(2): that factor (lack of access to appropriate clinical management) applies only to material contribution to, or aggravation of, the injury where the injury was suffered or contracted before or during (but did not arise out of) relevant service. In short, s 9(2) is limited to pre-existing injuries that have been materially contributed to or aggravated during the person's relevant service, rather than injuries that arose out of service.

Primary affected persons

• Veterans and serving members who lodge claims under the VEA or MRCA for cut, stab, abrasion and laceration, or death from such injuries, are directly affected because this Statement of Principles sets the medical factors used to determine whether the injury or death can be related to relevant service (s 5, s 7). The Schedule defines "relevant service" as eligible war service (other than operational) under the VEA; defence service (other than hazardous service and British nuclear test defence service) under the VEA; or peacetime service under the MRCA (Schedule 1). That definition narrows the pool of affected claimants to those whose service falls within those categories.

Administrative decision‑makers

• Decision-makers who apply the VEA and MRCA to determine entitlement claims will use this instrument as the authoritative RMA medical determination about causation for these injury categories (s 3, s 5). The instrument does not itself specify the adjudicative process, but its role is to set the medico‑scientific factors that adjudicators will assess against the facts of an individual's claim.

Medical practitioners and record-holders

• Treating clinicians, medical experts and institutions may be affected in practice because the instrument makes medical fact-finding relevant to entitlement outcomes. Specifically, evidence bearing on whether there was direct physical trauma to the affected site at the time of injury, or evidence demonstrating inability to obtain appropriate clinical management before clinical worsening, will be material (s 9). Medical notes that document timing of trauma, nature of the wound, whether the wound penetrated to subcutaneous tissue, and the course of clinical management will therefore be relevant to claim outcomes.

Family and dependants where death is asserted

• Where death is claimed as arising from the injury, claimants who are dependants or estate representatives will be affected because s 7(3) includes death from a terminal event or condition that was contributed to by the injury and Schedule 1 defines "terminal event" (s 7(3); Schedule 1). This can affect applications for death-related entitlements under the VEA or MRCA.

Service providers and insurers

• The instrument does not create payment rules or alter funding streams directly, but because it alters the RMA's medico‑legal framework for causation, it can indirectly affect the number and character of successful claims that pass statutory eligibility thresholds. Any entity that provides ancillary services to claimants (for example, independent medical examinations or medico-legal reports) will face changes in the evidentiary priorities they must address.

Duties created by the instrument

• The instrument primarily prescribes medical factors rather than duties in the sense of obligations imposed on regulated persons. It does, however, impose a requirement on adjudicators or body handling claims (implicitly through application under s 120B VEA or s 339 MRCA) to treat the RMA's Statement as the authoritative set of medico‑scientific factors when assessing whether cut, stab, abrasion and laceration or death from such injury is related to relevant service (ss 3, 5, 8). The instrument states the two factors that must exist on the balance of probabilities for a causal link (s 9). In practice, this creates an evidentiary duty for claimants to produce or point to evidence supporting at least one of those factors.

Rights or entitlements affected

• The instrument does not itself confer monetary entitlements, but it affects the legal right to receive benefits under the VEA and MRCA by setting the conditions under which causation can be established for the relevant injury types. Where a claimant satisfies the factors (and other statutory elements), the claimant may then be eligible for entitlements under the usual mechanisms of the VEA or MRCA. The instrument does not specify payment rates, scope of benefits, or administrative remedies.

Interpretive and procedural consequences

• Section 11 provides that where a factor in s 9 refers to an injury or disease previously covered by another Statement, the factors in that other Statement apply as in force from time to time. That creates a rights-related consequence: a claimant whose causal chain touches other RMA Statements must consider those Statements' factors as part of their entitlement pathway (s 11). The RMA’s determination that, on available medical‑scientific evidence, it is more probable than not that the injury can be related to relevant service (s 8) functions as a foundational right-to-claim threshold in medical terms; it does not automatically confer statutory entitlement but makes causation supportable under the balance of probabilities standard.

Limits on application and burden allocation

• Section 10(2) limits the application of the clinical management factor (s 9(2)) to circumstances where the injury was suffered or contracted before or during (but did not arise out of) relevant service. That limit allocates burdens in two ways: (a) it confines s 9(2) to aggravation or material contribution scenarios, not to injuries arising out of service; and (b) it sets a temporal constraint claimants must demonstrate. Those constraints effectively focus evidentiary efforts and may reduce the universe of circumstances in which s 9(2) can assist a claimant.

No penalties within the instrument

• The Statement contains no criminal or civil penalties, sanctions or enforcement provisions. It is a medical determination made by the RMA under s 196B(3) of the VEA and functions as an evidentiary tool for claims under the VEA and MRCA (s 3, s 5). The instrument does not create offences, monetary penalties, or administrative enforcement mechanisms.

Role in administrative decision-making

• Because the Statement is made under the statutory power of the RMA, its enforcement effect is procedural and evidentiary. The instrument provides the medico‑scientific framework that decision-makers applying the VEA and MRCA will use to determine causation. That framework will influence entitlement decisions, but the instrument itself does not prescribe how those decisions are enforced or the sanctions for non-compliance with any particular statutory requirement. Any sanctions or enforcement actions that flow from false claims, fraud, or administrative non-compliance are matters governed by the primary statutes or by administrative processes external to this Statement; the Statement does not set those rules.

Adjudicative consequences and review

• The instrument does not set out administrative review processes or judicial appeal routes. It does not purport to be a final adjudication of entitlements; it operates as the RMA's medical view which will be taken into account by departments, decision-makers and courts/tribunals that deal with VEA or MRCA claims. The instrument itself does not state how a decision-maker must treat conflicting medical evidence, how to resolve disputes over expert evidence, or what weight to ascribe to RMA determinations in particular cases. Those procedural and review matters remain within the VEA and MRCA frameworks, which are outside the text of this instrument.

Implementation and compliance risks relevant to enforcement

• Because the instrument’s operation depends on fact-intensive medical assessments , for example whether there was direct physical trauma at the time of injury (s 9(1)) or inability to obtain appropriate clinical management before clinical worsening (s 9(2)) , there is a practical risk that adjudicators will face contested expert evidence and gaps in records. The instrument does not provide a mechanism to resolve such evidentiary disputes; it only sets the factors to be established. The absence of penalties in the Statement means that enforcement in practice equates to administrative acceptance or rejection of claims, rather than imposition of fines or criminal liability.

Statutory pedigree

• The instrument is made under subsection 196B(3) of the VEA (s 3). It therefore operates within the statutory architecture of the VEA and is intended to be applied to claims under both the VEA and the MRCA in the specific ways described in s 5 (the Statement "applies to a claim to which section 120B of the VEA or section 339 of the MRCA applies"). The instrument itself does not reproduce those sections of the VEA or MRCA, nor does it alter them; it supplies medico‑scientific factors for use within the adjudication of claims under those Acts.

Interaction with other Statements of Principles

• Section 11 governs direct interaction with other RMA Statements of Principles. Where a factor in this Statement refers to an injury or disease for which a separate Statement exists, the factors in that other Statement apply "in accordance with the terms of that Statement of Principles as in force from time to time" (s 11). This makes the RMA's determinations modular and potentially cumulative: a claim that involves multiple pathologies or an injury that sits at the intersection of this Statement and another will be assessed against the applicable provisions of both Statements.

Scope of "relevant service"

• The Schedule defines "relevant service" for the purposes of this Statement. It is limited to eligible war service other than operational service under the VEA, defence service other than hazardous service and British nuclear test defence service under the VEA, and peacetime service under the MRCA (Schedule 1). That definitional choice interacts with the scope of the VEA and MRCA to determine who may rely on this Statement. If a claimant’s service falls outside those categories, this Statement will not apply to their claim.

Exclusions that steer claims to other provisions

• The instrument explicitly excludes particular mechanisms of injury (for example explosive device fragments, gunshot and missile wounds) (s 7(2)(c)(iii)-(v)). That exclusion signals that such injury types either are dealt with elsewhere within RMA determinations or are considered outside the RMA's purpose for this Statement. Practitioners must therefore map an injury to the correct Statement when preparing a claim.

No express alteration of MRCA or VEA substantive provisions

• The Statement does not itself change substantive entitlements, time limits, or appeal processes contained in the VEA or MRCA. It is a medico‑scientific determination to be used under those Acts. Any legal rights and obligations beyond causation , for example monetary rates, review rights, or recoupment , remain governed by the primary statutes and regulations, not by this Statement. The instrument does not claim to amend or supersede those statutory provisions.

Contents recorded in the instrument

• The instrument records its own key dates and changes: it is the Statement of Principles concerning cut, stab, abrasion and laceration (Balance of Probabilities) (No. 38 of 2025), dated 15 April 2025, and it commences on 19 May 2025 (s 1; s 2 front matter). It also records that it is made under subsection 196B(3) of the VEA (s 3) and that it repeals the prior Statement of Principles concerning the same injury, No. 54 of 2016 (s 4).

Replaced instrument

• The instrument expressly repeals the earlier Statement No. 54 of 2016 (s 4). The repealed instrument is identified by its Federal Register of Legislation number (F2016L00571) in the repeal clause. No transitional provisions are included in this text; the instrument does not state whether the new Statement applies to claims lodged before commencement or to matters decided under the old Statement. Practitioners and decision-makers must look to the VEA/MRCA or administrative guidance for transitional practice, as the instrument itself is silent.

Authority for amendments

• The instrument is an exercise of the RMA’s power under subsection 196B(3) of the VEA (s 3). That subsection is the statutory source authorising the RMA to determine Statements of Principles. The instrument does not record any further amendments, amendments pending, or subsequent modifications. It also does not include an amendment schedule or a history of earlier versions beyond the explicit repeal of No. 54 of 2016.

Amendment mechanics not detailed

• The instrument sets out a final form of the Statement as of its commencement date, but it does not provide a mechanism for further amendment within its text (for example, no clause on periodic review or scheduled revocation). The Schedule notes that where other Statements apply "as in force from time to time" their factors apply (s 11), implying other Statements can be updated; however, the instrument does not itself describe the process or frequency with which the RMA reviews or updates its Statements. The statutory source (s 196B(3) VEA) governs that process, but details of any procedural framework for amendment are absent from this instrument.

Implications for legacy claims

• The repeal of the 2016 Statement means that the medico‑scientific factors relied on for causation have changed as of the commencement date. The instrument does not say whether decisions made under the 2016 Statement remain valid, or how ongoing appeals or reviews should treat the change. Those matters, including any transitional rights, are not addressed in the instrument.

No litigation history recorded in the instrument

• The text of the instrument does not record any judicial decisions, tribunal determinations or litigation history concerning this Statement, its predecessor, or the RMA's approach to these injury types. It contains no citations to cases, no summaries of contested decisions, and no references to judicial interpretation. The instrument is a standalone RMA determination of medical factors.

Consequences for contested cases

• Because the instrument sets the RMA's medico‑scientific factors, decision-makers applying the VEA and MRCA will treat these factors as material evidence in entitlement determinations. The text does not state how courts or tribunals should resolve conflicts where competing medical opinions exist. Any legal challenges to decisions that rely on this Statement would proceed through the dispute resolution routes provided by the VEA and MRCA, but specifics are outside the instrument.

No recorded precedent

• The instrument does not attempt to catalogue authorities or prior determinations that might bear on judicial review. It does not identify any previous court findings about the RMA’s competence, the proper weight to be given to RMA Statements, or the RMA's evidentiary methodologies. Practitioners should not infer from this instrument any settled litigation posture; the instrument itself simply states the RMA’s conclusions on medical‑scientific causation as of its date.

Implication for litigators and reviewers

• In the absence of litigation history in the instrument, advocates and reviewers must rely on the plain terms of the Statement, the underlying Acts and any procedural guidance or jurisprudence external to the instrument when preparing or contesting claims. This instrument does not provide a record of judicial treatment of the RMA's determinations for these injury types.

Narrow definitions and exclusions

• The instrument’s definition of cut, stab, abrasion and laceration is specific and excludes several common traumatic mechanisms (s 7(2)). Practitioners must map a claimant’s injury precisely to the language of s 7(2). Notably, the instrument excludes: burns other than friction burns, dental abrasion, injuries from explosive devices or fragments, gunshot, missile, and traumatic contusion or haematoma (s 7(2)(c)). If an injury is caused by an excluded mechanism, this Statement is not the correct medico‑scientific instrument to apply.

Inclusive examples that may surprise

• The instrument expressly includes friction burns and needlestick injuries (s 7(2)(b)). Cases described as "needlestick" may be small puncture wounds, but the RMA has included them within scope. Conversely, the exclusion of dental abrasion separates oral surface wear from the class of injuries in this Statement (s 7(2)(c)(ii)).

Temporal and causal limitation on s 9(2)

• The inability to obtain appropriate clinical management (s 9(2)) is a factor only where the injury was suffered or contracted before or during (but did not arise out of) the person's relevant service and the issue is one of material contribution or aggravation (s 10(2)). That is a precise limitation. A claimant whose injury arose out of service cannot rely on s 9(2) to establish causation by showing post-injury lack of treatment. The "but did not arise out of" qualification is a critical textual limitation practitioners must attend to.

Service-type limitations

• The Schedule’s definition of "relevant service" excludes operational eligible war service and hazardous service and British nuclear test defence service under the VEA (Schedule 1). Claimants whose service falls into excluded categories may not be able to rely on this Statement even if they sustained the type of injury described.

Balance of probabilities framing vs. clinical certainty

• Section 8 states that the RMA is of the view that it is "more probable than not" on the medical‑scientific evidence that these injuries can be related to relevant service. That language sets an evidentiary threshold for the Statement itself and mirrors the legal standard of proof for claims. However, this does not mean that every individual claim will meet that standard; claimants must still produce evidence satisfying the balance of probabilities against the factors in s 9, as applied to their facts.

Evidence collection and case preparation (practical checklist)

• For claims under the VEA (s 120B) or MRCA (s 339) that invoke this Statement, assemble evidence targeted to the two statutory factors in s 9:
  • Direct physical trauma at the time of injury (s 9(1)): contemporaneous incident reports; emergency department records; witness statements describing the event and timing; photographs of wounds taken at the time; police reports if applicable; operation or procedure notes that specify the wound and its mechanism; and clinician descriptions confirming interruption of the epidermis or external tissue, and whether penetration to subcutaneous tissues occurred (s 7(2)(a)). The Statement allows for wounds that do not penetrate as well as those that do.
  • Inability to obtain appropriate clinical management before clinical worsening (s 9(2)): records showing attempts to obtain care, transfer delays, triage notes, referral refusals, remote-location constraints, military health service records documenting access limitations, and documentation of subsequent clinical deterioration tied to the initial failure to obtain appropriate care. Remember s 10(2) limits s 9(2) to injuries suffered or contracted before or during (but not arising out of) relevant service where material contribution or aggravation is alleged; evidence must therefore establish timing relative to service and the causal relationship of aggravation.
• Where death is claimed, obtain cause-of-death material and clinical opinion linking the injury to a terminal event as defined in Schedule 1 (for example, medical opinion that the injury contributed to pneumonia, respiratory failure or cardiac arrest) (s 7(3); Schedule 1).

Map injuries to the Statement’s scope

• Confirm the injury mechanism fits within the Statement’s definition and inclusions (s 7(2)(a)-(b)) and is not an excluded mechanism (s 7(2)(c)). For example, if the injury arose from a gunshot or explosive fragment, do not rely on this Statement; identify the correct RMA Statement instead (s 7(2)(c)(iii)-(v)).

Check relevant service category

• Verify that the claimant’s service is within the Schedule’s definition of "relevant service" (Schedule 1). The Statement’s application is limited to eligible war service (other than operational), defence service (other than hazardous service and British nuclear test defence service) under the VEA, or peacetime service under the MRCA. Prepare documentary proof of service category, dates, and the relationship of the injury to those service dates.