Statement of Principles

concerning

SUBCUTANEOUS LIPOMA
(Balance of Probabilities)

(No. 83 of 2024)

The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.

Dated 18 October 2024.

Contents

1 Name

2 Commencement

3 Authority

4 Repeal

5 Application

6 Definitions

7 Kind of injury, disease or death to which this Statement of Principles relates

8 Basis for determining the factors

9 Factors that must exist

10 Relationship to service

11 Factors referring to an injury or disease covered by another Statement of Principles

Schedule 1 - Dictionary

1 Definitions

1.                Name

This is the Statement of Principles concerning subcutaneous lipoma (Balance of Probabilities) (No. 83 of 2024).

1.                Commencement

              This instrument commences on 19 November 2024.

1.                Authority

This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.

1.                Repeal

The 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(No. 101 of 2015) (Federal Register of Legislation No. F2015L01316) made under subsection 196B(3) of the VEA is repealed.

1.                Application

This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.

1.                Definitions

The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.

1.                Kind of injury, disease or death to which this Statement of Principles relates
   1.           This Statement of Principles is about subcutaneous lipoma and death from subcutaneous lipoma.

Meaning of subcutaneous lipoma

1.           For the purposes of this Statement of Principles, subcutaneous lipoma:
   1.           means a benign neoplasm of mature adipose cells occurring in subcutaneous tissues, which is usually surrounded by a capsule; and
   2.           excludes:
      1.             breast lipoma;
      2.          fat hyperplasia;
      3.        liposarcoma; and
      4.         prolapse of adipose tissue.
2.           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).
3.           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.

Death from subcutaneous lipoma

1.           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.

Note: terminal event is defined in the Schedule 1 – Dictionary.

1.                Basis for determining the factors

On 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.

Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.

1.                Factors that must exist

At 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:

1.           having alcohol use disorder at the time of the clinical onset of benign symmetrical lipomatosis;

Note: 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.

1.           inability to obtain appropriate clinical management for subcutaneous lipoma before clinical worsening.

1.            Relationship to service
   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.
   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.
2.            Factors referring to an injury or disease covered by another Statement of Principles

In this Statement of Principles:

1.           if a factor referred to in section 9 applies in relation to a person; and
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;

then 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.

Schedule 1 - Dictionary  

Note:               See Section 6

1               Definitions

In this instrument:

                             MRCA means the Military Rehabilitation and Compensation Act 2004.

                             relevant service means:

(a)          eligible war service (other than operational service) under the VEA;

(b)          defence service (other than hazardous service and British nuclear test defence service) under the VEA; or

(c)          peacetime service under the MRCA.

Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.

                               subcutaneous lipoma—see subsection 7(2).

                             terminal event means the proximate or ultimate cause of death and includes the following:

(a)           pneumonia;

(b)           respiratory failure;

(c)           cardiac arrest;

(d)           circulatory failure; or

(e)           cessation of brain function.

                             VEA means the Veterans' Entitlements Act 1986.