Statement of Principles concerning cerebral meningioma (Reasonable Hypothesis) (No. 1 of 2018) (Cth)

Statement of Principles concerning CEREBRAL MENINGIOMA (Reasonable Hypothesis) (No. 1 of 2018) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

Dated 22 December 2017

The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:

Professor Nicholas Saunders AO Chairperson

Contents 1 Name 2 Commencement 3 Authority 4 Revocation 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 cerebral meningioma (Reasonable Hypothesis) (No. 1 of 2018). 2 Commencement This instrument commences on 29 January 2018. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Revocation The Statement of Principles concerning cerebral meningioma No. 19 of 2009, as amended, made under subsections 196B(2) and (8) of the VEA is revoked. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies. 6 Definitions The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument. 7 Kind of injury, disease or death to which this Statement of Principles relates (1) This Statement of Principles is about cerebral meningioma and death from cerebral meningioma. Meaning of cerebral meningioma (2) For the purposes of this Statement of Principles, cerebral meningioma means a primary benign or intermediate grade tumour of the cerebral meninges. (3) While cerebral meningioma attracts ICD‑10‑AM code D32.0 or D32.9, in applying this Statement of Principles the meaning of cerebral meningioma is that given in subsection (2). (4) 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 cerebral meningioma (5) For the purposes of this Statement of Principles, cerebral meningioma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's cerebral meningioma. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 Basis for determining the factors The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that cerebral meningioma and death from cerebral meningioma 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. Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary. 9 Factors that must exist At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting cerebral meningioma or death from cerebral meningioma with the circumstances of a person's relevant service: (1) having received a cumulative equivalent dose of at least 0.1 sievert of ionising radiation to the brain at least five years before the clinical onset of cerebral meningioma; Note: cumulative equivalent dose is defined in the Schedule 1 - Dictionary. (2) being overweight or obese for at least five years within the 20 years before the clinical onset of cerebral meningioma; Note: being overweight or obese is defined in the Schedule 1 - Dictionary. (3) being in the second or third trimester of pregnancy, or within the 30 days postpartum, at the time of the clinical onset of cerebral meningioma; (4) being treated with a drug as specified within the ten years before the clinical onset of cerebral meningioma; Note: being treated with a drug as specified is defined in the Schedule 1 - Dictionary. (5) using hormone replacement therapy for a continuous period of at least six months before the clinical onset of cerebral meningioma, and where the use of hormone replacement therapy has ceased, the clinical onset of cerebral meningioma has occurred within ten years of cessation; Note: hormone replacement therapy is defined in the Schedule 1 - Dictionary. (6) being in the second or third trimester of pregnancy, or within the 30 days postpartum, at the time of the clinical worsening of cerebral meningioma; (7) being treated with a drug as specified within the ten years before the clinical worsening of cerebral meningioma; Note: being treated with a drug as specified is defined in the Schedule 1 - Dictionary. (8) inability to obtain appropriate clinical management for cerebral meningioma. 10 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 factors set out in subsections 9(6) to 9(8) apply only to material contribution to, or aggravation of, cerebral meningioma where the person's cerebral meningioma was suffered or contracted before or during (but did not arise out of) the person's relevant service. 11 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(2) 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.