Statement of Principles concerning Hodgkin lymphoma (Balance of Probabilities) (No. 71 of 2023) (Cth)

Statement of Principles concerning HODGKIN LYMPHOMA (Balance of Probabilities) (No. 71 of 2023) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.

Dated 23 June 2023.

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

Professor Terence Campbell AM Chairperson

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 Hodgkin lymphoma (Balance of Probabilities) (No. 71 of 2023). 2 Commencement This instrument commences on 25 July 2023. 3 Authority This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning Hodgkin's lymphoma No. 36 of 2014 (Federal Register of Legislation No. F2014L00468) made under subsection 196B(3) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004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. 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 Hodgkin lymphoma and death from Hodgkin lymphoma. Meaning of Hodgkin lymphoma (2) For the purposes of this Statement of Principles, Hodgkin lymphoma: (a) means a specific group of malignant neoplasms of the lymph nodes and lymphoid tissue derived from B lymphocytes; and (b) includes: (i) nodular sclerosis classical Hodgkin lymphoma; (ii) lymphocyte-rich classical Hodgkin lymphoma; (iii) mixed cellularity classical Hodgkin lymphoma; (iv) lymphocyte-depleted classical Hodgkin lymphoma; and (v) nodular lymphocyte predominant Hodgkin lymphoma; and (c) excludes non-Hodgkin lymphoma. Note 1: Hodgkin lymphoma is also known as Hodgkin's lymphoma and Hodgkin's disease. Note 2: Symptoms of Hodgkin lymphoma include painless lymphadenopathy, fever, night sweats and loss of body mass. (3) While Hodgkin lymphoma attracts ICD‑10‑AM code C81, in applying this Statement of Principles the meaning of Hodgkin lymphoma 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 Hodgkin lymphoma (5) For the purposes of this Statement of Principles, Hodgkin lymphoma, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's Hodgkin lymphoma. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 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 Hodgkin lymphoma and death from Hodgkin lymphoma 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. 9 Factors that must exist At least one of the following factors must exist before it can be said that, on the balance of probabilities, Hodgkin lymphoma or death from Hodgkin lymphoma is connected with the circumstances of a person's relevant service: (1) having smoked tobacco products: (a) in an amount of at least 15 pack-years before the clinical onset of Hodgkin lymphoma; and (b) commencing at least 10 years before the clinical onset of Hodgkin lymphoma; and if smoking has ceased before the clinical onset of Hodgkin lymphoma, then that onset occurred within 5 years of cessation; Note: one pack-year is defined in the Schedule 1 - Dictionary. (2) being obese for at least 5 years within the 20 years before the clinical onset of Hodgkin lymphoma; Note: being obese is defined in the Schedule 1 - Dictionary. (3) having infection with human immunodeficiency virus before the clinical onset of Hodgkin lymphoma; (4) having serological evidence of infection with Epstein-Barr virus before the clinical onset of Hodgkin lymphoma; (5) having an autoimmune disease from the specified list of autoimmune diseases before the clinical onset of Hodgkin lymphoma; Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary. (6) having received a stem cell, bone marrow or solid organ transplantation before the clinical onset of Hodgkin lymphoma; (7) having mature B-cell lymphoid leukaemia/small lymphocytic lymphoma at the time of the clinical onset of Hodgkin lymphoma; Note: Mature B-cell lymphoid leukaemia/small lymphocytic lymphoma are also known as mature B-cell lymphoid leukaemia and small lymphocytic lymphoma, and chronic lymphocytic leukaemia/small lymphocytic lymphoma. (8) having an active tuberculosis disease before the clinical onset of Hodgkin lymphoma; Note: active tuberculosis disease is defined in the Schedule 1 - Dictionary. (9) inability to obtain appropriate clinical management for Hodgkin lymphoma before the clinical worsening of Hodgkin lymphoma. 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 factor set out in subsection 9(9) applies only to material contribution to, or aggravation of, Hodgkin lymphoma where the person's Hodgkin lymphoma 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(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.