Statement of Principles concerning inguinal hernia (Balance of Probabilities) (No. 48 of 2021)

Statement of Principles concerning inguinal hernia (Balance of Probabilities) (No. 48 of 2021)

made under subsection 196B(3) of the

Veterans' Entitlements Act 1986

Compilation No. 1  

Compilation date:   22 September 2025

Includes amendments: Amendment Statement of Principles concerning inguinal hernia (Balance of Probabilities) (No. 80 of 2025) (F2025L01077)

About this compilation

This compilation

This is a compilation of the Statement of Principles concerning inguinal hernia (Balance of Probabilities) (No. 48 of 2021) that shows the text of the law as amended and in force on 22 September 2025.

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the Register for the compiled law.

Self‑repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

Contents

1 Name

3 Authority

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

Endnotes

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

1.                Name

This is the Statement of Principles concerning inguinal hernia (Balance of Probabilities) (No. 48 of 2021).

1.                Authority

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

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 inguinal hernia and death from inguinal hernia.

Meaning of inguinal hernia

1.           For the purposes of this Statement of Principles, inguinal hernia means:
   1.           a protrusion of intra-abdominal tissue through the abdominal wall either:
      1.             through the inguinal canal; or
      2.          through a weakness in the posterior wall of the inguinal canal; and
   2.           includes direct and indirect inguinal hernia; and
   3.           excludes femoral hernia.
2.           While inguinal hernia attracts ICD‑10‑AM code K40, in applying this Statement of Principles the meaning of inguinal hernia 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 inguinal hernia

1.           For the purposes of this Statement of Principles, inguinal hernia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's inguinal hernia.

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 inguinal hernia and death from inguinal hernia 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, inguinal hernia or death from inguinal hernia is connected with the circumstances of a person's relevant service:

1.           having acute elevation of pressure within the abdominal cavity due to any one of the following:
   1.           anti-G straining manoeuvre;
   2.           lifting heavy weights;
   3.           physical trauma to the abdomen involving a direct blow to the abdomen;
   4.           pneumoperitoneum induced for laparoscopic surgery;
   5.           significant coughing;
   6.            significant sneezing;
   7.           straining at micturition due to bladder outlet or urethral obstruction; or
   8.           straining at stool due to constipation or diarrhoea;

within the 30 days before the clinical onset of inguinal hernia;

Note: clinical onset is defined in the Schedule 1 – Dictionary.

1.           having chronic elevation of pressure within the abdominal cavity due to any one of the following:
   1.           ascites;
   2.           chronic ambulatory or automatic peritoneal dialysis;
   3.           extensive intra-abdominal neoplastic disease or mass; or
   4.           pregnancy;

at the time of the clinical onset of inguinal hernia;

Note: Chronic elevation of pressure may be intermittent or continuous.

1.           undergoing radical retropubic prostatectomy, laparoscopic radical prostatectomy or robot-assisted laparoscopic radical prostatectomy within the five years before the clinical onset of inguinal hernia;
2.           having chronic onchocerciasis in the presence of a hanging groin at the time of the clinical onset of inguinal hernia;

Note 1: Onchocerciasis is a parasitic disease caused by the filarial worm Onchocerca volvulus that occurs in sub-Saharan African countries, and in some areas of South America and Yemen.  Symptoms include severe itching, disfiguring skin conditions and visual impairment.

Note 2: hanging groin is defined in the Schedule 1 - Dictionary.

1.           for uretero-inguinal hernia only, having a kidney transplant before the clinical onset of uretero-inguinal hernia;
2.           having acute elevation of pressure within the abdominal cavity due to any one of the following:
   1.           anti-G straining manoeuvre;
   2.           lifting heavy weights;
   3.           physical trauma to the abdomen involving a direct blow to the abdomen;
   4.           pneumoperitoneum induced for laparoscopic surgery;
   5.           significant coughing;
   6.            significant sneezing;
   7.           straining at micturition due to bladder outlet or urethral obstruction; or
   8.           straining at stool due to constipation or diarrhoea;

within the 30 days before the clinical worsening of inguinal hernia;

1.           having chronic elevation of pressure within the abdominal cavity due to any one of the following:
   1.           ascites;
   2.           chronic ambulatory or automatic peritoneal dialysis;
   3.           extensive intra-abdominal neoplastic disease or mass; or
   4.           pregnancy;

at the time of the clinical worsening of inguinal hernia;

Note: Chronic elevation of pressure may be intermittent or continuous.

1.           undergoing radical retropubic prostatectomy, laparoscopic radical prostatectomy or robot-assisted laparoscopic radical prostatectomy within the five years before the clinical worsening of inguinal hernia;
2.           having chronic onchocerciasis in the presence of a hanging groin at the time of the clinical worsening of inguinal hernia;

Note 1: Onchocerciasis is a parasitic disease caused by the filarial worm Onchocerca volvulus that occurs in sub-Saharan African countries, and in some areas of South America and Yemen.  Symptoms include severe itching, disfiguring skin conditions and visual impairment.

Note 2: hanging groin is defined in the Schedule 1 - Dictionary.

1.       for perforated inguinal hernia only, having a colonoscopy where the colonoscope enters the inguinal hernia within the 24 hours before the perforation of the inguinal hernia;
2.       inability to obtain appropriate clinical management for inguinal hernia.

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 factors set out in subsections 9(6) to 9(11) apply only to material contribution to, or aggravation of, inguinal hernia where the person's inguinal hernia 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:

                             clinical onset means the point backwards in time from the date of presentation to a registered medical practitioner first confirming the presence of inguinal hernia, to the date at which the signs and/or symptoms of the inguinal hernia were persistently present, as assessed by a registered medical practitioner.

                             hanging groin means a sac of atrophic skin containing enlarged, sclerosed inguinal or femoral lymph glands.

                               inguinal hernia—see subsection 7(2).

                             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.

                             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.

Endnotes

Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.

If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and “(md not incorp)” is added to the amendment history.

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history