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Statement of Principles

Inguinal hernia — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Inguinal hernia. DVA can only accept a claim for Inguinal hernia if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

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Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

Inguinal hernia

RH No. 47 of 2021 · BoP No. 48 of 202122 factors

Meaning of inguinal hernia: For the purposes of this Statement of Principles, inguinal hernia means: (a) a protrusion of intra-abdominal tissue through the abdominal wall either: (i) through the inguinal canal; or (ii) through a weakness in the posterior wall of the inguinal canal; and (b) includes direct and indirect inguinal hernia; and (c) excludes femoral hernia. (3) 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). (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.

Reasonable Hypothesis (RH) — Statement of Principles No. 47 of 2021

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

  1. (1)
    having acute elevation of pressure within the abdominal cavity due to any one of the following: (a) anti-G straining manoeuvre; (b) lifting heavy weights; (c) physical trauma to the abdomen involving a direct blow to the abdomen; (d) pneumoperitoneum induced for laparoscopic surgery; (e) significant coughing; (f) significant sneezing; (g) straining at micturition due to bladder outlet or urethral obstruction; or (h) straining at stool due to constipation or diarrhoea; within the 30 days before the clinical onset of inguinal hernia;
  2. (2)
    having chronic elevation of pressure within the abdominal cavity due to any one of the following: (a) ascites; (b) chronic ambulatory or automatic peritoneal dialysis; (c) extensive intra-abdominal neoplastic disease or mass; or (d) pregnancy; at the time of the clinical onset of inguinal hernia;

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

  3. (3)
    undergoing radical retropubic prostatectomy, laparoscopic radical prostatectomy or robot-assisted laparoscopic radical prostatectomy within the five years before the clinical onset of inguinal hernia;
  4. (4)
    having chronic onchocerciasis in the presence of a hanging groin at the time of the clinical onset of inguinal hernia;

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

  5. (5)
    for uretero-inguinal hernia only, having a kidney transplant before the clinical onset of uretero-inguinal hernia;
  6. (6)
    having acute elevation of pressure within the abdominal cavity due to any one of the following: (a) anti-G straining manoeuvre; (b) lifting heavy weights; (c) physical trauma to the abdomen involving a direct blow to the abdomen; (d) pneumoperitoneum induced for laparoscopic surgery; (e) significant coughing; (f) significant sneezing; (g) straining at micturition due to bladder outlet or urethral obstruction; or (h) straining at stool due to constipation or diarrhoea; within the 30 days before the clinical worsening of inguinal hernia;
  7. (7)
    having chronic elevation of pressure within the abdominal cavity due to any one of the following: (a) ascites; (b) chronic ambulatory or automatic peritoneal dialysis; (c) extensive intra-abdominal neoplastic disease or mass; or (d) pregnancy; at the time of the clinical worsening of inguinal hernia;

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

  8. (8)
    undergoing radical retropubic prostatectomy, laparoscopic radical prostatectomy or robot-assisted laparoscopic radical prostatectomy within the five years before the clinical worsening of inguinal hernia;
  9. (9)
    having chronic onchocerciasis in the presence of a hanging groin at the time of the clinical worsening of inguinal hernia;

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

  10. (10)
    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;
  11. (11)
    inability to obtain appropriate clinical management for inguinal hernia;

Aggravation-only factors: the factors in subsections 9(6) to 9(11) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 48 of 2021

11 factors

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. (1)
    having acute elevation of pressure within the abdominal cavity due to any one of the following: (a) anti-G straining manoeuvre; (b) lifting heavy weights; (c) physical trauma to the abdomen involving a direct blow to the abdomen; (d) pneumoperitoneum induced for laparoscopic surgery; (e) significant coughing; (f) significant sneezing; (g) straining at micturition due to bladder outlet or urethral obstruction; or (h) straining at stool due to constipation or diarrhoea; within the 30 days before the clinical onset of inguinal hernia;
  2. (2)
    having chronic elevation of pressure within the abdominal cavity due to any one of the following: (a) ascites; (b) chronic ambulatory or automatic peritoneal dialysis; (c) extensive intra-abdominal neoplastic disease or mass; or (d) pregnancy; at the time of the clinical onset of inguinal hernia;

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

  3. (3)
    undergoing radical retropubic prostatectomy, laparoscopic radical prostatectomy or robot-assisted laparoscopic radical prostatectomy within the five years before the clinical onset of inguinal hernia;
  4. (4)
    having chronic onchocerciasis in the presence of a hanging groin at the time of the clinical onset of inguinal hernia;

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

  5. (5)
    for uretero-inguinal hernia only, having a kidney transplant before the clinical onset of uretero-inguinal hernia;
  6. (6)
    having acute elevation of pressure within the abdominal cavity due to any one of the following: (a) anti-G straining manoeuvre; (b) lifting heavy weights; (c) physical trauma to the abdomen involving a direct blow to the abdomen; (d) pneumoperitoneum induced for laparoscopic surgery; (e) significant coughing; (f) significant sneezing; (g) straining at micturition due to bladder outlet or urethral obstruction; or (h) straining at stool due to constipation or diarrhoea; within the 30 days before the clinical worsening of inguinal hernia;
  7. (7)
    having chronic elevation of pressure within the abdominal cavity due to any one of the following: (a) ascites; (b) chronic ambulatory or automatic peritoneal dialysis; (c) extensive intra-abdominal neoplastic disease or mass; or (d) pregnancy; at the time of the clinical worsening of inguinal hernia;

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

  8. (8)
    undergoing radical retropubic prostatectomy, laparoscopic radical prostatectomy or robot-assisted laparoscopic radical prostatectomy within the five years before the clinical worsening of inguinal hernia;
  9. (9)
    having chronic onchocerciasis in the presence of a hanging groin at the time of the clinical worsening of inguinal hernia;

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

  10. (10)
    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;
  11. (11)
    inability to obtain appropriate clinical management for inguinal hernia;

Aggravation-only factors: the factors in subsections 9(6) to 9(11) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

A VHC Diagnostic Assessment addresses each of these factors one by one against your service record and clinical history. See how a VHC DVA claim works, see all fees ($600 + GST per stage) or book an appointment.

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Dr Perkins has spent more than thirteen years working exclusively with current and former ADF members — treating their conditions, writing their reports and navigating the DVA system alongside them. With over 100,000 claims submitted and 2,000 Permanent Impairment Assessments completed, he has seen precisely what separates an accepted claim from a rejected one at every level, from initial liability to the Veterans' Review Board.

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