{"id":"F2021L00003","name":"Statement of Principles concerning acute infectious mononucleosis (Balance of Probabilities) (No. 18 of 2021)","slug":"statement-of-principles-concerning-acute-infectious-mononucleosis-balance-of-probabilities-no-18-of-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440729,"registerId":"F2021L00003-fast-fetch-1775956266496","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning acute infectious mononucleosis (Balance of Probabilities) (No. 18 of 2021)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nACUTE INFECTIOUS MONONUCLEOSIS (Balance of Probabilities)\n\n(No. 18 of 2021)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 24 December 2020\n\n \n\n \n\n \n\n \n\n \n\n| The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:
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Professor Nicholas Saunders AO
Chairperson
|\n\n\n \n\n \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n\n\n\n1 Name\n\nThis is the Statement of Principles concerning acute infectious mononucleosis (Balance of Probabilities) (No. 18 of 2021).\n\n2 Commencement\n\n This instrument commences on 25 January 2021.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning acute infectious mononucleosis No. 4 of 2012 (Federal Register of Legislation No. F2012L00008) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n6 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about acute infectious mononucleosis and death from acute infectious mononucleosis.\n\nMeaning of acute infectious mononucleosis\n\n(2) For the purposes of this Statement of Principles, acute infectious mononucleosis means an illness caused by infection with the Epstein-Barr virus, accompanied by laboratory evidence of recently acquired Epstein-Barr virus infection.\n\nNote: Typical clinical features of acute infectious mononucleosis include pharyngitis, lymphadenopathy, splenomegaly, fever, fatigue, myalgia and atypical lymphocytosis.\n\n(3) While acute infectious mononucleosis attracts ICD‑10‑AM code B27.0, in applying this Statement of Principles the meaning of acute infectious mononucleosis is that given in subsection (2).\n\n(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.\n\nDeath from acute infectious mononucleosis\n\n(5) For the purposes of this Statement of Principles, acute infectious mononucleosis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's acute infectious mononucleosis.\n\nNote: terminal event is defined in the Schedule 1 - Dictionary.\n\n8 Basis for determining the factors\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that acute infectious mononucleosis and death from acute infectious mononucleosis can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 - Dictionary.\n\n9 Factors that must exist\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, acute infectious mononucleosis or death from acute infectious mononucleosis is connected with the circumstances of a person's relevant service:\n\n(1) being exposed to the Epstein-Barr virus between 12 and 50 days before the clinical onset of acute infectious mononucleosis;\n\nNote: being exposed to the Epstein-Barr virus is defined in the Schedule 1 - Dictionary. \n\n(2) inability to obtain appropriate clinical management for acute infectious mononucleosis.\n\n10 Relationship to service\n\n(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.\n\n(2) The factor set out in subsection 9(2) applies only to material contribution to, or aggravation of, acute infectious mononucleosis where the person's acute infectious mononucleosis was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nIn this Statement of Principles:\n\n(1) if a factor referred to in section 9 applies in relation to a person; and\n\n(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;\n\nthen 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.\n\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n acute infectious mononucleosis—see subsection 7(2).\n\n being exposed to the Epstein-Barr virus means:\n\n(a) having exposure of the oral mucosa to saliva infected with the Epstein-Barr virus; or\n\n(b) receiving a blood transfusion, blood products, a stem cell transplant or an organ transplant infected with the Epstein-Barr virus.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n relevant service means:\n\n(a) eligible war service (other than operational service) under the VEA;\n\n(b) defence service (other than hazardous service and British nuclear test defence service) under the VEA; or\n\n(c) peacetime service under the MRCA.\n\nNote: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\n terminal event means the proximate or ultimate cause of death and includes the following:\n\n(a) pneumonia;\n\n(b) respiratory failure;\n\n(c) cardiac arrest;\n\n(d) circulatory failure; or\n\n(e) cessation of brain function.\n\n VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument maintains its original narrow scope. It replaces the 2012 Statement of Principles concerning the same condition (acute infectious mononucleosis) without expanding into new medical conditions, new claimant categories, or new types of service. The structure and purpose remain consistent with the Repatriation Medical Authority's standard template for determining service-related medical conditions."},"complexity_factors":["Short, focused instrument (approximately 1,500 words) dealing with a single medical condition","Only 7 defined terms in the Dictionary (Schedule 1)","Simple binary structure: two alternative factors in section 9, with one limitation in section 10(2)","Minimal cross-referencing—only refers to parent Acts (VEA and MRCA) and one repealed instrument","Clear, sequential layout (sections 1-11 plus Schedule) without nested exceptions or conditional logic beyond the basic 'at least one factor' requirement","Single medical causation pathway (Epstein-Barr virus exposure) with straightforward temporal window (12-50 days)"],"plain_english_summary":"This rulebook sets criteria for awarding Australian veterans or defence members compensation when acute infectious mononucleosis (Epstein–Barr virus/mono) is linked to their service. It applies to peacetime and non-operational service and guides claims under the VEA and MRCA.\n\nClaimants can show a service connection by proving service-related exposure to EBV or that service prevented appropriate treatment which worsened the illness. It updates medical evidentiary standards and replaces the 2012 guidance."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2012 Statement of Principles (s4) and sets new definitional and causal criteria (e.g. lab‑evidence requirement s7(2); exposure window s9(1); clinical‑management factor s9(2)), so its scope as the operative SOP has changed. The text itself does not provide the 2012 instrument’s provisions, so specific differences in coverage or thresholds cannot be determined from this instrument alone."},"complexity_factors":["Narrow diagnostic requirement: acute infectious mononucleosis is defined as Epstein‑Barr virus infection accompanied by laboratory evidence of recently acquired infection (s7(2)).","Fixed exposure window: one causal factor requires exposure to EBV between 12 and 50 days before clinical onset (s9(1)).","Alternative causal factor tied to health system access: inability to obtain appropriate clinical management can establish connection (s9(2)).","Limit on application of management factor: that factor applies only to material contribution or aggravation where the disease was suffered or contracted before/during but did not arise out of relevant service (s10(2)).","Death included where acute infectious mononucleosis contributed to a terminal event; terminal events listed in Schedule 1 (s7(5); Schedule 1).","Interaction with other Statements of Principles: factors may invoke provisions of other SOPs where relevant (s11).","References an external diagnostic code set (ICD‑10‑AM Tenth Edition) by version and edition, creating an external-document dependency (s7(3)–(4)).","Administrative scope: instrument applies to claims under section 120B of the VEA or section 339 of the MRCA, so it governs decision-making in two statutory schemes (s5).","Replaces prior instrument (repeal of 2012 SOP), which may alter prior evidentiary or definitional positions (s4).","Standard of proof and evidentiary framing: connection must be established on the balance of probabilities and is premised on available medical‑scientific evidence (title; s8)."],"plain_english_summary":"This Statement of Principles sets the legal test for when acute infectious mononucleosis (caused by Epstein–Barr virus with laboratory evidence) and deaths from it can be treated as related to veterans’ or defence service for VEA/MRCA claims. It specifies the types of exposure and clinical-management failures that can, when tied to relevant service, establish causation on the balance of probabilities and replaces the earlier 2012 Statement."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-acute-infectious-mononucleosis-balance-of-probabilities-no-18-of-","history":"/api/acts/statement-of-principles-concerning-acute-infectious-mononucleosis-balance-of-probabilities-no-18-of-/history","analysis":"/api/acts/statement-of-principles-concerning-acute-infectious-mononucleosis-balance-of-probabilities-no-18-of-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-acute-infectious-mononucleosis-balance-of-probabilities-no-18-of-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-acute-infectious-mononucleosis-balance-of-probabilities-no-18-of-/important-cases","documents":"/api/acts/statement-of-principles-concerning-acute-infectious-mononucleosis-balance-of-probabilities-no-18-of-/documents"}}