{"id":"F2019L00642","name":"Statement of Principles concerning acute rheumatic fever (Balance of Probabilities) (No. 54 of 2019)","slug":"statement-of-principles-concerning-acute-rheumatic-fever-balance-of-probabilities-no-54-of-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440054,"registerId":"F2019L00642-fast-fetch-1775955837094","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning acute rheumatic fever (Balance of Probabilities) (No. 54 of 2019)","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 RHEUMATIC FEVER (Balance of Probabilities)\n\n(No. 54 of 2019)\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 26 April 2019\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 rheumatic fever (Balance of Probabilities) (No. 54 of 2019).\n\n2 Commencement\n\n This instrument commences on 27 May 2019.\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 rheumatic fever No. 24 of 2011 (Federal Register of Legislation No. F2011L00504) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 rheumatic fever and death from acute rheumatic fever.\n\nMeaning of acute rheumatic fever\n\n(2) For the purposes of this Statement of Principles, acute rheumatic fever:\n\n(a) means a systemic, inflammatory autoimmune disease that follows laboratory confirmed infection with beta-haemolytic streptococcus; and\n\n(b) excludes post-streptococcal reactive arthritis.\n\nNote 1: Acute rheumatic fever may affect the heart as clinical or subclinical carditis; the joints as polyarthritis, monoarthritis or polyarthralgia; the central nervous system; and the skin or subcutaneous tissues. It can also present as isolated Sydenham chorea or indolent subclinical carditis.\n\nNote 2: Laboratory confirmation of infection may occur at the time of the streptococcal infection using positive throat culture, positive rapid antigen test or positive molecular assay, or later using positive serology for streptococcus.\n\n(3) While acute rheumatic fever attracts ICD‑10‑AM code I00, I01 or I02, in applying this Statement of Principles the meaning of acute rheumatic fever 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 rheumatic fever\n\n(5) For the purposes of this Statement of Principles, acute rheumatic fever, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's acute rheumatic fever.\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 rheumatic fever and death from acute rheumatic fever 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 rheumatic fever or death from acute rheumatic fever is connected with the circumstances of a person's relevant service:\n\n(1) having a group A beta-haemolytic streptococcal infection of the pharynx within the three months before the clinical onset of acute rheumatic fever;\n\n(2) for acute rheumatic fever manifesting as isolated chorea or as indolent subclinical carditis only, having a group A beta-haemolytic streptococcal infection of the pharynx within the nine months before the clinical onset of acute rheumatic fever;\n\n(3) experiencing crowded living or working conditions within the one year before the clinical onset of acute rheumatic fever;\n\n(4) inability to obtain appropriate clinical management for acute rheumatic fever.\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(4) applies only to material contribution to, or aggravation of, acute rheumatic fever where the person's acute rheumatic fever 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 rheumatic fever—see subsection 7(2).\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 purpose: establishing the causal factors for acute rheumatic fever in veterans' compensation claims. It replaces the 2011 version without expanding into new areas of law or policy."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 5 defined terms in the Dictionary (Schedule 1)","Clear, numbered structure with straightforward conditional logic (section 9 lists 4 alternative factors, only one required)","Single cross-reference mechanism (section 11 links to other Statements of Principles if referenced factors apply)","Minimal nesting: only one conditional exception in section 10(2) regarding the 'inability to obtain appropriate clinical management' factor","No delegated legislation or regulation-making powers","Medical terminology is explained in plain language notes (e.g., laboratory confirmation methods in Note 2 to section 7)"],"plain_english_summary":"This rulebook sets the medical criteria for awarding compensation for acute rheumatic fever to current and former Australian Defence Force members and veterans claiming under the Veterans' Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004. It requires evidence linking the illness to service — for example a recent streptococcal infection, service-related crowded living or deployment conditions, or lack of access to treatment.\n\nIt replaces the 2011 version, updating the medical evidence and ensuring consistent national standards for service-related determinations."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument repeals the 2011 Statement (s4) but does not itself state any explicit expansion or narrowing of scope. It defines acute rheumatic fever (s7), sets the factors that can link the condition to relevant service (s9) and limits application to claims under specified provisions of the VEA and MRCA (s5). No express change of scope from the previous instrument is stated in the text provided."},"complexity_factors":["Legal nexus to two statutes (VEA and MRCA) and application to claims under specific sections (s5).","Medical definition with diagnostic detail and ICD‑10‑AM coding references (s7(2)–(4)).","Time-bound evidentiary windows linking infection to onset (s9(1)–(2): 3‑month and 9‑month periods) and a 1‑year exposure window for crowding (s9(3)).","Limited set of discrete causal factors (s9) plus an access-to-care factor (s9(4)) that applies only as a material contribution/aggravation in certain circumstances (s10(2)).","Interaction with other Statements of Principles where factors overlap (s11), requiring cross-reference to other instruments.","Repeal of the prior 2011 Statement (s4), requiring attention to transitional/administrative effects for existing claims."],"plain_english_summary":"Updates the Statement of Principles for acute rheumatic fever by defining the medical condition, clarifying how it is identified (including ICD codes and laboratory confirmation) and listing the specific factual factors that, if present, establish a connection between the condition and a person’s relevant service. It applies to claims under the Veterans’ Entitlements Act and the Military Rehabilitation and Compensation Act and matters because those listed factors determine whether service-related entitlements or contributions to death can be accepted."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-acute-rheumatic-fever-balance-of-probabilities-no-54-of-2019","history":"/api/acts/statement-of-principles-concerning-acute-rheumatic-fever-balance-of-probabilities-no-54-of-2019/history","analysis":"/api/acts/statement-of-principles-concerning-acute-rheumatic-fever-balance-of-probabilities-no-54-of-2019/analysis","conflicts":"/api/acts/statement-of-principles-concerning-acute-rheumatic-fever-balance-of-probabilities-no-54-of-2019/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-acute-rheumatic-fever-balance-of-probabilities-no-54-of-2019/important-cases","documents":"/api/acts/statement-of-principles-concerning-acute-rheumatic-fever-balance-of-probabilities-no-54-of-2019/documents"}}