{"id":"F2024L00040","name":"Statement of Principles concerning hepatitis A infection (Reasonable Hypothesis) (No. 9 of 2024)","slug":"statement-of-principles-concerning-hepatitis-a-infection-reasonable-hypothesis-no-9-of-2024","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442246,"registerId":"F2024L00040-fast-fetch-1775957293000","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning hepatitis A infection (Reasonable Hypothesis) (No. 9 of 2024)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nHEPATITIS A INFECTION (Reasonable Hypothesis)\n\n(No. 9 of 2024)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 22 December 2023.\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:
|\n| --- |\n|
Professor Terence Campbell AM
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 hepatitis A infection (Reasonable Hypothesis) (No. 9 of 2024).\n\n2 Commencement\n\n This instrument commences on 22 January 2024.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning hepatitis A No. 63 of 2015 (Federal Register of Legislation No. F2015L00645) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 hepatitis A infection and death from hepatitis A infection.\n\nMeaning of hepatitis A infection\n\n(2) For the purposes of this Statement of Principles, hepatitis A infection means infection with the hepatitis A virus resulting in an acute, symptomatic, clinical illness characterised by inflammation of the liver, and which is confirmed by laboratory testing for hepatitis A serological or nucleic acid markers.\n\nNote: Signs and symptoms of hepatitis A infection include fever, tiredness, loss of appetite, nausea, vomiting, abdominal discomfort, hepatomegaly and jaundice.\n\n(3) While hepatitis A infection attracts ICD‑10‑AM code B15, in applying this Statement of Principles the meaning of hepatitis A infection 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 hepatitis A infection\n\n(5) For the purposes of this Statement of Principles, hepatitis A infection, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's hepatitis A infection.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that hepatitis A infection and death from hepatitis A infection can be related to relevant service rendered by veterans, members of Peacekeeping Forces, 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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting hepatitis A infection or death from hepatitis A infection with the circumstances of a person's relevant service:\n\n(1) being exposed to the hepatitis A virus by:\n\n(a) being in the same living quarters or immediate work environment as a person infected with the hepatitis A virus;\n\n(b) consuming water or food contaminated with the hepatitis A virus;\n\n(c) having direct contact with human or primate faecal material contaminated with the hepatitis A virus;\n\n(d) having direct physical contact with a human or a primate infected with the hepatitis A virus;\n\n(e) having percutaneous (intravenous, intramuscular, subcutaneous or intradermal) exposure to blood or body fluids contaminated with the hepatitis A virus; or\n\n(f) receiving a transfusion of blood or blood products contaminated with the hepatitis A virus;\n\nwhere hepatitis A virus exposure occurs between 15 and 50 days before the clinical onset of hepatitis A infection;\n\n(2) having a solid organ transplant, where the tissue or organ is derived from a person infected with the hepatitis A virus, within the 4 months before the clinical onset of hepatitis A infection;\n\n(3) inability to access appropriate hepatitis A vaccination before exposure to hepatitis A virus, or appropriate hepatitis A post-exposure prophylaxis, in accordance with contemporary medical standards, before the clinical onset of hepatitis A infection;\n\nNote: post-exposure prophylaxis is defined in the Schedule 1 - Dictionary.\n\n(4) inability to obtain appropriate clinical management for hepatitis A infection before the clinical worsening of hepatitis A infection.\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, hepatitis A infection where the person's hepatitis A infection 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(2) 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 hepatitis A infection—see subsection 7(2).\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n post-exposure prophylaxis means providing immunoglobulin or a vaccine to a person who has been exposed to an infectious agent, in an effort to prevent them from developing the disease.\n\n relevant service means:\n\n(a) operational service under the VEA;\n\n(b) peacekeeping service under the VEA;\n\n(c) hazardous service under the VEA;\n\n(d) British nuclear test defence service under the VEA;\n\n(e) warlike service under the MRCA; or\n\n(f) non-warlike service under the MRCA.\n\nNote: MRCA and VEA are 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":{"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument repeals the 2015 Statement and replaces it with this Statement, but the text itself addresses hepatitis A infection and death linked to 'relevant service' and sets qualifying factors. The instrument does not expressly expand or narrow coverage beyond specifying exposures, timing, laboratory confirmation and treatment/vaccination access criteria; therefore no clear change of scope from the previous instrument can be identified from this text alone."},"complexity_factors":["Medical definition requires laboratory confirmation and references ICD‑10‑AM but provides its own definitional override (subsections 7(2)–(4)).","Specified exposure time window (15–50 days) for most exposure routes (section 9(1)).","Multiple distinct exposure pathways and clinical scenarios listed as alternative bases to raise a reasonable hypothesis (section 9).","Inclusion of inability to access vaccination/post‑exposure prophylaxis and inability to obtain appropriate clinical management, which rely on 'contemporary medical standards' and introduce administrative judgement (sections 9(3)–(4)).","Interaction with other Statements of Principles where overlapping injuries/diseases are governed by different instruments (section 11).","Application limited to claims under VEA/MRCA and cross‑references to those Acts and defined categories of 'relevant service' (sections 3, 5 and Schedule 1).","Treatment of death as including contribution to terminal events and the definition of 'terminal event', which affects causal attribution (subsection 7(5) and Schedule 1).","Repeal of prior Statement (No. 63 of 2015) introduces transition/consistency considerations for decision‑makers (section 4)."],"plain_english_summary":"This instrument replaces the earlier Statement of Principles for hepatitis A and sets the legal test decision‑makers must use to link hepatitis A infection (including death) to a veteran’s or serving member’s relevant service for VEA/MRCA claims. It defines the clinical case (lab confirmation), lists specific exposure pathways and time limits, and includes failure to access vaccination or timely clinical care as qualifying factors. The Statement matters because it determines which service‑related exposures or treatment gaps raise a reasonable hypothesis for entitlement decisions."},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a routine reissue and update of an existing Statement of Principles (replacing No. 63 of 2015). The scope remains tightly focused on establishing the medical connection between hepatitis A infection and eligible military service. The factors listed (exposure pathways, transplant, vaccination access, clinical management) represent standard epidemiological considerations for hepatitis A and do not represent scope creep beyond the original purpose of determining service-relatedness for this specific disease."},"complexity_factors":["Moderate cross-referencing between two major Acts (VEA and MRCA) with six different service types defined","Precise incubation period requirements (15-50 days for exposure, 4 months for transplants) that create conditional logic","Nested definitions requiring lookup in Schedule 1 (terminal event, post-exposure prophylaxis, relevant service)","Specific subsection 9(4) contains an exception limiting its application to pre-existing conditions only","Reference to external medical classification system (ICD-10-AM Tenth Edition) with specific ISBN and effective date","Incorporation by reference of other Statements of Principles through section 11, creating interdependence with unknown number of other instruments"],"plain_english_summary":"The Repatriation Medical Authority has updated its medical guideline for hepatitis A (replacing the 2015 version), setting the evidentiary framework for when a hepatitis A infection can be accepted as related to service for compensation.\n\nIt affects veterans and current/former defence members claiming under the VEA or MRCA who served on operations, peacekeeping, hazardous service or nuclear tests — important because deployment conditions can increase exposure and enable access to treatment and benefits."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hepatitis-a-infection-reasonable-hypothesis-no-9-of-2024","history":"/api/acts/statement-of-principles-concerning-hepatitis-a-infection-reasonable-hypothesis-no-9-of-2024/history","analysis":"/api/acts/statement-of-principles-concerning-hepatitis-a-infection-reasonable-hypothesis-no-9-of-2024/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hepatitis-a-infection-reasonable-hypothesis-no-9-of-2024/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hepatitis-a-infection-reasonable-hypothesis-no-9-of-2024/important-cases","documents":"/api/acts/statement-of-principles-concerning-hepatitis-a-infection-reasonable-hypothesis-no-9-of-2024/documents"}}