{"id":"F2025L00974","name":"Statement of Principles concerning hepatitis D infection (Balance of Probabilities) (No. 72 of 2025)","slug":"statement-of-principles-concerning-hepatitis-d-infection-balance-of-probabilities-no-72-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442933,"registerId":"F2025L00974-fast-fetch-1775957848832","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning hepatitis D infection (Balance of Probabilities) (No. 72 of 2025)","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![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nHEPATITIS D INFECTION  (Balance of Probabilities)\n\n(No. 72 of 2025)\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 22 August 2025\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\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\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning hepatitis D infection (Balance of Probabilities) (No. 72 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 22 September 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning hepatitis D (Balance of Probabilities) (No. 12 of 2017) (Federal Register of Legislation No. F2017L00021) made under subsection 196B(3) of the VEA is repealed.\n\n1.                Application\n\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\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about hepatitis D infection and death from hepatitis D infection.\n\n\nMeaning of hepatitis D infection\n\n1.           For the purposes of this Statement of Principles, hepatitis D infection:\n  1.           means infection with the hepatitis D virus, as a co-infection or superinfection with the hepatitis B virus, resulting in an illness characterised by inflammation of the liver, and which is confirmed by laboratory testing for hepatitis D serological or nucleic acid markers; and\n  2.           includes acute and chronic hepatitis D infection.\n\n\nNote 1: Signs and symptoms of acute hepatitis D infection include, but are not limited to, fever, tiredness, loss of appetite, nausea, vomiting, abdominal discomfort and jaundice. Chronic hepatitis D is an infection lasting for at least 6 months, which may involve both inflammation of the liver and the development of fibrosis in the longer term.\n\nNote 2: It will usually be the case that the date of the confirmation of laboratory evidence of hepatitis D serological or nucleic acid markers is after the date of clinical onset.\n\nNote 3: Clinical onset is defined in the schedule 1 – Dictionary.\n\n1.           While hepatitis D infection attracts ICD‑10‑AM code B16.0, B16.1 or B18.0, in applying this Statement of Principles the meaning of hepatitis D infection is that given in subsection (2).\n2.           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\n\nDeath from hepatitis D infection\n\n1.           For the purposes of this Statement of Principles, hepatitis D infection, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's hepatitis D infection.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that hepatitis D infection and death from hepatitis D infection 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\n1.                Factors that must exist\n\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, hepatitis D infection or death from hepatitis D infection is connected with the circumstances of a person's relevant service:\n\n1.           having percutaneous (intravenous, intramuscular, subcutaneous or intradermal) or permucosal exposure to a body substance which is derived from a person infected with the hepatitis D virus at least 14 days before clinical onset;\n\n\nNote: Body substances include blood, blood products or any body fluid containing blood, saliva, semen or vaginal secretions, serum-derived fluids (serous discharge, or amniotic, cerebrospinal, pericardial, peritoneal, pleural or synovial fluids), tissues and organs.\n\n1.           having hepatitis B infection at the time of clinical onset;\n2.           inability to access appropriate hepatitis B vaccination before exposure to hepatitis B virus, or appropriate hepatitis B post-exposure prophylaxis, in accordance with contemporary medical standards, before clinical onset;\n\n\nNote: post-exposure prophylaxis is defined in the Schedule 1 - Dictionary.\n\n1.           inability to obtain appropriate clinical management for hepatitis D infection before clinical worsening.\n\n\n1.            Relationship to service\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  2.           The factor set out in subsection 9(4) applies only to material contribution to, or aggravation of, hepatitis D infection where the person's hepatitis D infection was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 9 applies in relation to a person; and\n2.           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\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                               clinical onset means the point backwards in time from the first date of confirmation of laboratory evidence of hepatitis D serological or nucleic acid markers, to the date at which the symptoms of hepatitis D were persistently present, as assessed by a registered medical practitioner.\n\n                               hepatitis d 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)          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":{"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"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Repatriation Medical Authority Statements of Principles. It updates the specific disease criteria from the 2017 version without expanding beyond the original purpose of determining service-related compensation for hepatitis D infection in the veteran and defence community."},"complexity_factors":["Cross-referencing between multiple Acts: Veterans' Entitlements Act 1986 and Military Rehabilitation and Compensation Act 2004","Nested definitions requiring lookup in Schedule 1 (clinical onset, relevant service, terminal event, post-exposure prophylaxis)","Conditional logic in section 9 requiring at least one of four alternative factors to be satisfied","Temporal requirements (14-day window for exposure before clinical onset)","Exception handling in section 10(2) limiting subsection 9(4) to aggravation cases only","Incorporation by reference of ICD-10-AM codes (Tenth Edition, 2017) with specific ISBN","Circular definition structure: 'hepatitis D infection' refers to subsection 7(2), which is itself defined in the Dictionary referring back to subsection 7(2)","Requirement to link factors to 'relevant service' creating a two-step test (factor existence + service connection)"],"plain_english_summary":"This instrument updates the medical rules for Australian veterans and defence members (and their families) seeking compensation for hepatitis D infection or death, replacing the 2017 Statement of Principles. It requires laboratory-confirmed hepatitis D (which only occurs with hepatitis B) and applies the \"balance of probabilities\" test for service connection. Claims must link clinical onset to service through factors such as exposure to infectious blood, pre-existing hepatitis B, lack of timely vaccination/prophylaxis, or inadequate treatment."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"The instrument expressly repeals the 2017 Statement (section 4) and replaces it with revised operative content: it continues to apply to VEA and MRCA claims (section 5) but sets out clarified and specific causal factors (section 9) including inability to access hepatitis B vaccination or post‑exposure prophylaxis and inability to obtain appropriate clinical management, and it explicitly includes death from terminal events contributed to by hepatitis D (section 7(4) and Schedule 1). These changes modify the operative criteria claimants and decision‑makers must apply, even though the class of eligible claims remains defined by the same statutes."},"complexity_factors":["Medical-technical definitions and timing: clinical onset tied to lab confirmation and symptoms (Schedule 1 definition)","Requirement to link specified factors to 'relevant service' under VEA or MRCA (sections 5 and 10)","Discrete, burdened proof elements: laboratory confirmation, exposure timing (≥14 days before onset), and co‑infection status (section 9)","Interplay with other Statements of Principles where factors reference other injuries/diseases (section 11)","Procedural update: repeal and replacement of the 2017 Statement (section 4)","Elements that turn on availability/access to care or prophylaxis (sections 9(3)–9(4)), introducing factual inquiries about prior access to vaccination/post‑exposure prophylaxis and clinical management"],"plain_english_summary":"This Statement of Principles tells the Repatriation Medical Authority what medical evidence and causal factors must exist, on the balance of probabilities, for a veteran’s hepatitis D infection (or death from it) to be accepted as connected with VEA or MRCA service. It lists required factors (for example, exposure to infected body substances, concurrent hepatitis B, lack of timely hepatitis B vaccination or post‑exposure prophylaxis, or lack of access to appropriate clinical management), defines clinical onset and death, and repeals the 2017 Statement."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-balance-of-probabilities-no-72-of-2025","history":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-balance-of-probabilities-no-72-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-balance-of-probabilities-no-72-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-balance-of-probabilities-no-72-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-balance-of-probabilities-no-72-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-balance-of-probabilities-no-72-of-2025/documents"}}