{"id":"F2025L00973","name":"Statement of Principles concerning hepatitis D infection (Reasonable Hypothesis) (No. 71 of 2025)","slug":"statement-of-principles-concerning-hepatitis-d-infection-reasonable-hypothesis-no-71-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442934,"registerId":"F2025L00973-fast-fetch-1775957848834","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 (Reasonable Hypothesis) (No. 71 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  (Reasonable Hypothesis)\n\n(No. 71 of 2025)\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 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   \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 (Reasonable Hypothesis) (No. 71 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(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning hepatitis D (Reasonable Hypothesis) (No. 11 of 2017) (Federal Register of Legislation No. F2017L00020) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\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\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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that hepatitis D infection and death from hepatitis D 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\n1.                Factors that must exist\n\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 D infection or death from hepatitis D infection 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(2) 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)          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_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":false,"description":"The instrument repeals the 2017 Statement (section 4) and reissues a Statement of Principles that, on its face, applies to the same classes of claims (claims under s120A VEA or s338 MRCA (Application)). The text sets out medical definitions and qualifying factors but does not, within this instrument, expressly widen or narrow the categories of persons covered compared with the prior instrument."},"complexity_factors":["Medical-technical definitions and timing issues: detailed definition of 'hepatitis D infection' and 'clinical onset' requiring backward dating from lab confirmation (Schedule 1 - Dictionary; subsection 7(2); Note 2).","Evidentiary trigger: requirement for laboratory confirmation of serological or nucleic acid markers and relation to symptom onset (subsection 7(2) and Notes).","Multiple qualifying factors with different legal effects: Factors include exposure, concurrent hepatitis B infection, inability to access vaccination/post-exposure prophylaxis, and inability to obtain clinical management (section 9).","Service connection requirement: every listed factor must be related to 'relevant service' as defined, and one factor is limited to material contribution/aggravation where infection pre‑existed (section 10).","Cross-references to other instruments and codes: repeal of the 2017 Statement (section 4), dependence on other Statements of Principles when factors refer to other injuries/diseases (section 11), and reference to ICD-10-AM codes (subsection 7(4)).","Statutory decision-maker and legal base: instrument is made under s196B(2) of the VEA and applies to claims under s120A VEA or s338 MRCA, concentrating decision-making with the Repatriation Medical Authority (Authority and Application sections).","Compliance and burden of proof located on claimants: claimant must demonstrate a listed factor and its link to service (sections 9 and 10), creating requirements for medical evidence and potentially retrospective clinical assessment.","Potential overlap and sequencing issues: interplay between laboratory confirmation date, clinical onset dating, and eligibility for post-exposure prophylaxis or vaccination (Notes to subsection 7(2); Schedule 1 definitions)."],"plain_english_summary":"This instrument replaces the earlier Statement of Principles on hepatitis D and sets the medical test and timing rules used to decide whether a veteran’s hepatitis D infection (or death from it) can be linked to their service. It applies to claims under the VEA and MRCA and lists the clinical definition, required laboratory confirmation, and the qualifying factors (exposure to infected body substances, hepatitis B co‑infection, lack of access to vaccination/post‑exposure prophylaxis, or lack of clinical management). The Repatriation Medical Authority makes the decision; claimants must satisfy the listed factors."},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"The legislation maintains its original purpose of establishing medical criteria for veterans' compensation claims. The 2025 version appears to be a routine update replacing the 2017 version, with no significant expansion beyond the original scope of determining service connection for hepatitis D infection."},"complexity_factors":["Moderate cross-referencing between the main instrument and Schedule 1 (Dictionary)","Nested definitions requiring lookup (e.g., 'clinical onset' defined in Dictionary but used throughout)","Conditional logic in section 9 requiring at least one of four factors to exist","Specific temporal requirements (14-day window for exposure, 6-month threshold for chronic infection)","Dual legislative framework application (VEA and MRCA with different service categories)","Incorporation by reference to ICD-10-AM coding system (external medical classification)","Exception handling in section 10(2) limiting application of factor 9(4) to pre-existing conditions"],"plain_english_summary":"This instrument updates the medical criteria for when Australian veterans and defence members can claim compensation for hepatitis D, replacing the 2017 rules. It defines hepatitis D by laboratory-confirmed liver inflammation and specifies four service-related circumstances that can link the disease to military service (exposure to infected blood/body fluids, pre-existing hepatitis B, lack of access to hepatitis B vaccination/treatment after exposure, or inadequate care for the infection).\n\nIt applies to current and former Defence members claiming under the VEA or MRCA and matters because meeting one of these factors can establish a “reasonable hypothesis” connecting the condition to service."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-reasonable-hypothesis-no-71-of-2025","history":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-reasonable-hypothesis-no-71-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-reasonable-hypothesis-no-71-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-reasonable-hypothesis-no-71-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-reasonable-hypothesis-no-71-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-hepatitis-d-infection-reasonable-hypothesis-no-71-of-2025/documents"}}