{"id":"F2024L00737","name":"Statement of Principles concerning hepatitis E infection (Balance of Probabilities) (No. 40 of 2024)","slug":"statement-of-principles-concerning-hepatitis-e-infection-balance-of-probabilities-no-40-of-2024","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442435,"registerId":"F2024L00737-fast-fetch-1775957447058","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning hepatitis E infection (Balance of Probabilities) (No. 40 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 E INFECTION (Balance of Probabilities)\n\n(No. 40 of 2024)\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 21 June 2024.\n\n \n\n \n\n \n\n \n\n \n\n|
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Professor Terence Campbell AM
Chairperson
by and on behalf of
The Repatriation Medical Authority |\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 E infection (Balance of Probabilities) (No. 40 of 2024).\n\n2 Commencement\n\n This instrument commences on 23 July 2024.\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 hepatitis E (Balance of Probabilities) No. 113 of 2015 (Federal Register of Legislation No. F2015L01333) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 hepatitis E infection and death from hepatitis E infection.\n\nMeaning of hepatitis E infection\n\n(2) For the purposes of this Statement of Principles, hepatitis E infection means infection with the hepatitis E virus resulting in an illness characterised by inflammation of the liver, and which is confirmed by laboratory testing for hepatitis E serological or nucleic acid markers.\n\nNote 1: Signs and symptoms of hepatitis E infection include malaise, vomiting, loss of appetite, abdominal pain, fever, hepatomegaly and jaundice.\n\nNote 2: Clinical worsening may be indicated by the development of chronic hepatitis E from acute hepatitis E. Chronic hepatitis E is an infection lasting for at least 6 months.\n\nNote 3: It will usually be the case that the date of the confirmation of laboratory evidence of hepatitis E serological or nucleic acid markers is after the date of clinical onset.\n\nNote 4: Clinical onset is defined in the schedule 1 – Dictionary.\n\n(3) While hepatitis E infection attracts ICD‑10‑AM code B17.2, in applying this Statement of Principles the meaning of hepatitis E 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 E infection\n\n(5) For the purposes of this Statement of Principles, hepatitis E infection, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's hepatitis E infection.\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 hepatitis E infection and death from hepatitis E 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\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, hepatitis E infection or death from hepatitis E infection is connected with the circumstances of a person's relevant service:\n\n(1) being exposed to the hepatitis E virus by:\n\n(a) being in the same living quarters or immediate work environment as a person infected with the hepatitis E virus; \n\n(b) consuming water or food contaminated with the hepatitis E virus; \n\n(c) having direct contact with human or primate faecal material contaminated with the hepatitis E virus; \n\n(d) having direct physical contact with a human or a primate infected with the hepatitis E virus;\n\n(e) having percutaneous (intravenous, intramuscular, subcutaneous or intradermal) exposure to blood or body fluids contaminated with the hepatitis E virus; or\n\n(f) receiving a transfusion of blood or blood products contaminated with the hepatitis E virus;\n\nwhere hepatitis E virus exposure occurs between 14 and 70 days before clinical onset;\n\n(2) having a solid organ transplant (excluding corneal transplant), where the tissue or organ is derived from a person infected with the hepatitis E virus, within the 4 months before clinical onset;\n\n(3) having a liver, kidney, heart, lung, stem cell or bone marrow transplant before clinical worsening;\n\n(4) being pregnant at the time of death due to hepatitis E infection or being pregnant at the time of liver transplantation necessitated by hepatitis E infection;\n\nNote: Death due to hepatitis E infection is considered to be a clinical worsening. Liver transplantation necessitated by hepatitis E infection is considered to be a clinical worsening.\n\n(5) having chemotherapy for cancer at the time of clinical worsening;\n\n(6) inability to obtain appropriate clinical management for hepatitis E infection before clinical worsening.\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 factors set out in subsections 9(3) to 9(6) apply only to material contribution to, or aggravation of, hepatitis E infection where the person's hepatitis E 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(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 clinical onset means the point backwards in time from the first date of confirmation of laboratory evidence of hepatitis E serological or nucleic acid markers, to the date at which the symptoms of hepatitis E were persistently present, as assessed by a registered medical practitioner.\n\n hepatitis e infection—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":{"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 is a standard replacement Statement of Principles maintaining the established framework for determining service connection of hepatitis E infection. It updates the 2015 version but operates within the same statutory scheme and purpose under the Veterans' Entitlements Act 1986. No significant expansion beyond the original intent of providing medical criteria for veterans' compensation claims."},"complexity_factors":["Multiple defined terms in Schedule 1 (clinical onset, terminal event, MRCA, VEA, relevant service) that require cross-referencing","Precise temporal requirements (14-70 day window for exposure, 4-month window for organ transplants)","Dual application framework — applies to two different Acts (VEA and MRCA) with different service categories","Conditional logic in section 10(2) limiting certain factors (9(3)-9(6)) to aggravation cases only where infection pre-existed service","Cross-reference mechanism in section 11 allowing incorporation of other Statements of Principles by reference","Medical-legal hybrid language requiring understanding of both clinical concepts (serological markers, percutaneous exposure) and legal standards (balance of probabilities)"],"plain_english_summary":"This Statement of Principles replaces the 2015 version and sets the medical rules for when Australian veterans and defence force members can get compensation for hepatitis E (lab‑confirmed viral liver infection) and related death. It defines qualifying exposures (e.g. household contact, contaminated food/water, faecal contact, contaminated blood/organs), required exposure–symptom timeframes, and applies to claims under the VEA 1986 and MRCA 2004 for peacetime, eligible war and defence service. It is the gatekeeper for service connection on the balance of probabilities."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument repeals the 2015 Statement of Principles (s4) and restates criteria linking hepatitis E infection or death to relevant service for VEA/MRCA claims (s5). The text does not itself state an expansion or narrowing of eligibility; it establishes specific clinical and exposure criteria (ss7–9) without declaring a change in statutory scope."},"complexity_factors":["Medical definition requires laboratory confirmation and dating clinical onset (s7(2), Schedule 1 definition of clinical onset) — evidentiary/medical complexity.","Multiple exposure pathways and precise time window (14–70 days) for exposure before clinical onset (s9(1)), creating proof-of-exposure burdens.","Special-factor exceptions (transplant timing, organ types, pregnancy, chemotherapy, clinical worsening) with different temporal relationships to service (ss9(2)–(6), s10(2)).","Interaction with other Statements of Principles where factors overlap, requiring cross-referencing to other instruments (s11).","Application limited to claims under two statutes (VEA and MRCA), so administrative processes and decision-makers under those Acts control outcomes (s5, s3).","Replaces a prior Statement of Principles (repeal) which may require claim reassessment or interpretation of continuity (s4)."],"plain_english_summary":"This instrument, made by the Repatriation Medical Authority (s3), sets the medical criteria used to decide whether hepatitis E infection or death from it is connected to a veteran's or defence member's relevant service for claims under the Veterans' Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004 (s5). It defines laboratory‑confirmed hepatitis E, specifies exposure pathways and time windows (e.g. 14–70 days) and lists special risk or worsening factors (transplants, pregnancy, chemotherapy, lack of appropriate care) used to link the condition to service (ss7–9)."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-balance-of-probabilities-no-40-of-2024","history":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-balance-of-probabilities-no-40-of-2024/history","analysis":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-balance-of-probabilities-no-40-of-2024/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-balance-of-probabilities-no-40-of-2024/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-balance-of-probabilities-no-40-of-2024/important-cases","documents":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-balance-of-probabilities-no-40-of-2024/documents"}}