{"id":"F2024L00736","name":"Statement of Principles concerning hepatitis E infection (Reasonable Hypothesis) (No. 39 of 2024)","slug":"statement-of-principles-concerning-hepatitis-e-infection-reasonable-hypothesis-no-39-of-2024","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442438,"registerId":"F2024L00736-fast-fetch-1775957447060","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 (Reasonable Hypothesis) (No. 39 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 (Reasonable Hypothesis)\n\n(No. 39 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 21 June 2024\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n| Professor Terence Campbell AM
Chairperson
by and on behalf of
The 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\n1 Name\n\nThis is the Statement of Principles concerning hepatitis E infection (Reasonable Hypothesis) (No. 39 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning hepatitis E (Reasonable Hypothesis) No. 112 of 2015 (Federal Register of Legislation No. F2015L01332) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that hepatitis E infection and death from hepatitis E 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 E infection or death from hepatitis E infection 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 human immunodeficiency virus infection at the time of clinical worsening;\n\n(6) having chemotherapy for cancer at the time of clinical worsening;\n\n(7) 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(7) 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(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 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 MRCA means the Military Rehabilitation and Compensation Act 2004.\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 hepatitis e infection—see subsection 7(2).\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 periodic update replacing the 2015 version. The scope remains tightly focused on establishing medical causation for hepatitis E in veterans' compensation claims, consistent with the Repatriation Medical Authority's statutory function under section 196B of the VEA."},"complexity_factors":["Moderate cross-referencing between the VEA (Veterans' Entitlements Act 1986) and MRCA (Military Rehabilitation and Compensation Act 2004)","Precise medical definitions requiring laboratory confirmation and specific time windows (14–70 days for exposure, 4 months for transplants)","Conditional logic distinguishing between 'clinical onset' (first getting sick) and 'clinical worsening' (deterioration or death)","Nested application rules in section 11 allowing other Statements of Principles to be imported by reference","Technical medical terminology (percutaneous exposure, serological markers, nucleic acid markers) without plain English alternatives in the main text","Dual pathway structure: some factors apply to initial infection, others only to worsening/aggravation per section 10(2)"],"plain_english_summary":"This instrument sets the medical rules for when Australian veterans and current/former defence members (and in death cases, their families) can claim compensation for hepatitis E by defining the diagnosis and the service‑related circumstances that create a \"reasonable hypothesis\" linking infection to service. \n\nIt matters because hepatitis E risk is higher during deployments with contaminated water, food or close contact; showing one of the specified service exposures and the 14–70 day incubation window can open the door to pensions or other benefits."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument repeals and replaces the 2015 Statement of Principles (s.4). It restates the illness definition with required laboratory confirmation and a clinical-onset method (s.7(2), Schedule 1), sets a specific exposure window of 14–70 days for direct exposures (s.9(1)), and adds/clarifies factors tied to transplantation, pregnancy, immunosuppression, chemotherapy and inability to obtain appropriate clinical management as triggers for a reasonable hypothesis (s.9(2)–(7)). It applies to claims under VEA s.120A or MRCA s.338 (s.5), so claimants and decision-makers will follow the updated factors when assessing service connection."},"complexity_factors":["Medical definitions and evidentiary timing: requires laboratory confirmation and a defined clinical-onset concept assessed by a registered medical practitioner (s.7(2), Schedule 1).","Specific exposure windows and routes: exposure must occur between 14 and 70 days before clinical onset; multiple exposure pathways listed (s.9(1)).","Interaction with other medical conditions and procedures: transplants, immunosuppression (HIV, chemotherapy), pregnancy and clinical worsening modify applicability and require sequencing relative to service (s.9(2)–(7), s.10).","Relation-to-service constraint: any listed factor must be related to the person’s relevant service as defined in the schedule (s.10(1), Schedule 1).","Cross-references to other Statements of Principles: factors that refer to other injuries/diseases defer to those other Statements (s.11).","Administrative provenance and standard-setting: instrument is made by the Repatriation Medical Authority under s.196B(2) VEA and states the Authority's view of medical-scientific evidence (s.3, s.8), creating bounded but technical administrative discretion.","Application and claim-path: applies only to claims that fall under VEA s.120A or MRCA s.338, limiting its operational reach (s.5).","Repeal and update of prior instrument: replaces the 2015 Statement, so prior case treatment may change (s.4)."],"plain_english_summary":"This instrument sets the medical rules the Repatriation Medical Authority uses to decide whether hepatitis E infection (or death from it) can be linked to a veteran’s or service member’s time in the Forces, for claims under the Veterans’ Entitlements Act or the Military Rehabilitation and Compensation Act. It defines the illness, required laboratory confirmation and clinical-onset timing, and lists specific exposure and medical-risk factors that, if present and related to service, raise a reasonable hypothesis of connection."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-reasonable-hypothesis-no-39-of-2024","history":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-reasonable-hypothesis-no-39-of-2024/history","analysis":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-reasonable-hypothesis-no-39-of-2024/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-reasonable-hypothesis-no-39-of-2024/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-reasonable-hypothesis-no-39-of-2024/important-cases","documents":"/api/acts/statement-of-principles-concerning-hepatitis-e-infection-reasonable-hypothesis-no-39-of-2024/documents"}}