{"id":"F2021L00018","name":"Statement of Principles concerning hereditary haemochromatosis (Balance of Probabilities) (No. 24 of 2021)","slug":"statement-of-principles-concerning-hereditary-haemochromatosis-balance-of-probabilities-no-24-of-202","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440733,"registerId":"F2021L00018-fast-fetch-1775956268659","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning hereditary haemochromatosis (Balance of Probabilities) (No. 24 of 2021)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nHEREDITARY HAEMOCHROMATOSIS (Balance of Probabilities)\n\n(No. 24 of 2021)\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 24 December 2020\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 Nicholas Saunders AO
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 hereditary haemochromatosis (Balance of Probabilities) (No. 24 of 2021).\n\n2 Commencement\n\n This instrument commences on 25 January 2021.\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 haemochromatosis No. 22 of 2012 (Federal Register of Legislation No. F2012L00451) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 hereditary haemochromatosis and death from hereditary haemochromatosis.\n\nMeaning of hereditary haemochromatosis\n\n(2) For the purposes of this Statement of Principles, hereditary haemochromatosis:\n\n(a) means any genetic disorder of iron transport and metabolism which results in accumulation of excess iron, and with:\n\n(i) documented iron overload in parenchymatous organs; or\n\n(ii) clinical evidence of iron-related organ or tissue dysfunction; and\n\n(b) includes:\n\n(i) classical (type 1) hereditary haemochromatosis due to a mutation of the HFE gene; and\n\n(ii) non-classical hereditary haemochromatosis due to a mutation of a non-HFE related gene.\n\nNote: Hereditary haemochromatosis is characterised by the gradual increase in body iron stores in organs and tissues, which can lead to various clinical disorders, including lethargy, hepatic fibrosis or cirrhosis, hepatocellular carcinoma, heart failure, diabetes mellitus, hypogonadism, arthritis, hypopituitarism and skin pigmentation.\n\n(3) While hereditary haemochromatosis attracts ICD‑10‑AM code E83.1, in applying this Statement of Principles the meaning of hereditary haemochromatosis 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 hereditary haemochromatosis\n\n(5) For the purposes of this Statement of Principles, hereditary haemochromatosis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's hereditary haemochromatosis.\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 hereditary haemochromatosis and death from hereditary haemochromatosis 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, hereditary haemochromatosis or death from hereditary haemochromatosis is connected with the circumstances of a person's relevant service:\n\n(1) for males, consuming a total of at least 60 kilograms of alcohol within any five year period before the clinical worsening of hereditary haemochromatosis;\n\nNote 1: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.\n\nNote 2: The clinical worsening of hereditary haemochromatosis typically manifests as hepatic fibrosis or cirrhosis.\n\n(2) for females, consuming a total of at least 40 kilograms of alcohol within any five year period before the clinical worsening of hereditary haemochromatosis;\n\nNote 1: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.\n\nNote 2: The clinical worsening of hereditary haemochromatosis typically manifests as hepatic fibrosis or cirrhosis.\n\n(3) having infection with hepatitis C virus at the time of the clinical worsening of hereditary haemochromatosis;\n\nNote: The clinical worsening of hereditary haemochromatosis typically manifests as hepatic fibrosis or cirrhosis.\n\n(4) having steatohepatitis at the time of the clinical worsening of hereditary haemochromatosis;\n\nNote: The clinical worsening of hereditary haemochromatosis typically manifests as hepatic fibrosis or cirrhosis.\n\n(5) inability to obtain appropriate clinical management for hereditary haemochromatosis.\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(1) to 9(5) apply only to material contribution to, or aggravation of, hereditary haemochromatosis where the person's hereditary haemochromatosis 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 hereditary haemochromatosis—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":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the same scope as its predecessor and the broader framework of Repatriation Medical Authority Statements of Principles. It updates the specific condition (hereditary haemochromatosis) with current medical evidence but does not expand beyond the established purpose of determining service-related aggravation of genetic conditions for veterans' compensation purposes."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 5 defined terms in the Dictionary (hereditary haemochromatosis, MRCA, relevant service, terminal event, VEA)","Simple conditional structure: one of five factors must exist (section 9), plus service connection requirement (section 10)","Minimal cross-referencing — only refers to other Statements of Principles in section 11, and only 2 external statutes (VEA and MRCA)","Clear delineation between the genetic condition itself (not claimable as caused by service) and its aggravation/worsening (potentially claimable)","Quantified thresholds for alcohol consumption (60kg/40kg over 5 years) with explanatory notes","Single purpose instrument — no subordinate provisions, regulations, or delegated powers"],"plain_english_summary":"This instrument updates medical guidance for deciding veteran and defence member compensation claims for hereditary haemochromatosis, replacing the 2012 version and applying to claims under the VEA and MRCA. It uses the \"balance of probabilities\" test to assess whether service materially worsened an existing genetic condition.\n\nIt affects current and former ADF members and DVA decision-makers. A claim can succeed only if service-related contributors (e.g., heavy alcohol use, hepatitis C, steatohepatitis, or lack of treatment) worsened the pre‑existing condition."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument repeals the 2012 haemochromatosis Statement of Principles (section 4) and restates the criteria for linking hereditary haemochromatosis to relevant service for VEA/MRCA claims (sections 5 and 7–11). The text supplied does not include a comparison to the repealed instrument’s substantive terms, so no definitive determination of a scope change can be drawn from this instrument alone."},"complexity_factors":["Legal cross‑references to claims regimes under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004 (sections 3, 5)","Medical‑scientific standard required: ‘balance of probabilities’ for causation (section 8)","Technical medical definition of hereditary haemochromatosis and incorporation of ICD‑10‑AM coding (section 7(2)–(4))","Specified qualifying factors with quantitative thresholds (male/female alcohol thresholds expressed in kilograms over five years) and clinical states such as hepatitis C and steatohepatitis (section 9)","Requirement that any listed factor be related to the person’s relevant service and apply only to material contribution or aggravation where the condition pre‑existed or predated service (section 10)","Interaction with other Statements of Principles where a listed factor is itself an injury/disease covered elsewhere (section 11)","Administrative repeal of the prior Statement of Principles (section 4), requiring attention to transitional or historical claim handling"],"plain_english_summary":"This instrument sets the medical rules used to decide whether hereditary haemochromatosis (a genetic iron‑overload disorder) or death from it is connected with a veteran’s or service member’s eligible service for claims under the VEA or MRCA. It defines the condition, adopts a balance‑of‑probabilities test, and identifies specific clinical and exposure factors (including alcohol thresholds, liver disease, infection and lack of appropriate care) that must be present and linked to that service before a compensable connection is found."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hereditary-haemochromatosis-balance-of-probabilities-no-24-of-202","history":"/api/acts/statement-of-principles-concerning-hereditary-haemochromatosis-balance-of-probabilities-no-24-of-202/history","analysis":"/api/acts/statement-of-principles-concerning-hereditary-haemochromatosis-balance-of-probabilities-no-24-of-202/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hereditary-haemochromatosis-balance-of-probabilities-no-24-of-202/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hereditary-haemochromatosis-balance-of-probabilities-no-24-of-202/important-cases","documents":"/api/acts/statement-of-principles-concerning-hereditary-haemochromatosis-balance-of-probabilities-no-24-of-202/documents"}}