{"id":"F2018L00540","name":"Statement of Principles concerning herpes simplex (Reasonable Hypothesis) (No. 39 of 2018)","slug":"statement-of-principles-concerning-herpes-simplex-reasonable-hypothesis-no-39-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439600,"registerId":"F2018L00540-fast-fetch-1775955563856","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning herpes simplex (Reasonable Hypothesis) (No. 39 of 2018)","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\nHERPES SIMPLEX (Reasonable Hypothesis)\n\n(No. 39 of 2018)\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 27 April 2018\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 Revocation\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 herpes simplex (Reasonable Hypothesis) (No. 39 of 2018).\n\n2 Commencement\n\n This instrument commences on 28 May 2018.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 Revocation\n\nThe Statement of Principles concerning herpes simplex No. 3 of 2010 made under subsection 196B(2) of the VEA is revoked.\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 herpes simplex and death from herpes simplex.\n\nMeaning of herpes simplex\n\n(2) For the purposes of this Statement of Principles, herpes simplex means a clinical illness caused by herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). Lesions arising at an anatomical location where they have not previously occurred may be regarded as a new infection.\n\nNote 1: This infection is a lifelong, persistent infection of the peripheral nervous system ganglia. It is characterised by intermittent episodes of localised vesicular lesions on the skin or mucous membranes, but can also involve the central nervous system or other organs.\n\nNote 2: HSV-1 typically causes orofacial lesions and HSV-2 typically causes genital lesions, but either subtype may infect the oral mucosa or the genital tract and either may occur at other sites.\n\nNote 3: HSV complications include corneal scarring or significant skin scarring, eczema herpeticum, HSV dissemination or visceral involvement.\n\nNote 4: eczema herpeticum is defined in the Schedule 1 - Dictionary.\n\n(3) While herpes simplex attracts ICD‑10‑AM code B00 or A60, in applying this Statement of Principles the meaning of herpes simplex 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 herpes simplex\n\n(5) For the purposes of this Statement of Principles, herpes simplex, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's herpes simplex.\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 herpes simplex and death from herpes simplex 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 herpes simplex or death from herpes simplex with the circumstances of a person's relevant service:\n\n(1) being exposed to HSV-1 or HSV-2 within the 30 days before the clinical onset of herpes simplex;\n\nNote: being exposed to HSV-1 or HSV-2 is defined in the Schedule 1 - Dictionary. \n\n(2) having a severe thermal burn within the 30 days before the clinical onset of herpes simplex;\n\nNote: severe thermal burn is defined in the Schedule 1 - Dictionary.\n\n(3) having a thermal or chemical burn within the seven days before the clinical onset of herpes simplex at or close to the site of the burn;\n\nNote: close to the site is defined in the Schedule 1 - Dictionary.\n\n(4) being in an immunocompromised state as specified at the time of the clinical onset of herpes simplex;\n\nNote: immunocompromised state as specified is defined in the Schedule 1 - Dictionary.\n\n(5) having surgery to nerve root ganglia within the 30 days before the clinical onset of herpes simplex, where the cutaneous distribution of herpes simplex corresponds with the nerve roots which were manipulated during surgery;\n\n(6) being exposed to sunlight or ultraviolet light at a level sufficient to induce at least mild erythema, within the seven days before the clinical onset of herpes simplex;\n\n(7) being pregnant at the time of the clinical onset of herpes simplex;\n\n(8) for acute herpes simplex encephalitis or acute herpes simplex retinal necrosis only, having surgery to the brain within the 30 days before the clinical onset of herpes simplex;\n\n(9) for orofacial herpes simplex only:\n\n(a) having surgery to the face within the 30 days before the clinical onset of herpes simplex;\n\n(b) having an upper respiratory tract infection within the seven days before the clinical onset of herpes simplex; or\n\n(c) having a fever of at least 39 degrees Celsius in the 72 hours before the clinical onset of herpes simplex;\n\nNote: surgery to the face is defined in the Schedule 1 - Dictionary.\n\n(10) for orofacial herpes simplex or genital herpes simplex only, having a category 2 stressor at the time of the clinical onset of herpes simplex;\n\nNote: category 2 stressor is defined in the Schedule 1 - Dictionary.\n\n(11) for herpes simplex of the cornea (herpes simplex keratitis) only:\n\n(a) having cataract surgery within the six weeks before the clinical onset of herpes simplex;\n\n(b) having a corneal transplant, where the donor cornea is infected with HSV-1 or HSV-2, within the 30 days before the clinical onset of herpes simplex;\n\n(c) wearing contact lenses in the 24 hours before the clinical onset of herpes simplex; or\n\n(d) being treated with topical prostaglandin eye solution to the affected eye for at least one week before the clinical onset of herpes simplex;\n\nNote: topical prostaglandin eye solution is defined in the Schedule 1 - Dictionary.\n\n(12) for acute herpes simplex retinal necrosis of the eye only, having periocular trauma within the 30 days before the clinical onset of herpes simplex;\n\n(13) for herpes simplex of the eye only, having atopic dermatitis at the time of the clinical onset of herpes simplex;\n\n(14) for eczema herpeticum only:\n\nNote: eczema herpeticum is defined in the Schedule 1 - Dictionary.\n\n(a) having atopic dermatitis before the clinical onset of herpes simplex; or\n\n(b) having a specified dermatosis close to the site of the HSV-1 or HSV-2 infection, at the time of the clinical onset of herpes simplex;\n\nNote: close to the site and specified dermatosis are defined in the Schedule 1 - Dictionary.\n\n(15) for herpes simplex of the lip only:\n\n(a) having chapped lips in the 48 hours before the clinical onset of herpes simplex; or\n\n(b) playing a woodwind or brass musical instrument in the 48 hours before the clinical onset of herpes simplex;\n\nNote: chapped lips is defined in the Schedule 1 - Dictionary.\n\n(16) having a severe thermal burn within the 30 days before the clinical worsening of herpes simplex;\n\nNote: severe thermal burn is defined in the Schedule 1 - Dictionary.\n\n(17) having a thermal or chemical burn within the seven days before the clinical worsening of herpes simplex at or close to the site of the burn;\n\nNote: close to the site is defined in the Schedule 1 - Dictionary.\n\n(18) being in an immunocompromised state as specified at the time of the clinical worsening of herpes simplex;\n\nNote: immunocompromised state as specified is defined in the Schedule 1 - Dictionary.\n\n(19) having surgery to nerve root ganglia within the 30 days before the clinical worsening of herpes simplex, where the cutaneous distribution of herpes simplex corresponds with the nerve roots which were manipulated during surgery;\n\n(20) being exposed to sunlight or ultraviolet light at a level sufficient to induce at least mild erythema, within the seven days before the clinical worsening of herpes simplex;\n\n(21) being pregnant at the time of the clinical worsening of herpes simplex;\n\n(22) for acute herpes simplex encephalitis or acute herpes simplex retinal necrosis only, having surgery to the brain within the 30 days before the clinical worsening of herpes simplex;\n\n(23) for orofacial herpes simplex only:\n\n(a) having surgery to the face within the 30 days before the clinical worsening of herpes simplex;\n\n(b) having an upper respiratory tract infection within the seven days before the clinical worsening of herpes simplex; or\n\n(c) having a fever of at least 39 degrees Celsius in the 72 hours before the clinical worsening of herpes simplex;\n\nNote: surgery to the face is defined in the Schedule 1 - Dictionary.\n\n(24) for orofacial herpes simplex or genital herpes simplex only, having a category 2 stressor at the time of the clinical worsening of herpes simplex;\n\nNote: category 2 stressor is defined in the Schedule 1 - Dictionary.\n\n(25) for herpes simplex of the cornea (herpes simplex keratitis) only:\n\n(a) having cataract surgery within the six weeks before the clinical worsening of herpes simplex;\n\n(b) wearing contact lenses in the 24 hours before the clinical worsening of herpes simplex; or\n\n(c) being treated with topical prostaglandin eye solution to the affected eye for at least one week before the clinical worsening of herpes simplex;\n\nNote: topical prostaglandin eye solution is defined in the Schedule 1 - Dictionary.\n\n(26) for acute herpes simplex retinal necrosis of the eye only, having periocular trauma within the 30 days before the clinical worsening of herpes simplex;\n\n(27) for herpes simplex of the eye only, having atopic dermatitis at the time of the clinical worsening of herpes simplex;\n\n(28) for eczema herpeticum only:\n\nNote: eczema herpeticum is defined in the Schedule 1 - Dictionary.\n\n(a) having atopic dermatitis before the clinical worsening of herpes simplex; or\n\n(b) having a specified dermatosis close to the site of the HSV-1 or HSV-2 infection, at the time of the clinical worsening of herpes simplex;\n\nNote: close to the site and specified dermatosis are defined in the Schedule 1 - Dictionary.\n\n(29) for herpes simplex of the lip only:\n\n(a) having chapped lips in the 48 hours before the clinical worsening of herpes simplex; or\n\n(b) playing a woodwind or brass musical instrument in the 48 hours before the clinical worsening of herpes simplex;\n\nNote: chapped lips is defined in the Schedule 1 - Dictionary.\n\n(30) inability to obtain appropriate clinical management for herpes simplex.\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(16) to 9(30) apply only to material contribution to, or aggravation of, herpes simplex where the person's herpes simplex 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 being exposed to HSV-1 or HSV-2 means:\n\n(a) having direct exposure to saliva or respiratory droplets infected with HSV-1 or HSV-2; or\n\n(b) having percutaneous exposure to vesicular fluid infected with HSV-1 or HSV-2; or\n\n(c) having sexual contact with a person infected with HSV-1 or HSV-2; or\n\n(d) having skin contact with a person infected with HSV-1 or HSV-2.\n\n category 2 stressor means one of the following negative life events, the effects of which are chronic in nature and cause the person to feel ongoing distress, concern or worry:\n\n(a) being socially isolated and unable to maintain friendships or family relationships, due to physical location, language barriers, disability, or medical or psychiatric illness;\n\n(b) experiencing a problem with a long-term relationship including the break-up of a close personal relationship, the need for marital or relationship counselling, marital separation or divorce;\n\n(c) having concerns in the work or school environment including ongoing disharmony with fellow work or school colleagues, perceived lack of social support within the work or school environment, perceived lack of control over tasks performed and stressful workloads, or experiencing bullying in the workplace or school environment;\n\n(d) experiencing serious legal issues including being detained or held in custody, ongoing involvement with the police concerning violations of the law, or court appearances associated with personal legal problems;\n\n(e) having severe financial hardship including loss of employment, long periods of unemployment, foreclosure on a property or bankruptcy;\n\n(f) having a family member or significant other experience a major deterioration in their health; or\n\n(g) being a full-time caregiver to a family member or significant other with a severe physical, mental or developmental disability.\n\nNote: significant other is also defined in the Schedule 1 - Dictionary.\n\n chapped lips means excessive dryness of the vermillion border of the lips manifested by scaling, cracking and erythema.\n\n chronic renal failure means:\n\n(a) having a glomerular filtration rate of less than 15 mL/min/1.73 m2 for a period of at least three months; or\n\n(b) a need for renal replacement therapy (dialysis or transplantation) for treatment of complications of decreased glomerular filtration rate which would otherwise increase the risk of morbidity and mortality; or\n\n(c) undergoing chronic dialysis.\n\n close to the site means at or within one centimetre.\n\n eczema herpeticum means a clinical illness characterised by a dissemination of HSV infection across the skin, normally superimposed on a pre-existing, inactive or active skin disorder.\n\nherpes simplex—see subsection 7(2).\n\n immunocompromised state as specified means a condition of substantially lowered immune function, such as would occur in the following conditions or circumstances:\n\n(a) being infected with human immunodeficiency virus;\n\n(b) being treated with an immunosuppressive drug;\n\n(c) having a haematological or solid organ malignancy;\n\n(d) having asplenia or a splenectomy;\n\n(e) having chronic renal failure;\n\n(f) having severe malnutrition;\n\n(g) having a cardiopulmonary bypass procedure; or\n\n(h) undergoing solid organ, stem cell or bone marrow transplantation.\n\nNote: chronic renal failure and immunosuppressive drug are also defined in the Schedule 1- Dictionary.\n\n immunosuppressive drug means a drug or an agent which results in substantial suppression of immune responses.\n\nNote: Examples of an immunosuppressive drug include corticosteroids other than inhaled or topical corticosteroids, drugs used to prevent transplant rejection, tumour necrosis factor-α inhibitors and chemotherapeutic agents used for the treatment of cancer.\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 also defined in the Schedule 1 - Dictionary.\n\n severe thermal burn means a burn injury caused by the application of heat to body tissue, including inhalational burn, which is of sufficient severity to warrant hospital admission as an inpatient.\n\n significant other means a person who has a close family bond or a close personal relationship and is important or influential in one's life.\n\n specified dermatosis means one of the following:\n\n(a) allergic contact dermatitis;\n\n(b) irritant contact dermatitis; or\n\n(c) psoriasis.\n\n surgery to the face means surgery involving the face or the skin of the face, including chemical peels, dermabrasion and laser resurfacing.\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 topical prostaglandin eye solution means local application to the eye of latanoprost, bimatoprost, tafluprost or tavoprost.\n\n VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"This is a standard replacement Statement of Principles that revokes the 2010 version (No. 3 of 2010). It maintains the same scope: establishing medical criteria for linking herpes simplex to military service under the 'reasonable hypothesis' standard. The 2018 update appears to be a routine republication with updated ICD-10-AM references and potentially refined medical definitions, not an expansion beyond the original purpose of determining veterans' compensation eligibility for this specific condition."},"complexity_factors":["30 distinct factors with multiple sub-factors (some factors have up to 4 sub-clauses)","15 defined terms in Schedule 1, many with their own nested definitions (e.g., 'immunocompromised state as specified' contains 8 sub-conditions, one of which ('chronic renal failure') has 3 further sub-conditions)","Extensive cross-referencing between sections and the Dictionary (e.g., 'see subsection 7(2)', 'defined in Schedule 1')","Conditional logic with multiple qualifiers: 'for [specific type] only', 'within [specific time period]', 'at or close to the site'","Dual structure covering both 'clinical onset' (factors 1-15) and 'clinical worsening' (factors 16-30) with nearly identical but slightly varied conditions","Type-specific restrictions (e.g., factor 8 applies only to 'acute herpes simplex encephalitis or acute herpes simplex retinal necrosis'; factor 15 applies only to 'herpes simplex of the lip')","Incorporation by reference to external classification systems (ICD-10-AM Tenth Edition)","Interaction clause in section 11 requiring coordination with other Statements of Principles for related conditions"],"plain_english_summary":"This instrument tells when herpes simplex (cold sores, genital or eye herpes) or death from it can be presumed linked to Australian military service for veterans’ compensation. The Repatriation Medical Authority lists specific service‑related circumstances that create a “reasonable hypothesis” of causation or worsening, affecting current/former ADF members and veterans under veterans’ compensation laws. It narrows claims to cases with clear service links (e.g., combat burns, surgery, deployment stress) rather than automatic entitlement."},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":false,"description":"This instrument replaces the 2010 Statement of Principles (No. 3 of 2010) but does not materially alter the statutory purpose: both instruments set out the medical circumstances that raise a reasonable hypothesis that herpes simplex is related to relevant service. The 2018 instrument refines and expands the enumerated precipitating and aggravating factors, clarifies time windows and adds definitional detail (Schedule 1). Those are adjustments and refinements to application and evidentiary detail rather than a significant change in scope beyond the original purpose of defining service‑related causal factors for herpes simplex."},"complexity_factors":["Approximately 30 discrete causal factors with multiple subtype distinctions (initial onset versus clinical worsening) in section 9","Numerous time windows and differing temporal thresholds (30 days, 7 days, 48 hours, 72 hours, 24 hours, 6 weeks, 1 week) across factors","Schedule 1 contains multiple defined terms that materially affect application (e.g. being exposed to HSV-1/2, category 2 stressor, immunocompromised state, severe thermal burn, close to the site) — roughly 15–20 key definitions","Conditional application: subsections 9(16)–9(30) apply only to aggravation/material contribution where the condition pre-existed service (section 10(2))","Cross-references to other Statements of Principles where factors refer to injuries/diseases covered elsewhere (section 11)","Reference to external classification (ICD-10-AM) but clinical definition in the instrument controls (section 7(3)-(4))","Mixture of general medical states (immunocompromise) and very specific procedural/behavioural triggers (e.g. cataract surgery, playing brass/woodwind) requiring different types of evidentiary proof","Revocation and replacement of an earlier SoP (legal history/context) — requires comparing versions where relevant (section 4)"],"plain_english_summary":"**What this instrument does (mechanics)**\n\n- This is a Repatriation Medical Authority (RMA) Statement of Principles (SoP) that sets out the medical circumstances in which herpes simplex (HSV‑1 or HSV‑2) or death contributed to by herpes simplex can be regarded as related to a person’s military or peacekeeping service for the purposes of veteran compensation and treatment law (Veterans’ Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA)). (see sections 3, 5, 7 and 8).\n\n- The SoP lists specific factors — events, conditions or exposures — that, if present and connected to a person’s relevant service, are sufficient to raise a “reasonable hypothesis” that the herpes infection or death from it is related to that service. A claimant must have at least one of those factors for the SoP to be engaged. (see section 9).\n\n- The instrument replaces an earlier SoP (No. 3 of 2010) and commences operation from 28 May 2018. (see sections 2 and 4).\n\n**Who this affects**\n\n- Current and former members of the Australian Defence Force (including those who rendered operational, peacekeeping, hazardous or nuclear test service under the VEA, and those with warlike or non‑warlike service under the MRCA) and their dependants making claims under the VEA or MRCA. (see section 5 and Schedule 1 definitions of “relevant service”, MRCA, VEA).\n\n- Medical practitioners and decision-makers in the Department of Veterans’ Affairs (DVA) and related administrative bodies who assess whether a veteran’s herpes or herpes‑related death is service-related under the statutory tests. (see overall instrument context and sections 8–11).\n\n**How the causation test works (practical steps)**\n\n- The RMA lists 30 discrete factors (with subcategories) that cover exposures and risks immediately before a first episode and parallel factors for clinical worsening of pre‑existing herpes. Examples include documented exposure to HSV in the 30 days before onset, recent severe burns, certain surgeries, being immunocompromised, significant ultraviolet exposure, pregnancy, or specified ocular or dermatological circumstances. Time windows vary by factor (e.g. 30 days, 7 days, 48 hours, 72 hours, 24 hours, 6 weeks). (see section 9 and Schedule 1).\n\n- At least one of the listed factors must both exist in the person and be related to the person’s relevant service. The SoP distinguishes: (a) factors that support an initial occurrence arising out of service; and (b) separate factors (9(16)–9(30)) that apply only where the condition was contracted before or during service and the claim is for material contribution to, or aggravation of, that pre‑existing condition. (see section 10).\n\n- The SoP uses a legal evidentiary standard called “reasonable hypothesis” (set by s.196B(2) of the VEA, which authorises the RMA to make SoPs). Practically, that is a lower threshold than “balance of probabilities” — the SoP identifies what medical/scientific evidence is sufficient for a plausible link so DVA decision‑makers can accept service connection without requiring proof to the higher civil standard. (see sections 3, 8 and the instrument context).\n\n**Key definitions and precise details**\n\n- The Schedule (Schedule 1) defines technical terms used in the factors (for example: what counts as being exposed to HSV, a category 2 stressor, immunocompromised states, severe thermal burn, chapped lips, surgical definitions, topical prostaglandin eye solution, close to the site = within 1 cm, and terminal event). Those definitions are integral to determining whether a listed factor is established. (see Schedule 1).\n\n- The SoP refers to ICD‑10‑AM codes for informational purposes but makes clear that the clinical meaning in the SoP controls. (see section 7(3)–(4)).\n\n**Why this matters (purpose claims and trade-offs)**\n\n- The RMA states that medical-scientific evidence supports a link between herpes simplex (and death from it) and relevant service — the SoP operationalises that claim by listing the particular precipitating or aggravating factors and the timeframes that are sufficient to raise a reasonable hypothesis. (see section 8).\n\n- Concrete effects: if a claimant can establish one of the listed factors (and show it is related to relevant service), DVA decision-makers can accept a service connection on the basis of the SoP. That can unlock entitlements such as treatment, rehabilitation or compensation under the VEA/MRCA framework. (see sections 5, 9 and 10).\n\n**Costs, incentives and administrative implications**\n\n- Who pays: benefits and treatment funded or administered via DVA (the statutory compensation/rehabilitation scheme) may be triggered if the SoP is satisfied. The instrument does not itself appropriate funds; it provides a legal standard used by decision‑makers. (see sections 3, 5 and 8 for statutory role).\n\n- Evidence burden and compliance: claimants typically need clinical records, operative notes, laboratory or diagnostic evidence, or contemporaneous documentation establishing the timing and nature of the factor (for instance surgery dates, burn admissions, documentation of immunosuppressive therapy, pregnancy records, or evidence of inability to obtain appropriate clinical management). The defined time windows and precise definitions increase the granularity of medical evidence required. (see section 9 and Schedule 1).\n\n- Administrative discretion and implementation risk: decision‑makers must map clinical facts to the SoP’s technical definitions (for example, whether a stressor qualifies as a “category 2 stressor”, or whether a corneal donor was infected). Ambiguity in clinical records can lead to disputes and requests for further medical opinion.\n\n- Behavioural incentives: the instrument focuses eligibility on particular documented triggers (surgeries, burns, exposure, immunosuppression, specific eye/skin contexts, etc.). That concentrates benefits toward claimants who can demonstrate those triggers occurred in the time windows — and may create incentive to collect and present specific clinical evidence. It does not directly alter private contract freedom or market pricing outside the veteran support system.\n\n**Implementation notes and limits**\n\n- The SoP covers both first occurrence and clinical worsening (aggravation) of pre‑existing herpes, but the aggravation factors apply only where the condition predates or was contracted during service and did not originally arise out of service. (see section 10(2) and subsections 9(16)–9(30)).\n\n- The instrument cross‑references other SoPs: if a listed factor refers to an injury or disease that itself is the subject of another SoP, the terms of that other SoP apply. This creates dependencies where multiple statements can be relevant. (see section 11).\n\n**Bottom line (mechanical summary)**\n\n- The RMA sets a clear, enumerated list of medical circumstances and timeframes which, if present and linked to relevant service, are sufficient to raise a reasonable hypothesis that herpes simplex (or death to which it contributed) is connected to service. Meeting one of these factors simplifies the evidentiary path for veterans seeking DVA recognition and entitlements for service‑related herpes simplex. (see sections 7–10 and Schedule 1)."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-herpes-simplex-reasonable-hypothesis-no-39-of-2018","history":"/api/acts/statement-of-principles-concerning-herpes-simplex-reasonable-hypothesis-no-39-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-herpes-simplex-reasonable-hypothesis-no-39-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-herpes-simplex-reasonable-hypothesis-no-39-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-herpes-simplex-reasonable-hypothesis-no-39-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-herpes-simplex-reasonable-hypothesis-no-39-of-2018/documents"}}