{"id":"F2018L01478","name":"Statement of Principles concerning human T-cell lymphotropic virus type-1 infection (Reasonable Hypothesis) (No. 96 of 2018)","slug":"statement-of-principles-concerning-human-t-cell-lymphotropic-virus-type-1-infection-reasonable-hypot","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439808,"registerId":"F2018L01478-fast-fetch-1775955688853","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning human T-cell lymphotropic virus type-1 infection (Reasonable Hypothesis) (No. 96 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\nHUMAN T-CELL LYMPHOTROPIC VIRUS TYPE-1 INFECTION (Reasonable Hypothesis)\n\n(No. 96 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 26 October 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:
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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 human T-cell lymphotropic virus type-1 infection (Reasonable Hypothesis) (No. 96 of 2018).\n\n2 Commencement\n\n This instrument commences on 26 November 2018.\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 human T-cell lymphotropic virus type-1 No. 7 of 2010 (Federal Register of Legislation No. F2010L00014) 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 human T-cell lymphotropic virus type-1 infection and death from human T-cell lymphotropic virus type‑1 infection.\n\nMeaning of human T-cell lymphotropic virus type-1 infection\n\n(2) For the purposes of this Statement of Principles, human T-cell lymphotropic virus type-1 infection means an infection that is caused by the retrovirus human T-cell lymphotropic virus type-1 (HTLV-1).\n\n(3) While human T-cell lymphotropic virus type-1 infection attracts ICD‑10‑AM code Z22.6, in applying this Statement of Principles the meaning of human T-cell lymphotropic virus type-1 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 human T-cell lymphotropic virus type-1 infection\n\n(5) For the purposes of this Statement of Principles, human T-cell lymphotropic virus type-1 infection, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's human T-cell lymphotropic virus type-1 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 human T-cell lymphotropic virus type-1 infection and death from human T-cell lymphotropic virus type‑1 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 human T-cell lymphotropic virus type-1 infection or death from human T-cell lymphotropic virus type-1 infection with the circumstances of a person's relevant service:\n\n(1) being exposed to HTLV-1 before the clinical onset of human T-cell lymphotropic virus type-1 infection;\n\n Note: being exposed to HTLV-1 is defined in the Schedule 1 - Dictionary. \n\n(2) having:\n\n(a) herpes simplex virus type 2 anogenital infection; or\n\n(b) a genital ulcerative disease; or\n\n(c) a non-ulcerative anogenital sexually transmitted infection with clinical symptoms or signs, excluding genital warts;\n\nwithin the four weeks before the clinical onset of human T-cell lymphotropic virus type-1 infection;\n\n(3) having infection with human immunodeficiency virus at the time of the clinical worsening of human T-cell lymphotropic virus type-1 infection;\n\n(4) inability to obtain appropriate clinical management for human T-cell lymphotropic virus type-1 infection.\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) and 9(4) apply only to material contribution to, or aggravation of, human T-cell lymphotropic virus type-1 infection where the person's human T-cell lymphotropic virus type-1 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 being exposed to HTLV-1 means:\n\n(a) having percutaneous exposure (intravenous, intramuscular, subcutaneous or intradermal) or permucosal exposure to a specified body substance which is derived from a person infected with HTLV-1; or\n\n(b) having a tissue or organ transplant, where the tissue or organ is derived from a person infected with HTLV-1.\n\nNote: specified body substance is also defined in the Schedule 1 - Dictionary.\n\n human T-cell lymphotropic virus type-1 infection—see subsection 7(2).\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 specified body substance means:\n\n(a) blood, cellular blood products or any body fluid containing blood; or\n\n(b) semen or vaginal secretions.\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":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2010 Statement (s4) and replaces it with an updated Statement that restates the condition, defines exposures and terminal events (Schedule 1), and lists specific factors that raise a reasonable hypothesis (s7–9). The repeal plus new definitions and factor list indicates a change in the operative Statement of Principles; the text does not quantify how substantively the legal scope differs from the 2010 instrument."},"complexity_factors":["Legal/evidentiary standard is \"reasonable hypothesis\" rather than balance of probabilities or causation, requiring assessment of limited listed factors (s9)","Precise temporal requirement for some factors (eg. specified genital infections within four weeks before clinical onset) creates tight evidentiary timing demands (s9(2))","Technical medical definitions and ICD-10-AM reference for the condition require clinical diagnosis and coding familiarity (s7(2)–(4))","Detailed exposure definitions include percutaneous/permucosal contact and tissue/organ transplant, importing forensic proof burdens (Schedule 1)","Death is included when HTLV-1 contributed to a terminal event; terminal events are narrowly listed, affecting proof of contribution (Schedule 1)","Interplay with other Statements of Principles where a listed factor refers to another disease requires cross-referencing and following that other instrument’s terms (s11)","Limited application scope tied to VEA/MRCA claim schemes creates administrative boundary conditions for eligibility (s5, Schedule 1 definitions of relevant service)","Repatriation Medical Authority sets and interprets the factors under statutory authority, giving the RMA central decisional and interpretive discretion (s3, s8)","Repeal of a prior 2010 Statement means claimants and decision-makers must apply the updated instrument rather than earlier guidance (s4)","Subsections 9(3) and 9(4) are constrained to material contribution/aggravation where infection pre‑existed or was contracted before/during but not arising out of service, adding conditional complexity to causation assessments (s10(2))"],"plain_english_summary":"This Statement sets the medical-legal test the Repatriation Medical Authority uses to decide whether HTLV-1 infection (and deaths it contributed to) can be linked to Australian military, peacekeeping or related service for veterans’ compensation. It identifies specific exposure routes, recent anogenital infections, HIV co-infection at clinical worsening, and lack of appropriate clinical management as factors that can raise a \"reasonable hypothesis\" that service contributed to the condition. The RMA decides under the VEA (s3); claimants must prove the listed factors and timing (s9–10), creating evidentiary and clinical documentation requirements."},"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":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the standard scope of Repatriation Medical Authority Statements of Principles. It replaces the 2010 version with updated medical evidence but does not expand beyond the traditional purpose of establishing service connection criteria for specific diseases under veterans' compensation schemes."},"complexity_factors":["Moderate cross-referencing between the main instrument and Schedule 1 (Dictionary)","Conditional logic in section 10(2) limiting factors 9(3) and 9(4) to aggravation of pre-existing conditions only","Nested definitions: 'being exposed to HTLV-1' depends on 'specified body substance', which has its own definition","Reference to external medical classification system (ICD-10-AM Tenth Edition) with specific ISBN and effective date","Incorporation by reference of other Statements of Principles via section 11","Dual statutory framework application (VEA and MRCA) requiring understanding of six different service types"],"plain_english_summary":"This instrument sets medical rules for deciding when HTLV‑1 infection is treated as service‑related for Australian Defence Force members and veterans claiming under the VEA or MRCA, adopting a lower “reasonable hypothesis” standard so one plausible service‑linked risk gives the benefit of the doubt. It covers infections tied to service exposures (medical/needlestick, transfusion/organ donation), sexual‑health circumstances, HIV co‑infection, or service‑related lack of care. It updates the previous 2010 guidance to reflect current medical evidence."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-human-t-cell-lymphotropic-virus-type-1-infection-reasonable-hypot","history":"/api/acts/statement-of-principles-concerning-human-t-cell-lymphotropic-virus-type-1-infection-reasonable-hypot/history","analysis":"/api/acts/statement-of-principles-concerning-human-t-cell-lymphotropic-virus-type-1-infection-reasonable-hypot/analysis","conflicts":"/api/acts/statement-of-principles-concerning-human-t-cell-lymphotropic-virus-type-1-infection-reasonable-hypot/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-human-t-cell-lymphotropic-virus-type-1-infection-reasonable-hypot/important-cases","documents":"/api/acts/statement-of-principles-concerning-human-t-cell-lymphotropic-virus-type-1-infection-reasonable-hypot/documents"}}