{"id":"F2017L01449","name":"Statement of Principles concerning immune thrombocytopaenia (Balance of Probabilities) (No. 64 of 2017)","slug":"statement-of-principles-concerning-immune-thrombocytopaenia-balance-of-probabilities-no-64-of-2017","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":144251,"registerId":"commonwealth-F2017L01449-current","compilationNumber":null,"startDate":"2026-04-03","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning immune thrombocytopaenia (Balance of Probabilities) (No. 64 of 2017)","content":"![Commonwealth Coat of Arms](image.001.png)\n\nStatement of Principles concerning immune thrombocytopaenia (Balance of Probabilities) (No. 64 of 2017)\n\nmade under subsection 196B(3) of the\n\nVeterans' Entitlements Act 1986\n\nCompilation No. 1\n\nCompilation date: 30 May 2022\n\nIncludes amendments up to: Amendment Statement of Principles concerning immune thrombocytopaenia (Balance of Probabilities) (No. 58 of 2022) (F2022L00657)\n\nThe day of commencement of this Amendment Statement of Principles concerning immune thrombocytopaenia is 30 May 2022.\n\nAbout this compilation\n\nThis compilation\n\nThis is a compilation of the Statement of Principles concerning immune thrombocytopaenia (Balance of Probabilities) (No. 64 of 2017) that shows the text of the law as amended and in force on 30 May 2022.\n\nThe notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.\n\nUncommenced amendments\n\nThe effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.\n\nApplication, saving and transitional provisions for provisions and amendments\n\nIf the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.\n\nModifications\n\nIf the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.\n\nSelf‑repealing provisions\n\nIf a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.\n\nContents\n\n1 Name\n\n3 Authority\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\nEndnotes\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\n  \n\n1 Name\n\nThis is the Statement of Principles concerning immune thrombocytopaenia (Balance of Probabilities) (No. 64 of 2017).\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\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 immune thrombocytopaenia and death from immune thrombocytopaenia.\n\nMeaning of immune thrombocytopaenia\n\n(2) For the purposes of this Statement of Principles, immune thrombocytopaenia means:\n\n(a) an autoimmune disorder characterised by an isolated thrombocytopaenia, and a peripheral platelet count of less than 100 000 per microlitre, together with either:\n\n(i) the presence of bleeding symptoms; or\n\n(ii) the need for treatment to increase the platelet count; and\n\n> Note: Bleeding symptoms can include bruising (purpura), mucocutaneous bleeding (petechiae), retinal haemorrhage, intracranial haemorrhage, nose bleeds (epistaxis), bleeding from the bowels (melaena) and vaginal bleeding (menorrhagia).\n\n(b) excludes pseudothrombocytopaenia, thrombocytopaenia that is caused by non-immunological mechanisms, allergic and other non-thrombocytopaenic purpura, purpura caused by qualitative platelet defects, thrombotic thrombocytopaenic purpura, Evan's syndrome, pancytopaenia, and thrombocytopaenia occurring in the presence of abnormal red or white blood cells.\n\nDeath from immune thrombocytopaenia\n\n(3) For the purposes of this Statement of Principles, immune thrombocytopaenia, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's immune thrombocytopaenia.\n\n> Note: 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 immune thrombocytopaenia and death from immune thrombocytopaenia can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\n> Note: relevant service is 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, immune thrombocytopaenia or death from immune thrombocytopaenia is connected with the circumstances of a person's relevant service:\n\n(1) having a viral infection from the specified list of viral infections within the six weeks before the clinical onset of immune thrombocytopaenia;\n\n> Note: specified list of viral infections is defined in the Schedule 1 - Dictionary.\n\n(2) having a bacterial or fungal infection from the specified list of bacterial and fungal infections, within the six weeks before the clinical onset of immune thrombocytopaenia;\n\n> Note: specified list of bacterial and fungal infections is defined in the Schedule 1 \\- Dictionary.\n\n(3) being treated with a drug or a drug from a class of drugs from the specified list of drugs, within the six weeks before the clinical onset of immune thrombocytopaenia;\n\n> Note: specified list of drugs is defined in the Schedule 1 - Dictionary.\n\n(4) receiving a vaccine from the specified list of vaccines within the six weeks before the clinical onset of immune thrombocytopaenia;\n\n> Note: specified list of vaccines is defined in the Schedule 1 - Dictionary.\n\n(5) being treated with a drug or receiving a dose of vaccine which is associated in the individual with the following:\n\n(a) the development of immune thrombocytopaenia within six weeks of commencing drug therapy or receiving the dose of vaccine; and\n\n(b) an absence of immune thrombocytopaenia prior to commencing drug therapy or vaccination; and\n\n(c) sustained recovery from immune thrombocytopaenia on ceasing drug therapy or vaccination; and\n\n(d) exclusion of other aetiologies for thrombocytopaenia (including other drugs or vaccines);\n\n(6) being pregnant within the six weeks before the clinical onset of immune thrombocytopaenia;\n\n(7) having a lymphoproliferative disorder from the specified list of lymphoproliferative disorders, at the time of the clinical onset of immune thrombocytopaenia;\n\n> Note: specified list of lymphoproliferative disorders is defined in the Schedule 1 - Dictionary.\n\n(8) having an autoimmune or inflammatory disorder from the specified list of autoimmune and inflammatory disorders, at the time of the clinical onset of immune thrombocytopaenia;\n\n> Note: specified list of autoimmune and inflammatory disorders is defined in the Schedule 1 \\- Dictionary.\n\n(9) consuming a food or beverage from the specified list of food and beverages, within the six weeks before the clinical onset of immune thrombocytopaenia;\n\n> Note: specified list of food and beverages is defined in the Schedule 1 - Dictionary.\n\n(10) consuming a food or beverage which is associated in the individual with the following:\n\n(a) the development of immune thrombocytopaenia within six weeks of consuming the food or beverage; and\n\n(b) an absence of immune thrombocytopaenia prior to consuming the food or beverage; and\n\n(c) sustained recovery from immune thrombocytopaenia on ceasing consumption of the food or beverage; and\n\n(d) exclusion of other aetiologies for thrombocytopaenia; and\n\n(e) recurrence of immune thrombocytopaenia on re-exposure to the food or beverage; or\n\n(f) identification of platelet reactive antibodies specific to the food or beverage;\n\n(11) having a solid organ or stem cell transplant before the clinical onset of immune thrombocytopaenia;\n\n(12) having a solid organ cancer at the time of the clinical onset of immune thrombocytopaenia;\n\n(13) being treated with alemtuzumab in the two years before the clinical onset of immune thrombocytopaenia;\n\n(14) having a viral infection from the specified list of viral infections within the six weeks before the clinical worsening of immune thrombocytopaenia;\n\n> Note: specified list of viral infections is defined in the Schedule 1 - Dictionary.\n\n(15) having a bacterial or fungal infection from the specified list of bacterial and fungal infections, within the six weeks before the clinical worsening of immune thrombocytopaenia;\n\n> Note: specified list of bacterial and fungal infections is defined in the Schedule 1 - Dictionary.\n\n(16) being treated with a drug or a drug from a class of drugs from the specified list of drugs, within the six weeks before the clinical worsening of immune thrombocytopaenia;\n\n> Note: specified list of drugs is defined in the Schedule 1 - Dictionary.\n\n(17) receiving a vaccine from the specified list of vaccines within the six weeks before the clinical worsening of immune thrombocytopaenia;\n\n> Note: specified list of vaccines is defined in the Schedule 1 - Dictionary.\n\n(18) being treated with a drug or receiving a dose of vaccine which is associated in the individual with the following:\n\n(a) the worsening of immune thrombocytopaenia within six weeks of drug therapy or receiving the dose of vaccine; and\n\n(b) recovery to the individual's baseline platelet level on ceasing drug therapy or vaccination; and\n\n(c) exclusion of other aetiologies for thrombocytopaenia (including other drugs or vaccines);\n\n(19) being pregnant within the six weeks before the clinical worsening of immune thrombocytopaenia;\n\n(20) having a lymphoproliferative disorder from the specified list of lymphoproliferative disorders, at the time of the clinical worsening of immune thrombocytopaenia;\n\n> Note: specified list of lymphoproliferative disorders is defined in the Schedule 1 - Dictionary.\n\n(21) having an autoimmune or inflammatory disorder from the specified list of autoimmune and inflammatory disorders, at the time of the clinical worsening of immune thrombocytopaenia;\n\n> Note: specified list of autoimmune and inflammatory disorders is defined in the Schedule 1 \\- Dictionary.\n\n(22) consuming a food or beverage from the specified list of food and beverages, within the six weeks before the clinical worsening of immune thrombocytopaenia;\n\n> Note: specified list of food and beverages is defined in the Schedule 1 - Dictionary.\n\n(23) consuming a food or beverage which is associated in the individual with the following:\n\n(a) the worsening of immune thrombocytopaenia within six weeks of consuming the food or beverage; and\n\n(b) recovery to the individual's baseline platelet level on ceasing consumption of the food or beverage; and\n\n(c) exclusion of other aetiologies for thrombocytopaenia; and\n\n(d) recurrence of the worsening of immune thrombocytopaenia on re-exposure to the food or beverage; or\n\n(e) identification of platelet reactive antibodies specific to the food or beverage;\n\n(24) having a solid organ or stem cell transplant before the clinical worsening of immune thrombocytopaenia;\n\n(25) having a solid organ cancer at the time of the clinical worsening of immune thrombocytopaenia;\n\n(26) inability to obtain appropriate clinical management for immune thrombocytopaenia.\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(14) to 9(26) apply only to material contribution to, or aggravation of, immune thrombocytopaenia where the person's immune thrombocytopaenia 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\nSchedule 1 \\- Dictionary\n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\nimmune thrombocytopaenia—see subsection 7(2).\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\nrelevant 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\n> Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\nspecified list of autoimmune and inflammatory disorders means:\n\n(a) antiphospholipid syndrome;\n\n(b) autoimmune hepatitis;\n\n(c) coeliac disease;\n\n(d) dermatomyositis;\n\n(e) Graves' disease;\n\n(f) Hashimoto's thyroiditis;\n\n(g) inflammatory bowel disease;\n\n(h) rheumatoid arthritis;\n\n(i) sarcoidosis;\n\n(j) Sjögren's syndrome; or\n\n(k) systemic lupus erythematosus.\n\nspecified list of bacterial and fungal infections means:\n\n(a) Brucella species;\n\n(b) Candida albicans;\n\n(c) Helicobacter pylori; or\n\n(d) Mycobacterium tuberculosis.\n\nspecified list of drugs means:\n\n(a) abciximab;\n\n(b) aminosalicylic acid;\n\n(c) amiodarone;\n\n(d) amlodipine;\n\n(e) carbamazepine;\n\n(f) cephalosporins;\n\n(g) ciprofloxacin;\n\n(h) citalopram;\n\n(i) clopidogrel;\n\n(j) dactinomycin (actinomycin D);\n\n(k) diazoxide;\n\n(l) efalizumab;\n\n(m) eptifibatide;\n\n(n) ethambutol;\n\n(o) fludarabine;\n\n(p) furosemide (frusemide);\n\n(q) gentamicin;\n\n(r) glucagon;\n\n(s) haloperidol;\n\n(t) heparins;\n\n(u) hydrochlorothiazide;\n\n(v) imipramine;\n\n(w) infliximab;\n\n(x) interferon-α;\n\n(y) interferon-β;\n\n(z) irinotecan;\n\n(aa) isotretinoin;\n\n(bb) lamivudine;\n\n(cc) lamotrigine;\n\n(dd) levetiracetam;\n\n(ee) levofloxacin;\n\n(ff) lorazepam;\n\n(gg) melperone;\n\n(hh) methylphenidate;\n\n(ii) mirtazapine;\n\n(jj) nifedipine;\n\n(kk) nitrofurantoin;\n\n(ll) nivolumab;\n\n(mm) non-steroidal anti-inflammatory drugs, excluding aspirin;\n\n(nn) oxaliplatin;\n\n(oo) paracetamol;\n\n(pp) pembrolzumab;\n\n(qq) penicillin or penicillin derivatives;\n\n(rr) phenobarbital (phenobarbitone);\n\n(ss) phenytoin;\n\n(tt) quetiapine;\n\n(uu) quinidine;\n\n(vv) quinine;\n\n(ww) ranitidine;\n\n(xx) rifampicin;\n\n(yy) risperidone;\n\n(zz) sodium stibogluconate;\n\n(aaa) spironolactone;\n\n(bbb) sulfamethoxazole/trimethoprim;\n\n(ccc) sulfamethoxazole;\n\n(ddd) sulfasalazine;\n\n(eee) sulfonamides;\n\n(fff) suramin;\n\n(ggg) tamoxifen;\n\n(hhh) terazosin;\n\n(iii) tirofiban;\n\n(jjj) tolmetin;\n\n(kkk) tranilast;\n\n(lll) triamterene/hydrochlorothiazide;\n\n(mmm) triamterene;\n\n(nnn) trimethoprim; or\n\n(ooo) vancomycin.\n\nspecified list of food and beverages means:\n\n(a) cranberry juice;\n\n(b) Lupinus termis bean;\n\n(c) quinine-containing beverages;\n\n(d) tahini; or\n\n(e) walnuts.\n\nspecified list of lymphoproliferative disorders means:\n\n(a) acute lymphoblastic leukaemia;\n\n(b) chronic lymphocytic leukaemia/small lymphocytic lymphoma;\n\n(c) Hodgkin's lymphoma;\n\n(d) large granular lymphocytic leukaemia;\n\n(e) monoclonal gammopathy of unknown significance;\n\n(f) myeloma;\n\n(g) non-Hodgkin's lymphoma; or\n\n(h) Waldenstrom's macroglobulinaemia.\n\nspecified list of vaccines means:\n\n(aa) ChAdOx1 nCoV-19 vaccine (Vaxevria, Oxford/Astra-Zeneca);\n\n(a) hepatitis A vaccine;\n\n(b) hepatitis B vaccine;\n\n(c) influenza vaccine; or\n\n(d) measles-mumps-rubella vaccine.\n\nspecified list of viral infections means:\n\n(a) cytomegalovirus;\n\n(b) Epstein-Barr virus;\n\n(c) hepatitis A virus;\n\n(d) hepatitis B virus;\n\n(e) hepatitis C virus;\n\n(f) hepatitis E virus;\n\n(g) human immunodeficiency virus;\n\n(h) influenza virus;\n\n(i) measles virus;\n\n(j) mumps virus;\n\n(k) parvovirus B19;\n\n(l) rotavirus;\n\n(m) rubella virus;\n\n(ma) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2);\n\n(n) varicella-zoster virus (chickenpox); or\n\n(o) Zika virus.\n\nNote: SARS-CoV-2 is the virus which causes coronavirus disease 2019 (COVID-19).\n\nterminal 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\nVEA means the Veterans' Entitlements Act 1986.\n\n> Note: Endnotes\n\n> Note: Endnote 1—About the endnotes\n\nThe endnotes provide information about this compilation and the compiled law.\n\nThe following endnotes are included in every compilation:\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\nAbbreviation key—Endnote 2\n\nThe abbreviation key sets out abbreviations that may be used in the endnotes.\n\nLegislation history and amendment history—Endnotes 3 and 4\n\nAmending laws are annotated in the legislation history and amendment history.\n\nThe legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.\n\nThe amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.\n\nMisdescribed amendments\n\nA misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.\n\nIf a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.\n\n> Note: Endnote 2—Abbreviation key\n\n|                                                | o = order(s)                        |\n| ---------------------------------------------- | ----------------------------------- |\n| ad = added or inserted                         | Ord = Ordinance                     |\n| am = amended                                   | orig = original                     |\n| amdt = amendment                               | par = paragraph(s)/subparagraph(s)  |\n| c = clause(s)                                  | /sub‑subparagraph(s)                |\n| C[x] = Compilation No. x                       | pres = present                      |\n| Ch = Chapter(s)                                | prev = previous                     |\n| def = definition(s)                            | (prev…) = previously                |\n| Dict = Dictionary                              | Pt = Part(s)                        |\n| disallowed = disallowed by Parliament          | r = regulation(s)/rule(s)           |\n| Div = Division(s)                              |                                     |\n| exp = expires/expired or ceases/ceased to have | reloc = relocated                   |\n| effect                                         | renum = renumbered                  |\n| F = Federal Register of Legislation            | rep = repealed                      |\n| gaz = gazette                                  | rs = repealed and substituted       |\n| LA = Legislation Act 2003                      | s = section(s)/subsection(s)        |\n| LIA = Legislative Instruments Act 2003         | Sch = Schedule(s)                   |\n| (md) = misdescribed amendment can be given     | Sdiv = Subdivision(s)               |\n| effect                                         | SLI = Select Legislative Instrument |\n| (md not incorp) = misdescribed amendment       | SR = Statutory Rules                |\n| cannot be given effect                         | Sub‑Ch = Sub‑Chapter(s)             |\n| mod = modified/modification                    | SubPt = Subpart(s)                  |\n| No. = Number(s)                                | underlining = whole or part not     |\n|                                                | commenced or to be commenced        |\n\n> Note: Endnote 3—Legislation history\n\n| Name                                                                                                              | Registration               | Commencement    | Application, saving and transitional provisions |\n| ----------------------------------------------------------------------------------------------------------------- | -------------------------- | --------------- | ----------------------------------------------- |\n| Statement of Principles concerning immune thrombocytopaenia (Balance of Probabilities) (No. 64 of 2017)           | 6 November 2017F2017L01449 | 4 December 2017 |                                                 |\n| Amendment Statement of Principles concerning immune thrombocytopaenia (Balance of Probabilities) (No. 58 of 2022) | 2 May 2022F2022L00657      | 30 May 2022     |                                                 |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected                                                    | How affected      |\n| --------------------------------------------------------------------- | ----------------- |\n| Section 2……………….                                                      | rep LA s 48D      |\n| Section 4……………….                                                      | rep LA s 48C      |\n| Schedule 1 – Dictionary – specified list of vaccines…………...….         | am No. 58 of 2022 |\n| Schedule 1 – Dictionary – specified list of viral infections…………...…. | am No. 58 of 2022 |","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":4,"scope_assessment":{"changed":true,"description":"The original 2017 instrument has expanded via the 2022 amendment to include COVID-19 (SARS-CoV-2) and the ChAdOx1 nCoV-19 (AstraZeneca) vaccine as recognised triggers. This reflects the legislation's adaptive nature to incorporate emerging medical evidence, specifically pandemic-related causation factors that did not exist when the original instrument was drafted."},"complexity_factors":["26 distinct factors with specific temporal windows (mostly 'within 6 weeks')","Multiple defined terms requiring cross-reference to Schedule 1 (7 'specified lists' containing 60+ drugs, 15 viral infections, 4 vaccines, etc.)","Dual structure distinguishing 'clinical onset' (factors 1-13) from 'clinical worsening' (factors 14-26)","Factor 5 and Factor 18 require complex individual causation assessments (temporal association + absence prior + recovery on cessation + exclusion of other causes)","Factor 10 and Factor 23 require even more complex individual assessments including re-exposure challenge or antibody identification","Nested definitions: 'terminal event' defined in Dictionary, referenced in death provisions","Cross-reference mechanism in section 11 linking to other Statements of Principles for comorbid conditions"],"plain_english_summary":"This law sets the medical test for when veterans or current/former Defence members can get compensation for immune thrombocytopaenia (ITP). It defines ITP clinically and requires proof, on the balance of probabilities, that one of 26 listed triggers or circumstances linked to service caused onset or worsening.\n\nIt matters because eligibility rests on that checklist of causes — including infections, certain drugs and vaccines (notably AstraZeneca), pregnancy, cancers, foods, transplants, and poor medical management."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"The instrument has been amended (Compilation includes Amendment No. 58 of 2022; Endnote 4). Schedule 1’s specified lists of vaccines and viral infections were updated (affecting items in ss9(1)–9(4) and ss9(14)–9(17)), thereby changing which exposures can satisfy the factors that link ITP to relevant service and potentially expanding the set of compensable claims."},"complexity_factors":["Detailed medical definition with numeric clinical threshold (platelet count <100,000/μL) and symptom/treatment criteria (s7(2)).","Extensive enumerated lists of exposures (many individual drugs, infections, vaccines, foods, and disorders) increasing factual complexity for each claim (Schedule 1).","Multiple temporal rules and windows (generally within six weeks; alemtuzumab two‑year window) that must be established for causation (ss9(1)–9(26)).","Different legal relationships to service: factors must be related to relevant service and some only apply to material contribution/aggravation where ITP pre‑existed service (s10(1)–(2)).","Interaction with other Statements of Principles where referenced injuries/diseases exist, requiring cross‑instrument application (s11).","Requirement to exclude alternative aetiologies and show patterns of onset/recovery/rechallenge for some individual‑specific associations, increasing evidentiary and clinical assessment burden (ss9(5), 9(10), 9(18), 9(23)).","Amendable schedule structure: periodic updates to specified lists (see Endnote 4 and Schedule 1 amendments) create change management for practitioners and decision makers."],"plain_english_summary":"This instrument sets the medical criteria the Repatriation Medical Authority uses to decide, on the balance of probabilities, when immune thrombocytopaenia (ITP) or death from ITP is connected to a veteran’s relevant service for claims under the VEA or MRCA. It defines ITP clinically, lists specific exposures and conditions (infections, drugs, vaccines, pregnancy, cancers, transplants, certain foods) and timing rules (mostly a six‑week window) that can establish connection.\n\nThe Authority makes the criteria (s3, s8); decision‑makers apply them to entitlement claims and the Commonwealth pays benefits under the VEA/MRCA, affecting evidentiary burdens and how medical histories are used (s5, s10)."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-immune-thrombocytopaenia-balance-of-probabilities-no-64-of-2017","history":"/api/acts/statement-of-principles-concerning-immune-thrombocytopaenia-balance-of-probabilities-no-64-of-2017/history","analysis":"/api/acts/statement-of-principles-concerning-immune-thrombocytopaenia-balance-of-probabilities-no-64-of-2017/analysis","conflicts":"/api/acts/statement-of-principles-concerning-immune-thrombocytopaenia-balance-of-probabilities-no-64-of-2017/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-immune-thrombocytopaenia-balance-of-probabilities-no-64-of-2017/important-cases","documents":"/api/acts/statement-of-principles-concerning-immune-thrombocytopaenia-balance-of-probabilities-no-64-of-2017/documents"}}