{"id":"F2025L00144","name":"Statement of Principles concerning opisthorchiasis (Balance of Probabilities) (No. 22 of 2025)","slug":"statement-of-principles-concerning-opisthorchiasis-balance-of-probabilities-no-22-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442732,"registerId":"F2025L00144-fast-fetch-1775957683744","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning opisthorchiasis (Balance of Probabilities) (No. 22 of 2025)","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![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nOPISTHORCHIASIS  (Balance of Probabilities)\n\n(No. 22 of 2025)\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 18 February 2025.\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\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\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning opisthorchiasis (Balance of Probabilities) (No. 22 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 25 March 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning opisthorchiasis (Balance of Probabilities) (No. 46 of 2016) (Federal Register of Legislation No. F2016L00584) made under subsection 196B(3) of the VEA is repealed.\n\n1.                Application\n\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\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about opisthorchiasis and death from opisthorchiasis.\n\n\nMeaning of opisthorchiasis\n\n1.           For the purposes of this Statement of Principles, opisthorchiasis means an infestation of the biliary system by the trematodes (parasitic flatworms) Opisthorchis felineus or Opisthorchis viverrini. \n\n\nNote 1: Opisthorchis felineus is also known as the cat liver fluke and Opisthorchis viverrini is also known as the Southeast Asian liver fluke.\n\nNote 2: Symptoms of opisthorchiasis include loss of appetite, diarrhoea or a sense of abdominal pressure.\n\n1.           While opisthorchiasis attracts ICD‑10‑AM code B66.0, in applying this Statement of Principles the meaning of opisthorchiasis is that given in subsection (2).\n2.           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\n\nDeath from opisthorchiasis\n\n1.           For the purposes of this Statement of Principles, opisthorchiasis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's opisthorchiasis.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that opisthorchiasis and death from opisthorchiasis 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\n1.                Factors that must exist\n\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, opisthorchiasis or death from opisthorchiasis is connected with the circumstances of a person's relevant service:\n\n1.           ingesting the skin or flesh of raw, undercooked, iced, pickled or smoked freshwater fish at least 3 weeks before clinical onset;\n\n\nNote: Freshwater fish contaminated by Opisthorchis viverrini are mainly found in Southeast Asia and freshwater fish contaminated by Opisthorchis felineus are mainly found in Eastern and Central Europe and Southeast Asia.\n\n1.           having a liver transplant, where the liver is derived from a person infected with Opisthorchis viverrini or Opisthorchis felineus, within the 7 days before clinical onset;\n\n\n1.           inability to obtain appropriate clinical management for opisthorchiasis before clinical worsening.\n\n\n1.            Relationship to service\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  2.           The factor set out in subsection 9(3) applies only to material contribution to, or aggravation of, opisthorchiasis where the person's opisthorchiasis was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 9 applies in relation to a person; and\n2.           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\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                             MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                             opisthorchiasis—see subsection 7(2).\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":{"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the same narrow scope as its 2016 predecessor and the original legislative framework. It addresses only opisthorchiasis in the context of veterans' compensation, with no expansion into related conditions, broader populations, or additional policy areas. The update appears to be a routine republication to ensure currency of medical references (ICD-10-AM Tenth Edition) and legislative references."},"complexity_factors":["Short, focused instrument (approximately 1,500 words) dealing with a single medical condition","Only 5 defined terms in the Dictionary (MRCA, opisthorchiasis, relevant service, terminal event, VEA)","Straightforward structure: definitions, three specific causal factors, and relationship-to-service rules","Minimal cross-referencing — only refers to the parent Acts (VEA and MRCA) and the ICD-10-AM classification system","Simple conditional logic: 'at least one of the following factors must exist' — no nested exceptions or complex boolean operators","Single purpose instrument with no subordinate legislation or regulatory mechanisms"],"plain_english_summary":"This rulebook guides whether current and former Australian Defence Force members and veterans can get compensation for opisthorchiasis (a liver‑fluke infection from raw freshwater fish). It tells the Repatriation Medical Authority what evidence is needed—on the balance of probabilities—to link the infection to military service.\n\nClaims can succeed if service‑related exposure (e.g. eating risky fish during deployment), an infected donor liver, or inadequate treatment made the disease more likely or worse."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2016 Statement (section 4) and reissues a Statement that defines the conditions under which opisthorchiasis or death from it can be connected to relevant service and applies to claims under s120B VEA or s339 MRCA (sections 5, 7–11). The text itself does not state whether the substantive coverage is broader or narrower than the 2016 instrument; it only repeals the prior instrument and sets new criteria."},"complexity_factors":["Statutory cross‑references to entitlement schemes: applies only to claims under s120B of the VEA or s339 of the MRCA (section 5; Schedule 1 definitions).","Legal standard: applies a 'balance of probabilities' causation test informed by medical‑scientific evidence (section 8).","Prescriptive medical thresholds and temporal limits: specific exposure/timing requirements (e.g. ingestion ≥3 weeks before clinical onset; infected‑donor liver transplant within 7 days) create precise factual inquiries (section 9(1)–(2)).","Interaction with other Statements of Principles: factors that refer to other diseases invoke those Statements as in force, requiring cross‑instrument comparison (section 11).","Definitions and medical coding: relies on defined terms and an ICD‑10‑AM code reference, requiring medical record interpretation (section 7(4)–(5); Schedule 1).","Relationship‑to‑service constraints and limits on applicability: factors must be related to 'relevant service' and one factor (9(3)) applies only to material contribution/aggravation where the condition pre‑existed or was contracted before/during service (section 10).","Repeal and replacement: the 2016 Statement is expressly repealed, necessitating review of transitional or precedent questions for existing claims (section 4).","Technical medical definitions: inclusion of 'death from opisthorchiasis' via terminal events requires linking proximate causes listed in the dictionary to the listed disease (section 7(3); Schedule 1)."],"plain_english_summary":"This Statement of Principles sets the medical criteria used to decide, on the balance of probabilities, whether opisthorchiasis (a liver‑fluke infection) or death from it is connected to a person's relevant service under the Veterans' Entitlements Act or the Military Rehabilitation and Compensation Act. It lists specific exposure and timing conditions that must be present for a service connection, applies to eligible claims, and replaces the prior 2016 Statement."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-opisthorchiasis-balance-of-probabilities-no-22-of-2025","history":"/api/acts/statement-of-principles-concerning-opisthorchiasis-balance-of-probabilities-no-22-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-opisthorchiasis-balance-of-probabilities-no-22-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-opisthorchiasis-balance-of-probabilities-no-22-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-opisthorchiasis-balance-of-probabilities-no-22-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-opisthorchiasis-balance-of-probabilities-no-22-of-2025/documents"}}