{"id":"F2025L00143","name":"Statement of Principles concerning opisthorchiasis (Reasonable Hypothesis) (No. 21 of 2025)","slug":"statement-of-principles-concerning-opisthorchiasis-reasonable-hypothesis-no-21-of-2025","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442729,"registerId":"F2025L00143-fast-fetch-1775957681571","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning opisthorchiasis (Reasonable Hypothesis) (No. 21 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  (Reasonable Hypothesis)\n\n(No. 21 of 2025)\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    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   \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 (Reasonable Hypothesis) (No. 21 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(2) of the Veterans' Entitlements Act 1986.\n\n1.                Repeal\n\n\nThe Statement of Principles concerning opisthorchiasis (Reasonable Hypothesis) (No. 45 of 2016) (Federal Register of Legislation No. F2016L00579) made under subsection 196B(2) of the VEA is repealed.\n\n1.                Application\n\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\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\nThe Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that opisthorchiasis and death from opisthorchiasis 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\n1.                Factors that must exist\n\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 opisthorchiasis or death from opisthorchiasis 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;\n2.           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(2) 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)          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 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 standard scope of a Repatriation Medical Authority Statement of Principles. It replaces the 2016 version (No. 45 of 2016) with updated references to the current ICD-10-AM edition but does not expand beyond the original purpose of establishing the reasonable hypothesis test for opisthorchiasis in the veterans' compensation context."},"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)","Simple conditional structure: three alternative factors in section 9, only one of which must be satisfied","Minimal cross-referencing — primarily internal references to the Dictionary and standard references to the parent Acts (VEA and MRCA)","No nested exceptions or complex temporal calculations beyond straightforward time periods (3 weeks, 7 days)","Clear delineation between clinical onset and clinical worsening in section 10(2)","Standard boilerplate provisions for Statements of Principles under the VEA framework"],"plain_english_summary":"This instrument defines when Australian veterans and defence members can claim compensation for opisthorchiasis (liver fluke), applying to people covered by the VEA or MRCA who served in operational, peacekeeping, hazardous or nuclear test roles. It adopts a \"reasonable hypothesis\" test to make a service connection easier to establish.\n\nIt highlights key risk pathways—eating raw/undercooked freshwater fish, receiving an infected liver transplant, or lack of timely treatment—so those exposed during service (notably in Southeast Asia or parts of Europe) have a clearer route to compensation."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2016 Statement (s4) and restates the criteria for linking opisthorchiasis or death from it to relevant service. It sets three discrete qualifying factors (ingestion of raw/undercooked freshwater fish ≥3 weeks before clinical onset; infected‑donor liver transplant ≤7 days before onset; inability to obtain appropriate clinical management) and clarifies application to VEA and MRCA claims, definitions of relevant service, and inclusion of terminal events (s5, s7, s9, Schedule 1)."},"complexity_factors":["Statutory standard is a medical one ('reasonable hypothesis') requiring application of medical‑scientific evidence (s8), which invites technical medical assessment rather than straightforward legal analysis.","Specific qualifying factors with temporal thresholds: ingestion ≥3 weeks before clinical onset (s9(1)); liver transplant within 7 days before clinical onset (s9(2)), creating evidentiary timing requirements.","Open‑ended clinical management factor ('inability to obtain appropriate clinical management') (s9(3)) creates potential evidentiary and interpretive uncertainty and administrative discretion.","Requirement that any qualifying factor be related to 'relevant service' (s10) ties medical facts to service history, requiring cross‑checking of service records and medical timing.","Interplay with other Statements of Principles where a factor refers to another injury/disease (s11) requires cross‑reference and coordination with other instrument texts.","Defined technical terms and lists in Schedule 1 — e.g. 'relevant service' categories, 'terminal event' — require precise statutory interpretation (Schedule 1).","Reference to ICD‑10‑AM coding (s7(4)) and medical definitions (s7(2)) adds reliance on external medical classification systems for application.","Repeal of prior Statement (s4) means decision‑makers must track changes from the 2016 instrument when assessing legacy or ongoing claims (administrative transition).","Authority of the Repatriation Medical Authority to determine the Statement (s3) concentrates rule‑making and interpretive power in an administrative body, affecting predictability."],"plain_english_summary":"This Statement of Principles replaces the 2016 instrument and sets the medical criteria the Repatriation Medical Authority uses to link opisthorchiasis (a liver‑fluke infection) or death from it to a person’s relevant military service. It applies to claims under the Veterans’ Entitlements Act and the Military Rehabilitation and Compensation Act.\n\nA reasonable hypothesis is raised if, before clinical onset, the person ate raw or undercooked freshwater fish (≥3 weeks), received a liver from an infected donor (≤7 days), or could not obtain appropriate clinical management."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-opisthorchiasis-reasonable-hypothesis-no-21-of-2025","history":"/api/acts/statement-of-principles-concerning-opisthorchiasis-reasonable-hypothesis-no-21-of-2025/history","analysis":"/api/acts/statement-of-principles-concerning-opisthorchiasis-reasonable-hypothesis-no-21-of-2025/analysis","conflicts":"/api/acts/statement-of-principles-concerning-opisthorchiasis-reasonable-hypothesis-no-21-of-2025/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-opisthorchiasis-reasonable-hypothesis-no-21-of-2025/important-cases","documents":"/api/acts/statement-of-principles-concerning-opisthorchiasis-reasonable-hypothesis-no-21-of-2025/documents"}}