{"id":"F2021L00615","name":"Statement of Principles concerning porphyria cutanea tarda (Reasonable Hypothesis) (No. 69 of 2021)","slug":"statement-of-principles-concerning-porphyria-cutanea-tarda-reasonable-hypothesis-no-69-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440858,"registerId":"F2021L00615-fast-fetch-1775956335642","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning porphyria cutanea tarda (Reasonable Hypothesis) (No. 69 of 2021)","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\nPORPHYRIA CUTANEA TARDA (Reasonable Hypothesis)\n\n(No. 69 of 2021)\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 21 May 2021\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 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 porphyria cutanea tarda (Reasonable Hypothesis) (No. 69 of 2021).\n\n2 Commencement\n\n This instrument commences on 21 June 2021.\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 porphyria cutanea tarda No. 43 of 2012 (Federal Register of Legislation No. F2012L01357) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 porphyria cutanea tarda and death from porphyria cutanea tarda.\n\nMeaning of porphyria cutanea tarda\n\n(2) For the purposes of this Statement of Principles, porphyria cutanea tarda means a skin disorder resulting from decreased activity of the enzyme uroporphyrinogen decarboxylase in the liver and accumulation of porphyrins in the circulation.\n\nNote: Typical clinical manifestations of porphyria cutanea tarda include blistering of the skin in sun-exposed areas, hyperpigmentation and facial hypertrichosis.\n\n(3) While porphyria cutanea tarda attracts ICD‑10‑AM code E80.1, in applying this Statement of Principles the meaning of porphyria cutanea tarda 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 porphyria cutanea tarda\n\n(5) For the purposes of this Statement of Principles, porphyria cutanea tarda, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's porphyria cutanea tarda.\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 porphyria cutanea tarda and death from porphyria cutanea tarda 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 porphyria cutanea tarda or death from porphyria cutanea tarda with the circumstances of a person's relevant service:\n\n(1) for males, consuming a total of at least 100 kilograms of alcohol within the 10 years before the clinical onset of porphyria cutanea tarda;\n\nNote: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink. \n\n(2) for females, consuming a total of at least 50 kilograms of alcohol within the 10 years before the clinical onset of porphyria cutanea tarda;\n\nNote: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink. \n\n(3) having alcohol use disorder at the time of the clinical onset of porphyria cutanea tarda;\n\n(4) having cirrhosis of the liver or steatohepatitis at the time of the clinical onset of porphyria cutanea tarda;\n\n(5) having chronic renal failure at the time of the clinical onset of porphyria cutanea tarda;\n\nNote: chronic renal failure is defined in the Schedule 1 - Dictionary.\n\n(6) having hepatic iron overload at the time of the clinical onset of porphyria cutanea tarda;\n\nNote: iron overload is defined in the Schedule 1 - Dictionary.\n\n(7) having a viral infection from the specified list of viral infections at the time of the clinical onset of porphyria cutanea tarda;\n\nNote: specified list of viral infections is defined in the Schedule 1 - Dictionary. \n\n(8) taking a drug from the specified list of drugs within the 30 days before the clinical onset of porphyria cutanea tarda;\n\nNote: specified list of drugs is defined in the Schedule 1 - Dictionary.\n\n(9) taking a drug which is associated in the individual with the clinical onset of porphyria cutanea tarda during drug therapy and either:\n\n(a) the improvement of porphyria cutanea tarda within 2 months of discontinuing or tapering drug therapy; or \n\n(b) the redevelopment of porphyria cutanea tarda on rechallenge with the same drug; and\n\nwhere taking the drug continued for at least the 7 days before the clinical onset of porphyria cutanea tarda;\n\n(10) inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) within the 1 year before the clinical onset of porphyria cutanea tarda;\n\nNote: inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) is defined in the Schedule 1 - Dictionary.\n\n(11) ingesting food contaminated with hexachlorobenzene within the 1 year before the clinical onset of porphyria cutanea tarda;\n\n(12) having smoked tobacco products:\n\n(a) in an amount of at least 10 cigarettes per day or the equivalent thereof in other tobacco products; and\n\n(b) for at least the 6 months before the clinical onset of porphyria cutanea tarda; and\n\nif smoking has ceased before the clinical onset of porphyria cutanea tarda, then that onset occurred within 30 days of cessation; \n\nNote: cigarettes per day or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary. \n\n(13) for males, consuming a total of at least 100 kilograms of alcohol within the 10 years before the clinical worsening of porphyria cutanea tarda;\n\nNote: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink. \n\n(14) for females, consuming a total of at least 50 kilograms of alcohol within the 10 years before the clinical worsening of porphyria cutanea tarda;\n\nNote: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink. \n\n(15) having alcohol use disorder at the time of the clinical worsening of porphyria cutanea tarda;\n\n(16) having cirrhosis of the liver or steatohepatitis at the time of the clinical worsening of porphyria cutanea tarda;\n\n(17) having chronic renal failure at the time of the clinical worsening of porphyria cutanea tarda;\n\nNote: chronic renal failure is defined in the Schedule 1 - Dictionary.\n\n(18) having hepatic iron overload at the time of the clinical worsening of porphyria cutanea tarda;\n\nNote: iron overload is defined in the Schedule 1 - Dictionary.\n\n(19) having a viral infection from the specified list of viral infections at the time of the clinical worsening of porphyria cutanea tarda;\n\nNote: specified list of viral infections is defined in the Schedule 1 - Dictionary. \n\n(20) taking a drug from the specified list of drugs within the 30 days before the clinical worsening of porphyria cutanea tarda;\n\nNote: specified list of drugs is defined in the Schedule 1 - Dictionary.\n\n(21) taking a drug which is associated in the individual with:\n\n(a) the clinical worsening of porphyria cutanea tarda during drug therapy; and\n\n(b) the improvement of porphyria cutanea tarda within 2 months of discontinuing or tapering drug therapy; and\n\nwhere taking the drug continued for at least the 7 days before the clinical worsening of porphyria cutanea tarda;\n\n(22) inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) within the 1 year before the clinical worsening of porphyria cutanea tarda;\n\nNote: inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) is defined in the Schedule 1 - Dictionary.\n\n(23) ingesting food contaminated with hexachlorobenzene within the 1 year before the clinical worsening of porphyria cutanea tarda;\n\n(24) having smoked tobacco products:\n\n(a) in an amount of at least 10 cigarettes per day or the equivalent thereof in other tobacco products; and\n\n(b) for least 6 months before the clinical worsening of porphyria cutanea tarda; and\n\nif smoking has ceased before the clinical worsening of porphyria cutanea tarda, then that worsening occurred within 30 days of cessation; \n\nNote: cigarettes per day or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary. \n\n(25) inability to obtain appropriate clinical management for porphyria cutanea tarda.\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(13) to 9(25) apply only to material contribution to, or aggravation of, porphyria cutanea tarda where the person's porphyria cutanea tarda 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 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 3 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 cigarettes per day or the equivalent thereof in other tobacco products means:\n\n(a) cigarettes, pipe tobacco or cigars, alone or in any combination; and\n\n(b) 1 gram of cigar, pipe or other smoking tobacco (including roll your own smoking tobacco) is equivalent to one tailor made cigarette.\n\n inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by 2,3,7,8-tetrachlorodibenzo-para-dioxin (TCDD) means:\n\n(a) decanting or spraying;\n\n(b) cleaning or maintaining equipment used to apply;\n\n(c) being sprayed with;\n\n(d) handling or sawing timber treated with;\n\n(e) being in an environment shrouded in dust from timber treated with; or\n\n(f) using cutting oils contaminated with;\n\n one of the following chemicals:\n\n(i) 2,4,5-trichlorophenoxyacetic acid;\n\n(ii) 2,4,5-trichlorophenoxypropionic acid;\n\n(iii) 2,4,5-trichlorophenol;\n\n(iv) 2-(2,4,5-trichlorophenoxy)-ethyl 2,2-dichloropropionionate;\n\n(v) o,o-dimethyl-o-(2,4,5-trichlorophenyl)-phosphorothioate;\n\n(vi) pentachlorophenol;\n\n(vii) 2,3,4,6-tetrachlorophenol;\n\n(viii) 2,4,6-trichlorophenol;\n\n(ix) 1,3,5-trichloro-2-(4-nitrophenoxy)benzene;\n\n(x) 2,4-dichloro-1-(4-nitrophenoxy)benzene; or\n\n(xi) 2,4-dichloro-1-(3-methoxy-4-nitrophenoxy)-benzene.\n\n iron overload means an accumulation of excess iron in tissues and organs which has been confirmed by elevated ferritin or transferrin saturation levels.\n\nNote: Common causes of hepatic iron overload are haemochromatosis and blood transfusions.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n porphyria cutanea tarda—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 also defined in the Schedule 1 - Dictionary.\n\n specified list of drugs means:\n\n(a) carbamazepine;\n\n(b) chloroquine;\n\n(c) cyclophosphamide;\n\n(d) highly active antiretroviral therapy;\n\n(e) hydroxychloroquine;\n\n(f) imatinib;\n\n(g) interferons;\n\n(h) iron supplements;\n\n(i) olmesartan;\n\n(j) oral estrogens;\n\n(k) phenobarbital;\n\n(l) phenytoin;\n\n(m) ribavirin;\n\n(n) rifampicin;\n\n(o) sulfonylureas; or\n\n(p) tamoxifen.\n\n specified list of viral infections means:\n\n(a) hepatitis B virus;\n\n(b) hepatitis C virus; or\n\n(c) human immunodeficiency virus.\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":"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"},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument replaces the 2012 Statement of Principles for porphyria cutanea tarda (section 4) but remains narrowly focused on the same subject: specifying the medical factors that will raise a reasonable hypothesis of service connection for PCT and death from PCT. The replacement updates and restates the list of relevant factors and definitions (Schedule 1), clarifies sex‑specific alcohol thresholds and the distinction between causes of onset versus aggravation, and cross‑references other SOPs where relevant. There is no textual indication that the instrument expands coverage beyond that original purpose (it continues to apply only to claims under the VEA and MRCA — section 5), so it does not materially change the overall scope of the law beyond updating and clarifying the medical criteria."},"complexity_factors":["Relatively short instrument (11 sections plus Schedule 1) with clear structure","Multiple defined terms in Schedule 1 (at least 12 named definitions: chronic renal failure; cigarettes per day equivalence; TCDD exposure activities and chemical list; iron overload; MRCA; porphyria cutanea tarda; relevant service (6 subcategories); specified list of drugs (16 items); specified list of viral infections (3 items); terminal event; VEA)","Sex‑specific and time‑windowed thresholds (e.g. 100 kg alcohol males vs 50 kg females within 10 years) and separate rules for onset versus worsening (nested conditional logic in sections 9 and 10)","Lists of discrete exposure/drug items (specified list of drugs has 16 named entries; TCDD‑contaminated chemical list has 11 named chemicals)","Cross‑references to other instruments and classifications (ICD‑10‑AM; other Statements of Principles under subsection 196B(2) — section 11)","Conditional application of some factors only to material contribution/aggravation where condition pre‑existed service (section 10(2))","Several provisions require verification of clinical change tied to drug discontinuation/rechallenge or to timing of exposure (temporal conditions and improvement/rechallenge criteria in subsections 9(9) and 9(21))"],"plain_english_summary":"**What this instrument does (mechanics)**\n\n- This is a Repatriation Medical Authority (RMA) Statement of Principles (SOP) about porphyria cutanea tarda (PCT) and death from PCT. It comes into force on 21 June 2021 (section 2) and repeals the earlier 2012 SOP for the same condition (section 4).\n\n- The SOP is made under the Veterans' Entitlements Act 1986 (section 3) and applies to claims that fall under the VEA or the Military Rehabilitation and Compensation Act 2004 (MRCA) (section 5). In other words, decision‑makers assessing veterans’ or former service members’ compensation/entitlement claims will use this SOP as part of their medical/legal assessment.\n\n- The instrument defines what is meant by porphyria cutanea tarda for the SOP (a liver enzyme deficiency causing porphyrin accumulation and typical skin findings) and says that the ICD‑10‑AM code E80.1 is related but the SOP uses its own definition (section 7).\n\n- The RMA states there is sound medical‑scientific evidence that PCT can be related to relevant service (section 8). The SOP then sets out the specific factors which, if present, are sufficient to raise a “reasonable hypothesis” that a person’s PCT or death from PCT is related to their relevant service (section 9). Only one of the listed factors needs to be met to raise that reasonable hypothesis.\n\n- The listed factors include: sex‑specific cumulative alcohol consumption thresholds (100 kg over 10 years for males; 50 kg for females), alcohol use disorder, liver disease (cirrhosis or steatohepatitis), chronic renal failure, hepatic iron overload, specified viral infections (hepatitis B, hepatitis C, HIV), taking particular drugs (a listed set including oral estrogens, rifampicin, some anticonvulsants and others), exposure to TCDD‑contaminated agents or hexachlorobenzene in food within one year, a defined pattern of tobacco smoking, and inability to obtain appropriate clinical management (section 9 and Schedule 1 definitions).\n\n- The SOP distinguishes factors that can cause or trigger the initial clinical onset versus factors that can materially contribute to or aggravate an existing PCT (see section 10). Subsections 9(13)–9(25) apply only where PCT was suffered or contracted before or during (but did not arise out of) relevant service — i.e. those items are limited to material contribution or aggravation (section 10(2)).\n\n- If a factor listed in this SOP refers to an injury or disease that has its own SOP, that other SOP applies according to its terms (section 11). The Schedule contains definitions of terms used throughout (Schedule 1).\n\n**Who this affects**\n\n- Veterans, current or former members of the Australian Defence Force, and members of peacekeeping forces who lodge claims under the VEA or MRCA and allege PCT (section 5).\n\n- Treating clinicians and medical assessors who provide the medical evidence used in claims (because the SOP specifies which clinical findings, diagnoses and exposures are relevant — sections 7 and 9).\n\n- Decision‑makers in the Department/agency that administers benefits under the VEA and MRCA, who will use this SOP as the medical standard for establishing a connection between service and PCT.\n\n**Why it matters (practical effect)**\n\n- The SOP sets objective, enumerated factors which, if proved, are sufficient to raise a reasonable hypothesis that PCT (or death from PCT) is connected to a person’s relevant service. This materially affects the evidentiary hurdle for a successful service‑connection finding in compensation/entitlement claims (sections 8–10).\n\n- The SOP standardises what medical and exposure evidence decision‑makers should accept as linking PCT to service. Examples: documented viral infection with hepatitis C, laboratory evidence of hepatic iron overload, or a specified exposure to certain drugs or toxic chemicals can be decisive under the SOP (section 9; Schedule 1).\n\n**Who pays, who decides, and what behaviour changes**\n\n- The SOP itself does not create payments; it provides the medical test used by decision‑makers under the VEA and MRCA. If a decision‑maker accepts that a reasonable hypothesis is raised under this SOP, that finding can lead to entitlement decisions and payments under the governing Acts (see section 5 for application to those Acts).\n\n- The RMA sets the SOP; claims are determined by the agencies that administer the VEA and MRCA using this SOP as a medical standard (sections 3 and 5).\n\n- Behavioural and administrative effects: claimants and their medical providers will focus evidence on the listed factors (e.g. alcohol history, laboratory tests for iron overload, records of drug therapy, viral serology, documented exposures to listed chemicals). Decision‑makers may require specific medical records or investigations to verify the listed factors. That alters the kind of evidence assembled and relied upon in claims.\n\n**Implementation and evidentiary/administrative considerations**\n\n- The SOP reduces medical uncertainty for assessors by listing explicit, testable factors, but several of those factors rely on historical or self‑reported information (alcohol history, smoking history, occupational/chemical exposure), which may be difficult to verify and could increase evidentiary disputes.\n\n- Some factors require laboratory confirmation (e.g. hepatic iron overload by ferritin/transferrin saturation, chronic renal failure by GFR or dialysis) or documented diagnosis (cirrhosis, steatohepatitis, viral infection). Collecting or re‑ordering such tests imposes practical costs on claimants and on assessment processes.\n\n- The SOP cross‑refers to other SOPs when a listed factor is itself an injury/disease covered elsewhere (section 11). That creates dependency on the content and updates of other SOPs.\n\n**Trade‑offs and incentives**\n\n- Concentrated benefits: people who can document the enumerated risk factors (e.g. those with hepatitis C, clear hepatic iron overload, or documented exposure to listed drugs/chemicals) gain a clearer, lower‑uncertainty path to a service‑connection finding.\n\n- Diffuse costs: the administrative system may face increased demand for targeted medical testing and more records review; claimants without easily documented exposures may face higher evidentiary burdens.\n\n- The SOP narrows the kinds of medical relationships that will be treated as a reasonable hypothesis for service connection to the listed factors. That reduces assessors’ need to treat speculative or unlisted causes as sufficient, but may exclude plausible links not captured in the list unless another SOP applies (section 11).\n\n**Where to look in the instrument**\n\n- Key operative material: definitions and lists in Schedule 1; factors in section 9; relationship to service rules in section 10; application in section 5; repeal in section 4.\n\n(References: Sections 2–11 and Schedule 1 of the Statement of Principles concerning porphyria cutanea tarda (No. 69 of 2021).)"},"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 covers the specific disease (porphyria cutanea tarda) and its aggravation or causation in the veteran population. The 25 factors represent a comprehensive but conventional approach to this condition's known risk factors in medical literature. There is no evidence of scope creep beyond the original purpose of establishing service connection criteria for this specific disorder."},"complexity_factors":["25 distinct factors with specific quantitative thresholds (e.g., '100 kilograms of alcohol within 10 years', '10 cigarettes per day for 6 months')","12 defined terms in Schedule 1, including nested definitions (e.g., 'inhaling, ingesting or having cutaneous contact with a chemical agent contaminated by TCDD' contains 11 sub-clauses listing specific chemical exposures)","Parallel structure for onset vs. worsening — factors 1-12 cover initial disease onset, factors 13-24 cover worsening of existing disease, with nearly identical content creating duplication","Cross-references to external legislation (VEA and MRCA) and other Statements of Principles for related conditions","Temporal requirements ('within 10 years before', 'within 30 days before', 'within 1 year before', 'within 2 months of discontinuing') that vary by factor","Gender-specific thresholds for alcohol consumption (100kg for males, 50kg for females)","Conditional logic in factor 9 and 21 requiring drug rechallenge or improvement upon cessation to establish causation","Specific medical coding reference (ICD-10-AM Tenth Edition) with ISBN and effective date"],"plain_english_summary":"This Statement of Principles sets the medical rules for deciding whether Porphyria cutanea tarda (PCT) is service-related for Australian veterans claiming under the VEA or MRCA. It identifies 25 risk factors (e.g. alcohol use, liver disease, infections, certain drugs and chemical exposures) that, if shown to relate to service, create a “reasonable hypothesis” that service caused or aggravated PCT. Replacing the 2012 version, it updates the evidence and provides a relatively claimant‑favourable pathway to compensation."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-porphyria-cutanea-tarda-reasonable-hypothesis-no-69-of-2021","history":"/api/acts/statement-of-principles-concerning-porphyria-cutanea-tarda-reasonable-hypothesis-no-69-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-porphyria-cutanea-tarda-reasonable-hypothesis-no-69-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-porphyria-cutanea-tarda-reasonable-hypothesis-no-69-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-porphyria-cutanea-tarda-reasonable-hypothesis-no-69-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-porphyria-cutanea-tarda-reasonable-hypothesis-no-69-of-2021/documents"}}