{"id":"F2018L01163","name":"Statement of Principles concerning scrub typhus (Balance of Probabilities) (No. 78 of 2018)","slug":"statement-of-principles-concerning-scrub-typhus-balance-of-probabilities-no-78-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439730,"registerId":"F2018L01163-fast-fetch-1775955639845","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning scrub typhus (Balance of Probabilities) (No. 78 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\nSCRUB TYPHUS (Balance of Probabilities)\n\n(No. 78 of 2018)\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 24 August 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:
|\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 scrub typhus (Balance of Probabilities) (No. 78 of 2018).\n\n2 Commencement\n\n This instrument commences on 24 September 2018.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning scrub typhus No. 73 of 2009 (Federal Register of Legislation No. F2009L04044) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 scrub typhus and death from scrub typhus.\n\nMeaning of scrub typhus\n\n(2) For the purposes of this Statement of Principles, scrub typhus means a clinical illness caused by Orientia tsutsugamushi, formerly known as Rickettsia tsutsugamushi.\n\nNote 1: Humans usually acquire the infection from the bite of an infected trombiculid mite (chigger).\n\nNote 2: Typical symptoms of scrub typhus include eschar at the bite site, high fever, headache, myalgia, cough, a rash and lymphadenopathy.\n\n(3) While scrub typhus attracts ICD‑10‑AM code A75.3, in applying this Statement of Principles the meaning of scrub typhus 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 scrub typhus\n\n(5) For the purposes of this Statement of Principles, scrub typhus, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's scrub typhus.\n\nNote: 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 scrub typhus and death from scrub typhus 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\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, scrub typhus or death from scrub typhus is connected with the circumstances of a person's relevant service:\n\n(1) being exposed to Orientia tsutsugamushi within the 28 days before the clinical onset of scrub typhus;\n\nNote: being exposed to Orientia tsutsugamushi is defined in the Schedule 1 - Dictionary. \n\n(2) inability to obtain appropriate clinical management for scrub typhus.\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 factor set out in subsection 9(2) applies only to material contribution to, or aggravation of, scrub typhus where the person's scrub typhus 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\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n area endemic for scrub typhus means Africa, the Middle East, South America and Islands of the Pacific, and the part of the world known as the \"tsutsugamushi triangle\" which extends from northern Japan and far-eastern Russia in the north, to northern Australia in the south, and to Pakistan in the west.\n\n being exposed to Orientia tsutsugamushi means:\n\n(a) being bitten by a trombiculid mite (chigger) infected with Orientia tsutsugamushi; or\n\n(b) being in an area that is endemic for scrub typhus; or\n\n(c) having percutaneous exposure to blood contaminated with Orientia tsutsugamushi; or\n\n(d) receiving a blood transfusion, blood products or a stem cell transplant contaminated with Orientia tsutsugamushi.\n\nNote: area endemic for scrub typhus is also defined in the Schedule 1 - Dictionary.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\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 scrub typhus—see subsection 7(2).\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":true,"description":"This instrument repeals the earlier Statement of Principles concerning scrub typhus No. 73 of 2009 (s.4) and replaces it with criteria focused on either documented exposure within 28 days of clinical onset or inability to obtain appropriate clinical management (s.9). It clarifies application to VEA and MRCA claims (s.5), defines endemic areas and exposure routes in Schedule 1, and explicitly treats certain terminal events as death from scrub typhus (Schedule 1)."},"complexity_factors":["Narrow, medical causation test with a fixed temporal trigger (exposure within 28 days before onset) (s.9(1)).","Alternative non‑exposure pathway based on health‑care access (inability to obtain appropriate clinical management) that requires evidentiary proof and is limited by timing rules (s.9(2); s.10(2)).","Relies on multiple defined terms and technical definitions in Schedule 1 (area endemic for scrub typhus; being exposed to Orientia tsutsugamushi; terminal event).","Cross‑references and priority rules: textual definition of scrub typhus overrides the ICD‑10‑AM code for application purposes (s.7(2)–(4)).","Interplay with other Statements of Principles where overlapping injuries/diseases occur, requiring cross‑application of factors (s.11).","Administrative and evidentiary burden on claimants to prove exposure, timing, or lack of appropriate care for service connection (ss.5, 9, 10).","Repeal and replacement of an earlier instrument (No. 73 of 2009) requires attention to transitional or precedent claims (s.4).","Includes death causation via proximate/ultimate causes (terminal events) which broadens causal pathways for mortality findings (Schedule 1)."],"plain_english_summary":"This instrument, made by the Repatriation Medical Authority, sets the medical criteria used to decide whether scrub typhus (caused by Orientia tsutsugamushi) or death from it is connected to a veteran’s relevant service for claims under the VEA or MRCA. It replaces the earlier 2009 Statement.\n\nTo establish connection on the balance of probabilities, a claimant must show either exposure to the organism within 28 days before symptom onset or an inability to obtain appropriate clinical management; the instrument also defines endemic areas, exposure routes and what counts as death from scrub typhus."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument maintains its original narrow purpose: establishing the medical factors for connecting scrub typhus to veterans' service. It is a direct replacement of the 2009 version with the same scope, updated only for current medical classification (ICD-10-AM Tenth Edition) and minor definitional refinements. No expansion into new claimant categories or conditions."},"complexity_factors":["Short, self-contained instrument (approximately 1,500 words)","Only 7 defined terms in the Dictionary (Schedule 1)","Simple binary structure: two alternative factors in section 9, either of which satisfies the test","Minimal cross-referencing — only refers to external legislation (VEA, MRCA) for context, not for operative provisions","No nested exceptions or conditional logic beyond the basic 'at least one factor' requirement","Clear, sequential numbering (sections 1–11) with plain language headings","Medical terminology is explained in notes (e.g., 'trombiculid mite (chigger)')","Single purpose instrument — does not amend other laws or create subordinate provisions"],"plain_english_summary":"This instrument sets the medical and legal test for linking scrub typhus — a mite‑borne bacterial infection common in parts of Asia and the Pacific — to Australian military service, updating earlier guidance. It affects veterans and current/former defence members claiming under the Veterans' Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004.\n\nIt clarifies the evidence needed (e.g., recent service exposure or lack of treatment), the balance‑of‑probabilities standard, and potential death benefits."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-scrub-typhus-balance-of-probabilities-no-78-of-2018","history":"/api/acts/statement-of-principles-concerning-scrub-typhus-balance-of-probabilities-no-78-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-scrub-typhus-balance-of-probabilities-no-78-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-scrub-typhus-balance-of-probabilities-no-78-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-scrub-typhus-balance-of-probabilities-no-78-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-scrub-typhus-balance-of-probabilities-no-78-of-2018/documents"}}