{"id":"F2018L01162","name":"Statement of Principles concerning scrub typhus (Reasonable Hypothesis) (No. 77 of 2018)","slug":"statement-of-principles-concerning-scrub-typhus-reasonable-hypothesis-no-77-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439728,"registerId":"F2018L01162-fast-fetch-1775955639842","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning scrub typhus (Reasonable Hypothesis) (No. 77 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 (Reasonable Hypothesis)\n\n(No. 77 of 2018)\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 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:
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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 (Reasonable Hypothesis) (No. 77 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning scrub typhus No. 72 of 2009 (Federal Register of Legislation No. F2009L04043) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that scrub typhus and death from scrub typhus 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 scrub typhus or death from scrub typhus 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(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 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) 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 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":{"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument maintains its original narrow purpose: establishing the specific causal factors for scrub typhus claims. It replaces the 2009 version without expanding into new areas of law or medical conditions."},"complexity_factors":["Short, single-purpose instrument (11 sections plus dictionary)","Only 7 defined terms in Schedule 1","Simple binary test structure: one of two factors must exist (section 9)","Limited cross-referencing — primarily internal references to the Dictionary and standard veterans' legislation acronyms (VEA, MRCA)","Clear conditional logic with only one nested limitation (subsection 10(2) restricts the 'inability to obtain treatment' factor to pre-existing conditions)","Medical terminology is explained in plain English (e.g., 'tsutsugamushi triangle' defined geographically, symptoms listed in notes)"],"plain_english_summary":"This instrument sets the test for linking scrub typhus (Orientia tsutsugamushi) to Australian defence service under the \"reasonable hypothesis\" standard, replacing the 2009 rules. It applies to veterans, peacekeepers and current/former defence members claiming under the VEA and MRCA.\n\nA claim succeeds if service involved exposure to the bacteria within 28 days before symptoms (including mite bites or being in endemic areas) or if the person couldn’t access appropriate treatment (the treatment rule only if illness began before or during service)."},"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":3,"scope_assessment":{"changed":true,"description":"This instrument repeals the earlier Statement of Principles No. 72 of 2009 and reissues criteria for linking scrub typhus to relevant service (s4). The instrument itself establishes the operative factors (exposure within 28 days and lack of appropriate clinical management), definitions of exposure and endemic areas, and inclusion of death via terminal events (s7, s9, Schedule 1). Without the prior text it is not possible from this instrument alone to identify specific substantive differences between the old and new statements."},"complexity_factors":["Small number of discrete causal factors to establish a 'reasonable hypothesis' (s9) — reduces statutory complexity but places weight on factual proof.","Short temporal window for presumptive exposure (28 days before onset) requires precise clinical timing and record evidence (s9(1)).","Definition-heavy Schedule (area endemic, exposure modes, terminal events) requires cross-checking medical and geographic facts (Schedule 1).","Application limited to 'relevant service' categories under VEA/MRCA, so service classification evidence is required (s5, Schedule 1 'relevant service').","Includes death via contribution to a terminal event; medical causation may need expert interpretation to link scrub typhus to listed terminal events (s7(5), Schedule 1 'terminal event').","Cross-reference to other Statements of Principles for overlapping injuries/diseases introduces dependency on other instruments and potential interaction effects (s11).","Administrative effect: instrument repeals prior Statement and replaces it (s4), creating an implementation step for claims in transition.","Standard set is 'reasonable hypothesis' backed by sound medical‑scientific view (s8) — statutory discretion for medical assessors remains significant."],"plain_english_summary":"This instrument sets the medical criteria the Repatriation Medical Authority uses to decide whether scrub typhus (infection by Orientia tsutsugamushi) or death from it can be reasonably linked to a veteran's relevant service for VEA/MRCA claims. It identifies two primary connecting factors — exposure within 28 days before clinical onset, and inability to obtain appropriate clinical management — and defines exposure routes and endemic areas that claimants and decision‑makers must consider when assessing entitlement."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-scrub-typhus-reasonable-hypothesis-no-77-of-2018","history":"/api/acts/statement-of-principles-concerning-scrub-typhus-reasonable-hypothesis-no-77-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-scrub-typhus-reasonable-hypothesis-no-77-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-scrub-typhus-reasonable-hypothesis-no-77-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-scrub-typhus-reasonable-hypothesis-no-77-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-scrub-typhus-reasonable-hypothesis-no-77-of-2018/documents"}}