{"id":"F2025L01628","name":"Statement of Principles concerning smallpox (Balance of Probabilities) (No. 6 of 2026)","slug":"statement-of-principles-concerning-smallpox-balance-of-probabilities-no-6-of-2026","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":443105,"registerId":"F2025L01628-fast-fetch-1775958027915","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning smallpox (Balance of Probabilities) (No. 6 of 2026)","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\nSMALLPOX  (Balance of Probabilities)\n\n(No. 6 of 2026)\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 19 December 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 smallpox (Balance of Probabilities) (No. 6 of 2026).\n\n1.                Commencement\n\n\n              This instrument commences on 19 January 2026.\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 smallpox (Balance of Probabilities) (No. 90 of 2016) (Federal Register of Legislation No. F2016L01670) made under subsection 196B(3) of the VEA is repealed.\n\n1.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 smallpox and death from smallpox.\n\n\nMeaning of smallpox\n\n1.           For the purposes of this Statement of Principles, smallpox:\n  1.           means a clinical illness caused by infection with the variola virus, a member of the Orthopoxvirus genus, which has been confirmed by laboratory testing; and\n  2.           includes smallpox caused by infection with variola major or variola minor strains.\n\n\nNote: The most common clinical presentation of smallpox may include an acute onset of fever, prostration, headache, body aches and a vesicular or pustular rash, known as the ordinary form of smallpox caused by variola major virus.\n\n1.           While smallpox attracts ICD‑10‑AM code B03, in applying this Statement of Principles the meaning of smallpox 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 smallpox\n\n1.           For the purposes of this Statement of Principles, smallpox, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's smallpox.\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 smallpox and death from smallpox 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, smallpox or death from smallpox is connected with the circumstances of a person's relevant service:\n\n1.           being exposed to the variola virus by:\n  1.           having close contact with a person who has smallpox; or\n  1.           having direct contact with body fluids or tissue from a person infected with the variola virus; or\n  2.           having direct contact with a laboratory strain of the variola virus; or\n  3.           handling clothing, bedding, or objects contaminated with the variola virus; or\n  4.           having skin penetration by an instrument contaminated with the variola virus; or\n  5.            inhaling droplet nuclei or aerosols of the variola virus.   \n\n\nwhere variola virus exposure occurs within the 4 weeks immediately preceding clinical onset;\n\n1.           inability to access the appropriate smallpox vaccination in accordance with contemporary medical standards of the time, within the 2 years immediately preceding clinical onset;\n2.           being pregnant within the 6 weeks immediately preceding clinical onset of haemorrhagic type smallpox or death from smallpox;\n\n\nNote: haemorrhagic type smallpox typically involves a more severe clinical course, haemorrhage into skin lesions, multiorgan failure and is usually fatal.\n\n1.           inability to obtain appropriate clinical management for smallpox 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 clinical worsening aspect of factors set out in section 9 apply only to material contribution to, or aggravation of, smallpox where the person's smallpox 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                             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                               smallpox—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":"This instrument maintains the same narrow scope as its 2016 predecessor and the original intent of the Statements of Principles framework under the Veterans' Entitlements Act 1986. It deals solely with establishing the medical connection between smallpox and military service for compensation purposes. The 2026 version updates the instrument number and repeal reference but does not expand beyond the original purpose of providing disease-specific medical criteria for veterans' claims."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 5 defined terms in the Dictionary (MRCA, relevant service, smallpox, terminal event, VEA)","Clear, numbered structure with logical flow (Name → Commencement → Application → Definitions → Factors)","Limited cross-referencing — primarily internal references to the Dictionary and definitions within the instrument","Simple conditional logic: 'at least one of the following factors must exist' with straightforward time-based qualifiers (4 weeks, 2 years, 6 weeks)","Single purpose instrument dealing with one specific disease, avoiding the complexity of multi-condition instruments","No nested exceptions or complex deeming provisions — the 'clinical worsening' provision in section 10 is a standard limitation found in most Statements of Principles"],"plain_english_summary":"This instrument replaces the 2016 rules and sets medical criteria for when smallpox (variola virus infection) or death from smallpox is treated as connected to Australian military service. It applies to veterans and current or former defence members claiming under the Veterans' Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004.\n\nIt specifies the types of exposure and circumstances (eg. recent exposure, lack of vaccination, pregnancy, inadequate treatment) that can establish service connection on the balance of probabilities — important for historical claims despite global eradication."},"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 expressly repeals the Statement of Principles concerning smallpox (No. 90 of 2016) (s.4) and replaces it with the current criteria (commencing s.2). From the text provided, scope is now governed by the definitions, exposure routes, time windows and linking rules set out here (ss.7–11). The instrument itself does not include the earlier text, so specific differences in coverage or threshold compared with the 2016 Statement cannot be determined from this document alone."},"complexity_factors":["Laboratory confirmation requirement for smallpox (definition of smallpox requires confirmed infection) increases evidentiary burden (s.7(2)).","Time‑limited causal windows: exposure must occur within 4 weeks before onset; vaccination access assessed within 2 years; pregnancy window 6 weeks for haemorrhagic smallpox—these precise limits raise proof and timing complexity (s.9).","Multiple distinct exposure pathways listed (close contact, fluids/tissue, lab strain, contaminated fomites, skin penetration, inhalation) require different forms of proof and investigation (s.9(1)).","Interaction with other Statements of Principles means relevant factors may invoke criteria in other instruments, creating cross‑reference complexity (s.11).","Decision standard stated as 'balance of probabilities' and explicit medical‑scientific basis gives the Repatriation Medical Authority a technical evaluative role, requiring medical interpretation of evidence (s.8; overall instrument).","Relationship‑to‑service rules distinguish causation, aggravation and clinical worsening tied to timing of service, complicating causal analysis for pre‑existing infections (s.10).","Application limited to particular claim pathways under the VEA and MRCA, requiring familiarity with those statutory schemes and claim procedures (s.5; Schedule 1 definitions).","Repeal of the prior 2016 Statement means practitioners must use the new text, and may need to reinterpret existing claims against updated wording (s.4)."],"plain_english_summary":"This Statement of Principles sets the medical rules the Repatriation Medical Authority will use to decide whether laboratory‑confirmed smallpox (or death from it) is connected to a veteran's or serving member's relevant service for claims under the VEA and MRCA. It lists specific exposure routes and time windows, plus factors about vaccination access, pregnancy and clinical care, that—if proved on the balance of probabilities and tied to relevant service—can establish entitlement. The Authority's finding determines whether entitlements under the VEA or MRCA may apply."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-smallpox-balance-of-probabilities-no-6-of-2026","history":"/api/acts/statement-of-principles-concerning-smallpox-balance-of-probabilities-no-6-of-2026/history","analysis":"/api/acts/statement-of-principles-concerning-smallpox-balance-of-probabilities-no-6-of-2026/analysis","conflicts":"/api/acts/statement-of-principles-concerning-smallpox-balance-of-probabilities-no-6-of-2026/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-smallpox-balance-of-probabilities-no-6-of-2026/important-cases","documents":"/api/acts/statement-of-principles-concerning-smallpox-balance-of-probabilities-no-6-of-2026/documents"}}