Statement of Principles concerning hepatitis A infection (Reasonable Hypothesis) (No. 9 of 2024)

The instrument defines a closed set of legal‑medical concepts and links them to claim assessment. Central concepts are hepatitis A infection, death from hepatitis A infection, relevant service, exposure events, and the evidentiary windows and thresholds that create a “reasonable hypothesis” of service connection.

Hepatitis A infection. The operative definition is in subsection 7(2): infection with hepatitis A virus causing an acute, symptomatic clinical illness with liver inflammation and confirmed by laboratory testing for hepatitis A serological or nucleic acid markers. The instrument notes typical clinical features (fever, tiredness, anorexia, nausea, vomiting, abdominal discomfort, hepatomegaly and jaundice) (s7(2), note). Although the ICD‑10‑AM code B15 is acknowledged (s7(3)), the statutory meaning is that given in s7(2). Laboratory confirmation is therefore a threshold evidentiary requirement embedded in the definition.

Death from hepatitis A infection. Subsection 7(5) extends “hepatitis A infection” to encompass death from a terminal event or condition that was contributed to by the person’s hepatitis A infection. “Terminal event” is defined in the Schedule to include causes such as pneumonia, respiratory failure, cardiac arrest, circulatory failure and cessation of brain function (Schedule, terminal event). This makes explicit that death causation can be indirect: if hepatitis A materially contributed to a terminal event, the death is within scope.

Relevant service. The instrument applies to persons who rendered the forms of “relevant service” listed in the Schedule: operational, peacekeeping, hazardous, British nuclear test defence service under the VEA, and warlike or non‑warlike service under the MRCA (Schedule, relevant service). Section 5 states that the instrument applies to claims to which s120A VEA or s338 MRCA applies. The SoP therefore operates within the statutory claims architecture of the VEA and MRCA.

Factors that raise a reasonable hypothesis. Section 9 is the core: it prescribes the minimum factors that must exist for a reasonable hypothesis to be raised. The list in s9(1) is exposure‑based and specific about routes (shared living/work environment with an infected person (s9(1)(a)), contaminated food or water (s9(1)(b)), direct contact with contaminated faecal material (s9(1)(c)), direct physical contact with an infected human or primate (s9(1)(d)), percutaneous exposure to contaminated blood/body fluids (s9(1)(e)), and transfusion of contaminated blood/products (s9(1)(f))). Timing is specified: exposure must be between 15 and 50 days before clinical onset (s9(1)). Section 9(2) covers solid organ transplant from an infected donor within 4 months before onset. Sections 9(3) and 9(4) cover missed prevention and missed clinical management respectively, but these are framed by the standard “inability to access” and “inability to obtain” appropriate interventions in accordance with contemporary medical standards (s9(3)-(4), Schedule definition of post‑exposure prophylaxis).

Relationship to service. Section 10 requires that any factor in s9 be “related to the relevant service rendered by the person.” Section 10(2) places a precise limitation on s9(4), making that factor available only where the infection was suffered or contracted before or during, but did not arise out of, the person’s relevant service; in those cases s9(4) is confined to material contribution to or aggravation of hepatitis A infection.

Reference to other SoPs. Section 11 provides that where a factor in this SoP refers to an injury or disease already covered by another SoP, the factors in that other SoP apply according to its terms as in force, so the SoP can interact with other SoPs dynamically.

Administrative basis. Section 8 records the Repatriation Medical Authority’s view that “sound medical‑scientific evidence” indicates hepatitis A infection and death from it can be related to relevant service (s8). That is the Authority’s stated evidentiary foundation; the instrument itself, however, contains the legal criteria that adjudicators must apply when assessing whether a reasonable hypothesis is raised.

Key technical definitional terms are set out in the Schedule: post‑exposure prophylaxis means providing immunoglobulin or vaccine to a person exposed to an infectious agent, to prevent disease; terminal event is defined as above; MRCA and VEA are defined by name (Schedule, definitions).

Primary affected parties. The instrument directly affects persons making claims under the VEA or MRCA in relation to hepatitis A infection or death from hepatitis A infection. Section 5 says the SoP applies to claims to which s120A of the VEA or s338 of the MRCA applies. Those statutory claim pathways are the vehicle by which affected persons will seek to link illness or death to relevant service. The instrument therefore governs claimants who are veterans, members of Peacekeeping Forces or members of the Forces as defined under the VEA and MRCA (see s8 and Schedule definitions of relevant service).

Medical decision‑makers and claim assessors. The SoP is an evidentiary instrument issued by the Repatriation Medical Authority (s3). While the instrument does not itself adjudicate claims, it sets the medical criteria that decision‑makers applying the VEA or MRCA should use to decide whether a “reasonable hypothesis” of service connection exists. That affects medical assessors, statutory decision‑makers within the Department administering veterans’ entitlements and any tribunal or court that reviews decisions under those Acts, as they will take the SoP into account when applying the statutory test (s3, s9).

Healthcare providers. Although the SoP does not regulate clinical practice directly, it ties entitlement outcomes to clinical events and management: laboratory confirmation of infection (s7(2)), timing of exposures (s9(1)-(2)), and the availability or not of vaccination, immunoglobulin post‑exposure prophylaxis, or appropriate clinical management (s9(3)-(4), Schedule). Medical records, laboratory reports and contemporaneous clinical notes will be primary evidence in claims. Providers who maintain or can access such records are therefore relevant to claim preparation and adjudication.

Family or dependants in death claims. Where death is claimed to have been contributed to by hepatitis A infection, the SoP extends to death outcomes (s7(5)). The Schedule defines terminal events that can count as proximate or ultimate causes (pneumonia, respiratory failure, cardiac arrest, circulatory failure, cessation of brain function). Dependants and estate representatives making claims for death benefits will be affected because the SoP sets the nexus criteria for death caused or contributed to by hepatitis A infection.

Administrators of blood and organ systems. The factors include transfusion of contaminated blood or blood products (s9(1)(f)) and solid organ transplant from an infected donor (s9(2)). Operators of blood services, transplant services and procurement chains are indirectly implicated because incidents in those systems can be central to establishing a factor under the SoP. The SoP requires timing detail (transfusion exposure window 15-50 days before clinical onset; transplant within 4 months before onset), so record-keeping in those services will be important.

Policy and legislative actors. The Repatriation Medical Authority framed the instrument on the basis of its view of medical‑scientific evidence (s8). Parliament, Departments and Ministers who oversee the VEA and MRCA will have to accommodate this SoP in claims administration. The SoP also interacts with other Statements of Principles; where a factor in s9 refers to disease covered by another SoP, that other SoP’s factors apply as in force from time to time (s11). This means changes to other SoPs can affect how factors in this SoP are applied.

Incentive effects on claim behaviour. The presence of specific, bounded factors and timing windows (s9) clarifies for claimants what evidence is needed to raise a reasonable hypothesis. That clarity will focus evidence‑gathering efforts on laboratory confirmation, precise exposure histories and contemporaneous medical records showing inability to access vaccination, prophylaxis or clinical treatment. The SoP’s definitions and windows therefore shape the practical behaviour of claimants and their advisers.

What it does not do. The instrument does not specify benefits, payments or administrative processes beyond defining the medical criteria for a reasonable hypothesis. It does not itself adjudicate claims or provide detail on appeal rights. It does not list or cite the underlying medical studies; it records only the Authority’s view that there is “sound medical‑scientific evidence” (s8).

Who decides and what the standard is. The Repatriation Medical Authority made the SoP under its statutory power (s3). The instrument prescribes the criteria that must be present to raise a “reasonable hypothesis” connecting hepatitis A infection or death to relevant service (s9). The primary legal duty for decision‑makers under the VEA and MRCA is to apply these criteria when assessing claims to which those Acts’ specified claim provisions apply (s5). The SoP therefore places a duty on claim assessors to consider whether at least one of the s9 factors exists and is related to the claimant’s relevant service (s9, s10).

Evidentiary duties on claimants. The SoP establishes the factual elements that claimants must be able to demonstrate to raise a reasonable hypothesis. These include:

• laboratory confirmation of hepatitis A infection by serological or nucleic acid markers (s7(2));
• timing of exposure relative to clinical onset (exposure 15-50 days before clinical onset for the s9(1) exposures, s9(1) end);
• where relevant, evidence of a solid organ transplant from an infected donor within 4 months before clinical onset (s9(2));
• evidence of inability to access appropriate vaccination or post‑exposure prophylaxis before clinical onset in accordance with contemporary medical standards (s9(3) and Schedule definition of post‑exposure prophylaxis); and
• evidence of inability to obtain appropriate clinical management before clinical worsening where the infection was contracted before or during (but not arising out of) service (s9(4), s10(2)).

Duty to relate factor to service. Section 10(1) requires that any s9 factor relied upon must be related to the relevant service rendered by the person. This is the nexus element for a reasonable hypothesis: the factual factor must be connected to service. The SoP does not separately define how to prove the connection; that will be determined under the procedural framework of the VEA and MRCA and relevant claims practice, but the statutory text mandates that relationship.

Rights arising from the SoP. The instrument creates a legal framework that, if satisfied, supports a claimant’s right to have a reasonable hypothesis of service connection recognised for further administrative consideration under the VEA or MRCA. The SoP itself does not create or define entitlement to particular benefits; it defines the medical threshold that influences whether a claim proceeds.

Cross‑application of other SoPs. Section 11 creates a duty to apply other SoPs where a factor in s9 refers to an injury or disease already covered by another SoP, and to do so according to the terms of that other SoP “as in force from time to time”. This creates a duty for decision‑makers to keep the interaction between SoPs current when assessing claims.

Limitations and exclusions. The SoP limits a s9(4) reliance (inability to obtain appropriate clinical management) to circumstances where the infection was suffered or contracted before or during, but did not arise out of, the person’s relevant service (s10(2)). That places a definitional constraint on when clinical management failures can be used to establish a reasonable hypothesis of material contribution or aggravation.

Administrative expectations. The Authority records its evidentiary basis in s8, but the SoP itself sets out what must be proved to raise a reasonable hypothesis. Decision‑makers applying the VEA/MRCA have the right to evaluate compliance with the SoP’s specifics (laboratory confirmation, timing windows, link to relevant service). Claimants have the countervailing right to present evidence that satisfies those criteria.

No express enforcement provisions in the instrument. The SoP does not create criminal offences, civil penalties or administrative sanctions. Its operative effect concerns claim assessment under the VEA/MRCA framework. Enforcement and remedies remain governed by those Acts and their dispute resolution processes, which are not detailed in this instrument.

Scope of penalties. The Statement of Principles itself contains no penalty, sanction or criminal civil penalty regime. It is an evidentiary instrument made under subsection 196B(2) of the Veterans' Entitlements Act 1986 (s3). Its operation is to identify factors that will establish whether a reasonable hypothesis exists; it does not impose fines, imprisonment or administrative penalties. Any consequences that flow from an application of the SoP will occur within the operative administration of the VEA and MRCA, including acceptance or rejection of claims and any benefits, compensation or rehabilitation outcomes determined under those Acts. The SoP does not set those outcomes or sanctions.

Enforcement actors and mechanisms. The SoP was made by the Repatriation Medical Authority and is directed at decisions under the VEA and MRCA (s3, s5). Enforcement in the sense of ensuring the SoP is used properly will occur through the routine claim assessment, internal review, and merits and judicial review processes available under the VEA and MRCA and their associated administrative and court pathways. The SoP itself does not set or change those processes.

Evidentiary enforcement. The SoP enforces evidentiary thresholds by prescribing what facts, if established and related to relevant service, will raise a reasonable hypothesis (s9). This creates an evidentiary enforcement mechanism: claims that fail to establish laboratory confirmation of hepatitis A infection, timing connections, or inability to access vaccination/prophylaxis or clinical management in accordance with contemporary standards will ordinarily fail to raise a reasonable hypothesis. Adjudicators are therefore entitled to require and assess such evidence in the claim process.

Administrative compliance. Because the SoP cross‑refers to other SoPs where factors refer to injuries or diseases already covered, decision‑makers are required to apply those other SoPs “as in force from time to time” (s11). This creates an administrative obligation to monitor changes to other SoPs and to apply their terms when appropriate. Failure to do so could be raised as a procedural error in claim reviews or appeals, but the SoP itself does not create independent sanctioning powers.

No special investigative powers. The instrument does not confer investigative powers, information‑gathering authorities or compulsory production powers. Any evidence gathering to establish the SoP criteria will rely on existing powers and processes under the VEA, MRCA and other general law mechanisms.

Practical consequence for non‑compliance. The practical enforcement consequence of failing to meet the SoP criteria is that a claim will not meet the legal threshold of a reasonable hypothesis that the condition is connected to relevant service. That outcome affects entitlement determinations under the VEA or MRCA. The SoP therefore functions as an administrative gatekeeper: compliance with its factual requirements is a precondition to further favourable claim consideration.

No administrative discretion in the text to extend timing windows. The SoP specifies timing windows and definition requirements (laboratory confirmation, exposure windows, transplant window) without textual delegation for extension. Decision‑makers applying the SoP will have to work within those prescribed parameters unless another statutory mechanism in the VEA or MRCA provides otherwise; the SoP itself does not provide discretion to alter those thresholds.

Statutory context. The SoP is made under subsection 196B(2) of the VEA (s3) and applies to claims to which s120A of the VEA or s338 of the MRCA apply (s5). It operates as a medical‑legal instrument within the statutory claims framework of those Acts. The SoP does not displace the substantive operation of the VEA or the MRCA; rather it provides the medical criteria that decision‑makers use in assessing whether a reasonable hypothesis of service connection exists. The instrument therefore interacts with those Acts by informing the medical nexus inquiry central to many claim decisions.

Interaction with other Statements of Principles. Section 11 sets a specific interaction rule: if a factor in s9 refers to an injury or disease covered by another SoP determined under subsection 196B(2) of the VEA, then the factors in that other SoP apply in accordance with its terms “as in force from time to time.” Practically, this means that where, for example, a route of exposure or a co‑condition is already covered by a separate SoP, adjudicators must consult and apply that other SoP’s provisions. The cross‑application therefore creates a dynamic link: amendments to other SoPs can alter how factors in this SoP are applied.

Medical coding and clinical definitions. While the SoP recognises ICD‑10‑AM code B15 for hepatitis A infection, it makes clear that the operative meaning is the clinical and laboratory definition in s7(2) (s7(3)). The instrument refers to a specific edition of ICD‑10‑AM (Tenth Edition effective 1 July 2017) for coding references (s7(4)). This means that clinical documentation and coding practices may be relevant to claim evidence, but the legal test remains the statutory clinical definition.

Interaction with public health and clinical standards. Sections 9(3) and 9(4) require assessment against “contemporary medical standards” when determining inability to access appropriate vaccination, post‑exposure prophylaxis or clinical management. The Schedule defines post‑exposure prophylaxis as immunoglobulin or vaccine provided after exposure. The SoP therefore requires assessors to judge evidence in light of prevailing clinical standards at the time of exposure or onset. That invites interaction with public health guidelines, vaccine availability and accepted clinical practice, though the SoP does not itself set or define those medical standards.

Overlap with blood and transplant system rules. Because s9(1)(f) covers contaminated transfusions and s9(2) covers solid organ transplants from infected donors, the SoP will interact with laws and regulations governing blood safety, transfusion practice and transplant donor screening. Records and practices from those regulated systems will be relevant evidence in establishing whether the factor is present and temporally related to onset.

No conflict resolution mechanism in the SoP. The instrument does not provide a hierarchical rule for resolving conflicts between it and other statutory provisions. It operates as a specialised evidentiary instrument to be applied within the VEA and MRCA frameworks. Where there is tension between the SoP and the parent Acts or other laws, the Acts themselves and administrative or judicial review channels will determine the resolution. The SoP’s s11 cross‑reference means decision‑makers must account for other SoPs where relevant.

Temporal application and effect of amendments. Section 11’s “as in force from time to time” language means that the SoP’s application may change if other SoPs are amended. The SoP itself has a commencement date (s2) and repeals the prior 2015 SoP (s4); thus the legal regime governing claims is time‑dependent and requires administrators and claimants to consider which SoP was in force at relevant times and whether changes affect ongoing or new claims.

No mention of overlap with worker compensation or non‑veteran statutory schemes. The instrument is limited to the VEA and MRCA context (s5). It does not address interactions with State worker compensation schemes, public health compensation schemes, or private insurance. Any such interactions would need to be managed outside the terms of this SoP.

Express repeal and replacement. The instrument expressly repeals the Statement of Principles concerning hepatitis A No. 63 of 2015 (Federal Register of Legislation No. F2015L00645) made under subsection 196B(2) of the VEA (s4). The instrument therefore replaces the 2015 SoP with the current text. The instrument is numbered No. 9 of 2024 and dated 22 December 2023 (cover sheet and s1), and it commences on 22 January 2024 (s2).

Authority for amendment. The Repatriation Medical Authority made the instrument under subsection 196B(2) of the VEA (s3). The instrument therefore follows the statutory process by which the Authority issues Statements of Principles. The instrument does not set out the internal decision‑making process or the evidentiary materials relied on; it records only the Authority’s view that there is “sound medical‑scientific evidence” linking hepatitis A infection and death to relevant service (s8).

No textual history beyond repeal. The instrument does not contain a schedule of amendments, notes on changes from the 2015 SoP, or legislative history detail. The only explicit amendment history recorded in this text is the repeal of the 2015 SoP (s4) and the new commencement date (s2). Any further legislative or policy background to the change is not contained in this instrument.

Implications of “as in force from time to time”. Section 11 requires that where a factor in s9 refers to an injury or disease covered by another SoP, decision‑makers apply that other SoP “as in force from time to time”. This language makes the SoP’s operational effects contingent on future amendments to other SoPs: subsequent amendments to those instruments will affect how cross‑referenced factors are assessed without any amendment to this SoP. That is an ongoing amendment‑interaction mechanism embedded by cross‑reference, rather than a direct amendment to this SoP.

No transitional provisions in the text. The instrument does not include express transitional rules for claims that straddle the repeal of the 2015 SoP and the commencement of this instrument. It simply repeals the 2015 SoP (s4) and sets the commencement date (s2). Application to particular claims will therefore be governed by the VEA and MRCA and by administrative practice regarding which SoP applies to claims made after commencement; the instrument itself does not set transitional application rules.

Record of authority action. The instrument includes the Authority’s seal and a signature block indicating the Chairperson affixed the Common Seal at the direction of Professor Terence Campbell AM (cover sheet). That indicates formal execution and provides the documentary record of the instrument’s issuance.

No further amendments recorded. The instrument does not record any amendments after its execution. Any future amendments would be reflected in later instruments or notices but are not part of this text.

No cases or litigation history are supplied in the instrument. The Statement of Principles itself contains no reference to any court or tribunal decisions, and it does not name or rely on specific judicial authorities. Section 8 records the Authority’s view that there is “sound medical‑scientific evidence” linking hepatitis A infection and death from hepatitis A infection to relevant service, but the instrument does not cite, summarise or annex the studies, expert reports or litigation that might underlie that view (s8).

Implication for legal research. Because the instrument contains no litigation references, practitioners must look to the VEA, MRCA and any adjudicative decisions under those Acts for precedential material on how Statements of Principles are used in disputes. This instrument does not itself provide case law or examples of how claim assessors, review bodies or courts have applied similar SoPs in practice.

Potential sources of challenge (procedural). While the SoP does not include litigation history, potential grounds for litigation in other contexts typically arise from: disagreement about the application of a SoP to particular facts; procedural fairness in the way the SoP was applied by decision‑makers; or contesting the interpretation of “contemporary medical standards” or timing windows. The instrument does not itself record such challenges. Any litigation concerning this SoP would likely be located in the administrative law and merits review pathways established under the VEA and MRCA; the instrument does not change those pathways.

No statutory appeals or dispute resolution detailed. The instrument does not set out appeals, review rights or dispute resolution mechanisms. Those remain the domain of the VEA and MRCA statutory frameworks. Any litigation history relevant to the application of this SoP will therefore be found in decisions under those parent Acts and not in the SoP itself.

Absence of named expert reports or committee records. The SoP’s stated basis in “sound medical‑scientific evidence” (s8) is not accompanied by references to expert reports, scientific literature or committee deliberations in the instrument text. If litigants seek to challenge the SoP or decisions founded on it, they will need to trace the Authority’s underlying material through administrative records or Freedom of Information processes rather than through the SoP itself.

Advice for litigators. Given the instrument’s silence on litigation, practitioners should assume that any legal challenge to the application of the SoP will turn on: the sufficiency of the evidentiary material presented in a claim to meet the s9 factors and the relationship to relevant service under s10; the interpretation and application of defined terms such as “contemporary medical standards” and “post‑exposure prophylaxis”; and any procedural or jurisdictional issues arising from the way decision‑makers applied the SoP in individual cases. The SoP itself offers no direct litigation record.

Timing windows are strict and determinative. Section 9 sets precise timing requirements that are central to whether an exposure factor will raise a reasonable hypothesis. For the exposure modes listed in s9(1) the instrument requires hepatitis A virus exposure to have occurred between 15 and 50 days before clinical onset. For solid organ transplant, the transplant must have been within 4 months before clinical onset (s9(1)-(2)). Missing or imprecise onset dates, incomplete exposure records, or delayed laboratory confirmation can make it difficult to satisfy these temporal thresholds. Claimants and assessors must align exposure and onset dates to these windows; failure to do so may result in the factor not being established.

Laboratory confirmation is a threshold requirement. The definition of hepatitis A infection in s7(2) requires that the acute symptomatic illness be confirmed by laboratory testing for hepatitis A serological or nucleic acid markers. Absent such laboratory proof, the statutory definition is not met even if symptoms are consistent with hepatitis A (s7(2)). Relying solely on clinical features or coding (ICD‑10‑AM) is insufficient because s7(3) clarifies that the operative meaning is the laboratory‑confirmed clinical definition. Practitioners should ensure laboratory reports are available and accurately linked to clinical onset.

“Contemporary medical standards” introduces a moving target. Sections 9(3) and 9(4) require inability to access vaccination, post‑exposure prophylaxis or appropriate clinical management “in accordance with contemporary medical standards.” This phrase imports a contextual standard that may vary by time and place. The SoP does not define how to identify or fix those standards. Claimants will need contemporaneous public health guidance, clinical protocols or expert evidence to show what the standard was at the relevant time and that access was not available consistent with that standard.

s9(4) limitation is narrow and conditional. Section 10(2) narrows the application of the s9(4) factor: inability to obtain appropriate clinical management applies only to material contribution to, or aggravation of, hepatitis A infection where the infection was suffered or contracted before or during (but did not arise out of) the person’s relevant service. That means if the infection “arose out of” the person’s service, s9(4) is not available as a route to establish material contribution or aggravation. This is a subtle drafting point that may trap claimants who attempt to rely on clinical management failures without checking whether the infection was contracted as a result of service activities.

Cross‑references to other SoPs can change outcome. Section 11 requires that where a s9 factor refers to an injury or disease covered by another SoP, the terms of that other SoP apply “as in force from time to time.” A change in another SoP after the date of this instrument may alter how a s9 factor is treated. Practitioners must check all potentially relevant SoPs current at the time of claim assessment rather than relying solely on this instrument’s text.

Transfusion and transplant traces may be hard to obtain. Factors include contaminated transfusion (s9(1)(f)) and transplant from an infected donor (s9(2)). Establishing contamination and donor infection status within precise windows requires access to blood service records, donor testing results and transplant documentation. Those records may be held by third parties and subject to privacy rules or archival issues, which can complicate proof.

Definition of death causation is proximate or contributory, not limited to immediate cause. Section 7(5) extends the scope to death from a terminal event or condition that was “contributed to” by hepatitis A infection. The Schedule defines terminal events broadly (pneumonia, respiratory failure, cardiac arrest, circulatory failure, cessation of brain function). This means hepatitis A need not be the immediate cause of death; contribution to a terminal event is sufficient. However, claimants must show the contribution, which could require medical opinion linking past hepatitis A infection to the terminal event listed.

ICD coding is secondary to statutory definition. Although s7(3) notes that hepatitis A infection attracts ICD‑10‑AM code B15, the instrument states that the meaning for these purposes is the laboratory‑confirmed clinical definition in s7(2). Reliance on hospital coding alone without laboratory markers and recorded clinical onset will not satisfy the statutory definition.

No express transitional rules for claims straddling repeal. The repeal of the 2015 SoP is addressed in s4, and the new SoP commences on a stated date (s2). The instrument does not provide transitional provisions explaining how claims that span the repeal date are to be treated. Practitioners should check administrative practice and relevant sections of the VEA and MRCA for guidance.

Practical evidentiary burden. The SoP clarifies what evidence is relevant but does not allocate who bears the evidentiary burdens in particular proceedings. Administrative practice under the VEA and MRCA determines procedural burdens; the SoP provides the factual ingredients that need to be shown.

“Post‑exposure prophylaxis” narrowly defined. The Schedule defines post‑exposure prophylaxis as provision of immunoglobulin or a vaccine to prevent disease after exposure. If a claimant alleges other prophylactic measures or non‑standard interventions, they may fall outside the Schedule definition and thus outside s9(3)’s scope.

No express discretion in the SoP to override technical failures. The SoP’s wording suggests rigid thresholds (timing windows, laboratory confirmation) without built‑in exceptions. Decision‑makers will be required to apply these criteria literally unless other statutory mechanisms in the VEA or MRCA permit a different approach.

Evidence collection plan. To meet the SoP’s requirements, assemble the following main categories of evidence: laboratory confirmation of hepatitis A infection (serological or nucleic acid markers) linked to the person’s clinical illness (s7(2)); detailed chronology linking exposure events to clinical onset with dates sufficient to test the 15-50 day exposure window (s9(1)); documentation of any transfusions or solid organ transplants with donor status and timing evidence (s9(1)(f), s9(2)); contemporaneous records showing attempts to access vaccination, post‑exposure prophylaxis or clinical management and that such access was unavailable in accordance with the relevant contemporary medical standards (s9(3)-(4), Schedule definition of post‑exposure prophylaxis); and, where death is claimed, medical records and expert opinion linking hepatitis A infection to the terminal event or condition that contributed to death (s7(5), Schedule definition of terminal event).

Pin down onset and exposure dates. Given the 15-50 day exposure window in s9(1) and the 4‑month window for transplants in s9(2), it is essential to establish reliable dates for symptom onset and for any putative exposure. Extract precise dates from hospital notes, general practice records, laboratory result timestamps, blood transfusion logs and transplant records. Where onset dates are uncertain, obtain expert medical opinion interpreting the clinical timeline against the SoP windows.

Secure laboratory evidence. Ensure that serology or nucleic acid test reports used to confirm hepatitis A infection are included, with sample collection dates and test types specified (s7(2)). The SoP makes laboratory confirmation part of the definition; absence of such reports will prevent satisfaction of the definition regardless of symptoms.

Document attempts to access prevention and treatment. For s9(3) and s9(4) claims concerning inability to access vaccination, post‑exposure prophylaxis or clinical management, compile contemporaneous records showing requests for vaccination, referrals, communications with public health units or military medical services, supply interruption notices, or other documentation demonstrating lack of access. Provide contemporaneous public health guidelines, military immunisation policies or clinical protocols in force at the relevant time to establish what “contemporary medical standards” required (s9(3)-(4)). If possible, obtain statements from treating clinicians or public health officers confirming the standard and that the claimant could not access it.

Trace transfusion and transplant records. For transfusion/transplant claims (s9(1)(f), s9(2)), request blood service traceability reports, transfusion reaction reports, donor testing records and transplant donor screening documentation. Where contaminated blood or an infected donor is alleged, obtain the relevant test results and dates to link donor infection to the recipient’s clinical onset.

Link factors to relevant service. Section 10(1) requires that a s9 factor be related to the person’s relevant service. Assemble service records, deployment location logs, accommodation records showing living quarters or immediate work environment, peacekeeping or deployment rosters, and other administrative records demonstrating the presence of the claimant in the location and timeframe corresponding to the exposure. For the s9(4) limitation, confirm whether the infection was contracted before or during, but did not arise out of, service (s10(2)) because s9(4) applies only in that narrow scenario.

Obtain expert medical opinion where factual complexities exist. Use clinical experts to explain incubation timing, the plausibility of exposure routes given the claimant’s service environment, the significance of any delays in access to vaccination or treatment, and whether hepatitis A infection could have materially contributed to a terminal event for death claims. Experts can translate clinical records into findings that fit the SoP criteria.

Check other SoPs and current versions. Because s11 requires application of other SoPs “as in force from time to time” when factors refer to diseases covered elsewhere, identify any cross‑referenced SoPs and confirm their current text. If a s9 factor refers to another disease or injury, ensure evidence also meets that other SoP’s criteria.

Prepare for potential gaps. Anticipate evidentiary gaps such as missing lab reports or incomplete service records. Where primary records are missing, gather secondary corroboration: contemporaneous witness statements, unit logs, medical evacuation records, supplier or pharmacy records showing vaccine unavailability, or official communications about outbreaks. Where such evidence is used, support it with reasoned medical opinion tying the secondary evidence to the SoP criteria.

Document the standard applied. For s9(3)-(4) involving “contemporary medical standards,” identify and include contemporaneous clinical guidelines, WHO or Australian public health guidance, military immunisation policies, or hospital protocols that establish what was considered appropriate prophylaxis or clinical management at the relevant time.

For death claims, assemble cause‑of‑death and terminal event evidence. Include death certificates, autopsy reports if available, treating clinician opinions, and evidence linking prior laboratory‑confirmed hepatitis A infection to the terminal event or condition listed in the Schedule (pneumonia, respiratory failure, etc.) (s7(5), Schedule).

Coordinate with record holders. Where critical records are held by third parties (blood services, transplant centres, military units, public health authorities), obtain consent and use statutory channels where necessary to secure access. Be mindful of privacy rules and any statutory disclosure mechanisms available under the VEA/MRCA administration.

Maintain contemporaneous claim narratives. Prepare a clear chronology and statement of the facts that maps service, exposure, clinical onset, laboratory confirmation, and attempts to obtain vaccination or treatment onto the SoP’s elements. Explicitly address each relevant subparagraph of s9 and the relationship requirement in s10.

Monitor for updates to other SoPs. Because s11 imports other SoPs’ terms, monitor the Federal Register of Legislation and the Repatriation Medical Authority’s releases for amendments to related SoPs which might change the evidentiary landscape.

Record execution details. Given the SoP’s effective dates (instrument dated 22 December 2023 and commences 22 January 2024; s1-s2), note which SoP was operative at the time the claim is lodged and whether the claim relates to exposures or clinical events before or after commencement. The instrument itself does not give transitional rules, so administrative guidance or legal advice may be needed for claims overlapping the repeal and commencement dates.

Engage early specialist assistance. Because the SoP frames technical medical and timing requirements, engagement with clinicians experienced in infectious disease, public health, transfusion medicine or transplant medicine and with experience preparing medico‑legal reports for VEA/MRCA claims will materially assist in meeting the SoP’s thresholds.