Statement of Principles concerning hepatitis D infection (Balance of Probabilities) (No. 72 of 2025)

The instrument organises around legal-medical concepts that govern causal attribution for compensation claims. The principal concepts in the text are: the disease definition, evidence threshold, causation factors, temporal rules for onset and exposure, interaction with vaccination and clinical management, the notion of relevant service, and incorporation of other Statements of Principles.

Disease definition and scope. "Hepatitis D infection" is defined as infection with hepatitis D virus occurring as a co‑infection or superinfection with hepatitis B virus, resulting in an illness characterised by liver inflammation, and confirmed by laboratory testing for hepatitis D serological or nucleic acid markers. The definition expressly includes both acute and chronic hepatitis D (s7(2)(a)-(b)). The text notes typical signs and symptoms of acute infection and explains that chronic infection is an infection lasting at least 6 months with possible fibrosis over time (notes to s7). The instrument also clarifies that death from a terminal event or condition contributed to by hepatitis D infection is treated as included in the disease concept (s7(4); Schedule 1 definition of "terminal event").

Evidence threshold and standard of proof. The instrument's title and s8 frame the causation standard as balance of probabilities. Section 8 states that, on the sound medical‑scientific evidence available, the Authority is of the view that it is more probable than not that hepatitis D infection and death from it can be related to relevant service rendered by veterans or members under the VEA and MRCA. That establishes the internal standard used by the Authority when setting the medical causal factors, and it requires claimants to meet at least the "balance of probabilities" threshold in any assessment that applies the Statement.

Causation factors. Section 9 lists the alternative factors any one of which must be present to connect the infection to service. These factors fall into exposure events (s9(1)); host status at onset, specifically concurrent hepatitis B infection (s9(2)); preventive-care access issues, namely inability to access appropriate hepatitis B vaccination or appropriate post-exposure prophylaxis before clinical onset, measured against "contemporary medical standards" (s9(3); Schedule 1 definition of post‑exposure prophylaxis); and inability to obtain appropriate clinical management for hepatitis D infection before clinical worsening (s9(4)). The exposure factor includes percutaneous or permucosal exposure to body substances derived from a person infected with hepatitis D at least 14 days before clinical onset and specifies what counts as body substances (note to s9(1)).

Temporal and definitional controls. "Clinical onset" is defined in the Schedule as the point obtained by working backwards from the date of the first laboratory confirmation of hepatitis D serological or nucleic acid markers to the date when symptoms were persistently present as assessed by a registered medical practitioner (Schedule 1). The instrument notes that usually the laboratory confirmation date will be after clinical onset (note to s7(2)). The exposure factor requires the exposure to have occurred at least 14 days before clinical onset (s9(1)).

Relationship to service and cross-application. Section 10 requires the existence of any factor listed in s9 to be related to the person's relevant service as defined in the Schedule (for example, eligible war service, defence service other than hazardous service and British nuclear test defence service under the VEA, or peacetime service under the MRCA) (Schedule 1 definition of "relevant service"; s10(1)). Section 10(2) narrows the reach of s9(4): inability to obtain appropriate clinical management applies only to material contribution to or aggravation of hepatitis D infection where the infection was suffered or contracted before or during, but did not arise out of, the person's relevant service. Section 11 provides that if a factor in s9 refers to an injury or disease covered by another Statement of Principles, the factors in that other Statement then apply as in force from time to time.

ICD code cross-reference. The instrument references ICD‑10‑AM codes B16.0, B16.1, and B18.0 as the codes that hepatitis D infection attracts but states that the operative meaning for the Statement is the textual definition given in s7(2) (s7(6)-(7)). It also specifies the edition of ICD‑10‑AM referenced (Tenth Edition, effective date 1 July 2017) and attributes copyright to the Independent Hospital Pricing Authority (s7(7)).

Administrative and statutory context. The instrument is made under s196B(3) of the VEA (s3) and applies to claims falling under s120B of the VEA or s339 of the MRCA (s5). It repeals the prior 2017 Statement on hepatitis D (s4). The Statement therefore operates as a medical causation standard within the statutory claims framework rather than as an autonomous regulatory instrument imposing obligations on third parties.

Directly affected claimants. The Statement applies to persons making claims under statutory provisions: it explicitly applies to claims to which section 120B of the VEA or section 339 of the MRCA applies (s5). That ties the instrument to veterans or members of the Forces seeking treatment, compensation, or recognition within the VEA/MRCA claims processes. A person with hepatitis D infection or a death where hepatitis D contributed will be affected when their case is assessed for connection with "relevant service" as defined in the Schedule (Schedule 1 definition of "relevant service"; s10(1)).

Decision-makers and medical assessors. The Repatriation Medical Authority made the Statement (s3) and sets the medical findings. Administratively, the Statement is designed to be applied by decision-makers undertaking claim assessments under the VEA and MRCA. While the instrument does not name specific administrative decision bodies beyond the Authority, its role is to guide medical causation determinations used in those statutory processes. Registered medical practitioners will play an evidentiary role since "clinical onset" requires assessment by a registered medical practitioner (Schedule 1).

Medical providers and hospital record keepers. The Statement makes documentary medical evidence material. Laboratory confirmation of hepatitis D serological or nucleic acid markers is required in the definition of hepatitis D infection (s7(2)(a)). Medical records that document symptoms, dates of persistent symptoms, hepatitis B status at time of clinical onset, vaccination history, attempts to access post‑exposure prophylaxis, and the timing of clinical management relative to clinical worsening are all relevant to satisfying the factors in s9.

Veterans and defence administrative systems. The instrument interacts with administrative records of service. "Relevant service" is defined in the Schedule and includes categories of service under the VEA and MRCA (Schedule 1). Therefore, proof or dispute over whether an applicant's service falls within those categories will determine whether the Statement applies to that person's claim (s5; Schedule 1 definition of "relevant service").

Family members and dependants in death cases. The Statement explicitly includes death from a terminal event or condition contributed to by hepatitis D infection within its scope (s7(4); Schedule 1 definition of "terminal event"). Thus, dependants and estates pursuing claims in which death is alleged to have been contributed to by hepatitis D infection will be affected by the Statement's definitions and factors.

Other Statements of Principles and medical domains. The instrument contemplates cross-reference to other Statements of Principles: if a factor in s9 refers to an injury or disease covered by another Statement, that other Statement's factors apply (s11). That can affect claimants where co-morbid conditions or sequelae tie the case into other established Statements.

No criminal or civil third-party obligations imposed. The instrument does not create criminal offences, private civil causes of action, or regulatory compliance obligations on non-claimant third parties. Its effect is within the VEA/MRCA claims environment. It does not impose duties on private employers, health services, or other third parties within the text provided.

Nature of rights created by the Statement. The instrument itself does not grant monetary entitlements or administrative procedure rights directly; rather it establishes the medical factors that must be satisfied for a finding that hepatitis D infection or death from it is connected with relevant service on the balance of probabilities (s8; s9). The person's substantive right to have a claim treated under this Statement derives from the interaction between the Statement and the statutory claims processes of the VEA and MRCA, which the instrument expressly targets by application (s5).

Obligations on claimants for evidentiary proof. Practically, the Statement places an evidentiary duty on claimants seeking a connection to show that at least one of the factors in s9 exists and that the factor is related to their relevant service (s9; s10(1)). The Statement requires laboratory confirmation of hepatitis D serological or nucleic acid markers as part of the disease definition (s7(2)(a)). The Schedule requires "clinical onset" to be assessed by a registered medical practitioner, which imposes a requirement that medical opinion evidence be tendered to establish timing of onset relative to confirmation and exposures (Schedule 1 definition of "clinical onset"). For factors concerning inability to access vaccination, post‑exposure prophylaxis, or clinical management, claimants will need factual proof supporting those assertions, because the instrument makes those unavailability factors themselves the grounds for finding service connection (s9(3)-(4)).

Decision-maker duties. The Repatriation Medical Authority is the statutory authority that has made the Statement (s3). The Statement creates a duty on decision-makers applying the VEA/MRCA claims framework to adopt these medical findings when assessing claims that fall under the specified statutory sections (s5). The instrument also provides that if a factor in s9 refers to a condition covered by another Statement of Principles, then that other Statement applies as in force from time to time (s11), thereby placing a duty on decision-makers to cross-apply other Statements where relevant.

Temporal and interpretive obligations. The instrument requires an interpretation of "contemporary medical standards" when assessing inability to access vaccination or appropriate post‑exposure prophylaxis (s9(3); Schedule 1 definition of "post-exposure prophylaxis"). This imposes an interpretive task on decision-makers to assess what constitutes appropriate vaccination or prophylaxis at the time before clinical onset. Similarly, the Schedule's definition of "clinical onset" sets an evidentiary procedure for establishing onset by working backwards from laboratory confirmation to the date when symptoms were persistently present, as assessed by a registered medical practitioner (Schedule 1), obliging claimants and decision-makers to use that frame for timing analyses.

Limits on applicability of specific factors. Section 10(2) circumscribes the operation of s9(4), the inability to obtain appropriate clinical management factor. It applies only to material contribution to, or aggravation of, hepatitis D infection where the infection was suffered or contracted before or during, but did not arise out of, relevant service. This limits the rights claimants can derive from s9(4) to particular factual scenarios and imposes a duty on decision-makers to assess the sequence of events that determine whether s9(4) can be applied.

No penalties or enforcement obligations in the text. The Statement does not create penal duties, fines, or enforcement mechanisms directed at claimants, medical practitioners, or third parties. Its effect is procedural and evidentiary within the VEA/MRCA decision-making architecture (s3; s5). Decision-makers retain their usual statutory duties under the VEA and MRCA to determine entitlement, but those are external to the Statement text.

No penal provisions in the instrument. The Statement of Principles, as provided, contains no provisions creating criminal offences, civil penalties, administrative fines, or other sanctions. It is a medical‑causation instrument that sets out the factual and medical factors decision-makers must apply when assessing claims under specified statutory provisions (s3; s5). The text does not allocate enforcement powers or specify compliance penalties for non‑compliance with medical or administrative obligations.

Enforcement effect is indirect via claims decision-making. The practical enforcement mechanism is the incorporation of the Statement into the VEA/MRCA claims adjudication process. Because the Statement applies to claims to which s120B of the VEA or s339 of the MRCA applies (s5), decision-makers charged with determining entitlement under those sections will apply the Statement as a determinative medical framework. The "enforcement" therefore occurs when a claims decisionmaker accepts or rejects a claim on the basis of whether the factors in s9 are satisfied and related to relevant service, using the standard of proof implicit in the Statement (s8).

No new investigatory or sanction powers granted. The instrument does not grant the Repatriation Medical Authority or other agencies any new investigatory powers, discovery mechanisms, or sanctioning authorities distinct from their existing statutory functions. The Authority's role is to make the Statement under s196B(3) of the VEA (s3); other functions and powers of the Authority or decision-makers are not restated or expanded in the instrument.

Relevance to compensation outcomes. While there are no penalties, the Statement has a material impact on whether a claimant obtains a positive entitlement decision under the VEA or MRCA. The absence of a listed factor required by s9 will typically mean the claimant cannot establish the medical causal link required by the Statement, and that will be a ground for refusal or denial in a claims determination. The instrument thereby functions as a gatekeeper within the entitlement enforcement architecture, without invoking traditional penalty mechanisms.

No administrative appeal process described within the instrument. The Statement does not itself set out appeal rights, review process steps, or timelines. Those procedural elements remain located in the VEA and MRCA statutory frameworks and their implementing regulations and policies. The Statement is silent about any penalties for false claims, perjury, or fraudulent evidence. Any such penalties would have to be sought under other statutory provisions not specified within this instrument.

Relevance of repeal. The instrument repeals the earlier Statement of Principles concerning hepatitis D (No. 12 of 2017) (s4). That repeal changes which Statement of Principles will be applied by decision-makers and thus alters the medical framework used in claim assessments. There are no transitional or penalty clauses in the text about claims decided under the repealed Statement; the instrument simply repeals the earlier instrument.

Primary statutory anchor: VEA and MRCA. The Statement is made under subsection 196B(3) of the Veterans' Entitlements Act 1986 (s3) and expressly applies to claims to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies (s5). That situates the instrument within the statutory architecture that governs veterans' entitlements and military rehabilitation and compensation. The Statement provides the medical causation template that decision-makers will apply when resolving entitlement questions under those statutory provisions.

Cross-reference to other Statements of Principles. Section 11 provides a mechanism for inter‑Statement interaction. If a factor in s9 refers to an injury or disease that is the subject of another Statement of Principles made under subsection 196B(3) of the VEA, that other Statement applies in accordance with its current terms. This creates a web of mutual applicability where comorbid conditions or causally related diseases are governed by the pertinent Statements as standing medical findings. Decision-makers must, therefore, look beyond this instrument when factors invoke other diseases.

Definitions and external standards. The instrument cross-references the ICD‑10‑AM classification for coding purposes but clarifies that the operative definition for claim assessment is the textual definition in subsection 7(2) rather than merely the ICD code label (s7(6)). It specifically references the Tenth Edition effective 1 July 2017 for the relevant ICD‑10‑AM codes (s7(7)), which provides a linkage to an external classificatory standard but does not replace the textual definition.

Interaction with clinical standards and medical practice. The instrument uses terms that reference contemporary medical practice. For instance, s9(3) refers to inability to access appropriate hepatitis B vaccination or appropriate hepatitis B post‑exposure prophylaxis "in accordance with contemporary medical standards". The term "post‑exposure prophylaxis" is defined in the Schedule as provision of immunoglobulin or a vaccine to prevent disease following exposure. These references require decision-makers to interpret the Statement in light of prevailing medical standards at the relevant time, creating an intersection between statutory evaluation and medical practice standards.

Temporal interaction with service definitions. "Relevant service" is defined in the Schedule and includes categories of service under both the VEA and the MRCA (Schedule 1). Whether a particular period of service qualifies as relevant service under the definitions will determine whether the Statement applies to a claim. Determinations about the nature of the service are governed by the VEA and MRCA statutory provisions; the Statement depends on those definitions rather than replacing them.

No express conflict resolution clause. The instrument does not include a specific clause describing how conflicts between it and other statutory provisions should be resolved. The instrument assumes standard statutory interpretation principles will apply, with the Statement operating as an evidentiary/medical instrument used within the decision-making processes under the VEA and MRCA.

Repeal of prior Statement and transitional application. Section 4 repeals the 2017 Statement. The text does not provide transitional arrangements, grandfathering rules, or savings for claims decided under the repealed instrument. How bodies apply the repeal in practice will depend on the broader administrative rules and transitional provisions in the statutory claims processes, none of which are included in this Statement.

Limits on private law interaction. The Statement is silent on interactions with private law claims such as workers compensation or tort claims. It does not expressly bind courts or arbiters acting outside the VEA/MRCA framework, although the medical findings may be persuasive in other contexts. The instrument confines its scope to the VEA/MRCA claims processes through its application clause (s5).

Dates and formalities in the instrument. The Statement is dated 22 August 2025 (front matter) and commences on 22 September 2025 (s2). It is made under subsection 196B(3) of the VEA (s3). The instrument itself includes a repeal provision that terminates the earlier Statement of Principles concerning hepatitis D (Balance of Probabilities) (No. 12 of 2017) and identifies that instrument by its Federal Register of Legislation number F2017L00021 (s4).

Single-step repeal recorded. Section 4 expressly repeals the 2017 Statement. The instrument does not record any intervening amendments between 2017 and 2025, nor does it supply an amending history beyond the replacement of the 2017 Statement. The instrument itself appears to be a full replacement rather than a narrow amendment, as evidenced by the repeal clause.

No transitional or savings provisions included. The text supplies no transitional provisions, savings clauses, or directions about how claims assessed or determined under the repealed 2017 Statement should be treated. The absence of transitional language means that the 2025 Statement will operate from its commencement date, with administrative application determined by the VEA/MRCA decision-makers consistent with their statutory powers.

No internal amendment power clause included. The instrument does not create an internal power for the Repatriation Medical Authority to make future amendments by instrument or regulation; it is made under the existing statutory authority in subsection 196B(3) of the VEA (s3). Any future amendments would be expected to be effected by further Statement instruments under that statutory head, but the instrument does not itself provide a delegatory or procedural history.

Document provenance and versioning. The instrument includes a bibliographic reference to the ICD‑10‑AM (Tenth Edition, effective 1 July 2017) in s7(7). It also notes the prior Statement's Federal Register entry, which is the only specific cross-document provenance identified in the text. The instrument does not include version control metadata beyond the dates and the repeal of the earlier instrument.

Implication for users. For practitioners and claimants, the actionable amendment history is limited: the 2017 Statement is replaced by this 2025 Statement as at 22 September 2025. The absence of transitional language requires attention to how decision-makers apply the new Statement to ongoing or pending claims; however, the Statement itself does not state any transitional rules.

No cases or litigation references included. The Statement contains no references to judicial decisions, litigation outcomes, or case law. The text makes no mention of any proceedings that have interpreted previous Statements of Principles or of any appellate review concerning hepatitis D causation under the VEA or MRCA. The only documentary jurisprudential referent in the text is the statutory provision under which the Repatriation Medical Authority operates, subsection 196B(3) of the VEA (s3).

Practical implication of silence on litigation. The absence of litigation history in the instrument means that decision-makers, claimants, and advisers must treat the Statement as the current medical-causation guidance without established judicial clarifications in this document. Any dispute over interpretation or application, for example about what amounts to "inability to access appropriate hepatitis B vaccination" measured against "contemporary medical standards", would likely be litigated in the context of claims decision appeals under the VEA or MRCA, but the instrument itself contains no guidance about prior litigation or judicially settled principles.

Potential areas likely to generate disputes based on the text. The instrument contains several phrases and formulations that, in practice, can be sources of contested legal issues: the "at least 14 days before clinical onset" timing requirement for percutaneous or permucosal exposure (s9(1)); the need for laboratory confirmation and the Schedule's working-back method for "clinical onset" (s7(2); Schedule 1); the temporal qualifier that s9(4) applies only to infection that was suffered or contracted before or during, but did not arise out of, relevant service (s10(2)); and the reference to "contemporary medical standards" for vaccination and post-exposure prophylaxis (s9(3)). These textual features are natural focal points for litigation; however, the instrument contains no past decisions to cite.

No express indication of expected administrative review pathways. The Statement does not specify how disputes about its interpretation should be channelled beyond the normal statutory appeal routes under the VEA and MRCA. It does not create any bespoke dispute resolution mechanism. Any litigation history relevant to the application of this Statement would therefore derive from court materials and appeal records external to this instrument.

Key timing pitfalls , clinical onset versus laboratory confirmation. The Statement defines "clinical onset" in the Schedule by a backward calculation from the first date of laboratory confirmation of hepatitis D serological or nucleic acid markers to the date when symptoms were persistently present, as assessed by a registered medical practitioner (Schedule 1). The instrument notes that it will usually be the case that the date of confirmation is after clinical onset (note to s7(2)). Practitioners must not confuse the laboratory confirmation date with clinical onset. The 14-day exposure window in s9(1) is measured relative to clinical onset, not confirmation date. Failing to establish persistent symptoms with medical assessment that predate the lab confirmation by at least 14 days where required will risk non-satisfaction of the exposure factor.

Laboratory confirmation is mandatory for the disease definition. The textual definition of hepatitis D infection requires confirmation by laboratory testing for hepatitis D serological or nucleic acid markers (s7(2)(a)). A lack of laboratory confirmation as defined will prevent the instrument's disease definition applying, even if clinical features strongly suggest hepatitis D. The Schedule requires a registered medical practitioner to assess the date of persistent symptoms for clinical onset. Evidence that is clinical only, without the specified laboratory markers, does not meet the Statement's definitional requirement.

The exposure factor requires specific exposure types and body substances. Section 9(1) requires percutaneous or permucosal exposure to a body substance derived from a person infected with hepatitis D virus, and it specifies categories of body substances in a note (blood, blood products, body fluids with blood, saliva, semen, vaginal secretions, serum-derived fluids, tissues and organs). General or indirect contact without the specified exposure types will not satisfy s9(1). Additionally, the exposure must have been at least 14 days before clinical onset (s9(1)); exposures closer in time will not meet this factor.

"Contemporary medical standards" is an interpretive hinge. The inability-to-access-vaccine or prophylaxis factor in s9(3) is qualified by "in accordance with contemporary medical standards". That phrase imposes a time-sensitive benchmark for what was appropriate or available before clinical onset. It may require evidence about what vaccination and post-exposure prophylaxis practices were standard at the time of exposure or before onset. Where standards change over time, practitioners must adduce contemporaneous medical guidance or testimony rather than relying on present-day practices.

Narrow application of the clinical management factor. Section 9(4) and the limitation in s10(2) together constrain use of inability-to-obtain-appropriate-clinical-management as a causation factor: s10(2) makes that factor applicable only to cases of material contribution to or aggravation of hepatitis D infection where the infection was suffered or contracted before or during, but did not arise out of, relevant service. That means the management-based factor cannot be used to ground causation where the infection arose out of the relevant service; it is specifically directed at aggravation or material contribution where the infection pre-existed or was contracted before/during service but not as a result of service. Claimants and advisors may overlook that limitation.

ICD‑10‑AM codes are referenced but not the legal definition. Section 7(6) notes that hepatitis D infection attracts ICD‑10‑AM codes B16.0, B16.1 or B18.0, but s7(2) provides the operative meaning of hepatitis D infection for this Statement. Practitioners should not rely solely on coding labels; they must ensure the textual criteria in s7(2) are met.

Dependency on other Statements. Where a factor in s9 refers to another disease for which a Statement exists, that other Statement applies "as in force from time to time" (s11). This creates potential evidentiary complexity where a case hinges on the application of multiple Statements and on whether later amendments to other Statements alter the applicability of the factors relevant to the claimant. Advisors should check the current status of any cross-referenced Statements.

No transitional rules for the repeal. The 2017 Statement is repealed (s4) but no transitional or savings clauses are provided. For claims made around the repeal/commencement dates, parties should not assume continuity without checking administrative practice. The Statement is silent on whether claims assessed under the old Statement will be re-opened or re-assessed under the new one.

Practical evidentiary burden for inability contentions. Factors s9(3) and s9(4) require proof of inability to access vaccination, prophylaxis or appropriate clinical management. Those are fact‑intensive and context‑specific inquiries likely to require documentary evidence of attempts to obtain care, correspondence, medical facility capability records, or contemporaneous practitioner statements. Vague assertions of inability without supporting documentation will be difficult to satisfy.

Definition of "relevant service" may be contested. The Schedule defines "relevant service" with several categories. Whether a particular period of service qualifies as "eligible war service", "defence service" (excluding hazardous service and British nuclear test defence service), or "peacetime service" under the MRCA may be disputed and will affect whether the Statement applies to a claim (Schedule 1). This is an administrative and jurisdictional gateway issue.

Evidence priorities mapped to the factors. To satisfy the Statement, a claimant must establish at least one of the factors in s9 and that the factor relates to relevant service (s9; s10(1)). Practical evidence aligned to each factor:

• For the exposure factor (s9(1)): obtain and produce documentation or sworn statements establishing percutaneous or permucosal exposure to body substances derived from a person infected with hepatitis D at least 14 days before clinical onset. Medical records, incident reports, workplace exposure logs, witness statements, and laboratory results confirming the source person’s infection status will be directly relevant. Ensure dates are precise enough to connect the exposure date to the clinical onset date as defined in the Schedule.

• For hepatitis B co-infection at clinical onset (s9(2)): secure laboratory evidence demonstrating hepatitis B infection status at or immediately before the defined clinical onset. Laboratory reports, serology panels, and treating practitioner notes are the primary documents. The Statement treats co-infection with hepatitis B as one of the alternative causation factors.

• For inability to access vaccination or post-exposure prophylaxis (s9(3)): assemble contemporaneous records evidencing a claimant’s inability to obtain appropriate hepatitis B vaccination, or appropriate post-exposure prophylaxis, prior to clinical onset and measured against the "contemporary medical standards" that applied at the relevant time. Evidence could include occupational health records showing vaccine unavailability, clinic or hospital correspondence, military medical service records indicating vaccine policy at the time, refusal or declination notices, or documented attempts to obtain immunoglobulin or vaccine.

• For inability to obtain appropriate clinical management before clinical worsening (s9(4)): collect records showing attempts to obtain clinical management, any refusals, or the unavailability of specific treatments prior to the point of clinical worsening. Because s10(2) narrows the applicability, also document that the hepatitis D infection was suffered or contracted before or during, but did not arise out of, relevant service. Treatment logs, referral records, triage notes, and practitioner statements about management options available at the time are evidence types to prioritise.

Establishing clinical onset and laboratory confirmation. Because the disease definition requires laboratory confirmation for hepatitis D serological or nucleic acid markers (s7(2)(a)), obtain the earliest available laboratory reports. For clinical onset, obtain treating practitioner assessments that set out when symptoms were persistently present and use the Schedule’s backward calculation from confirmation date to the date of persistent symptoms (Schedule 1 definition).

Proving relationship to relevant service. Compile service records to demonstrate that the claimant’s period of service qualifies as "relevant service" under the Schedule (for example, eligible war service, defence service other than hazardous and British nuclear test defence service, or peacetime service under MRCA). Service stamps, unit assignments, deployment logs, and any official service classification documents will be necessary for demonstrable proof of relevant service status (s5; Schedule 1 definition of "relevant service").

Cross-check for other applicable Statements. If any s9 factor refers to an injury or disease covered by another Statement of Principles, identify that Statement and collect the evidence required under it, because s11 makes the other Statement applicable as in force from time to time. This may require reviewing current versions of other Statements and assembling evidence meeting their criteria.

Medical expert evidence. The Schedule requires that clinical onset be assessed by a registered medical practitioner (Schedule 1). Procure contemporaneous or retrospective medical opinions that explain the timing of onset, the clinical progression, and the relationship between the exposure or failure of prophylaxis and the disease progression. Where "contemporary medical standards" is in issue, have a medical expert address what those standards were at the relevant time and whether the claimant’s experience met or failed to meet those standards.

Document attempts to obtain prophylaxis or management. For s9(3) and s9(4), keep records of dates, times, correspondence, referrals, and any institutional policies that explain inability to obtain vaccination, prophylaxis, or specific treatment. Absence of documentation will weaken the claim. Where possible, secure letters or statements from health clinics, hospitals, or military medical services confirming lack of availability or denial of service.

Use the coding and definitional guidance properly. While the instrument references ICD‑10‑AM codes (s7(6)-(7)), ensure that submissions rely on the textual definition in s7(2) rather than on code alone. Provide laboratory reports showing the serological or nucleic acid markers referred to in the definition.

Sequence your legal submissions. In administrative claims, structure submissions to first establish the disease definition with laboratory evidence, then demonstrate clinical onset timing, next show which s9 factor is relied upon with supporting documentary and medical opinion evidence, and finally establish the link between that factor and the claimant’s relevant service under the Schedule. Where other Statements are implicated, include an annex that maps cross-references and evidence to the other Statement’s factors.

Anticipate and address the 14-day exposure rule. For claims invoking s9(1), explicitly calculate and show that the exposure occurred at least 14 days prior to clinical onset as defined. If dates are ambiguous, secure medical practitioner assessments that can reasonably and consistently locate the date of persistent symptoms.

Prepare for challenges on "contemporary medical standards". If relying on s9(3), include contemporaneous clinical guidance, military medical policy documents, or expert evidence to prove what standard prophylaxis or vaccination practice was at the time of exposure. Current standards alone are insufficient where the relevant timeframe predates changes in clinical practice.

Check the effect of the repeal on timing of claims. Because the prior 2017 Statement is repealed (s4) and this instrument commences on 22 September 2025 (s2), verify which Statement applies to claims lodged or decided near the commencement date in administrative practice. Absent transitional provisions in the instrument, confirm with the relevant claims authority whether they will apply the 2025 Statement to pending claims.

Keep records of source-person infection status. For exposure-based claims, the exposure must be to a body substance derived from a person infected with hepatitis D. Therefore, where possible, secure laboratory evidence or official medical records demonstrating that the source person was infected with hepatitis D virus around the time of exposure.

Engage legal and medical advisors early. Given the medically technical and temporally precise nature of many of the Statement’s requirements, engage counsel and medical experts early to frame evidence collection and to prepare medical assessments that align with the Statement’s definitions and timing rules.