Statement of Principles concerning warts (Balance of Probabilities) (No. 8 of 2023)

The instrument organises the legal assessment of causation around a short set of medical concepts defined in the text. The main concepts are:

• Warts, as the covered condition (s 7(2)). For this Statement, warts are defined substantively as "abnormal benign hyperplastic lesions of the skin or mucous membranes caused by human papillomavirus infection" and the definition lists included forms (flat, filiform, digitate, plantar including mosaic, anogenital/condyloma acuminatum) and explicit exclusions (seborrheic keratosis, skin cancers, keratoacanthoma, skin tags and papilloma of the bladder) (s 7(2)(a)-(c)). The instrument emphasises that, although ICD‑10‑AM codes A63.0 and B07 are associated with warts, the operative meaning for this Statement is the text of s 7(2) (s 7(3)-(4)).

• Death from warts (s 7(5)). The instrument treats "death from warts" as death from a terminal event or condition that was contributed to by the person’s warts; "terminal event" is separately defined and includes examples such as pneumonia, respiratory failure, cardiac arrest, circulatory failure and cessation of brain function (Schedule 1).

• Relevant service (Schedule 1). The instrument's application is limited to claims arising from particular classes of service: eligible war service (other than operational service), defence service (other than hazardous service and British nuclear test defence service) under the VEA, and peacetime service under the MRCA. This definition determines whose service is "relevant" for the causation enquiries mandated by the Statement (Schedule 1).

• Factors and temporal limits (s 9). The Statement is factor‑based: at least one of the listed factors must exist for a connection to relevant service to be established on the balance of probabilities. Many factors impose precise temporal limits (usually "within the 12 months before the clinical onset of warts") and location‑specific constraints (for example, separate factors for cervical, anogenital, oral/laryngeal, plantar and hand warts).

• Immunocompromised state as specified (Schedule 1). This is a narrow, enumerated concept in this instrument: it is "a condition of substantially lowered immune function" and the examples given are infection with HIV, taking an immunosuppressive drug which causes substantial suppression of immune responses, or undergoing renal transplantation. The instrument distinguishes immunocompromise at clinical onset (s 9(7)) and at clinical worsening (s 9(8)).

• Direct physical contact (Schedule 1). That phrase is defined as physical contact where no protective or impermeable barrier exists; it is used in s 9(1) to require contact with another person's cutaneous warts within the 12 months before clinical onset.

• Relationship to other Statements (s 11). Where a s 9 factor refers to an injury or disease already covered by another Statement of Principles, the terms of that other Statement govern the application of that factor.

• Evidentiary standard. The Statement is explicit that causation is judged on the balance of probabilities and that the RMA's adoption of the factors is premised on its view of the sound medical‑scientific evidence available (s 8).

These concepts are the building blocks for adjudicating a claim under the institutional framework set out in s 5. Practically, they determine what evidence a claimant must bring and what a decision maker must evaluate when assessing whether warts or death from warts are service‑related for the purposes of the VEA or MRCA claim provisions.

The instrument affects three broad groups by design and effect: (1) people lodging or assessing statutory claims for warts or death from warts under the specific claim provisions named in s 5; (2) medical and administrative decision makers who must apply this Statement in adjudicating those claims; and (3) individuals whose clinical profile or service circumstances align with the specific factors enumerated in s 9.

1. Claimants and potential claimants

• The instrument applies to claims to which s 120B of the VEA or s 339 of the MRCA applies (s 5). Its definition of "relevant service" (Schedule 1) limits the class of eligible claimants: eligible war service (excluding operational service), defence service (excluding hazardous service and British nuclear test defence service), or peacetime service under the MRCA. Only persons whose service fits those categories are within the statutory ambit for application of this Statement (Schedule 1).
• Clinical scope: the Statement covers a range of wart types and sites (s 7(2)), including cutaneous variants, plantar (including mosaic), and anogenital forms. It explicitly excludes certain lesions or conditions (for example, skin cancers, papilloma of the bladder) (s 7(2)(c)). Claimants whose lesions fall within these exclusions will not have their condition assessed under this Statement.

2. People who served or members of Forces

• The factors are site‑ and exposure‑specific. They target exposures and conditions common in communal and service settings: direct physical contact with another person’s cutaneous warts (s 9(1)), use of communal showering or bathing facilities (s 9(5)), and use of shared gloves or shared utensils in food preparation on more days than not for 3 months (s 9(6)). Those who were in such service environments are likely to be affected by the evidentiary requirements.

3. People with altered immune function, and those with limited access to care

• The Statement recognises immunocompromise as both an initial risk factor (s 9(7)) and a factor for clinical worsening (s 9(8)). However, "immunocompromised state as specified" is narrowly enumerated (HIV infection, taking an immunosuppressive drug that causes substantial suppression, or undergoing renal transplantation) (Schedule 1). Only persons demonstrably within those categories are covered by those factors.
• The list includes "inability to obtain appropriate clinical management for warts" as a factor (s 9(9)). This potentially affects claimants who, during or after service, were unable to access appropriate clinical management. The instrument does not define that phrase further; claimants who rely on it will confront that lack of definition when proving the factor.

4. Decision makers and medical assessors

• The Repatriation Medical Authority is the maker of the Statement (s 3). Decision makers applying the VEA and MRCA claims provisions will be required to consult and apply this Statement when determining causation for warts or death from warts. Section 11 further requires decision makers to defer to other Statements of Principles where a factor refers to a condition already governed by another Statement.

In sum, affected persons are those who have wart lesions or deaths claimed to be service related and whose service falls within the "relevant service" definition, together with the administrative and medical professionals who must apply the Statement when assessing such claims. The instrument imposes narrow, enumerated factual gateways that shape which claimants will meet the causation threshold and which will not.

The instrument itself sets out medical‑causation criteria rather than prescriptive duties or rights in administrative law language; nevertheless, it creates clear legal obligations for claimants and operative duties for decision makers by specifying what must be established for causation to be found. The key operative duties and rights derived from the text are:

Duties that follow from the Statement’s requirements

• Duty to prove at least one listed factor: The Statement provides that, before it can be said on the balance of probabilities that warts or death from warts is connected with relevant service, at least one of the factors in s 9 must exist (s 9). This creates a claimant’s evidentiary duty to adduce material sufficient to satisfy a decision maker that one of the enumerated factors is present and linked to relevant service per s 10(1).
• Duty to show temporal and site specificity: Several factors require occurrences within specified temporal windows, commonly "within the 12 months before the clinical onset of warts" (eg s 9(1)-(6)). Specific factors apply only to particular anatomical sites (eg s 9(2) for cervix uteri, s 9(3) for anogenital region, s 9(4) for oral cavity or larynx, s 9(5) for plantar warts, s 9(6) for hands). Claimants bear the duty of establishing both onset timing and anatomical location consistent with the factor relied on.
• Duty to establish service relationship: Section 10(1) requires that the existence of any factor in s 9 must be related to the relevant service rendered by the person. That places a further duty on claimants to connect the factor they rely on to their relevant service as defined in Schedule 1.
• Narrow scope for immunocompromise evidence: The instrument confines the "immunocompromised state as specified" to the enumerated examples in Schedule 1. If a claimant relies on immune suppression as a factor, they must show the condition meets one of the listed examples (HIV infection, substantial suppression from an immunosuppressive drug, or renal transplantation) and time the condition to clinical onset or worsening as required by s 9(7)-(8).

Rights or entitlements that follow from the Statement’s content

• Right to have causation assessed under these criteria: Where a claim falls under s 120B of the VEA or s 339 of the MRCA, the claimant has the legal right to have causation for warts or death from warts assessed against the factors set out in this Statement (s 5). The Statement thereby prescribes the legal test used to decide the causation element of the claim under the named statutory provisions.
• Right to rely on other Statements where a factor refers to a condition already covered elsewhere: Section 11 grants a claimant the procedural right that, if a s 9 factor refers to an injury or disease governed by another Statement of Principles, then the other Statement’s factors and terms apply in place of or alongside the references in s 9, as appropriate.

Duties on decision makers implied by the instrument

• Duty to apply this Statement to relevant claims: Decision makers adjudicating claims under the cited statutory sections must apply the Statement’s factors in determining causation. The Statement is the Authority’s determination under s 196B(3) of the VEA (s 3).
• Duty to apply other Statements where referenced: Section 11 imposes an obligation to follow the terms of other Statements where a s 9 factor refers to a condition already covered by another Statement.

What the instrument does not itself do

• The Statement does not set out procedural or evidentiary rules beyond the medical factors. It does not specify the standard forms, document formats or exact proof required to meet the factors; nor does it set out appeal or review pathways. Those administrative processes remain governed by the underlying statutory scheme (the VEA and MRCA) and their implementing rules, not by the Statement text.

In practical terms the claimant’s duty is to marshal evidence that satisfies the factor list and links that factor to relevant service (s 9, s 10). The decision maker’s duty is to treat the Statement as the operative medical causation guide when making determinations under the nominated statutory claim provisions (s 3, s 5, s 11).

The instrument is a medical‑causation Statement of Principles; it does not itself create criminal offences, civil penalties, or an enforcement regime. The text contains no penalty provisions. Enforcement and any consequences flow indirectly through the decision‑making structures of the VEA and MRCA claims regimes, as follows from the instrument’s stated scope and authority.

What the instrument does specify about enforcement mechanics

• Regulatory status: The Statement is declared to be made under subsection 196B(3) of the VEA (s 3). That subsection is the statutory power by which the Repatriation Medical Authority issues Statements of Principles for the purposes of determining causal connection. The instrument’s legal effect is as an Authority determination under that statutory power; enforcement, meaning application of these causation rules in individual claims, is achieved by decision makers applying the Statement when assessing claims under s 120B of the VEA or s 339 of the MRCA (s 5).
• No sanctions in the instrument: There are no express sanctions, penalty amounts, compliance notices, or enforcement mechanisms described in this document. It does not, for example, create administrative fines, criminal liability, or a statutory enforcement process targeted at individuals or providers for breach of any of the factors.

Consequences that will flow from application of the Statement (procedural and substantive)

• Determinations using the Statement can produce substantive entitlements under the parent statutes: while the Statement itself does not grant benefits, a finding that a claimant’s warts or death from warts is connected with relevant service (using the Statement’s factors) will be an input to the statutory process under the VEA or MRCA that determines entitlement to benefits. The instrument therefore operates as a causal gatekeeper: it governs whether a claimant clears the causation hurdle needed for eligibility for statutory benefits. The Statement itself provides no remedy for persons who fail to satisfy a factor; any remedial or compensatory consequences arise under the underlying statutes and their procedural rules, not in this instrument.

Administrative enforcement and review

• The instrument does not set appeal, review or compliance steps; those processes will be those incorporated in the VEA and MRCA administrative and judicial review regimes. This Statement only provides the causation framework to be applied inside those processes.

Practically, "enforcement" of this Statement occurs when decision makers decline or allow claims on causation grounds using these factors. The instrument creates a legal standard to be applied, but not a separate enforcement or penalty apparatus within its own text.

The Statement sits inside the statutory framework established by the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). The instrument itself contains direct references and cross‑references that shape how it interacts with other legal instruments and classifications.

Direct statutory linkage

• Made under s 196B(3) of the VEA (s 3): The Statement is an Authority determination under the VEA. That statutory origin means the Statement’s prime legal function is to inform causal determinations under the VEA and, as it expressly provides, the MRCA where the claim provision named in s 5 applies.
• Application to claims under designated statutory sections (s 5): The instrument expressly applies to claims to which s 120B of the VEA or s 339 of the MRCA applies. Those references link this Statement’s medical causation rules to the statutory processes those sections govern. The Statement does not itself reproduce or modify the substantive entitlement provisions of those statutes; it supplies the causal test to be used within them.

Interaction with other Statements of Principles

• Section 11 creates an operational interface with other Statements of Principles: if a s 9 factor refers to an injury or disease governed by another Statement determined under s 196B(3) of the VEA, then the factors in that other Statement apply "in accordance with the terms of that Statement of Principles as in force from time to time." This establishes a cross‑Statement deference rule: factors that relate to other covered injuries/diseases are to be interpreted consistent with the other Statement rather than exclusively by reference to this instrument. Practically, this requires decision makers to consult and harmonise multiple Statements where linkages exist.

Interaction with clinical classification systems

• ICD‑10‑AM references (s 7(3)-(4)): The instrument notes that warts attract ICD‑10‑AM codes A63.0 and B07 but expressly states that, for applying the Statement, the meaning of warts is that given in s 7(2). The text also defines that a reference to an ICD‑10‑AM code is a reference to the Tenth Edition (effective 1 July 2017) of the Australian modification of the ICD‑10, coded by the Independent Hospital Pricing Authority. That places the Statement in dialogue with clinical classification systems: ICD codes may be used in documentation and records, but they do not replace the Statement’s substantive definition.

Interplay with the definition of relevant service

• The instrument’s Schedule 1 defines "relevant service" in terms that feed back into the VEA and MRCA definitions and in turn determine which statutory claims this Statement can be used to assess. The narrow list in Schedule 1 circumscribes the reach of the Statement within the broader statute.

No substitution or override of statutes

• The Statement does not purport to amend, abrogate, or override the provisions of the VEA or MRCA that govern entitlement, procedural rights, or appeals. It functions as an interpretive and evidentiary tool to be used within the statutory claim‑assessment process defined by those Acts.

Repeal and continuity

• The Statement repeals the earlier Statement of Principles concerning warts No. 71 of 2014 (s 4). That repeal creates a continuity rule: from the declaration date, the new Statement governs and the prior Statement ceases to have effect. Decision makers and practitioners must use the new text for claims falling after commencement.

Operational consequence

• Because s 11 requires application of other Statements where relevant, a single claim may require consultation of multiple Statements of Principles and clinical classifications when factors crosscut other covered conditions. Decision makers must therefore reconcile this Statement with any other Statements it references when a factor in s 9 points to a condition covered elsewhere.

In short, the instrument is an evidentiary rulebook that operates inside and alongside the VEA and MRCA statutory schemes and other Statements of Principles, and it must be read in conjunction with those instruments and with clinical documentation that may use standard ICD‑10‑AM codes.

The instrument itself contains the discrete amendment and provenance history relevant to its effect:

• Instrument identification and date: The text is titled "Statement of Principles concerning warts (Balance of Probabilities) (No. 8 of 2023)", and it is dated 27 February 2023 (front matter and s 1). The instrument commences on 27 March 2023 (s 2).

• Repeal of prior Statement: Section 4 expressly repeals the Statement of Principles concerning warts No. 71 of 2014 (Federal Register of Legislation No. F2014L00927) that was made under subsections 196B(3) of the VEA. The effect is that, on commencement, the 2014 instrument is no longer in force and is replaced by this 2023 Statement.

• Source of authority: Section 3 records that the instrument is made under subsection 196B(3) of the VEA. That identifies the statutory power under which the RMA may determine Statements of Principles and is essential for tracing any future amendments , modifications to this instrument would occur, in formal terms, through the RMA exercising the same statutory power and issuing an updated Statement.

What the instrument does not contain as history

• The text contains no schedule of prior amendments to this instrument (it is a standalone determination) other than the express repeal of the 2014 Statement (s 4). There is no record in this instrument of earlier drafts, consultation outcomes, transitional arrangements for legacy claims adjudicated under the repealed 2014 Statement, or specific amendment dates other than the commencement and making dates recorded.

Practical consequence for practitioners and decision makers

• For any claims or assessments, it is necessary to apply this instrument from its commencement date forward and to be aware that it supersedes the 2014 Statement. The repeal clause in s 4 is the operative amendment history that changes the applicable Statement of Principles for warts. Any future amendment would appear as a new RMA determination made under the statutory power referenced in s 3; such amendments would similarly be reflected by a new instrument and reflected in the official registers.

The instrument itself contains no record of litigation, judicial determinations, or Tribunal decisions that interpret or apply its terms. The text does not cite or purport to summarise any cases, nor does it contain a section documenting prior judicial engagement with the earlier Statement of Principles. The only historical legal instrument referenced is the replaced Statement of Principles No. 71 of 2014, which the present Statement repeals (s 4).

What the absence of litigation references means for practice

• The Statement, being a determination under subsection 196B(3) of the VEA (s 3), is a medical‑evidentiary instrument intended for application in claims. Judicial or Tribunal interpretation of these factors would typically occur in the administrative review or judicial review process under the appeal mechanisms of the VEA and MRCA. However, this instrument does not itself summarise any such decisions.
• In the absence of litigated authorities cited in the text, practitioners handling claims that raise borderline or ambiguous applications of the factors must be prepared to construct arguments de novo about how the Statement’s terms apply to their client's facts, relying on the instrument’s language and any clinical evidence. Where a s 9 factor refers to a condition governed by another Statement of Principles, s 11 requires application of that other Statement; if disputes arise about interpretation, those disputes will be routed into the statutory review channels rather than resolved within this instrument.

Implications for evidence and advocacy

• Because the Statement does not canvass interpretative caselaw, the primary legal source of authority to rely upon for causation is this instrument’s text and the underlying statutory power (s 3 and s 5). Claimants and decision makers will therefore focus on aligning factual proofs with the precise formulations in s 9 and Schedule 1.
• If factual disputes or interpretive conflicts reach administrative or judicial review, the Statement will be the foundational document courts or Tribunals consult to decide issues of medical causation. The instrument does not provide pre‑existing judicial interpretations that would bind arguing parties or adjudicators.

In short, the instrument itself contains no litigation history. Any case law that later emerges interpreting or applying this Statement will be external to the instrument and will need to be considered by practitioners alongside the text when advising or litigating claims.

The Statement’s brevity, precision and site‑specific factors create a number of practical pitfalls and evidentiary difficulties for claimants and decision makers. The following are the concrete "gotchas" that arise directly from the text.

1. Narrow, enumerated definition of "immunocompromised state as specified"

• The Schedule limits immunocompromise to a short list: HIV infection, taking an immunosuppressive drug that causes substantial suppression of immune responses, or undergoing renal transplantation (Schedule 1). Common clinical states of reduced immunity that are not on that list (for example, diabetes, chronic corticosteroid use not amounting to "substantial" suppression as conceived by the RMA, malnutrition or other transplant types) are not expressly covered. A claimant relying on immune dysfunction must show it fits within one of the enumerated categories (s 9(7)-(8); Schedule 1).

2. Strict temporal windows and onset linkage

• Many factors require the specified exposure to have occurred "within the 12 months before the clinical onset of warts" (s 9(1)-(6)). Determining the clinical onset date is critical and can be contested; the claimant must establish that onset date and demonstrate that exposures occurred within the 12‑month window.

3. Site‑specific exposure rules

• Several factors apply only to warts at specific anatomical sites, and the required exposure is tailored to those sites:
  • Cervix uteri warts require penetrative sexual intercourse with a person with genital warts within the 12 months before clinical onset (s 9(2)).
  • Anogenital warts require contact with the anogenital warts of another person within the 12 months before clinical onset (s 9(3)).
  • Oral cavity or larynx warts require oral sex with a person with anogenital warts within the 12 months before clinical onset (s 9(4)).
  • Plantar warts rely on use of communal showering or bathing facilities within 12 months (s 9(5)).
  • Hand warts require using shared gloves or shared utensils on more days than not for 3 months in the preparation of meat, poultry or fish for consumption within 12 months before onset (s 9(6)).
• These tailored rules mean an exposure that might plausibly transmit HPV in other contexts may not satisfy the precise factor for the wart location in question.

4. Definition of "direct physical contact" narrows contact evidence

• "Direct physical contact" is defined as physical contact where no protective or impermeable barrier exists (Schedule 1). Contact covered by a barrier (for example, glove use) would not be "direct physical contact" for the purposes of s 9(1). This interacts directly with s 9(6), where shared gloves can be a risk factor for hand warts: ironically, shared glove use is itself a special factor, but the general "direct contact" route excludes contact where a barrier was used.

5. "More days than not for 3 months" is a specific quantitative threshold

• The s 9(6) factor for hands requires shared gloves or utensils "on more days than not for 3 months" when preparing meat, poultry or fish. This is an exacting, quantifiable standard. Proving "more days than not" over a 3‑month stretch will require documentary or reliable witness evidence; casual or sporadic glove/utensil sharing will likely fail this test.

6. "Inability to obtain appropriate clinical management" is undefined in the instrument

• Section 9(9) lists inability to obtain appropriate clinical management as a factor. The Statement does not define what constitutes "appropriate clinical management", nor does it specify what evidence will satisfy proof of inability to obtain it. Practitioners should note the evidentiary challenge: the text imposes the factor but leaves it open how a decision maker should determine sufficiency of attempts to obtain care, whether service conditions that impeded access suffice, or whether contemporaneous evidence of denial or lack of available care is required.

7. Application limitation for worsening and contribution factors

• Section 10(2) restricts subsections 9(8) (immunocompromised state at clinical worsening) and 9(9) (inability to obtain appropriate clinical management) to only material contribution to, or aggravation of, warts where the person's warts "was suffered or contracted before or during (but did not arise out of) the person's relevant service." That phrase is factually loaded: it excludes the use of these two factors in cases where the warts "arose out of" the person's service. Practically, if a claimant alleges onset caused by service, they cannot rely on 9(8) and 9(9) as aggravating or contributory factors; those factors are limited to pre‑existing or concurrent conditions not caused by service.

8. Death from warts requires contribution to a terminal event

• "Death from warts" is death from a terminal event or condition that was contributed to by the person's warts (s 7(5)). The Statement defines "terminal event" with examples (Schedule 1). Claimants will need to show a causal contribution of warts to a recognised terminal event; an isolated diagnosis of warts with death from unrelated cause will not meet the test.

9. ICD‑10‑AM codes do not supplant the substantive definition

• Although s 7(3) references ICD‑10‑AM codes A63.0 and B07, the instrument expressly states that for application of the Statement the meaning of warts is the statutory definition in s 7(2). Clinical records that rely solely on ICD coding may not be determinative if the pathology or clinical description falls outside the Statement’s inclusive/exclusive list.

10. Cross‑Statement complexity

• Section 11 requires applying other Statements of Principles where a s 9 factor refers to an injury or disease already covered elsewhere. This can complicate evidence gathering: practitioners must not only get proof for the s 9 factor but also ensure compliance with the referenced Statement’s terms, which may impose additional or different thresholds.

Each of these items is a concrete practical trap that follows from the text. The Statement’s precision is helpful for predictability but raises strict proof requirements that claimants must meet to establish causation on the balance of probabilities.

The Statement’s text creates a clear checklist approach for preparing and presenting claims. Compliance for claimants and advising practitioners involves aligning evidence with the precise language and temporal windows of the factors in s 9, and showing the relationship to relevant service as required by s 10. Below are practical, document‑focused steps derived from the instrument itself.

1. Establish the clinical diagnosis and anatomical site

• Obtain contemporaneous clinical records that diagnose warts and specify anatomical location(s). The Statement’s coverage is location‑sensitive (s 7(2), s 9(2)-(6)). Where pathology or specialist reports exist, include them. Note that although ICD‑10‑AM codes A63.0 and B07 are mentioned (s 7(3)), the operative meaning is the text of s 7(2) , so the clinical description must match that statutory definition.

2. Fix the clinical onset date

• Many factors hinge on events occurring within "the 12 months before the clinical onset of warts" (s 9). Identify and document the earliest clinical signs or recorded diagnosis that can be reliably used as the onset date. Where onset is contested, collate GP notes, specialist letters, nurse entries, and photographic records to support the onset date.

3. Identify and document the applicable factor(s)

• Review s 9 and match the claimant’s facts to at least one factor. The factors are discrete; select the one that most closely fits. For each factor, gather targeted evidence:
  • s 9(1) Direct physical contact with another person’s cutaneous warts within 12 months before onset: obtain statements, incident reports, or contemporaneous records showing the physical contact and absence of protective barriers (recall that "direct physical contact" excludes contact where a protective or impermeable barrier existed; Schedule 1).
  • s 9(2) Cervix uteri warts: record evidence of penetrative sexual intercourse with a person with genital warts within 12 months before clinical onset. Medical records, sexual history recorded by clinicians, partner treatment records or partner diagnoses will be relevant.
  • s 9(3) Anogenital warts: evidence of contact with another’s anogenital warts within 12 months before onset.
  • s 9(4) Oral cavity or larynx warts: evidence of oral sex with a person with anogenital warts within 12 months before onset.
  • s 9(5) Plantar warts: evidence of using communal showering or bathing facilities within 12 months before onset (duty statements, base accommodation records, and contemporaneous declarations).
  • s 9(6) Hand warts: evidence of using shared gloves or shared utensils on more days than not for 3 months in the preparation of meat, poultry or fish for consumption within 12 months before onset; documentary workplace logs, rosters, and witness statements are likely necessary to prove the "more days than not" quantitative threshold.
  • s 9(7) and s 9(8) Immunocompromised state at clinical onset or worsening: produce medical records confirming HIV infection, prescriptions and specialist letters confirming an immunosuppressive drug causing substantial suppression, or records confirming renal transplantation, and time them to clinical onset or worsening as needed (Schedule 1).
  • s 9(9) Inability to obtain appropriate clinical management: collect detailed contemporaneous evidence of attempts to obtain treatment (referrals, appointment bookings, denials), local service‑availability records where relevant, and clinician statements detailing what appropriate management would have been and why it was unavailable.

4. Demonstrate relationship to relevant service

• Section 10(1) requires that the factor relied upon be related to the person’s relevant service. Document how the relevant exposure occurred in the course of relevant service defined in Schedule 1. Evidence could include service postings, accommodation arrangements, unit rosters, workplace tasks and duties that show the nexus between the exposure and the service period.

5. Be mindful of s 10(2) for aggravation/worsening claims

• If relying on s 9(8) or s 9(9) as material contribution to or aggravation of warts, ensure the claimant’s warts were suffered or contracted before or during (but did not arise out of) the person’s relevant service (s 10(2)). For an aggravation claim, produce pre‑service and pre‑worsening clinical notes to show that the wart condition pre‑existed service and was then materially worsened during the relevant timeframe.

6. Where a factor refers to another Statement of Principles, follow that Statement

• If a chosen factor references an injury/disease governed by a different Statement, comply with the other Statement’s terms (s 11). Practically, identify the referenced Statement, pull its current terms, and align evidence to that Statement’s factor list as well.

7. For death claims, link warts to a terminal event

• Where the claim concerns death from warts (s 7(5)), demonstrate that the wart condition contributed to a terminal event as defined in Schedule 1 (for example, pneumonia, respiratory failure, cardiac arrest). Obtain cause of death certificates, coronial reports where relevant, and expert medical opinion linking the wart pathology to the terminal event.

8. Use targeted medical expert reports

• Because the Statement is a technical medical causation instrument, obtaining a focused medical expert opinion that maps clinical facts to the precise statutory formulations will be important. For example, an expert can explain whether a claimed immunosuppressive drug creates "substantial suppression of immune responses" as required by Schedule 1.

9. Quantify assertions and use contemporaneous records

• Many factors turn on fine factual distinctions (timing within 12 months, "more days than not for 3 months", lack of protective barrier). Use contemporaneous records, service documentation, workplace logs, witness statements and medical records wherever possible; retrospective, uncorroborated assertions are weaker evidence.

10. Prepare for cross‑reference and harmonisation

• Anticipate that decision makers will check other Statements of Principles where s 9 factors cross‑refer. Compile any potentially relevant Statements cited in s 11 and ensure evidence aligns with their requirements as well.

11. Record and prepare for exclusions

• Ensure the lesion claimed is not one of the express exclusions in s 7(2)(c). If pathology is ambiguous, obtain biopsy or specialist confirmation to establish the lesion falls within the Statement’s operative definition of "warts".

12. Timing and procedural practice

• The Statement commenced on 27 March 2023 (s 2) and repealed the 2014 Statement (s 4). Use the 2023 text for claims after commencement; for historic claims, be alert to whether the older Statement was operative at the relevant application time (the instrument itself contains no transitional directions).

In short, compliance requires a claims strategy that maps the facts to one or more s 9 factors, establishes onset dates, links the exposure to relevant service, and compiles contemporaneous medical and service documentation aligned with the precise statutory phrases. The Statement’s specificity means that proof must be focused and documentary wherever feasible.