Statement of Principles concerning warts (Reasonable Hypothesis) (No. 7 of 2023)

The Statement is organised around a handful of controlling concepts that determine when war‑related claims involving warts can meet the statutory threshold of a “reasonable hypothesis”.

Definition of the injury: The instrument gives a medical‑style definition of “warts” as “abnormal benign hyperplastic lesions of the skin or mucous membranes caused by human papillomavirus infection” and enumerates included clinical presentations (flat, filiform/digitate, plantar, anogenital) and excluded lesions (seborrheic keratosis, skin cancers, keratoacanthoma, skin tags, papilloma of the bladder) (s 7(2)(a)-(c)). The instrument also notes common anatomic sites and alternative names and records that while ICD‑10‑AM codes A63.0 and B07 usually apply, the statutory meaning is the textual definition at s 7(2) (s 7(3)-(4)).

Reasonable hypothesis threshold: The Authority states that there is sound medical‑scientific evidence indicating warts and death from warts can be related to relevant service (s 8). Operationally, the instrument prescribes that at least one of the factors in section 9 must exist “before it can be said that a reasonable hypothesis has been raised” connecting warts or death from warts with relevant service (s 9). This makes the Statement an evidentiary checklist that claimants must be able to meet at a threshold level.

Factor specificity and temporal windows: Section 9 contains a closed list of factors and, in many cases, attaches an explicit temporal window , typically within 20 months before the clinical onset of warts , to be satisfied for that factor (for example, direct physical contact, sexual contact for cervical warts, oral sex for oral/laryngeal warts, communal showering for plantar warts, shared gloves/utensils for hand warts) (s 9(1)-(6)). Some factors relate to clinical worsening (s 9(8)) or inability to obtain appropriate clinical management (s 9(9)), with s 10(2) limiting those two factors to claims of material contribution or aggravation where the wart pre‑existed service.

Relation to service: The instrument requires that any factor relied on under s 9 must be related to the person’s “relevant service”, a term the Schedule defines as operational, peacekeeping, hazardous, British nuclear test defence service under the VEA, or warlike/non‑warlike service under the MRCA (Schedule 1). Section 10 requires a causal or relational link between the existence of a factor and the person’s relevant service.

Interplay with other Statements: Section 11 provides that if a factor in s 9 refers to an injury or disease covered by another Statement of Principles made under subsection 196B(2) of the VEA, the factors in that other Statement apply according to their terms. This creates a mechanism for cross‑reference where conditions overlap.

Definitions and clinical judgement: The Schedule provides specific definitions for direct physical contact (“where no protective or impermeable barrier exists”) and lists examples of “immunocompromised state as specified” including HIV infection, taking an immunosuppressive drug which causes substantial immune suppression, or undergoing renal transplantation (Schedule 1). The Schedule also defines “terminal event” by naming examples such as pneumonia and respiratory failure, thereby clarifying what is meant by “death from warts” for the purposes of the Statement (Schedule 1).

The core concepts therefore are: a textual medical definition of warts, a finite list of evidence‑based exposure or vulnerability factors (many with 20‑month temporal windows), an explicit requirement that a factor be related to the person’s relevant service, and cross‑referencing to other Statements where a factor overlaps with an injury or disease already covered.

The instrument applies to persons making claims under provisions of the VEA and the MRCA: specifically, it “applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies” (s 5). That means the Statement is targeted at claimants who are veterans, members of Peacekeeping Forces, or members of the Forces as those terms are used in the VEA and MRCA; the Schedule also defines “relevant service” categories that bind the instrument’s application (Schedule 1).

Who is a potential claimant: The Statement will be used in adjudication of claims alleging that warts, or death from warts, were caused by, materially contributed to, or were aggravated by relevant service. It is therefore directly relevant to claimants seeking a statutory link between warts and specified types of service , operational, peacekeeping, hazardous, British nuclear test defence service under the VEA, and warlike or non‑warlike service under the MRCA , as defined in Schedule 1. The instrument is not framed to create rights for non‑service persons; its application is limited to claims under the referenced statutory provisions (s 5; Schedule 1).

Medical practitioners and decision makers: The Statement will also affect medical assessors, treating clinicians, and decision makers who must apply it when assessing whether the “reasonable hypothesis” threshold is satisfied. The Authority’s approach prescribes the factors that must be considered and the temporal and contextual limits which must be applied when making causation findings for claims. For example, clinicians providing opinions will need to address the existence and timing of the section 9 factors, whether those factors can be related to service per section 10, and whether the person met an “immunocompromised state as specified” at the relevant times (Schedule 1).

Administrative agencies and insurers: Decision‑makers under the VEA and MRCA will use the Statement as an evidentiary instrument when deciding entitlements. Although the instrument itself does not lay down decision processes or awards, its presence will shape what evidence must be collected and what medical opinions will be persuasive in establishing a reasonable hypothesis.

Persons affected by exclusions: The instrument explicitly excludes certain skin lesions from the definition of warts (seborrheic keratosis, skin cancers, keratoacanthoma, skin tags, and papilloma of the bladder) (s 7(2)(c)). Where a claimant’s lesion falls within one of these exclusions, the Statement’s factors will not be designed to support a reasonable hypothesis linking that lesion to service under this Statement.

Those involved in overlapping conditions: Section 11 creates a mechanism for overlap with other Statements of Principles. If a factor in s 9 refers to an injury or disease already covered by another Statement, that other Statement’s factors will apply. Accordingly, claimants and practitioners dealing with conditions that interrelate with warts may have to apply multiple Statements according to their terms.

In summary, the instrument affects claimants under the VEA and MRCA, clinicians and medical assessors preparing evidence, and administrative decision‑makers who will apply the Statement to determine whether a reasonable hypothesis is established linking warts (or death from warts) to relevant service. The instrument’s scope is circumscribed to claims under the referenced statutory provisions and to the medical definition and factors set out in the instrument.

This instrument sets out an evidentiary framework; it does not itself impose civil or criminal duties or create standalone entitlement rights. Rather, the Statement prescribes the minimum factual or medical circumstances that must exist to say a “reasonable hypothesis” has been raised connecting warts or death from warts with relevant service (s 9). Users of the Statement therefore have operational duties in the form of evidentiary burdens and obligations to address the prescribed factors when making or assessing claims under the VEA and MRCA.

Duty to establish a qualifying factor: The primary obligation for a claimant is to demonstrate that at least one of the factors in section 9 exists in relation to the person and that the factor is related to the person’s relevant service (s 9; s 10(1)). The Statement is precise in this requirement: “At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised” (s 9). The duty is therefore to marshal evidence that satisfies one or more of those enumerated factors.

Duty to link the factor to relevant service: Section 10(1) requires that the existence of any factor referred to in s 9 “must be related to the relevant service rendered by the person.” This creates an evidential duty to go beyond showing the factor existed; the claimant must show a relationship between that factor and the person’s relevant service as defined in the Schedule.

Temporal and causation limits for aggravation/material contribution: Section 10(2) places a specific limitation on subsections 9(8) and 9(9), which relate to clinical worsening and inability to obtain appropriate clinical management respectively: those factors “apply only to 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 is a qualification on which types of claims those particular factors can support.

Rights in proceedings using the Statement: The Statement operates as the medical‑scientific basis adopted by the Repatriation Medical Authority for use in claims under the specified sections of the VEA and MRCA (s 8; s 5). Practically, claimants have the right to have decision‑makers consider the Statement when assessing whether the “reasonable hypothesis” threshold is raised, and decision‑makers have the right to require evidence addressing the factors and definitions contained in the Statement. Section 11 also entitles parties to rely on other Statements of Principles where a factor in s 9 refers to an injury or disease already covered under subsection 196B(2) of the VEA; the other Statement’s factors apply “in accordance with the terms of that Statement” as in force from time to time.

Interpretive obligations on medical assessors: The Schedule supplies several definitions intended to limit interpretive variability (for example, “direct physical contact” defined as contact where no protective or impermeable barrier exists; “immunocompromised state as specified” illustrated with specific examples; and “terminal event” enumerated) (Schedule 1). Medical assessors and decision‑makers must apply these definitions when determining whether the factual prerequisites are satisfied.

No penalty provisions in the instrument: The Statement does not purport to create disciplinary, penal, or sanctioning duties; it is an instrument invoked in the evidentiary evaluation of claims. Where duties, rights and remedies arise will be determined by the provisions of the VEA or MRCA to which the Statement applies (s 5). The Statement itself does not set award levels, payment obligations, or administrative penalties; it defines factors for causation assessment.

In summary, the instrument creates operational duties to demonstrate at least one listed factor and to relate it to relevant service, limits applicability of some factors to pre‑existing conditions, prescribes definitions that constrain interpretation, and allows cross‑application of other Statements where factors overlap. The rights conferred are procedural: claimants and decision‑makers must treat the Statement as the Authority’s medical‑scientific view for establishing a reasonable hypothesis under the referenced statutory claims processes.

The Statement itself contains no standalone penalty provisions, nor does it set out enforcement mechanisms or administrative sanctions. The instrument is made under the statutory power in subsection 196B(2) of the Veterans' Entitlements Act 1986 (s 3) and is expressed to apply to claims under section 120A of the VEA or section 338 of the MRCA (s 5). The document therefore functions as a medical‑scientific standard for assessing causation in those statutory claim frameworks, rather than as a punitive or enforcement instrument.

What the Statement does specify for decision processes is the threshold required to raise a “reasonable hypothesis”: at least one factor in section 9 must exist and be related to relevant service (s 9; s 10(1)). This has an operational enforcement effect inside the claims process: if the required factors are not shown, the threshold for linking warts or death from warts to service will not have been met under this Statement. The instrument does not itself prescribe the administrative consequences of failing to meet the threshold , for example whether a claim is rejected or requires further evidence , because those procedural outcomes are governed by the VEA and MRCA provisions to which the Statement applies (s 5). Those statutes are outside the text of the instrument and are not detailed here.

The Schedule supplies definitions intended to clarify application (Schedule 1). For example, the definition of “direct physical contact” limits what contact counts for evidentiary purposes to contact where no protective or impermeable barrier exists (Schedule 1). That specification is enforceable in the sense that medical assessors or decision makers applying the Statement must treat contact behind a barrier as not meeting the “direct physical contact” factor in s 9(1).

Section 11 provides an enforcement‑relevant mechanism: where a factor in s 9 refers to an injury or disease already covered by another Statement of Principles made under subsection 196B(2) of the VEA, the factors in that other Statement “apply in accordance with the terms of that Statement as in force from time to time” (s 11). This cross‑reference means that enforcement of causation findings may require simultaneous application of another Statement’s factors as the Authority has determined from time to time.

Finally, the instrument repeals the 2014 Statement of Principles concerning warts (s 4). That repeal is an administrative action that alters which Statement of Principles applies; compliance and enforcement going forward will be governed by the 2023 Statement from its commencement date (s 2).

Because the Statement is an evidentiary and interpretive instrument under the Authority’s statutory power, the practical enforcement consequences (such as acceptance or rejection of claims, or later review or appeal rights) will operate through the VEA/MRCA statutory processes to which the Statement is applied. Those statutes and their procedures are not reproduced in this instrument.

The instrument is expressly made under the Authority conferred by subsection 196B(2) of the Veterans' Entitlements Act 1986 (s 3) and is designed to be used in the adjudication of claims under both the VEA and the MRCA: it applies to claims under section 120A of the VEA or section 338 of the MRCA (s 5). The instrument therefore operates as a medical‑scientific input to the statutory decision‑making processes prescribed by those Acts.

Cross‑references to other Statements of Principles: Section 11 creates a formal interaction point with other Statements of Principles made under subsection 196B(2) of the VEA. If a factor in s 9 refers to an injury or disease that is the subject of another Statement, then the factors in that other Statement apply “in accordance with the terms of that Statement as in force from time to time” (s 11). That mechanism requires users of this Statement to identify when a section 9 factor overlaps with another condition and to apply the other Statement’s terms where relevant.

Interaction with ICD codes: The instrument notes that warts “attracts ICD‑10‑AM codes A63.0 and B07” and provides the edition and copyright details of the ICD‑10‑AM reference (s 7(3)-(4)); however, it states that “in applying this Statement of Principles the meaning of warts is that given in subsection (2).” That means the text’s medical definition in s 7(2) controls application, with the ICD codes provided as a cross‑reference rather than an authoritative determinative instrument. Users must therefore follow the textual definition rather than assuming code assignments are dispositive.

Relationship to the statutory claims framework: The instrument does not itself create entitlement or award parameters; rather, it is an evidentiary standard to be applied within the VEA and MRCA decision frameworks. Section 5 makes that clear by limiting application to claims to which s 120A VEA or s 338 MRCA applies. Any legal effects (acceptance, denial, compensation) arising from the Statement’s application flow from those statutes and their processes, which are not reproduced in the instrument.

Definitions aligning with statutory categories: The Schedule defines “relevant service” by reference to the categories used in the VEA and MRCA , operational, peacekeeping, hazardous, British nuclear test defence service under the VEA, and warlike/non‑warlike service under the MRCA (Schedule 1). Because the instrument uses the statutory categories, it aligns its application to the classifications used in the parent statutes; as a result, interactions with other laws will follow the underlying statutory definitions and thresholds of the VEA and MRCA.

Limitations imposed by the Statement on aggravation/material contribution claims: Section 10(2) restricts the operation of subsections 9(8) and 9(9) , clinical worsening and inability to obtain appropriate clinical management , to claims of material contribution or aggravation where the wart was suffered or contracted before or during (but not arising out of) the person’s relevant service. This is an internal constraint that interacts with the parent statutes’ concepts of material contribution and aggravation as applied in claims under those statutes.

No explicit interaction with other non‑referenced laws: The instrument does not mention interaction with other legislative regimes (for example, workers’ compensation, general tort law, Medicare, public health regulation) and contains no provisions that purport to override or modify other legislation. Its legal role is limited to the evidentiary/medical domain within the claims under the VEA and MRCA.

In summary, the instrument is constructed to operate as an authoritative medical framework within the VEA and MRCA claims processes, cross‑referencing other Statements of Principles where relevant and referencing ICD codes for clarity while preserving the instrument’s textual definition as controlling.

The instrument records its own administrative chronology in two explicit places. It is titled “Statement of Principles concerning warts (Reasonable Hypothesis) (No. 7 of 2023)” and is dated 27 February 2023 (document header). The instrument states that it commences on 27 March 2023 (s 2). Section 4 expressly repeals the earlier Statement of Principles concerning warts No. 70 of 2014 (Federal Register of Legislation No. F2014L00926) that had been made under subsection 196B(2) of the VEA.

The 2014 Statement is therefore removed from force as of this instrument’s commencement. The 2023 Statement replaces it as the Repatriation Medical Authority’s Statement of Principles on warts for the purposes of the VEA and MRCA claims processes. The instrument is made under the Authority in subsection 196B(2) of the VEA, which is cited as the enabling provision (s 3).

The instrument does not contain a schedule of amendments or a history of prior modifications beyond the one repeal. It does not note transitional arrangements in respect of claims pending at commencement, nor does it set out savings provisions for earlier decisions made under the repealed 2014 Statement; any such transitional treatment would be governed by the enabling statute and administrative practice but is not specified in the text of this instrument.

Because section 11 contemplates that factors in this Statement may refer to injuries or diseases covered by other Statements “as in force from time to time,” the instrument is structured to operate within an evolving body of Statements of Principles maintained by the Authority. That mechanism implicitly permits future amendments to other Statements to affect how overlap is resolved, without this instrument itself being amended.

The instrument is signed and sealed by the Authority’s Chairperson, indicating formal execution and administrative effect (document header). There are no incremental amendment entries recorded in the text beyond the stated repeal of the 2014 instrument and the new commencement date for the 2023 Statement.

The Statement text contains no record of litigation, judicial review, or case law that has interpreted or tested this Statement. It does not cite any court decisions or administrative rulings. The instrument is a legislative administrative instrument issued by the Repatriation Medical Authority and is presented as the Authority’s medical‑scientific view for use within the statutory claims frameworks of the VEA and MRCA (s 8; s 5).

Because the Statement is designed to be applied in claims under section 120A of the VEA or section 338 of the MRCA (s 5), disputes arising from decisions that apply this Statement could, in principle, be the subject of administrative review or judicial proceedings under the remedies and review mechanisms provided in the VEA or MRCA. The Statement itself, however, does not document any such proceedings, nor does it reference any precedent interpreting its defined terms or factors.

The absence of litigation history in the instrument means practitioners and decision makers must rely on the text of the instrument (including its definitions and factor list) and on the parent statutes when preparing cases or assessments. If and when disputes arise in practice about the interpretation or application of this Statement (for example, the meaning of “direct physical contact,” the scope of “immunocompromised state as specified,” the sufficiency of the evidentiary link to relevant service, or the interpretation of “death from warts” and “terminal event”), those matters will be resolved through the statutory review and appeal channels applicable to VEA and MRCA decisions; the Statement itself provides no litigated authority.

Practitioners should therefore note that while the instrument is the Repatriation Medical Authority’s expressed medical‑scientific position, any legal contest about that position’s application or about a particular decision using the Statement will need to be evaluated in the context of the VEA and MRCA legal frameworks. The Statement does not supply examples of interpreted disputes or settled litigation guidance.

This instrument is short and precise, but several features can give rise to interpretive traps, evidentiary burden shifts, or application errors for claimants and advisers. The following are points to watch closely, grounded in the instrument’s text.

Single‑factor minimum: The Statement requires that “at least one” of the factors in section 9 must exist “before it can be said that a reasonable hypothesis has been raised” (s 9). Practically this means that absence of any listed factor will prevent a claimant from relying on this Statement to meet the reasonable hypothesis threshold. Claimants and their medical advisers must therefore ensure that evidence directly addresses one or more listed factors rather than relying on general assertions of exposure or susceptibility.

Tight temporal windows: Many exposure factors require the exposure to have occurred “within the 20 months before the clinical onset of warts” (s 9(1)-(6)). The instrument is precise on the 20‑month window for most listed exposures. Failure to demonstrate timing within that window risks disqualification under the Statement, even where an exposure occurred earlier or later. Practitioners should not assume longer incubation or exposure windows unless another Statement or evidence outside this instrument supports it. The instrument’s temporal specificity is a common source of defeat if records or testimony do not align.

Site‑specific factors: Several factors are tied to anatomical site: cervical warts (penetrative sexual intercourse with a person with genital warts) (s 9(2)), anogenital region (contact with anogenital warts) (s 9(3)), oral cavity/larynx (oral sex with anogenital warts) (s 9(4)), plantar warts (communal showers) (s 9(5)), and warts on the hands (shared gloves/utensils in food preparation) (s 9(6)). Applying the correct factor to the correct clinical presentation is essential; mis‑matching site and factor will fail the Statement test.

Narrow definition of direct physical contact: The Schedule defines “direct physical contact” as physical contact where no protective or impermeable barrier exists (Schedule 1). Contact mediated by gloves, clothing, or other barriers will not meet the s 9(1) factor. This is an evidentiary trap where a claimant asserts contact but the contact was protected.

Limited examples for immunocompromise: “Immunocompromised state as specified” is defined with examples , HIV infection, taking an immunosuppressive drug causing substantial suppression, or undergoing renal transplantation (Schedule 1). The Schedule frames these as examples of “a condition of substantially lowered immune function, such as would occur in the following conditions or circumstances,” which leaves room for clinical judgment but anchors the concept to specific circumstances. Claimants asserting other immunosuppressive states not listed will need to show how those states are materially equivalent to the specified examples.

Aggravation/material contribution limits: Sections 9(8) and 9(9), which cover clinical worsening while immunocompromised and inability to obtain appropriate clinical management respectively, are limited by s 10(2) to apply only where the wart “was suffered or contracted before or during (but did not arise out of) the person's relevant service.” That is a narrow construct: those factors cannot be used to assert that wart first contracted after service was materially worsened by service; the wart must pre‑exist or be contracted before or during service (but not arising out of it). Misreading s 10(2) is a potential procedural pitfall.

Death from warts definition: The instrument includes “death from a terminal event or condition that was contributed to by the person's warts” (s 7(5)) and defines “terminal event” by example (Schedule 1). Where a claim involves death, practitioners must show contribution to a listed terminal event or its proximate cause. The instrument does not quantify contribution thresholds; the wording “contributed to” requires causal linkage but leaves the degree of contribution to clinical judgment.

ICD codes are not controlling: Although the Statement notes the usual ICD‑10‑AM codes for warts, it expressly states that the meaning of “warts” for applying this Statement is the textual definition in s 7(2) (s 7(3)). Relying solely on ICD coding without demonstrating the textual elements risks misapplication.

Cross‑Statement application can complicate evidence: Section 11 requires applying factors from other Statements when a s 9 factor refers to an injury or disease covered elsewhere. That means claimants and clinicians must check other Statements and apply potentially different factor lists and definitions as in force, which adds procedural complexity and can lead to omitted evidence if not anticipated.

No transitional guidance for the 2014 repeal: The instrument repeals the 2014 Statement (s 4) but contains no transitional provisions. For claims initiated around the commencement date, dependence on the newer factor set versus the 2014 set is not addressed in this document and could complicate evidence collection timing.

No procedural or evidentiary guidance beyond factor lists: The Statement sets out what factors must exist but does not give procedural guidance on how to prove them, what documentary evidence is acceptable, or how to treat contested factual accounts. Claimants and advisers must therefore build evidentiary cases cognisant of the strict, textual requirements rather than expecting the Statement to supply proof standards.

In short, the practicable “gotchas” are: single‑factor minimum; precise timing windows; correct anatomical matching of factors; the barrier test for direct contact; narrow, exemplar‑based immunocompromise definitions; the restriction on aggravation/material contribution factors to pre‑existing warts; ICD codes are not determinative; cross‑Statement interactions can increase evidentiary complexity; and there is no procedural detail on proof standards or transitional arrangements.

Compliance, in this context, means assembling the factual and clinical material required to satisfice the instrument’s threshold that a “reasonable hypothesis” has been raised linking warts or death from warts to relevant service. The Statement is explicit about what must be shown and how it must relate to the person’s service; below are concrete, text‑based steps derived from the instrument.

1. Identify the clinical diagnosis within the instrument’s textual definition:

   • Confirm that the lesion is a “wart” as defined in s 7(2): an abnormal benign hyperplastic lesion caused by human papillomavirus infection, and that it is not an excluded lesion (seborrheic keratosis, skin cancers, keratoacanthoma, skin tags, papilloma of the bladder) (s 7(2)(a)-(c)). Although ICD‑10‑AM codes A63.0 and B07 are acknowledged, the statutory meaning for application is s 7(2), not the ICD codes alone (s 7(3)-(4)).

2. Establish which factor(s) in section 9 are relevant to the clinical presentation and gather precise evidence:

   • For direct cutaneous transmission claims, document “direct physical contact” with another person’s cutaneous warts within 20 months before clinical onset (s 9(1)). The Schedule defines direct physical contact as contact where no protective or impermeable barrier exists (Schedule 1).
   • For cervical warts, document penetrative sexual intercourse with a person with genital warts within 20 months before onset (s 9(2)).
   • For anogenital warts, document contact with another person’s anogenital warts within 20 months before onset (s 9(3)).
   • For oral cavity or laryngeal warts, document oral sex with a person with anogenital warts within 20 months before onset (s 9(4)).
   • For plantar warts, document use of communal showering or bathing facilities within 20 months before onset (s 9(5)).
   • For hand warts, document shared gloves or shared utensils on more days than not for three months in preparing meat, poultry or fish for consumption within 20 months before onset (s 9(6)). Collect contemporaneous records, witness statements, workplace records, service activity logs, or medical notes that support the timing and nature of the exposure.

3. Where immunocompromise is relied upon, tie the state to the Schedule examples:

   • To rely on s 9(7) or s 9(8), establish that the person was in an “immunocompromised state as specified” at the time of clinical onset or clinical worsening. The Schedule lists HIV infection, taking an immunosuppressive drug which causes substantial suppression, or undergoing renal transplantation as examples (Schedule 1). Provide clinical records, treatment histories, and specialist opinion showing the immunocompromised state coincided with the relevant clinical event.

4. If inability to obtain appropriate clinical management is relied upon (s 9(9)):

   • Document the attempts made to obtain appropriate management, the barriers encountered, and the timing relative to the wart’s clinical course. Remember s 10(2) limits the application of s 9(8) and s 9(9) to material contribution or aggravation claims where the wart was suffered or contracted before or during (but did not arise out of) the person’s relevant service. Ensure the wart’s chronology satisfies that constraint.

5. Relate the proven factor to “relevant service”:

   • Section 10(1) requires that any factor relied on must be related to the person’s relevant service. The Schedule defines relevant service categories (Schedule 1). Evidence should therefore link the exposure event to the time and context of relevant service , for example, occurrence while on operational deployment, while using communal facilities during peacekeeping service, or while engaged in food‑preparation duties using shared gloves. Use service records, unit logs, deployment itineraries, workplace descriptions and sworn statements that place the exposure in the context of the person’s relevant service.

6. Consider overlapping Statements:

   • If a s 9 factor refers to an injury or disease that is the subject of another Statement of Principles, section 11 requires applying the other Statement’s factors. Review the other Statement(s) and gather any additional evidence those Statements require. Make sure to apply those Statements “in accordance with the terms of that Statement as in force from time to time” (s 11).

7. For death claims, demonstrate contribution:

   • Where death is alleged to be from warts, show that death involved a “terminal event” that was contributed to by the person’s warts (s 7(5)). The Schedule lists examples of terminal events such as pneumonia or respiratory failure (Schedule 1). Obtain clinical records, death certificates, pathology, and treating clinician opinions linking the wart‑related pathology to the terminal event.

8. Pay attention to exclusions and correct classification:

   • Ensure the lesion is not one of the exclusions in s 7(2)(c). If pathology or clinical description suggests an excluded lesion, this Statement will not directly apply.

9. Document timing carefully:

   • Because many exposure factors are tied to a 20‑month window before clinical onset, precise documentation of onset dates and exposure dates is essential. Obtain clinical onset records, dated photographs, GP and specialist notes, and contemporaneous service records.

10. Prepare medico‑legal evidence that addresses the Statement’s structure:

    • In medical opinions, explicitly address the instrument’s elements: diagnosis under s 7(2), presence of a section 9 factor with dates and description, relationship to relevant service per s 10(1), and, where relevant, immunocompromised status per the Schedule or contribution to terminal event for death claims. Also address any cross‑referenced Statements under s 11.

11. Anticipate audit of barrier/protection details:

    • If relying on direct contact, clarify whether protective or impermeable barriers were present at the contact time, as any barrier will negate “direct physical contact” under the Schedule’s definition.

12. Be mindful of the repeal timing:

    • The 2014 Statement was repealed by s 4. Claims straddling the commencement date should be approached by reference to this instrument; the Statement contains no transitional rules, so document the factual case so it satisfies the 2023 factors.

Following these steps aligns evidence collection and medico‑legal testimony to the textual requirements of the Statement. The instrument’s formulation leaves little margin for non‑specific evidence: it requires factor‑by‑factor proof tied to service contexts and temporal limits. Practitioners should therefore assemble precise, dated, service‑contextual evidence and medical opinions mapped directly to the instrument’s sections.