Statement of Principles concerning opisthorchiasis (Reasonable Hypothesis) (No. 45 of 2016) (Cth)

Statement of Principles concerning OPISTHORCHIASIS (Reasonable Hypothesis) (No. 45 of 2016) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

Dated 22 April 2016

The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:

Professor Nicholas Saunders AO Chairperson

Contents 1 Name 2 Commencement 3 Authority 4 Revocation 5 Application 6 Definitions 7 Kind of injury, disease or death to which this Statement of Principles relates 8 Basis for determining the factors 9 Factors that must exist 10 Relationship to service 11 Factors referring to an injury or disease covered by another Statement of Principles Schedule 1 - Dictionary 1 Definitions

1 Name This is the Statement of Principles concerning opisthorchiasis (Reasonable Hypothesis) (No. 45 of 2016). 2 Commencement This instrument commences on 23 May 2016. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Revocation The Statement of Principles concerning opisthorchiasis No. 111 of 2007 made under subsection 196B(2) of the VEA is revoked. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies. 6 Definitions The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument. 7 Kind of injury, disease or death to which this Statement of Principles relates (1) This Statement of Principles is about opisthorchiasis and death from opisthorchiasis. Meaning of opisthorchiasis (2) For the purposes of this Statement of Principles, opisthorchiasis means a symptomatic clinical infection of the biliary system by the trematodes Opisthorchis felineus or Opisthorchis viverrini. This infection is characterised by loss of appetite, diarrhoea, or a sense of abdominal pressure. (3) While opisthorchiasis attracts ICD‑10‑AM code B66.0, in applying this Statement of Principles the meaning of opisthorchiasis is that given in subsection (2). (4) For subsection (3), a reference to an ICD‑10‑AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD‑10‑AM), Ninth Edition, effective date of 1 July 2015, copyrighted by the Independent Hospital Pricing Authority, ISBN 978‑1‑76007‑020‑5. Death from opisthorchiasis (5) For the purposes of this Statement of Principles, opisthorchiasis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's opisthorchiasis. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 Basis for determining the factors The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that opisthorchiasis and death from opisthorchiasis can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA. Note: relevant service is defined in the Schedule 1 – Dictionary. 9 Factors that must exist At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting opisthorchiasis or death from opisthorchiasis with the circumstances of a person's relevant service: (1) for infection with Opisthorchis viverrini only: (a) ingesting the skin or flesh of raw, undercooked, iced, pickled or smoked freshwater fish containing encysted larvae of Opisthorchis viverrini, at least three weeks before the clinical onset of opisthorchiasis; or