Statement of Principles concerning chickenpox (Balance of Probabilities) (No. 30 of 2023) (Cth)

Statement of Principles concerning CHICKENPOX (Balance of Probabilities) (No. 30 of 2023) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.

Dated 24 April 2023.

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

Professor Terence Campbell AM Chairperson

Contents 1 Name 2 Commencement 3 Authority 4 Repeal 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 chickenpox (Balance of Probabilities) (No. 30 of 2023). 2 Commencement This instrument commences on 23 May 2023. 3 Authority This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning chickenpox No. 88 of 2015 (Federal Register of Legislation No. F2015L00920) made under subsection 196B(3) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004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 chickenpox and death from chickenpox. Meaning of chickenpox (2) For the purposes of this Statement of Principles, chickenpox: (a) means an infection caused by the varicella-zoster virus, usually manifesting with a vesicular eruption involving the skin or mucous membranes; and (b) excludes: (i) herpes simplex; (ii) shingles or postherpetic neuralgia; (iii) Mpox; and (iv) smallpox. Note: Chickenpox can also involve the lungs (pneumonia), the brain (encephalitis or meningitis) and other organs, and can produce disseminated intravascular coagulation. (3) While chickenpox attracts ICD‑10‑AM code B01, in applying this Statement of Principles the meaning of chickenpox 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), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4. Death from chickenpox (5) For the purposes of this Statement of Principles, chickenpox, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's chickenpox. Note: terminal event is defined in the Schedule 1 – Dictionary. 8 Basis for determining the factors On the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that chickenpox and death from chickenpox can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA. Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary. 9 Factors that must exist At least one of the following factors must exist before it can be said that, on the balance of probabilities, chickenpox or death from chickenpox is connected with the circumstances of a person's relevant service: (1) being exposed to the varicella-zoster virus: (a) between 10 and 21 days before the clinical onset of chickenpox; or (b) between 10 and 28 days before the clinical onset of chickenpox in someone who: (i) is in an immunocompromised state as specified; or (ii) has received varicella-zoster immunoglobulin or normal human immunoglobulin as prophylaxis following varicella-zoster virus exposure; Note: being exposed to the varicella-zoster virus and immunocompromised state as specified are defined in the Schedule 1 – Dictionary. (2) for vaccine strain chickenpox only, having live attenuated varicella vaccine between 5 and 45 days before the clinical onset of chickenpox; Note: vaccine strain chickenpox is defined in the Schedule 1 - Dictionary. (3) being prevented from accessing appropriate varicella-zoster vaccination in accordance with contemporary medical standards of the time, between 1 year and 10 years before the clinical onset of chickenpox; (4) being in an immunocompromised state as specified at the time of the clinical worsening of chickenpox; Note: immunocompromised state as specified is defined in the Schedule 1 – Dictionary. (5) being pregnant at the time of the clinical worsening of chickenpox; (6) inability to obtain appropriate clinical management for chickenpox. 10 Relationship to service (1) The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person. (2) The factors set out in subsections 9(4) to 9(6) apply only to material contribution to, or aggravation of, chickenpox where the person's chickenpox was suffered or contracted before or during (but did not arise out of) the person's relevant service. 11 Factors referring to an injury or disease covered by another Statement of Principles In this Statement of Principles: (1) if a factor referred to in section 9 applies in relation to a person; and (2) that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA; then the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.