Shingles and postherpetic neuralgia — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 27 of 2023

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 shingles and postherpetic neuralgia or death from shingles and postherpetic neuralgia with the circumstances of a person's relevant service:

1. (1)
   having chickenpox before the clinical onset of shingles or postherpetic neuralgia;
2. (2)
   for vaccine strain shingles only, having live attenuated varicella vaccine before the clinical onset of shingles or postherpetic neuralgia;

   Note: Vaccine strain shingles is diagnosed by detecting the vaccine strain in the vesicular liquid.

   Note: This factor applies to live attenuated varicella zoster vaccines.

3. (3)
   being prevented from accessing appropriate varicella-zoster vaccination in accordance with contemporary medical standards of the time, between 1 and 5 years before the clinical onset of shingles or postherpetic neuralgia;
4. (4)
   being in an immunocompromised state as specified at the time of the clinical onset of shingles or postherpetic neuralgia;

   Note: immunocompromised state as specified is defined in the Schedule 1 - Dictionary.

5. (5)
   having trauma, including surgery, involving: (a) the dermatome affected by shingles or postherpetic neuralgia; or (b) the nerve supply to the dermatome affected by shingles or postherpetic neuralgia; within the 8 weeks before the clinical onset of shingles or postherpetic neuralgia;

   Note: Examples of trauma include blunt or penetrating trauma.

6. (6)
   having diabetes mellitus at the time of the clinical onset of shingles or postherpetic neuralgia;
7. (7)
   having an autoimmune disease from the specified list of autoimmune diseases at the time of the clinical onset of shingles or postherpetic neuralgia;

   Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.

8. (8)
   having a depressive disorder at the time of the clinical onset of shingles or postherpetic neuralgia;
9. (9)
   having a chronic medical condition from the specified list of chronic medical conditions before the clinical onset of shingles or postherpetic neuralgia;

   Note: specified list of chronic medical conditions is defined in the Schedule 1 - Dictionary.

10. (10)
    having a moderate to severe traumatic brain injury before the clinical onset of shingles or postherpetic neuralgia;
11. (11)
    having a splenectomy before the clinical onset of shingles or postherpetic neuralgia;
12. (12)
    having an active symptomatic infection resulting in SARS-CoV-2 within the 6 months before the clinical onset of shingles or postherpetic neuralgia;

    Note: active symptomatic infection resulting in SARS-CoV-2 is defined in the Schedule 1 - Dictionary.

13. (13)
    being in an immunocompromised state as specified at the time of the clinical worsening of shingles or postherpetic neuralgia;

    Note: immunocompromised state as specified is defined in the Schedule 1 - Dictionary.

14. (14)
    having diabetes mellitus at the time of the clinical worsening of shingles or postherpetic neuralgia;
15. (15)
    inability to obtain appropriate clinical management for shingles and postherpetic neuralgia;

Aggravation-only factors: the factors in subsections 9(13) to 9(15) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.