SoP LibrarySteatohepatitis

Statement of Principles

Steatohepatitis — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Steatohepatitis. DVA can only accept a claim for Steatohepatitis if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

Steatohepatitis

RH No. 86 of 2022 · BoP No. 87 of 202226 factors

Meaning of steatohepatitis: For the purposes of this Statement of Principles, steatohepatitis: (a) means the presence of fatty change and inflammation of the liver with hepatocyte injury, with or without fibrosis; and (b) includes alcoholic steatohepatitis and non-alcoholic steatohepatitis; and (c) excludes: (i) alpha-1 antitrypsin deficiency; (ii) biliary obstruction; (iii) haemochromatosis; and (iv) Wilson's disease.

Reasonable Hypothesis (RH) — Statement of Principles No. 86 of 2022

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 steatohepatitis or death from steatohepatitis with the circumstances of a person's relevant service:

  1. (1)
    having hypertension before the clinical onset of steatohepatitis;
  2. (2)
    having diabetes mellitus at the time of the clinical onset of steatohepatitis;
  3. (3)
    being obese at the time of the clinical onset of steatohepatitis;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  4. (4)
    having rapid weight loss causing protein-calorie malnutrition within the 18 months before the clinical onset of steatohepatitis;

    Note: rapid weight loss is defined in the Schedule 1 - Dictionary.

  5. (5)
    undergoing jejunoileal bypass surgery before the clinical onset of steatohepatitis;
  6. (6)
    receiving total parenteral nutrition for at least 3 months within the 1 year before the clinical onset of steatohepatitis;

    Note: total parenteral nutrition is defined in the Schedule 1 - Dictionary.

  7. (7)
    having dyslipidaemia at the time of the clinical onset of steatohepatitis;

    Note: dyslipidaemia is defined in the Schedule 1 - Dictionary.

  8. (8)
    for males, consuming at least 55 kilograms of alcohol within any 5 year period before the clinical onset of steatohepatitis;

    Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

  9. (9)
    for females, consuming at least 30 kilograms of alcohol within any 5 year period before the clinical onset of steatohepatitis;

    Note: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.

  10. (10)
    having hyperuricaemia at the time of the clinical onset of steatohepatitis;

    Note: hyperuricaemia is defined in the Schedule 1 - Dictionary.

  11. (11)
    taking irinotecan for at least the 30 days before the clinical onset of steatohepatitis;
  12. (12)
    taking a drug specified in the Schedule 2 - Drugs of this Instrument, that cannot be ceased or substituted, for at least the 30 days before the clinical onset of steatohepatitis;
  13. (13)
    taking a drug that cannot be ceased or substituted and which is associated in the individual with: (a) the development of steatohepatitis within 30 days of first taking the drug; and (b) the redevelopment of steatohepatitis on rechallenge with the same drug;
  14. (14)
    inability to obtain appropriate clinical management for steatohepatitis;

Aggravation-only factors: the factors in subsection 9(14) 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.

Balance of Probabilities (BoP) — Statement of Principles No. 87 of 2022

12 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, steatohepatitis or death from steatohepatitis is connected with the circumstances of a person's relevant service:

  1. (1)
    having diabetes mellitus at the time of the clinical onset of steatohepatitis;
  2. (2)
    being obese at the time of the clinical onset of steatohepatitis;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  3. (3)
    having rapid weight loss causing protein-calorie malnutrition within the 18 months before the clinical onset of steatohepatitis;

    Note: rapid weight loss is defined in the Schedule 1 - Dictionary.

  4. (4)
    undergoing jejunoileal bypass surgery before the clinical onset of steatohepatitis;
  5. (5)
    receiving total parenteral nutrition for at least 6 months within the 1 year before the clinical onset of steatohepatitis;

    Note: total parenteral nutrition is defined in the Schedule 1 - Dictionary.

  6. (6)
    having dyslipidaemia at the time of the clinical onset of steatohepatitis;

    Note: dyslipidaemia is defined in the Schedule 1 - Dictionary.

  7. (7)
    for males, consuming at least 75 kilograms of alcohol within any 5 year period before the clinical onset of steatohepatitis;

    Note: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.

  8. (8)
    for females, consuming at least 40 kilograms of alcohol within any 5 year period before the clinical onset of steatohepatitis;

    Note: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.

  9. (9)
    taking irinotecan for at least the 30 days before the clinical onset of steatohepatitis;
  10. (10)
    taking a drug specified in the Schedule 2 - Drugs of this Instrument, that cannot be ceased or substituted, for at least the 30 days before the clinical onset of steatohepatitis;
  11. (11)
    taking a drug that cannot be ceased or substituted and which is associated in the individual with: (a) the development of steatohepatitis within 30 days of first taking the drug; and (b) the redevelopment of steatohepatitis on rechallenge with the same drug;
  12. (12)
    inability to obtain appropriate clinical management for steatohepatitis;

A VHC Diagnostic Assessment addresses each of these factors one by one against your service record and clinical history. See how a VHC DVA claim works, see all fees ($600 + GST per stage) or book an appointment.

About Dr Thomas Perkins

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Dr Perkins has spent more than thirteen years working exclusively with current and former ADF members — treating their conditions, writing their reports and navigating the DVA system alongside them. With over 100,000 claims submitted and 2,000 Permanent Impairment Assessments completed, he has seen precisely what separates an accepted claim from a rejected one at every level, from initial liability to the Veterans' Review Board.

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