Reasonable Hypothesis SOP [1] | 112 of 2015 |
Balance of Probabilities SOP [2] | 113 of 2015 |
SOP Bulletin 185 [3]
ICD-9-CM: 070.53
ICD-10-AM: B17.2
Hepatitis E is a viral infection of the liver similar in form to hepatitis A and as such is contracted normally through faecally contaminated food, water or fomites. A fomite is an inanimate object which is capable of carrying and transmitting the infection between persons.
To confirm the diagnosis there needs to be both:
AND
Either symptoms/signs alone or serological evidence alone is insufficient for diagnosis, both components must be present.
The serology during an active infection should have positive IgM antibodies. A negative IgM in combination with a positive IgG indicates a past infection. Asymptomatic past infection is common.
The relevant medical specialist is a gastroenterologist or an infectious disease physician.
Hepatitis A*, B*, C*, D*
Viral hepatitis not due to hepatitis E –
Acute infecious mononucleosis*
Cytomegalovirus#
Herpes simplex*
Coxsackievirus#
* another SOP applies - the SOP has the same name unless otherwise specified
# non-SOP condition
To have a clinical onset of hepatitis E there needs to be both serology testing showing recent or current infection and a clinical illness at around that time (no more than a six months before) with symptoms consistent with Hepatitis E. The clinical onset will then be when the symptoms of that illness started. The clinical onset is not the date of the positive serology.
Clinical worsening of hepatitis E is unlikely, as it is an acute infection which normally resolves without residual impairment, or causes death. There is no chronic form of Hepatitis E.
Hepatitis E is an acute viral infection of the liver. It resolves completely, usually within 2 months and in no longer than 12 months. A relapsing course over a number of months is possible, but there are no long term effects. A claim for hepatitis E determined more than 1 year after disease onset should be diagnosed as “Hepatitis E – resolved”, or “No Incapacity Found”.
Place holder node for Rulebase for hepatitis E
Hepatitis E - Being exposed to the hepatitis E virus Factor
Last reviewed for CCPS 26 September 2007.
Investigative Documents
Claimant Report - Exposure to the Hepatitis E Virus [CR9022] Preliminary questions [38575] 38576 — the veteran has been exposed to the hepatitis E virus at some time. 38577 — the veteran satisfies the occurrence provisions for exposure to the hepatitis E virus and VEA service for the clinical onset of hepatitis E. or 38578 — the veteran has established the causal connection between exposure to the hepatitis E virus and VEA service for the clinical onset of hepatitis E. 38579 — the veteran has established the causal connection between exposure to the hepatitis E virus and operational service for the clinical onset of hepatitis E. or 38580 — the veteran has established the causal connection between exposure to the hepatitis E virus and eligible service for the clinical onset of hepatitis E. Clinical onset and operational service [38579] or
38589 [10] as a consequence of the identified illness or injury, the veteran was exposed to the hepatitis E virus between 15 and 80 days before the clinical onset of hepatitis E. 38591 — the identified illness or injury, as a consequence of which the veteran was exposed to the hepatitis E virus, is causally related to operational service. [11] [12] Clinical onset and eligible service [38580] or
38590 [16] as a consequence of the identified illness or injury, the veteran was exposed to the hepatitis E virus between 15 and 65 days before the clinical onset of hepatitis E. [17]
38592 — the identified illness or injury, as a consequence of which the veteran was exposed to the hepatitis E virus, is causally related to eligible service. [18] [12]
Hepatitis E - Being pregnant Factor
Last reviewed for CCPS 26 September 2007.
Investigative Documents
Claimant Report - Pregnancy [CR9027] Preliminary questions [38593]
1169 — the veteran is a woman. [20] the veteran has been pregnant at some time. the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. 38594 — the veteran has established the causal connection between the pregnancy and operational service for the clinical worsening of hepatitis E. Clinical worsening and operational service [38594]
Hepatitis E - Inability to obtain appropriate clinical management for hepatitis E Factor
Last reviewed for CCPS 26 September 2007.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [7565] 11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7334 [30] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 [31] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration. 11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration. 11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration. or 11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration. Clinical worsening and operational service [11235] or 7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [35] [36] Clinical worsening and eligible service [11236] or 7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [35] [36]
Links
[1] http://www.rma.gov.au/SOP/15/112.pdf
[2] http://www.rma.gov.au/SOP/15/113.pdf
[3] https://clik.dva.gov.au/system/files/media/Bull185.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63612%23comment-form
[5] https://clik.dva.gov.au/ccpsclaimant-154
[6] https://clik.dva.gov.au/reasons-decision-162
[7] clikpopup://CCPS/reject38582No
[8] clikpopup://CCPS/reject38583No
[9] clikpopup://CCPS/rejectwilful
[10] clikpopup://CCPS/Exposed to hepatitis E between 15 and 80 days before onset of hepatitis E due to illness
[11] clikpopup://CCPS/reject38589No
[12] clikpopup://CCPS/reject38591,38592No
[13] clikpopup://CCPS/Exposed to hepatitis E between 15 and 65 days before onset of hepatitis E on El service
[14] clikpopup://CCPS/reject38584No
[15] clikpopup://CCPS/reject38585No
[16] clikpopup://CCPS/Exposed to hepatitis E between 15 and 65 days before onset of hepatitis E due to illness
[17] clikpopup://CCPS/reject38590No
[18] clikpopup://CCPS/reject38592No
[19] https://clik.dva.gov.au/ccpsclaimant-127
[20] clikpopup://CCPS/reject1169No
[21] https://clik.dva.gov.au/ccpsg002rc-4
[22] clikpopup://CCPS/reject8240No
[23] clikpopup://CCPS/Reject/OnsetAfterService
[24] clikpopup://CCPS/Reject/NoPermanentWorsening
[25] https://clik.dva.gov.au/reasons-decision-12
[26] clikpopup://CCPS/reject8246No
[27] clikpopup://CCPS/reject26889No
[28] clikpopup://CCPS/reject26890No
[29] https://clik.dva.gov.au/ccpsother-31
[30] https://clik.dva.gov.au/node/70943
[31] clikpopup://CCPS/Hepatitis E/ACM - contributed to worsening
[32] clikpopup://CCPS/ACM/NoContribution
[33] clikpopup://CCPS/ACM/NotOpService
[34] clikpopup://CCPS/ACM/NotOperDuties
[35] clikpopup://CCPS/ACM/NoIllness
[36] clikpopup://CCPS/reject7390,7391No
[37] clikpopup://CCPS/Hepatitis E/ACM %C2%96 onset prior to operational service
[38] clikpopup://CCPS/ACM/OnsetFailOper
[39] clikpopup://CCPS/ACM/NotEligService
[40] clikpopup://CCPS/ACM/NotEligDuties
[41] clikpopup://CCPS/Hepatitis E/ACM %C2%96 onset prior to eligible service
[42] clikpopup://CCPS/ACM/OnsetFailElig