Statement of Principles concerning iliotibial band syndrome (Balance of Probabilities) (No. 4 of 2019) (Cth)

Statement of Principles

concerning

ILIOTIBIAL BAND SYNDROME
 (Balance of Probabilities)

(No. 4 of 2019)

The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.

Dated    21 December 2018

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

Professor Nicholas Saunders AO
Chairperson

Contents

1Name........................................................................................................................................... 3

2Commencement........................................................................................................................ 3

3Authority..................................................................................................................................... 3

4Repeal......................................................................................................................................... 3

5Application................................................................................................................................. 3

6Definitions.................................................................................................................................. 3

7Kind of injury, disease or death to which this Statement of Principles relates............... 3

8Basis for determining the factors........................................................................................... 4

9Factors that must exist............................................................................................................. 4

10Relationship to service............................................................................................................. 6

11Factors referring to an injury or disease covered by another Statement of Principles. 6

Schedule 1 - Dictionary............................................................................................. 7

1Definitions.................................................................................................................................. 7

1. Name

This is the Statement of Principles concerning iliotibial band syndrome (Balance of Probabilities) (No. 4 of 2019).

1. Commencement

This instrument commences on 28 January 2019.

1. Authority

This instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.

1. Repeal

The Statement of Principles concerning iliotibial band syndrome No. 35 of 2010 (Federal Register of Legislation No. F2010L01051) made under subsection 196B(3) of the VEA is repealed.

1. 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.

1. Definitions

The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.

1. Kind of injury, disease or death to which this Statement of Principles relates

(1)This Statement of Principles is about iliotibial band syndrome and death from iliotibial band syndrome.

Meaning of iliotibial band syndrome

(2)For the purposes of this Statement of Principles, iliotibial band syndrome:

(a)means a condition of the distal portion of the iliotibial tract where it courses over the lateral femoral epicondyle; and

(b)is characterised by pain and tenderness over the lateral aspect of the knee which usually worsens with physical activity; and

(c)excludes proximal iliotibial band syndrome and iliotibial band insertional tendinosis.

(3)While iliotibial band syndrome attracts ICD‑10‑AM code M76.3, in applying this Statement of Principles the meaning of iliotibial band syndrome 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 iliotibial band syndrome

(5)For the purposes of this Statement of Principles, iliotibial band syndrome, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's iliotibial band syndrome.

Note: terminal event is defined in the Schedule 1 – Dictionary.

1. 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 iliotibial band syndrome and death from iliotibial band syndrome 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.

1. Factors that must exist

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

(1)running or jogging an average of at least 60 kilometres per week for at least the four weeks before the clinical onset of iliotibial band syndrome;

(2)undertaking weight bearing exercise involving repeated flexion and extension of the affected knee, at a minimum intensity of five METs for at least six hours per week, for at least the four weeks before the clinical onset of iliotibial band syndrome;

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

(3)increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical onset of iliotibial band syndrome;

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

(4)cycling at a minimum intensity of five METs for at least ten hours per week, for at least the four weeks before the clinical onset of iliotibial band syndrome;

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

(5)increasing the frequency, duration or intensity of cycling by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical onset of iliotibial band syndrome;

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

(6)undergoing knee reconstruction surgery with placement of an implant in the distal lateral femur within the one year before the clinical onset of iliotibial band syndrome;

(7)running or jogging an average of at least 60 kilometres per week for at least the four weeks before the clinical worsening of iliotibial band syndrome;

(8)undertaking weight bearing exercise involving repeated flexion and extension of the affected knee, at a minimum intensity of five METs for at least six hours per week, for at least the four weeks before the clinical worsening of iliotibial band syndrome;

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

(9)increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical worsening of iliotibial band syndrome;

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

(10)cycling at a minimum intensity of five METs for at least ten hours per week, for at least the four weeks before the clinical worsening of iliotibial band syndrome;

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

(11)increasing the frequency, duration or intensity of cycling by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical worsening of iliotibial band syndrome;

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

(12)undergoing knee reconstruction surgery with placement of an implant in the distal lateral femur within the one year before the clinical worsening of iliotibial band syndrome;

(13)inability to obtain appropriate clinical management for iliotibial band syndrome.

1. 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(7) to 9(13) apply only to material contribution to, or aggravation of, iliotibial band syndrome where the person's iliotibial band syndrome was suffered or contracted before or during (but did not arise out of) the person's relevant service.

1. 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.

Schedule 1 - Dictionary

Note: See Section 6

1. Definitions

In this instrument:

iliotibial band syndrome—see subsection 7(2).

MET means a unit of measurement of the level of physical exertion.  1 MET = 3.5 ml of oxygen/kg of body weight per minute, 1.0 kcal/kg of body weight per hour or resting metabolic rate.

MRCAmeans the Military Rehabilitation and Compensation Act 2004.

relevant service means:

(a)eligible war service (other than operational service) under the VEA;

(b)defence service (other than hazardous service and British nuclear test defence service) under the VEA; or

(c)peacetime service under the MRCA.

Note: MRCA and VEA are also defined in the Schedule 1 - Dictionary.

terminal event means the proximate or ultimate cause of death and includes the following:

(a) pneumonia;

(b) respiratory failure;

(c) cardiac arrest;

(d) circulatory failure; or

(e) cessation of brain function.

VEA means the Veterans' Entitlements Act 1986.