Statement of Principles concerning metatarsalgia No. 39 of 1996 (Cth)
Instrument No.39 of 1996
Determination
of
Statement of Principles
concerning
METATARSALGIA
ICD CODE: 726.70
Veterans’ Entitlements Act 1986
This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act).
Kind of injury, disease or death
(a) This Statement of Principles is about metatarsalgia and death from metatarsalgia.
(b) For the purposes of this Statement of Principles, “metatarsalgia” means chronic pain emanating from the ball of the foot region due to disorders of the structures therein, attracting ICD code 726.70.
Note: (this note does not form part of the instrument) Specific causes of chronic midfoot pain are to be dealt with in the relevant disease specific Statements of Principles. For example, a midfoot pain from a bony neoplasm in the foot would be dealt with under Statements of Principles relating to malignant neoplasm of the bone and articular cartilage, attracting ICD code 170.8.
Basis for determining the factors
The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that metatarsalgia can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces.
Factors that must be related to service
Subject to clause 6, the factors set out in at least one of the paragraphs in clause 5 must be related to any relevant service rendered by the person.
Factors
The factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting metatarsalgia or death from metatarsalgia with the circumstances of a person’s relevant service are:
(a) suffering a fracture in a metatarsal head, neck or shaft or in a proximal phalangeal base, of the affected foot, within the three months immediately before the clinical onset of metatarsalgia; or
(b) suffering from a soft tissue lesion in the area of a metatarsal head of the affected foot, from the specified list of soft tissue lesions at the time of the clinical onset of metatarsalgia; or
(c) suffering from a deformity of the affected foot, from the specified list of foot deformities at the time of clinical onset of metatarsalgia; or
(d) suffering a fracture in a metatarsal head, neck or shaft or in a proximal phalangeal base, of the affected foot, within the three months immediately before the clinical worsening of metatarsalgia; or
(e) suffering from a soft tissue lesion in the area of a metatarsal head of the affected foot, from the specified list of soft tissue lesions at the time of the clinical worsening of metatarsalgia; or
(f) suffering from a deformity of the affected foot, from the specified list of foot deformities, at the time of clinical worsening of metatarsalgia; or
(g) inability to obtain appropriate clinical management for the metatarsalgia.
Factors that apply only to material contribution or aggravation
Paragraphs 5(d) to 5(g) apply only to material contribution to, or aggravation of, metatarsalgia where the person’s metatarsalgia was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70(5A)(d) of the Act refers.
Other definitions
For the purposes of this Statement of Principles:
“fracture” means an acquired break or rupture in a bone, attracting ICD code 733.1 or ICD codes in the range 800 - 829;
“ICD code” means a number assigned to a particular kind of injury or disease in the Australian Version of The International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM), effective date of 1 July 1995, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 22235 5;
“relevant service” means:
(a) operational service; or
(b) peacekeeping service; or
(c) hazardous service;
“specified list of foot deformities” means the following:
Hallux valgus, attracting ICD code 735.0;
Pes cavus, attracting ICD code 736.73;
Pes planus, attracting ICD code 734;
Hammer toes, attracting ICD code 735.3;
Metatarsal splaying, attracting ICD code 736.79;
Digiti quinti varus, attracting ICD code 735.8;
Forefoot valgus, attracting ICD code 736.79; or
Forefoot varus, attracting ICD code 736.79;
“specified list of soft tissue lesions” means the following:
Ganglion cyst, attracting ICD code 727.4;
Tenosynovitis, attracting ICD code 727.06;
Bursitis, attracting ICD code 726.79;
Sesamoiditis, attracting ICD code 733.99; or
Neoplasms, attracting ICD code 170.8, 171.3, 198.89, 215.3, 238.1, or 239.2;
Dated this Fourteenth day of March 1996
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN
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