Statement of Principles concerning posterior adventitial heel bursitis (Balance of Probabilities) (No. 48 of 2019) (Cth)

Statement of Principles

concerning

POSTERIOR ADVENTITIAL HEEL BURSITIS
(Balance of Probabilities)

(No. 48 of 2019)

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

Dated    26 April 2019

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............................................................................................................. 4

11Factors referring to an injury or disease covered by another Statement of Principles. 5

Schedule 1 - Dictionary............................................................................................. 6

1Definitions.................................................................................................................................. 6

1. Name

This is the Statement of Principles concerning posterior adventitial heel bursitis (Balance of Probabilities) (No. 48 of 2019).

1. Commencement

This instrument commences on 27 May 2019.

1. Authority

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

1. Repeal

The Statement of Principles concerning heel bursitis No. 78 of 2010 (Federal Register of Legislation No. F2010L02317) 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 posterior adventitial heel bursitis and death from posterior adventitial heel bursitis.

Meaning of posterior adventitial heel bursitis

(2)For the purposes of this Statement of Principles, posterior adventitial heel bursitis:

(a)means inflammation of the superficial retro-Achilles bursa located between the skin and the distal Achilles tendon; and

(b)is characterised by a painful and tender swelling of the posterior aspect of the heel; and

(c)excludes retrocalcaneal bursitis and plantar calcaneal bursitis.

Note: plantar calcaneal bursitis is defined in the Schedule 1 – Dictionary.

Death from posterior adventitial heel bursitis

(3)For the purposes of this Statement of Principles, posterior adventitial heel bursitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's posterior adventitial heel bursitis.

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 posterior adventitial heel bursitis and death from posterior adventitial heel bursitis 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, posterior adventitial heel bursitis or death from posterior adventitial heel bursitis is connected with the circumstances of a person's relevant service:

(1)wearing footwear that causes friction or pressure on the posterior aspect of the heel of the affected foot, at the time of the clinical onset of posterior adventitial heel bursitis;

(2)having a Haglund deformity at the time of the clinical onset of posterior adventitial heel bursitis;

Note: Haglund deformity is defined in the Schedule 1 - Dictionary.

(3)wearing footwear that causes friction or pressure on the posterior aspect of the heel of the affected foot, at the time of the clinical worsening of posterior adventitial heel bursitis;

(4)having a Haglund deformity at the time of the clinical worsening of posterior adventitial heel bursitis;

Note: Haglund deformity is defined in the Schedule 1 - Dictionary.

(5)inability to obtain appropriate clinical management for posterior adventitial heel bursitis.

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(3) to 9(5) apply only to material contribution to, or aggravation of, posterior adventitial heel bursitis where the person's posterior adventitial heel bursitis 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:

Haglund deformity means an abnormality of the posterosuperior part of the calcaneus, where there is a bony enlargement at the attachment of the Achilles tendon.

MRCAmeans the Military Rehabilitation and Compensation Act 2004.

plantar calcaneal bursitis means inflammation of the adventitial bursa located on the inferior aspect of the calcaneus near the insertion of the plantar fascia, characterised by heel pain at the plantar surface of the heel, mild warmth and swelling.

posterior adventitial heel bursitis—see subsection 7(2).

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.