Statement of Principles concerning metatarsalgia No. 40 of 1996

Overview

The Statement of Principles concerning Metatarsalgia, established under the Veterans' Entitlements Act 1986, aims to address the issue of metatarsalgia among veterans, providing a clear framework for determining the connection between the condition and relevant service. This legislation was enacted by the Repatriation Medical Authority, operating under the auspices of the Commonwealth of Australia, to ensure that veterans suffering from metatarsalgia are appropriately recognised and compensated. The policy objective of this Statement of Principles is to facilitate the recognition and assessment of metatarsalgia as a service-related injury, thereby providing necessary medical and financial support to affected veterans. The Statement outlines specific criteria and factors that must be present to establish a link between metatarsalgia and relevant service, ensuring a consistent and evidence-based approach to these claims.

Scope and Application

This Statement of Principles, determined under the Veterans’ Entitlements Act 1986 by the Repatriation Medical Authority, pertains specifically to metatarsalgia, defined as chronic pain originating from the ball of the foot due to structural disorders, as well as death from metatarsalgia. The determination applies to veterans and members of the Australian Defence Force who have experienced relevant service, such as eligible war service or defence service, and who suffer from metatarsalgia or have died from it. This encompasses individuals who have endured a fracture, soft tissue lesion, or foot deformity related to metatarsalgia during or shortly before their service, or those who were unable to obtain appropriate clinical management for their condition. The Statement of Principles excludes specific causes of midfoot pain, such as those arising from bony neoplasms, which are to be addressed under disease-specific Statements of Principles. The determination extends to the Commonwealth jurisdiction and may be subject to modifications through subordinate instruments. The instrument delineates the factors that must be linked to the service to establish a connection between metatarsalgia and the service rendered. These factors include suffering a fracture, soft tissue lesion, or foot deformity within a specified timeframe around the onset or worsening of metatarsalgia, or the inability to obtain suitable clinical management. It is important to note that certain factors only apply to material contribution or aggravation of metatarsalgia if it was already present before or during service but not arising out of the service itself. This detailed determination ensures that eligible veterans and members of the Defence Force can receive appropriate recognition and support for their service-related metatarsalgia.

Key Provisions

The Statement of Principles (SoP) under the Veterans’ Entitlements Act 1986 (section 196B(3)) pertains to metatarsalgia, a chronic pain condition in the ball of the foot due to disorders of the foot structures, with an ICD code of 726.70 (section 2). The SoP aims to establish a link between metatarsalgia and relevant service rendered by veterans or members of the Forces. To make this connection, certain factors must be present (section 3). Specifically, the claimant must have suffered a fracture in a metatarsal head, neck, or shaft, or in a proximal phalangeal base, within three months before the clinical onset or worsening of metatarsalgia (section 5(a) and 5(d)); a soft tissue lesion in the area of a metatarsal head (section 5(b) and 5(e)); a deformity of the affected foot from a specified list (section 5(c) and 5(f)); or an inability to obtain appropriate clinical management for the metatarsalgia (section 5(g)). For material contribution to, or aggravation of, metatarsalgia, the condition must have been suffered or contracted before or during relevant service (section 6). Relevant service for this SoP includes eligible war service (other than operational service) and defence service (other than hazardous service) (section 7). The Act imposes obligations on veterans or members of the Forces who claim benefits related to metatarsalgia to provide evidence that the condition is connected to their service. This evidence must demonstrate one of the specified factors outlined in the SoP. The claimant must present medical records, reports, and any other documentation that substantiates the presence of the factors before the clinical onset or worsening of metatarsalgia. The Repatriation Medical Authority will review the submitted evidence to determine if the factors are related to the claimant's service, and if so, whether the metatarsalgia can be considered connected to the service. The claimant must also ensure that the documentation provided is accurate and complete to support their claim effectively. There are no specific offences or penalties outlined in the SoP for breach of the requirements. However, providing false or misleading information in support of a claim under the Veterans’ Entitlements Act 1986 can lead to serious legal consequences. Under section 221 of the Act, any person who makes a false statement or representation in a claim for a benefit can be liable to a penalty of up to 20 penalty units, which as of 2023 is $4,200. Additionally, such actions can result in the recovery of any benefits paid out under false pretences and may also lead to criminal charges, which can result in fines or imprisonment depending on the severity of the offence.