REPATRIATION MEDICAL AUTHORITY

INSTRUMENT NO. 20 of 2007

VETERANS’ ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

EXPLANATORY NOTES FOR TABLING

1. The Repatriation Medical Authority ('the Authority'), under subsection 196B(8) of the Veterans’ Entitlements Act 1986 ('the VEA') revokes Instrument No. 4 of 2000 of 28 January 2000, as amended by Instrument No. 48 of 2003 of 7 October 2003, determined under subsection 196B(3) of the VEA concerning plantar fasciitis and death from plantar fasciitis.

2.             The Authority is of the view that on the sound medical-scientific evidence available it is more probable than not that plantar fasciitis and death from plantar fasciitis can be related to particular kinds of service.  The Authority has therefore determined pursuant to subsection 196B(3) of the VEA a Statement of Principles, Instrument No. 20 of 2007 concerning plantar fasciitis.  This Instrument will in effect replace the revoked Statements of Principles.

3.             The provisions of the Military Rehabilitation and Compensation Act 2004 ('the MRCA') relating to claims for compensation commenced on 1 July 2004.  Claims under section 319 of the MRCA for acceptance of liability for a service injury sustained, a service disease contracted or service death on or after 1 July 2004 are determined by the Military Rehabilitation and Compensation Commission by reference to Statements of Principles issued by the Authority pursuant to the VEA.

4.             The Statement of Principles sets out the factors that must exist, and which of those factors must be related to the following kinds of service rendered by a person:

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

 defence service (other than hazardous service) under the VEA;

 peacetime service under the MRCA,

before it can be said that, on the balance of probabilities, plantar fasciitis or death from plantar fasciitis is connected with the circumstances of that service.

5.             This new instrument results from an investigation notified by the Authority in the Government Notices Gazette of 19 November 2003 concerning plantar fasciitis in accordance with section 196G of the Act.  The investigation involved an examination of the sound medical-scientific evidence now available to the Authority, including the sound medical-scientific evidence it has previously considered.

6.             The contents of the new Instrument are in similar terms as the revoked Instruments.  Comparing the new and the revoked Instruments, the differences include:

• adopting the latest revised Instrument format, which commenced in 2005;
• deleting the ICD-10-AM code from the Instrument header;
• revising the definition of 'plantar fasciitis' in clause 3;
• rewording and amending factors 6(a) & 6(k) concerning trauma;
• new factors 6(b) & 6(l) concerning infection involving the plantar fascia;
• rewording factors 6(c) & 6(m) concerning running;
• new factors 6(d) & 6(n) concerning undertaking weight bearing exercise;
• new factors 6(e) & 6(o) concerning increasing the frequency, duration, or intensity of weight bearing exercise;
• new factors 6(f) & 6(p) concerning undergoing prolonged weight bearing while on a hard surface;
• new factors 6(g) & 6(q) concerning body mass index, revising the factor relating to obesity;
• rewording factors 6(h) & 6(r) concerning systemic arthritic disease;
• new factors 6(i) & 6(s) concerning injury or disease that has resulted in a specified biomechanical abnormality, revising the factor relating to fracture of the calcaneus;
• new factors 6(j) & 6(t) concerning wearing inappropriate footwear during weight bearing exercise;
• revising the definitions of 'ICD-10-AM code' and 'relevant service'; in clause 9;
• deleting definitions of 'arthritic conditions in the specified list' and 'being obese'; from clause 9;
• including new definitions of 'a specified biomechanical abnormality'; 'a systemic arthritic disease'; 'Body Mass Index (BMI)'; 'crystal-induced arthropathy'; 'inappropriate footwear'; 'MET'; 'reactive arthropathy' and 'trauma to the plantar aspect of the affected foot'; in clause 9; and
• specifying a date of effect for the Instrument in clause 11.

7.             Further changes to the format of the Instrument reflect the commencement of the MRCA and clarify that pursuant to subsection 196B(3A) of the VEA, the Statement of Principles has been determined for the purposes of both the VEA and the MRCA.

8.             Prior to determining this instrument, the Authority advertised its intention to undertake an investigation in relation to plantar fasciitis in the Government Notices Gazettes of 19 November 2003, and circulated a copy of the notice of intention to investigate to a wide range of organisations representing veterans, service personnel and their dependants. The Authority invited submissions from the Repatriation Commission, organisations and persons referred to in section 196E of the VEA, and any person having expertise in the field.  No submissions were received for consideration by the Authority.

9.             Following the commencement of the MRCA, the Authority published a "Further Notice of Investigations" in the Government Notices Gazette of 14 July 2004, extending the closing date for submissions in relation to the above mentioned investigation until 10 September 2004. The Authority again invited submissions from the Repatriation Commission, organisations and persons referred to in section 196E of the VEA (who include persons eligible to make a claim under the MRCA), as well as the Military Rehabilitation and Compensation Commission and any person having expertise in the field. No further submissions were received for consideration by the Authority during the investigation.

10.         The determining of this new instrument finalises the investigation in relation to plantar fasciitis as advertised in the Government Notices Gazette of 19 November 2003.

11.         A list of references relating to the above condition is available, on written request, from the Repatriation Medical Authority Secretariat.