Instrument No.56 of 1996
Determination
of
Statement of Principles
concerning
POSTERIOR ADVENTITIAL HEEL BURSITIS
ICD CODE: 726.79
Veterans’ Entitlements Act 1986
1. This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the Act).
Kind of injury, disease or death
2. (a) This Statement of Principles is about posterior adventitial heel bursitis and death from posterior adventitial heel bursitis.
(b) For the purposes of this Statement of Principles, “posterior adventitial heel bursitis” means a painful and tender swelling of the ankle due to inflammation and thickening of the superficial subcutaneous adventitial bursa of the Achilles tendon, attracting ICD code 726.79.
Basis for determining the factors
3. 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 can be related to relevant service rendered by veterans or members of the Forces.
Factors that must be related to service
4. 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
5. The factors that 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 are:
(a) wearing ill fitting closed shoes at the time of the clinical onset of posterior adventitial heel bursitis; or
(b) wearing ill fitting closed shoes at the time of the clinical worsening of posterior adventitial heel bursitis; or
(c) inability to obtain appropriate clinical management for posterior adventitial heel bursitis.
Factors that apply only to material contribution or aggravation
6. Paragraphs 5(b) to 5(c) 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 not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e) or 70(5)(d) of the Act refers.
Other definitions
7. For the purposes of this Statement of Principles:
“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;
“ill fitting closed shoes” means footwear which encloses the heel and the back of the foot and which exerts painful pressure upon the posterior aspect of the calcaneus or heel bone;
“relevant service” means:
(a) eligible war service (other than operational service); or
(b) defence service (other than hazardous service).
Dated this Eighteenth day of April 1996
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of )
KEN DONALD
CHAIRMAN
Overview
The Determination of Statement of Principles concerning Posterior Adventitial Heel Bursitis ICD Code: 726.79 under the Veterans' Entitlements Act 1986 was enacted in 1996. This legislation was introduced to address the need for a clear medical-scientific basis for linking certain medical conditions to military service, ensuring that veterans could receive appropriate recognition and compensation for service-related injuries. The Repatriation Medical Authority, acting under the authority of the Act, established these principles to provide a framework for assessing whether posterior adventitial heel bursitis, a condition involving painful swelling of the ankle due to inflammation of the superficial subcutaneous adventitial bursa of the Achilles tendon, could be related to the circumstances of a veteran's service. The determination emphasises that the condition can be linked to service where specific factors, such as wearing ill-fitting closed shoes or the inability to obtain appropriate clinical management, are present and related to the veteran's service. This legislative instrument aims to ensure that veterans receive the support they need by clarifying the conditions under which posterior adventitial heel bursitis can be considered service-related.
Scope and Application
This Statement of Principles is determined under the Veterans’ Entitlements Act 1986 and pertains to posterior adventitial heel bursitis, a painful and tender swelling of the ankle due to inflammation and thickening of the superficial subcutaneous adventitial bursa of the Achilles tendon, identified by the ICD code 726.79. The Statement applies to veterans and members of the Australian Defence Force who may have developed this condition, either from service or due to factors that arose during their service, such as wearing ill-fitting closed shoes or experiencing difficulties in obtaining appropriate clinical management. The Repatriation Medical Authority, which determines these principles, considers it probable that posterior adventitial heel bursitis can be linked to service under certain conditions. The conditions that must exist before it can be said that the condition is connected with the circumstances of the person's service include wearing ill-fitting closed shoes at the time of the clinical onset or worsening of the condition, or an inability to obtain appropriate clinical management.
The determination is applicable nationally and extends to all veterans and members of the Defence Force who meet the specified criteria, ensuring that they may receive appropriate entitlements and benefits under the Act. The Statement of Principles does not apply to cases where the condition arose out of the person's service but rather focuses on the circumstances during service that may have contributed to or aggravated the condition. The legislative instrument further specifies that certain factors apply only to material contribution or aggravation of the condition, depending on the timing of the onset of the condition in relation to the service.
Key Provisions
The main operative sections of the Statement of Principles concerning posterior adventitial heel bursitis (paragraph 2) and its relation to relevant service (paragraph 3) are fundamental. This determination, made by the Repatriation Medical Authority under section 196B(3) of the Veterans’ Entitlements Act 1986, identifies the condition of posterior adventitial heel bursitis and its ICD code, 726.79. This condition is described as a painful and tender swelling of the ankle due to inflammation and thickening of the superficial subcutaneous adventitial bursa of the Achilles tendon. The Authority concludes, based on medical-scientific evidence, that this condition is more likely than not related to the relevant service of veterans or members of the Forces. The document outlines specific factors that must be related to the service, such as wearing ill-fitting closed shoes at the onset or worsening of the condition or inability to obtain appropriate clinical management.
The obligations and requirements imposed by the Act primarily concern the establishment of a connection between the condition of posterior adventitial heel bursitis and the relevant service. To meet these criteria, at least one of the factors outlined in clause 5 must be related to the service rendered by the individual. These factors include wearing ill-fitting closed shoes at the onset or worsening of the condition, or the inability to obtain appropriate clinical management for the condition. Furthermore, it specifies that certain factors only apply to cases where the condition existed before or during service, but not arising out of the service itself, as per paragraphs 5(b) to 5(c). The determination also clarifies the definitions of terms such as "ICD code," "ill fitting closed shoes," and "relevant service," ensuring that all parties have a clear understanding of the terminology used.
In terms of offences, penalties, or consequences for breach, the Statement of Principles does not explicitly detail criminal or civil penalties. However, it does set out the criteria and requirements that must be met for a condition to be considered related to service. Failure to meet these criteria could result in a denial of entitlements under the Act. The consequences for such a denial could be significant for affected veterans, potentially impacting their eligibility for benefits and compensation related to their service. The document emphasizes the importance of providing sound medical-scientific evidence to support any claims related to conditions like posterior adventitial heel bursitis, ensuring that the entitlements are granted fairly and accurately.