Statement of Principles concerning trochanteric bursitis and gluteal tendinopathy No. 45 of 2015

Statement of Principles concerning trochanteric bursitis and gluteal tendinopathy No. 45 of 2015

made under subsection 196B(2) of the

Veterans' Entitlements Act 1986

Compilation No. 1  

Compilation date:   28 September 2020

Includes amendments up to: Amendment Statement of Principles concerning trochanteric bursitis and gluteal tendinopathy No. 68 of 2020 (F2020L01115)

The day of commencement of this Amendment Statement of Principles concerning trochanteric bursitis and gluteal tendinopathy is 28 September 2020.

About this compilation

This compilation

This is a compilation of the Statement of Principles concerning trochanteric bursitis and gluteal tendinopathy No. 45 of 2015 that shows the text of the law as amended and in force on 28 September 2020.

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self‑repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

Statement of Principles

concerning

TROCHANTERIC BURSITIS AND GLUTEAL TENDINOPATHY

No. 45 of 2015

for the purposes of the

Veterans’ Entitlements Act 1986

and

Military Rehabilitation and Compensation Act 2004

Title

1. This Instrument may be cited as Statement of Principles concerning trochanteric bursitis and gluteal tendinopathy No. 45 of 2015.

Determination

2. This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the VEA).

Kind of injury, disease or death

3. (a) This Statement of Principles is about trochanteric bursitis and gluteal tendinopathy and death from trochanteric bursitis and gluteal tendinopathy.

(b) For the purposes of this Statement of Principles:

"trochanteric bursitis" means a condition involving inflammation or swelling of the bursae around the greater trochanter. This condition is characterised by pain and tenderness in the region of the lateral hip or buttock that usually worsens with physical activity; and

"gluteal tendinopathy" means a condition involving inflammation, degeneration or tears of the gluteus medius or gluteus minimus tendons or muscles at or near their insertion into the greater trochanter of the hip. This condition is characterised by pain and tenderness in the region of the lateral hip or buttock that usually worsens with physical activity.

(c) Trochanteric bursitis and gluteal tendinopathy attracts ICD-10-AM code M70.6.

(d) In the application of this Statement of Principles, the definition of "trochanteric bursitis and gluteal tendinopathy" is that given at paragraph 3(b) above.

Basis for determining the factors

4. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that trochanteric bursitis or gluteal tendinopathy and death from trochanteric bursitis or gluteal tendinopathy can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).

Factors that must be related to service

5. Subject to clause 7, at least one of the factors set out in clause 6 must be related to the relevant service rendered by the person.

Factors

6. The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting trochanteric bursitis or gluteal tendinopathy or death from trochanteric bursitis or gluteal tendinopathy with the circumstances of a person’s relevant service is:

(a)                running or jogging an average of at least 30 kilometres per week for the one month before the clinical onset of trochanteric bursitis or gluteal tendinopathy; or

(b)               undertaking weight bearing exercise involving repeated activity of the hip on the affected side, at a minimum intensity of five METs, for at least four hours per week for the one month before the clinical onset of trochanteric bursitis or gluteal tendinopathy; or

(c)                increasing the frequency, duration or intensity of weight bearing activity involving the hip on the affected side by at least 100 percent, to a minimum intensity of five METs for at least two hours per day, within the seven days before the clinical onset of trochanteric bursitis or gluteal tendinopathy; or

(d)               having direct trauma to the affected tendon or bursa within the one month before the clinical onset of trochanteric bursitis or gluteal tendinopathy; or

(e)                having surgery to the hip of the affected side within the one month before the clinical onset of trochanteric bursitis or gluteal tendinopathy; or

(f)                for trochanteric bursitis only, having an infection of the affected bursa at the time of the clinical onset of trochanteric bursitis; or

(g)               having rheumatoid arthritis before the clinical onset of trochanteric bursitis or gluteal tendinopathy; or

(h)               having a significant disturbance of normal gait for at least the four weeks before the clinical onset of trochanteric bursitis or gluteal tendinopathy; or

Note: Examples of conditions which may cause a significant disturbance of normal gait include a deformity of a joint or bone of a lower limb, lower limb amputation, osteoarthritis of a joint of a lower limb and chronic neurological disorders.

(i)                 running or jogging an average of at least 30 kilometres per week for the one month before the clinical worsening of trochanteric bursitis or gluteal tendinopathy; or

(j)                 undertaking weight bearing exercise involving repeated activity of the hip on the affected side, at a minimum intensity of five METs, for at least four hours per week for the one month before the clinical worsening of trochanteric bursitis or gluteal tendinopathy; or

(k)               increasing the frequency, duration or intensity of weight bearing activity involving the hip on the affected side by at least 100 percent, to a minimum intensity of five METs for at least two hours per day, within the seven days before the clinical worsening of trochanteric bursitis or gluteal tendinopathy; or

(l)                 having direct trauma to the affected tendon or bursa within the one month before the clinical worsening of trochanteric bursitis or gluteal tendinopathy; or

(m)             having surgery to the hip of the affected side within the one month before the clinical worsening of trochanteric bursitis or gluteal tendinopathy; or

(n)               for trochanteric bursitis only, having an infection of the affected bursa at the time of the clinical worsening of trochanteric bursitis; or

(o)               having rheumatoid arthritis before the clinical worsening of trochanteric bursitis or gluteal tendinopathy; or

(p)               having a significant disturbance of normal gait for at least the four weeks before the clinical worsening of trochanteric bursitis or gluteal tendinopathy; or

Note: Examples of conditions which may cause a significant disturbance of normal gait include a deformity of a joint or bone of a lower limb, lower limb amputation, osteoarthritis of a joint of a lower limb and chronic neurological disorders.

(q)               inability to obtain appropriate clinical management for trochanteric bursitis or gluteal tendinopathy.

Factors that apply only to material contribution or aggravation

7. Paragraphs 6(i) to 6(q) apply only to material contribution to, or aggravation of, trochanteric bursitis or gluteal tendinopathy where the person’s trochanteric bursitis or gluteal tendinopathy was suffered or contracted before or during (but not arising out of) the person’s relevant service.

Inclusion of Statements of Principles

8. In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.

Other definitions

9. For the purposes of this Statement of Principles:

"death from trochanteric bursitis or gluteal tendinopathy" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s trochanteric bursitis or gluteal tendinopathy;

"ICD-10-AM code" means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM), Eighth Edition, effective date of 1 July 2013, copyrighted by the Independent Hospital Pricing Authority, and having ISBN 978-1-74128-213-9;

"MET" means a unit of measurement of the level of physical exertion. 1 MET = 3.5 ml of oxygen/kg of body weight per minute, 1.0 kcal/kg of body weight per hour or resting metabolic rate;

"relevant service" means:

(a)                operational service under the VEA;

(b)               peacekeeping service under the VEA;

(c)                hazardous service under the VEA;

(d)               British nuclear test defence service under the VEA;

(e)                warlike service under the MRCA; or

(f)                non-warlike service under the MRCA;

"terminal event" means the proximate or ultimate cause of death and includes:

(a)               pneumonia;

(b)              respiratory failure;

(c)               cardiac arrest;

(d)              circulatory failure; or

(e)               cessation of brain function;

"trauma to the affected tendon or bursa" means an injury to the affected tendon or bursa that causes the development, within the 24 hours of the injury being sustained, of pain and tenderness in the lateral hip or buttock, and altered mobility or range of movement of the hip.  In the case of sustained unconsciousness or the masking of pain by analgesic medication, these symptoms and signs must appear on return to consciousness or the withdrawal of the analgesic medication.  These symptoms and signs must last for a continuous period of at least seven days following their onset, save for where medical intervention for the injury to that hip has occurred and that medical intervention involves either:

(a)               immobilisation of the hip by splinting, or similar external agent;

(b)               injection of corticosteroids or local anaesthetics into that hip; or

(c)               surgery to that hip.

Endnotes

Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history. 

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history