Statement of Principles concerning posterior adventitial heel bursitis (Reasonable Hypothesis) (No. 47 of 2019) (Cth)

Statement of Principles concerning POSTERIOR ADVENTITIAL HEEL BURSITIS (Reasonable Hypothesis) (No. 47 of 2019) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) 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 1 Name 2 Commencement 3 Authority 4 Repeal 5 Application 6 Definitions 7 Kind of injury, disease or death to which this Statement of Principles relates 8 Basis for determining the factors 9 Factors that must exist 10 Relationship to service 11 Factors referring to an injury or disease covered by another Statement of Principles Schedule 1 - Dictionary 1 Definitions

1 Name This is the Statement of Principles concerning posterior adventitial heel bursitis (Reasonable Hypothesis) (No. 47 of 2019). 2 Commencement This instrument commences on 27 May 2019. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning heel bursitis No. 77 of 2010 (Federal Register of Legislation No. F2010L02316) made under subsection 196B(2) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies. 6 Definitions The terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument. 7 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. 8 Basis for determining the factors The Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that posterior adventitial heel bursitis and death from posterior adventitial heel bursitis 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 MRCA. Note: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary. 9 Factors that must exist At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting posterior adventitial heel bursitis or death from posterior adventitial heel bursitis 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. 10 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. 11 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(2) 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.