Statement of Principles concerning sprain and strain (Reasonable Hypothesis) (No. 27 of 2020) (Cth)

Statement of Principles concerning SPRAIN AND STRAIN (Reasonable Hypothesis) (No. 27 of 2020) The Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.

Dated 24 April 2020

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 sprain and strain (Reasonable Hypothesis) (No. 27 of 2020). 2 Commencement This instrument commences on 25 May 2020. 3 Authority This instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986. 4 Repeal The Statement of Principles concerning sprain and strain No. 94 of 2011 (Federal Register of Legislation No. F2011L01726) made under subsection 196B(2) of the VEA is repealed. 5 Application This instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004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 sprain and strain and death from sprain and strain. Meaning of sprain (2) For the purposes of this Statement of Principles, sprain: (a) means an injury involving the tearing or stretching of one or more joint ligaments, associated with the onset of pain and tenderness at that site within the 24 hours following the injury; and (b) includes complete tear or rupture of a ligament; and (c) excludes recurrent sprain due to joint instability. Meaning of strain (3) For the purposes of this Statement of Principles, strain: (a) means an injury involving the tearing or stretching of a muscle or tendon, associated with the onset of pain and tenderness at that site within the 24 hours following the injury; and (b) includes complete tear or rupture of a muscle or tendon; and (c) excludes drug-induced disease of tendons or muscles. Death from sprain and strain (4) For the purposes of this Statement of Principles, sprain or strain, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's sprain or strain. 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 sprain or strain and death from sprain or strain 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 sprain or strain or death from sprain or strain with the circumstances of a person's relevant service: (1) experiencing a significant physical force applied to or through the affected joint, at the time of the clinical onset of a sprain to that joint ligament; Note: Examples of activities and circumstances involving significant physical force applied to or through the affected joint include falls, collisions, lifting weights, running, jumping or stepping down from a height, throwing objects and climbing. (2) forceful stretching or high intensity use of a muscle or tendon at the time of the clinical onset of a strain to that muscle or tendon; Note: Examples of activities and circumstances involving forceful stretching or high intensity use of a muscle or tendon include lifting weights, push ups, pull ups, throwing objects, running, kicking, jumping and climbing. (3) experiencing a significant physical force applied to or through the affected joint, at the time of the clinical worsening of a sprain to that joint ligament; Note: Examples of activities and circumstances involving significant physical force applied to or through the affected joint include falls, collisions, lifting weights, running, jumping or stepping down from a height, throwing objects and climbing. (4) forceful stretching or high intensity use of a muscle or tendon at the time of the clinical worsening of a strain to that muscle or tendon; Note: Examples of activities and circumstances involving forceful stretching or high intensity use of a muscle or tendon include lifting weights, push ups, pull ups, throwing objects, running, kicking, jumping and climbing. (5) inability to obtain appropriate clinical management for sprain or strain. 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, sprain or strain where the person's sprain or strain 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.