{"id":"F2024L01696","name":"Statement of Principles concerning distal biceps brachii tendinopathy (Reasonable Hypothesis) (No. 3 of 2025)","slug":"statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-reasonable-hypothesis-no-3-of-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442675,"registerId":"F2024L01696-fast-fetch-1775957629433","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning distal biceps brachii tendinopathy (Reasonable Hypothesis) (No. 3 of 2025)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nDISTAL BICEPS BRACHII TENDINOPATHY  (Reasonable Hypothesis)\n\n(No. 3 of 2025)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n \n\nDated                                                           17 December 2024.\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\n\n \n\n \n\n   \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Application\n\n5 Definitions\n\n6 Kind of injury, disease or death to which this Statement of Principles relates\n\n7 Basis for determining the factors\n\n8 Factors that must exist\n\n9 Relationship to service\n\n10 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n \n\n\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning distal biceps brachii tendinopathy (Reasonable Hypothesis) (No. 3 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 28 January 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n1.                Application\n\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about distal biceps brachii tendinopathy and death from distal biceps brachii tendinopathy.\n\n\nMeaning of distal biceps brachii tendinopathy\n\n1.           For the purposes of this Statement of Principles, distal biceps brachii tendinopathy:\n  1.           means a clinically symptomatic inflammation or degeneration of the distal biceps brachii tendon; and\n  2.           includes partial or complete tears of the distal biceps brachii tendon; and\n  3.           excludes biciptitoradial bursitis not accompanied by distal biceps brachii tendinopathy.\n\n\nNote: Distal biceps brachii tendinopathy is also known as distal biceps brachii tendonitis/tendinitis or distal biceps brachii tendonosis/tendinosis.\n\n \n\nDeath from distal biceps brachii tendinopathy\n\n1.           For the purposes of this Statement of Principles, distal biceps brachii tendinopathy, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's distal biceps brachii tendinopathy.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that distal biceps brachii tendinopathy and death from distal biceps brachii 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 MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.\n\n1.                Factors that must exist\n\n\nAt least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting distal biceps brachii tendinopathy or death from distal biceps brachii tendinopathy with the circumstances of a person's relevant service:\n\n1.           having sudden forceful extension of the elbow, during elbow flexion, on the affected side at the time of clinical onset;\n\n\nNote: Examples of activities that can cause sudden forceful extension of the elbow, during elbow flexion, include catching a heavy load with a bent arm, a fall on an outstretched hand and contact sports.\n\n1.           performing forceful activities with the hand or forearm on the affected side, in combination with:\n  1.           repetitive activities with the hand or forearm on the affected side; or\n  2.           sustained activities with the hand or forearm on the affected side;\n\n\nfor at least 1 hour per day, on more days than not, over a period of at least the 4 weeks before clinical onset;\n\n1.           abusing anabolic steroids at the time of clinical onset;\n2.           inability to obtain appropriate clinical management for distal biceps brachii tendinopathy before clinical worsening.\n\n\n1.                Relationship to service\n  1.           The existence in a person of any factor referred to in section 8, must be related to the relevant service rendered by the person.\n  2.           The factor set out in subsection 8(4) applies only to material contribution to, or aggravation of, distal biceps brachii tendinopathy where the person's distal biceps brachii tendinopathy was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 8 applies in relation to a person; and\n2.           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;\n\n\nthen 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.\n\n \n\n \n\nSchedule 1 - Dictionary  \n\nNote:               See Section 5\n\n1               Definitions\n\nIn this instrument:\n\n                               distal biceps brachii tendinopathy—see subsection 6(2).\n\n                             MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                             relevant service means:\n\n(a)          operational service under the VEA;\n\n(b)          peacekeeping service under the VEA;\n\n(c)          hazardous service under the VEA;\n\n(d)          British nuclear test defence service under the VEA;\n\n(e)          warlike service under the MRCA; or\n\n(f)           non-warlike service under the MRCA.\n\nNote: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\n                             terminal event means the proximate or ultimate cause of death and includes the following:\n\n(a)           pneumonia;\n\n(b)           respiratory failure;\n\n(c)           cardiac arrest;\n\n(d)           circulatory failure; or\n\n(e)           cessation of brain function.\n\n                             VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains its original narrow scope. It is a specific Statement of Principles for a single medical condition (distal biceps brachii tendinopathy) under the established framework of section 196B(2) of the Veterans' Entitlements Act 1986. The structure and purpose align with the long-standing Repatriation Medical Authority practice of issuing individual Statements of Principles for specific diseases and injuries. There is no evidence of scope creep; it does not expand into unrelated medical conditions, alter the statutory test, or modify the underlying veterans' compensation scheme."},"complexity_factors":["Short, focused instrument (approximately 1,500 words) dealing with a single medical condition","Only 5 defined terms in the Dictionary (distal biceps brachii tendinopathy, MRCA, relevant service, terminal event, VEA)","Simple conditional structure: 4 alternative factors in section 8, where only one must be satisfied","Minimal cross-referencing — only refers to the parent Veterans' Entitlements Act 1986 and Military Rehabilitation and Compensation Act 2004 for foundational definitions","Clear delineation between clinical onset factors (subsections 8(1)-(3)) and clinical worsening factor (subsection 8(4))","Single nested condition in section 9(2) limiting the application of the clinical worsening factor to pre-existing conditions","No exceptions to exceptions or deeply layered conditional logic"],"plain_english_summary":"This instrument sets when Australian veterans and defence members can claim compensation for distal biceps brachii tendinopathy by applying a \"reasonable hypothesis\" test to link the elbow tendon injury to service.  \n\nIt matters because it clarifies that a plausible connection — for example from sudden trauma, repetitive strain, anabolic steroid use, or inadequate access to care during service — is sufficient to meet the initial claim threshold under veterans' no‑fault compensation rules."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument defines its own scope to apply to claims under section 120A of the VEA or section 338 of the MRCA and to distal biceps brachii tendinopathy (including related death). It does not purport to expand or narrow that statutory claims framework beyond setting medical linkage criteria."},"complexity_factors":["Technical medical definition and inclusion/exclusion rules for the condition (see s.6(2))","Multiple, specific exposure criteria with duration/intensity requirements (s.8(2))","Cross-reference to other Statements of Principles and to VEA/MRCA claims framework (ss.4, 10; Schedule 1)","Legal evidentiary threshold—‘reasonable hypothesis’—which is a modest but legally significant standard (express authority s.3; factors in s.8)","Limited discretionary medical interpretation by the Repatriation Medical Authority in applying medical‑scientific evidence (s.7)"],"plain_english_summary":"This Statement of Principles, commencing 28 January 2025, sets the medical criteria the Repatriation Medical Authority uses to decide when distal biceps brachii tendinopathy (including partial/complete tears and death where contributed) can be connected to relevant military service for claims under the VEA or MRCA. It lists specific exposure and clinical factors—sudden forceful elbow extension, forceful/repetitive/sustained forearm/hand use, anabolic steroid abuse, or lack of appropriate treatment—and requires at least one be related to service, thereby shaping the claimant's evidential burden and administrative decision-making (see ss.6–9)."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-reasonable-hypothesis-no-3-of-","history":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-reasonable-hypothesis-no-3-of-/history","analysis":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-reasonable-hypothesis-no-3-of-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-reasonable-hypothesis-no-3-of-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-reasonable-hypothesis-no-3-of-/important-cases","documents":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-reasonable-hypothesis-no-3-of-/documents"}}