{"id":"F2024L00221","name":"Statement of Principles concerning hallux valgus (Reasonable Hypothesis) (No. 25 of 2024)","slug":"statement-of-principles-concerning-hallux-valgus-reasonable-hypothesis-no-25-of-2024","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442298,"registerId":"F2024L00221-fast-fetch-1775957344389","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning hallux valgus (Reasonable Hypothesis) (No. 25 of 2024)","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\n\n \n\nStatement of Principles\n\nconcerning\n\nHALLUX VALGUS (Reasonable Hypothesis)\n\n(No. 25 of 2024)\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 22 February 2024.\n\n \n\n \n\n \n\n \n\n \n\n| The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:
|\n| --- |\n|
Professor Terence Campbell AM
Chairperson
|\n\n\n \n\n \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 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\n1 Name\n\nThis is the Statement of Principles concerning hallux valgus (Reasonable Hypothesis) (No. 25 of 2024).\n\n2 Commencement\n\n This instrument commences on 26 March 2024.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning hallux valgus (Reasonable Hypothesis) (No. 98 of 2015) (Federal Register of Legislation No. F2015L01334) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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\n6 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about hallux valgus and death from hallux valgus .\n\nMeaning of hallux valgus\n\n(2) For the purposes of this Statement of Principles:\n\nhallux valgus means a symptomatic deformity of the foot, where\n\nthe great toe is deviated laterally at the first metatarsophalangeal joint,\n\nand often causing a bony prominence or bunion to develop over the\n\nmedial aspect of the first metatarsal head and neck.\n\nDeath from hallux valgus\n\n(3) For the purposes of this Statement of Principles, hallux valgus , in relation to a person, includes death from a terminal event or condition that was contributed to by the person's hallux valgus .\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that hallux valgus and death from hallux valgus 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\n9 Factors that must exist\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 hallux valgus or death from hallux valgus with the circumstances of a person's relevant service:\n\n(1) wearing footwear that causes substantial lateral deviation of the great toe of the affected foot, for at least 7 hours per day, on more days than not for a period of at least 18 months before the clinical onset or clinical worsening of hallux valgus;\n\n(2) having rheumatoid arthritis involving the first metatarsophalangeal joint of the affected foot before the clinical onset or clinical worsening of hallux valgus;\n\n(3) having gout or calcium pyrophosphate deposition disease (also known as pseudogout) involving the first metatarsophalangeal joint of the affected foot before the clinical onset or clinical worsening of hallux valgus;\n\n(4) having pes planus of the affected foot before the clinical worsening of hallux valgus;\n\n(5) having acquired loss of one or more of the phalanges of the second toe or the second metatarsal head of the affected foot, before the clinical onset or clinical worsening of hallux valgus;\n\n(6) having a tumour involving the first metatarsophalangeal joint or second metatarsal bone of the affected foot at the time of the clinical onset or clinical worsening of hallux valgus;\n\n(7) having trauma to the affected forefoot that results in:\n\n(a) disruption of the first metatarsophalangeal joint capsule;\n\n(b) disruption of the sesamoid complex of the hallux;\n\n(c) fracture of the medial side of the first proximal phalanx base;\n\n(d) fracture resulting in shortening of the second metatarsal;\n\n(e) tarso-metatarsal joint complex injury; or\n\n(f) tear of the medial collateral ligament of the first metatarsophalangeal joint;\n\nwithin the 5 years before the clinical onset or clinical worsening of hallux valgus;\n\nNote: trauma to the affected forefoot is defined in the Schedule 1 - Dictionary.\n\n(8) inability to obtain appropriate clinical management for hallux valgus before the clinical worsening of hallux valgus.\n\n10 Relationship to service\n\n(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.\n\n(2) The clinical worsening aspects of factors set out in section 9 apply only to material contribution to, or aggravation of, hallux valgus where the person's hallux valgus was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nIn this Statement of Principles:\n\n(1) if a factor referred to in section 9 applies in relation to a person; and\n\n(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;\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 6\n\n1 Definitions\n\nIn this instrument:\n\n hallux valgus —see subsection 7(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 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 trauma to the affected forefoot means a discrete event involving the application of significant physical force to or through the affected forefoot, that causes:\n\n(a) damage to the forefoot; and\n\n(b) the development, within 24 hours of the event occurring, of symptoms and signs of pain, tenderness and either altered mobility or range of movement of the forefoot. 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; and\n\n(c) the persistence of these symptoms and signs for a period of at least 7 days following their onset, save for where medical intervention for the trauma to that forefoot has occurred and that medical intervention involves one of the following:\n\n(i) immobilisation of the forefoot in a boot or similar external agent;\n\n(ii) injection of a corticosteroid or local anaesthetic into that forefoot; or\n\n(iii) surgery to that forefoot.\n\n VEA means the Veterans' Entitlements Act 1986.\n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Repatriation Medical Authority Statements of Principles. It replaces the 2015 version concerning the same condition (hallux valgus) without expanding into new areas of law or medical conditions. The structure follows the standard template for RMA SoPs: definition, factors, relationship to service, and dictionary. No scope creep is evident."},"complexity_factors":["Multiple nested definitions: 'trauma to the affected forefoot' contains 3 sub-elements (damage, 24-hour symptom onset, 7-day persistence) with an exception for medical intervention that itself has 3 sub-types","Cross-referencing structure: Section 11 creates dynamic incorporation of other Statements of Principles by reference, meaning the full legal effect depends on external instruments not contained in this document","Temporal conditions: Factor (1) requires calculation of '7 hours per day, on more days than not, for at least 18 months' — a compound temporal test","Dual-trigger terminology: Distinguishes between 'clinical onset' and 'clinical worsening' with different factor applicability (notably factor 4 only applies to worsening, not onset)","Defined terms in Schedule 1: 6 defined terms including recursive definitions (MRCA/VEA defined in Dictionary which notes they are defined in Dictionary)","Conditional logic in section 10(2): Creates a limitation where worsening factors only apply to pre-existing conditions 'suffered or contracted before or during (but did not arise out of)' service — a double negative conditional"],"plain_english_summary":"This instrument sets medical rules used by the Repatriation Medical Authority to decide when hallux valgus (bunion) can be considered service-related for veterans, peacekeepers and current/former Defence personnel claiming under the VEA or MRCA. It identifies specific clinical scenarios (for example, prolonged use of tight/service footwear, pre‑existing joint disease, or foot injury) that, if proven, create a \"reasonable hypothesis\" linking the condition to military service, easing access to compensation."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"The instrument repeals the 2015 Statement (s4) but within this text it does not explicitly expand or narrow the classes of persons or claims covered: it applies to claims to which section 120A of the VEA or section 338 of the MRCA apply (s5). Any substantive change in what medical circumstances qualify will depend on differences in the medical criteria here versus the repealed instrument, rather than an express change to statutory coverage in this instrument."},"complexity_factors":["Medical specificity and formal clinical definition of hallux valgus (s7(2); Schedule 1)","Multiple alternative causation or contributing factors with distinct temporal thresholds (s9(1)–(9))","Service‑connection and clinical‑worsening rules that limit when factors count (s10(1)–(2))","Cross‑reference to other Statements of Principles when factors overlap (s11)","Evidentiary threshold expressed as a 'reasonable hypothesis' informed by medical‑scientific evidence (s8)","Detailed, technical definition of trauma to the forefoot including symptom onset and persistence requirements (Schedule 1)","Inclusion of death via contribution to terminal events with a defined list (s7(3); Schedule 1)","Formal commencement and repeal mechanics (s2, s4) and explicit application to VEA/MRCA claim provisions (s5)"],"plain_english_summary":"This instrument sets the medical rules for deciding whether hallux valgus (bunions) — and deaths to which it contributed — can be connected to a person’s Australian military or peacekeeping service. It defines the condition, lists specific medical and exposure factors (for example certain footwear use, arthritis, trauma and timing requirements) that must be present to raise a reasonable hypothesis of service connection, and replaces the 2015 statement. It applies to claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hallux-valgus-reasonable-hypothesis-no-25-of-2024","history":"/api/acts/statement-of-principles-concerning-hallux-valgus-reasonable-hypothesis-no-25-of-2024/history","analysis":"/api/acts/statement-of-principles-concerning-hallux-valgus-reasonable-hypothesis-no-25-of-2024/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hallux-valgus-reasonable-hypothesis-no-25-of-2024/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hallux-valgus-reasonable-hypothesis-no-25-of-2024/important-cases","documents":"/api/acts/statement-of-principles-concerning-hallux-valgus-reasonable-hypothesis-no-25-of-2024/documents"}}