{"id":"F2018L01839","name":"Statement of Principles concerning iliotibial band syndrome (Balance of Probabilities) (No. 4 of 2019)","slug":"statement-of-principles-concerning-iliotibial-band-syndrome-balance-of-probabilities-no-4-of-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439887,"registerId":"F2018L01839-fast-fetch-1775955738056","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning iliotibial band syndrome (Balance of Probabilities) (No. 4 of 2019)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nILIOTIBIAL BAND SYNDROME (Balance of Probabilities)\n\n(No. 4 of 2019)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 21 December 2018\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 Nicholas Saunders AO
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 iliotibial band syndrome (Balance of Probabilities) (No. 4 of 2019).\n\n2 Commencement\n\n This instrument commences on 28 January 2019.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning iliotibial band syndrome No. 35 of 2010 (Federal Register of Legislation No. F2010L01051) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 iliotibial band syndrome and death from iliotibial band syndrome.\n\nMeaning of iliotibial band syndrome\n\n(2) For the purposes of this Statement of Principles, iliotibial band syndrome:\n\n(a) means a condition of the distal portion of the iliotibial tract where it courses over the lateral femoral epicondyle; and\n\n(b) is characterised by pain and tenderness over the lateral aspect of the knee which usually worsens with physical activity; and\n\n(c) excludes proximal iliotibial band syndrome and iliotibial band insertional tendinosis.\n\n(3) While iliotibial band syndrome attracts ICD‑10‑AM code M76.3, in applying this Statement of Principles the meaning of iliotibial band syndrome is that given in subsection (2).\n\n(4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.\n\nDeath from iliotibial band syndrome\n\n(5) For the purposes of this Statement of Principles, iliotibial band syndrome, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's iliotibial band syndrome.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that iliotibial band syndrome and death from iliotibial band syndrome can be related to relevant service rendered by veterans 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 exist before it can be said that, on the balance of probabilities, iliotibial band syndrome or death from iliotibial band syndrome is connected with the circumstances of a person's relevant service:\n\n(1) running or jogging an average of at least 60 kilometres per week for at least the four weeks before the clinical onset of iliotibial band syndrome;\n\n(2) undertaking weight bearing exercise involving repeated flexion and extension of the affected knee, at a minimum intensity of five METs for at least six hours per week, for at least the four weeks before the clinical onset of iliotibial band syndrome;\n\nNote: MET is defined in the Schedule 1 - Dictionary. \n\n(3) increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical onset of iliotibial band syndrome;\n\nNote: MET is defined in the Schedule 1 - Dictionary. \n\n(4) cycling at a minimum intensity of five METs for at least ten hours per week, for at least the four weeks before the clinical onset of iliotibial band syndrome;\n\nNote: MET is defined in the Schedule 1 - Dictionary.\n\n(5) increasing the frequency, duration or intensity of cycling by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical onset of iliotibial band syndrome;\n\nNote: MET is defined in the Schedule 1 - Dictionary.\n\n(6) undergoing knee reconstruction surgery with placement of an implant in the distal lateral femur within the one year before the clinical onset of iliotibial band syndrome;\n\n(7) running or jogging an average of at least 60 kilometres per week for at least the four weeks before the clinical worsening of iliotibial band syndrome;\n\n(8) undertaking weight bearing exercise involving repeated flexion and extension of the affected knee, at a minimum intensity of five METs for at least six hours per week, for at least the four weeks before the clinical worsening of iliotibial band syndrome;\n\nNote: MET is defined in the Schedule 1 - Dictionary. \n\n(9) increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical worsening of iliotibial band syndrome;\n\nNote: MET is defined in the Schedule 1 - Dictionary. \n\n(10) cycling at a minimum intensity of five METs for at least ten hours per week, for at least the four weeks before the clinical worsening of iliotibial band syndrome;\n\nNote: MET is defined in the Schedule 1 - Dictionary.\n\n(11) increasing the frequency, duration or intensity of cycling by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical worsening of iliotibial band syndrome;\n\nNote: MET is defined in the Schedule 1 - Dictionary.\n\n(12) undergoing knee reconstruction surgery with placement of an implant in the distal lateral femur within the one year before the clinical worsening of iliotibial band syndrome;\n\n(13) inability to obtain appropriate clinical management for iliotibial band syndrome.\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 factors set out in subsections 9(7) to 9(13) apply only to material contribution to, or aggravation of, iliotibial band syndrome where the person's iliotibial band syndrome 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(3) 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 iliotibial band syndrome—see subsection 7(2).\n\n 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.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n relevant service means:\n\n(a) eligible war service (other than operational service) under the VEA;\n\n(b) defence service (other than hazardous service and British nuclear test defence service) under the VEA; or\n\n(c) peacetime 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":{"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":false,"description":"This instrument repeals the earlier Statement of Principles (No. 35 of 2010) (s4) and restates the rules that apply to claims under section 120B of the VEA or section 339 of the MRCA (s5). The text does not itself assert a narrowing or broadening of scope; it replaces the prior instrument but, on its face, sets out definitions and factors without an explicit statement of changed scope."},"complexity_factors":["Technical medical definition and explicit exclusions (iliotibial band syndrome defined and proximal/insertional variants excluded) — see s7(2)-(4).","Multiple quantified physical-activity thresholds with precise distances, durations and timing (e.g. ≥60 km/week running; cycling/running at ≥5 METs; 4 week and 7 day windows) — see s9(1)-(5) and s9(7)-(11).","Use of MET (metabolic equivalent) as a technical intensity metric requiring conversion or clinical interpretation — Schedule 1 (MET definition) and notes in s9.","Separate rules for clinical onset versus clinical worsening, with overlapping but distinct trigger criteria and temporal limits — see s9 and s10(2).","Surgical timing factor tied to knee reconstruction with implant placement within one year before onset/worsening — s9(6) and s9(12).","Inclusion of inability to obtain appropriate clinical management as a standalone factor — s9(13), creating evidentiary and causation issues.","Relationship-to-service requirement: every listed factor must be related to the person's relevant service, and the instrument applies only to claims under specified VEA/MRCA provisions — see s10(1) and s5.","Authority and standard of determination: instrument is made by the Repatriation Medical Authority under s196B(3) of the VEA and rests on the 'balance of probabilities' view of available medical-scientific evidence — see s3 and s8.","Interaction with other Statements of Principles where factors refer to injuries/diseases covered elsewhere, requiring cross-reference and applying those other SOPs' terms — s11.","Inclusion of death where a terminal event was contributed to by the condition and a list of defined terminal events, adding medico-legal causation complexity — s7(5) and Schedule 1 (terminal event).","Repeal of the prior Statement (No. 35 of 2010) creates a replacement rule-set; comparing substantive changes requires review beyond this text — s4."],"plain_english_summary":"This Statement of Principles sets the medical rules the Repatriation Medical Authority uses to decide if iliotibial band syndrome is connected to a veteran’s service for claims under the VEA or MRCA. It defines the condition narrowly, and lists specific activity, surgical and timing thresholds (running/cycling, MET intensity, surgery, treatment access) and includes death when a terminal event is contributed to by the condition; meeting these criteria affects entitlement decisions."},"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"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard Statement of Principles instrument that operates within its intended scope. It replaces an earlier 2010 version (No. 35 of 2010) with updated medical criteria but does not expand beyond the established purpose of determining service connection for specific medical conditions under veterans' compensation legislation."},"complexity_factors":["13 distinct factual scenarios with specific quantitative thresholds (e.g., '60 kilometres per week', 'five METs', '100 percent increase')","Multiple cross-references to defined terms in Schedule 1 (MET, MRCA, VEA, relevant service, terminal event)","Conditional logic distinguishing between 'clinical onset' (factors 1-6) and 'clinical worsening' (factors 7-13)","Nested limitation in section 10(2) restricting factors 7-13 to aggravation cases only","Incorporation by reference of external medical classification system (ICD-10-AM Tenth Edition)","Technical medical terminology requiring specialist knowledge (distal portion, lateral femoral epicondyle, flexion and extension)","Dual statutory framework application (Veterans' Entitlements Act 1986 and Military Rehabilitation and Compensation Act 2004)"],"plain_english_summary":"This Statement of Principles tells the Repatriation Medical Authority how to decide if a veteran’s or defence member’s iliotibial band syndrome (ITBS) is connected to service so they can seek compensation. It applies to veterans with war or defence service and current/former ADF members.\n\nConnection is judged on the balance of probabilities against specified pre‑onset exposures and events; some factors only apply when service aggravated pre‑existing ITBS. This determines entitlement under veterans’ compensation law."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-iliotibial-band-syndrome-balance-of-probabilities-no-4-of-2019","history":"/api/acts/statement-of-principles-concerning-iliotibial-band-syndrome-balance-of-probabilities-no-4-of-2019/history","analysis":"/api/acts/statement-of-principles-concerning-iliotibial-band-syndrome-balance-of-probabilities-no-4-of-2019/analysis","conflicts":"/api/acts/statement-of-principles-concerning-iliotibial-band-syndrome-balance-of-probabilities-no-4-of-2019/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-iliotibial-band-syndrome-balance-of-probabilities-no-4-of-2019/important-cases","documents":"/api/acts/statement-of-principles-concerning-iliotibial-band-syndrome-balance-of-probabilities-no-4-of-2019/documents"}}