{"id":"F2018L01844","name":"Statement of Principles concerning internal derangement of the knee (Balance of Probabilities) (No. 8 of 2019)","slug":"statement-of-principles-concerning-internal-derangement-of-the-knee-balance-of-probabilities-no-8-of","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439894,"registerId":"F2018L01844-fast-fetch-1775955740200","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning internal derangement of the knee (Balance of Probabilities) (No. 8 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\nINTERNAL DERANGEMENT OF THE KNEE (Balance of Probabilities)\n\n(No. 8 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 internal derangement of the knee (Balance of Probabilities) (No. 8 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 internal derangement of the knee No. 52 of 2010 (Federal Register of Legislation No. F2010L01665) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 internal derangement of the knee and death from internal derangement of the knee.\n\nMeaning of internal derangement of the knee\n\n(2) For the purposes of this Statement of Principles, internal derangement of the knee:\n\n(a) means a chronic disorder of the knee due to a torn meniscus of the knee, or a torn or stretched collateral, cruciate or capsular ligament of the knee; and\n\n(b) excludes chondromalacia patella and other disorders of the patella, congenital discoid meniscus, osteochondritis dissecans, cysts of the menisci, degenerative tears of the menisci, and other degenerative processes such as osteoarthritis and loose bodies in the knee joint.\n\nNote: Internal derangement of the knee is characterised by ongoing or recurrent signs and symptoms of pain, swelling, instability, locking or altered mobility.\n\n(3) While internal derangement of the knee attracts ICD‑10‑AM code M23.2, M23.5, M23.8 or M23.9, in applying this Statement of Principles the meaning of internal derangement of the knee 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 internal derangement of the knee\n\n(5) For the purposes of this Statement of Principles, internal derangement of the knee, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's internal derangement of the knee.\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 internal derangement of the knee and death from internal derangement of the knee 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, internal derangement of the knee or death from internal derangement of the knee is connected with the circumstances of a person's relevant service:\n\n(1) having a sprain involving a ligament of the affected knee within the one year before the clinical onset of internal derangement of the knee;\n\n(2) having an acute meniscal tear of the affected knee within the one year before the clinical onset of internal derangement of the knee;\n\n(3) having a sprain involving a ligament of the affected knee within the one year before the clinical worsening of internal derangement of the knee;\n\n(4) having an acute meniscal tear of the affected knee within the one year before the clinical worsening of internal derangement of the knee;\n\n(5) inability to obtain appropriate clinical management for internal derangement of the knee.\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(3) to 9(5) apply only to material contribution to, or aggravation of, internal derangement of the knee where the person's internal derangement of the knee 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 internal derangement of the knee—see subsection 7(2).\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":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"The instrument maintains its original narrow purpose: establishing causation criteria for a specific knee condition under veterans' compensation law. The 2019 revision updates medical coding references (ICD-10-AM 10th Edition) and repeals the 2010 version, but does not expand beyond the original scope of determining service connection for internal derangement of the knee."},"complexity_factors":["Short, focused instrument (approximately 1,500 words) dealing with a single medical condition","Only 6 defined terms in the Dictionary, with straightforward cross-references to the VEA and MRCA","Clear conditional structure: 5 alternative factors in section 9, any one of which satisfies the test","Simple temporal limitation (one year before clinical onset/worsening) without nested exceptions","Single cross-reference mechanism in section 11 for related Statements of Principles","Exclusion list in section 7(2)(b) is explicit but not conditional — straightforward carve-outs","No delegated legislation, regulations, or subordinate instruments referenced beyond the parent Acts"],"plain_english_summary":"This Statement of Principles sets the medical criteria used to decide whether internal derangement of the knee (meniscal tears or ligament injury) is service-related for veterans and defence members seeking compensation. Claims are assessed on the balance of probabilities and require evidence of a clear traumatic or untreated injury linked to service, not degenerative or wear‑and‑tear conditions.\n\nBy tightening the one‑year trauma window and excluding age‑related degeneration, it raises the evidentiary threshold for entitlement."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"The instrument repeals the 2010 Statement (s4) and clarifies and narrows scope by restating a medical definition with specific exclusions (s7(2)), referencing ICD codes (s7(3)-(4)), adding inability to obtain appropriate clinical management as a qualifying factor (s9(5)), and specifying one‑year temporal windows for causal events (s9). It also clarifies how pre-existing conditions are treated as material contribution or aggravation (s10(2))."},"complexity_factors":["Technical medical definition with express exclusions (internal derangement vs patellar disorders, degenerative processes) — s7(2)","Use of ICD-10-AM codes for cross-reference while retaining the instrument’s own definition — s7(3)-(4)","Short, specific temporal windows for causation (sprain or acute meniscal tear within one year before onset or worsening) — s9(1)-(4)","Non‑medical evidentiary factor: inability to obtain appropriate clinical management as a basis for connection — s9(5)","Different causation tests depending on whether condition arose before/during service (material contribution/aggravation vs arising out of service) — s10(1)-(2)","Cross-application to other Statements of Principles for overlapping injuries/diseases, requiring inter-instrument coordination — s11","Inclusion of death via terminal events and their defined examples, linking morbidity to fatal outcomes — s7(5) and Schedule","Statutory standard and authority references (balance of probabilities; made under VEA s196B(3)) which guide evidentiary burden and decision-maker discretion — ss3,8","Repeal and replacement of the 2010 instrument, implying changed drafting and potential evidentiary implications for existing claims — s4"],"plain_english_summary":"This instrument defines \"internal derangement of the knee\", lists what medical findings are excluded, and sets the specific factual factors that must exist to link the condition (or death from it) to a person’s relevant service under the VEA or MRCA. It replaces the 2010 Statement.\n\nIt matters to veterans and serving members claiming compensation because it prescribes which injuries, timing (generally within one year of onset or worsening), and evidence (including inability to obtain appropriate clinical management) will be treated as connected to service."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-balance-of-probabilities-no-8-of","history":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-balance-of-probabilities-no-8-of/history","analysis":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-balance-of-probabilities-no-8-of/analysis","conflicts":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-balance-of-probabilities-no-8-of/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-balance-of-probabilities-no-8-of/important-cases","documents":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-balance-of-probabilities-no-8-of/documents"}}