{"id":"F2018L01843","name":"Statement of Principles concerning internal derangement of the knee (Reasonable Hypothesis) (No. 7 of 2019)","slug":"statement-of-principles-concerning-internal-derangement-of-the-knee-reasonable-hypothesis-no-7-of-20","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439893,"registerId":"F2018L01843-fast-fetch-1775955740202","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 (Reasonable Hypothesis) (No. 7 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 (Reasonable Hypothesis)\n\n(No. 7 of 2019)\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 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 (Reasonable Hypothesis) (No. 7 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(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning internal derangement of the knee No. 51 of 2010 (Federal Register of Legislation No. F2010L01664) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that internal derangement of the knee and death from internal derangement of the knee 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 internal derangement of the knee or death from internal derangement of the knee 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(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 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) 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":{"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"},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals and replaces the 2010 Statement (s4) and restates the definition of internal derangement of the knee while listing specific qualifying factors and temporal limits (ss.7,9). It therefore changes the operative instrument governing how knee derangement is connected to relevant service for VEA/MRCA claims (s5), clarifying exclusions and evidentiary thresholds that decision-makers must apply."},"complexity_factors":["Legal-medical hybrid definitions and explicit exclusions for the condition (internal derangement defined; excludes degenerative and other patellar conditions) (s7(2)).","Temporal proximity requirements—events must occur within one year before clinical onset or worsening, creating a strict evidentiary window (s9(1)–(4)).","Alternative qualifying pathway: inability to obtain appropriate clinical management (s9(5)) which may require proof of access barriers or treatment attempts.","Causation standard: \"reasonable hypothesis\" linking the factor to relevant service, requiring evidential and medical connection to service (ss.8,9,10).","Cross‑legislation application: applies only to claims under specific VEA and MRCA provisions, tying medical findings to statutory entitlement processes (s5).","Interaction with other Statements of Principles where an injury/disease is covered elsewhere, requiring cross-reference and potential reliance on other instruments (s11).","Repeal of prior instrument means potential changes in qualifying criteria or administrative interpretation that decision-makers must apply (s4).","Inclusion of death from a terminal event contributed to by the knee condition expands outcomes beyond morbidity to mortality considerations (s7(5); Schedule definition of terminal event)."],"plain_english_summary":"Mechanically, this instrument replaces the 2010 Statement and sets the medical definition and the minimum qualifying factors that raise a “reasonable hypothesis” linking internal derangement of the knee to service — for example, a ligament sprain or an acute meniscal tear within one year, or inability to obtain appropriate clinical management (ss.4,7,9). \n\nIt applies to veterans and former ADF members claiming under the VEA or MRCA and therefore determines which clinical events and timing can establish a service connection for entitlement decisions (ss.5,10)."},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"The legislation maintains its original narrow purpose: establishing the medical-scific basis for connecting internal derangement of the knee to military service. It replaces a 2010 version (No. 51 of 2010) with updated references (ICD-10-AM Tenth Edition) but does not expand beyond its original scope of determining liability for this specific knee condition under veterans' compensation schemes."},"complexity_factors":["Limited cross-referencing: only references the Veterans' Entitlements Act 1986 and Military Rehabilitation and Compensation Act 2004, plus ICD-10-AM coding system","Straightforward conditional structure: five specific factors in section 9 with clear temporal requirements ('within the one year before')","Minimal defined terms: only 5 definitions in Schedule 1 (internal derangement of the knee, MRCA, relevant service, terminal event, VEA)","Single layer of exclusions in the definition section (subsection 7(2)(b)) excluding specific conditions like chondromalacia patella and osteoarthritis","Simple operational logic: 'at least one' of five factors must exist (section 9), with a service connection requirement (section 10)","No nested exceptions or complex mathematical formulas","Short length: approximately 1,500 words across 11 sections plus dictionary"],"plain_english_summary":"This Statement of Principles sets the medical test for when chronic knee problems (defined as internal derangement from torn meniscus or damaged ligaments, not degenerative arthritis or patella disorders) can be accepted as service-related. It requires specified clinical links between the knee condition and a veteran’s military service or service-related events.\n\nIt affects veterans, peacekeepers and current/former Defence Force members claiming compensation under the VEA or MRCA and determines eligibility for pensions and treatment."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-reasonable-hypothesis-no-7-of-20","history":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-reasonable-hypothesis-no-7-of-20/history","analysis":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-reasonable-hypothesis-no-7-of-20/analysis","conflicts":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-reasonable-hypothesis-no-7-of-20/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-reasonable-hypothesis-no-7-of-20/important-cases","documents":"/api/acts/statement-of-principles-concerning-internal-derangement-of-the-knee-reasonable-hypothesis-no-7-of-20/documents"}}