{"id":"F2018L00854","name":"Statement of Principles concerning olecranon bursitis (Reasonable Hypothesis) (No. 63 of 2018)","slug":"statement-of-principles-concerning-olecranon-bursitis-reasonable-hypothesis-no-63-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439665,"registerId":"F2018L00854-fast-fetch-1775955604002","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning olecranon bursitis (Reasonable Hypothesis) (No. 63 of 2018)","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\nOLECRANON BURSITIS (Reasonable Hypothesis)\n\n(No. 63 of 2018)\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 June 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:
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Professor Nicholas Saunders AO
Chairperson
|\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\n1 Name\n\nThis is the Statement of Principles concerning olecranon bursitis (Reasonable Hypothesis) (No. 63 of 2018).\n\n2 Commencement\n\n This instrument commences on 23 July 2018.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 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\n5 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n6 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about olecranon bursitis and death from olecranon bursitis.\n\nMeaning of olecranon bursitis\n\n(2) For the purposes of this Statement of Principles, olecranon bursitis means inflammation or infection of the bursa overlying the olecranon process of the ulna.\n\nNote: Typical features of olecranon bursitis are pain, tenderness, redness, swelling and thickening of the bursa and skin in the region of the external elbow.\n\n(3) While olecranon bursitis attracts ICD‑10‑AM code M70.2, in applying this Statement of Principles the meaning of olecranon bursitis 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 olecranon bursitis\n\n(5) For the purposes of this Statement of Principles, olecranon bursitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's olecranon bursitis.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n7 Basis for determining the factors\n\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that olecranon bursitis and death from olecranon bursitis 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\n8 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 olecranon bursitis or death from olecranon bursitis with the circumstances of a person's relevant service:\n\n(1) having a bacterial, fungal or algal infection involving the affected bursa at the time of the clinical onset of olecranon bursitis;\n\n(2) having trauma to the external elbow of the affected side in the 30 days before the clinical onset of olecranon bursitis;\n\nNote: Examples of types of trauma include cuts, abrasions and lacerations of the affected elbow, repeated rubbing or knocking of the affected elbow, needle aspiration of the affected olecranon bursa and injection of the affected olecranon bursa with corticosteroids.\n\n(3) having surgery to the external elbow of the affected side in the 30 days before the clinical onset of olecranon bursitis;\n\n(4) for septic olecranon bursitis only, being in an immunocompromised state as specified at the time of the clinical onset of olecranon bursitis;\n\nNote: immunocompromised state as specified is defined in the Schedule 1 - Dictionary. \n\n(5) having a disorder from the specified list of disorders at the time of the clinical onset of olecranon bursitis;\n\nNote: specified list of disorders is defined in the Schedule 1 - Dictionary. \n\n(6) having psoriasis, localised sclerosis, atopic dermatitis or another inflammatory skin disorder, where the skin disorder involves the skin of the extensor surface of the affected elbow, at the time of the clinical onset of olecranon bursitis;\n\n(7) being treated with a tyrosine kinase inhibitor within the 30 days before the clinical onset of olecranon bursitis;\n\n(8) having a bacterial, fungal or algal infection involving the affected bursa at the time of the clinical worsening of olecranon bursitis;\n\n(9) having trauma to the external elbow of the affected side in the 30 days before the clinical worsening of olecranon bursitis;\n\nNote: Examples of types of trauma include cuts, abrasions and lacerations of the affected elbow, repeated rubbing or knocking of the affected elbow, needle aspiration of the affected olecranon bursa and injection of the affected olecranon bursa with corticosteroids.\n\n(10) having surgery to the external elbow of the affected side in the 30 days before the clinical worsening of olecranon bursitis;\n\n(11) for septic olecranon bursitis only, being in an immunocompromised state as specified at the time of the clinical worsening of olecranon bursitis;\n\nNote: immunocompromised state as specified is defined in the Schedule 1 - Dictionary. \n\n(12) having a disorder from the specified list of disorders at the time of the clinical worsening of olecranon bursitis;\n\nNote: specified list of disorders is defined in the Schedule 1 - Dictionary. \n\n(13) having psoriasis, localised sclerosis, atopic dermatitis or another inflammatory skin disorder, where the skin disorder involves the skin of the extensor surface of the affected elbow, at the time of the clinical worsening of olecranon bursitis;\n\n(14) being treated with a tyrosine kinase inhibitor within the 30 days before the clinical worsening of olecranon bursitis;\n\n(15) inability to obtain appropriate clinical management for olecranon bursitis.\n\n9 Relationship to service\n\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\n(2) The factors set out in subsections 8(8) to 8(15) apply only to material contribution to, or aggravation of, olecranon bursitis where the person's olecranon bursitis was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n10 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 8 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 5\n\n1 Definitions\n\nIn this instrument:\n\n chronic renal failure means:\n\n(a) having a glomerular filtration rate of less than 15 mL/min/1.73 m2 for a period of at least three months; or\n\n(b) a need for renal replacement therapy (dialysis or transplantation) for treatment of complications of decreased glomerular filtration rate which would otherwise increase the risk of morbidity and mortality; or\n\n(c) undergoing chronic dialysis.\n\n crystal-induced arthropathy means arthropathy resulting from the deposition of monosodium urate, calcium pyrophosphate dihydrate, calcium hydroxyapatite or calcium oxalate.\n\n immunocompromised state as specified means a condition of substantially lowered immune function, such as would occur in the following conditions or circumstances:\n\n(a) being infected with human immunodeficiency virus;\n\n(b) being treated with an immunosuppressive drug;\n\n(c) having a haematological or solid organ malignancy;\n\n(d) having chronic renal failure;\n\n(e) having severe malnutrition; or\n\n(f) undergoing solid organ, stem cell or bone marrow transplantation.\n\nNote: chronic renal failure and immunosuppressive drug are also defined in the Schedule 1 – Dictionary.\n\n immunosuppressive drug means a drug or an agent which results in substantial suppression of immune responses.\n\nNote: Examples of an immunosuppressive drug include corticosteroids other than inhaled or topical corticosteroids, drugs used to prevent transplant rejection, tumour necrosis factor-α inhibitors and chemotherapeutic agents used for the treatment of cancer.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n olecranon bursitis—see subsection 6(2).\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 specified list of disorders means:\n\n(a) diabetes mellitus;\n\n(b) gout, pseudogout or other crystal-induced arthropathy; or\n\n(c) rheumatoid arthritis.\n\nNote: crystal-induced arthropathy is 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":"This instrument maintains its original narrow scope. It addresses only olecranon bursitis in veterans and defence personnel, consistent with the Repatriation Medical Authority's function of creating specific, condition-by-condition instruments under section 196B(2) of the VEA. There is no evidence of scope creep; the instrument follows the standard template for Statements of Principles."},"complexity_factors":["15 distinct factors with parallel structure (8 for onset, 7 for worsening, with significant overlap)","Conditional limitation on factor 4 and 11: 'for septic olecranon bursitis only' creates a nested condition","Cross-references to external legislation (VEA and MRCA) for service definitions","8 defined terms in Schedule 1, with some definitions containing nested definitions (e.g., 'immunocompromised state as specified' references 'chronic renal failure' and 'immunosuppressive drug', which are also defined)","Specific temporal requirements ('within 30 days') that require precise date calculations","Reference to external medical classification system (ICD-10-AM Tenth Edition) with specific ISBN and effective date","Section 10 creates a recursive application — factors can trigger other Statements of Principles, creating potential chaining of instruments"],"plain_english_summary":"This Statement of Principles sets the medical criteria used to decide whether olecranon bursitis (painful swelling at the elbow) can be reasonably linked to Australian defence service. It applies to veterans, current and former defence members, and peacekeepers claiming under the VEA or MRCA.\n\nMeeting one of the listed medical factors and a connection to service creates a reasonable hypothesis for compensation—so this instrument is the clinical gateway for service‑related claims for \"student's\" or \"miner's\" elbow."},"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":3,"scope_assessment":{"changed":false,"description":"The Statement does not alter which veterans or types of service are covered by the VEA or MRCA. It sets the medical criteria used to link olecranon bursitis (and related death) to relevant service for entitlement decisions, rather than expanding or narrowing the classes of service covered."},"complexity_factors":["Medical terminology and diagnostic criteria (olecranon bursitis definition vs ICD‑10‑AM code)","Multiple temporal distinctions (factors at clinical onset vs clinical worsening)","Defined medical states with sub‑conditions (eg. 'immunocompromised state' and 'specified list of disorders')","Cross‑references to other legislation (VEA and MRCA) and to other Statements of Principles","Binary legal threshold (‘‘reasonable hypothesis’’) requiring evidentiary support from clinical facts","Practical evidentiary burden on claimants to show specified factors existed near onset/worsening"],"plain_english_summary":"This instrument tells decision‑makers what medical facts will, as a matter of law, raise a “reasonable hypothesis” that a veteran’s olecranon bursitis (inflammation or infection of the elbow bursa) is connected to their military relevant service. It applies to claims under the Veterans’ Entitlements Act and the Military Rehabilitation and Compensation Act. A link is acceptable if at least one specified factor existed around the clinical onset or worsening (for example, infection, recent elbow trauma or surgery, certain systemic disorders, immunocompromise, skin disease at the elbow, or recent specific drug treatment)."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-olecranon-bursitis-reasonable-hypothesis-no-63-of-2018","history":"/api/acts/statement-of-principles-concerning-olecranon-bursitis-reasonable-hypothesis-no-63-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-olecranon-bursitis-reasonable-hypothesis-no-63-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-olecranon-bursitis-reasonable-hypothesis-no-63-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-olecranon-bursitis-reasonable-hypothesis-no-63-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-olecranon-bursitis-reasonable-hypothesis-no-63-of-2018/documents"}}