{"id":"F2021L00613","name":"Statement of Principles concerning pes planus (Reasonable Hypothesis) (No. 67 of 2021)","slug":"statement-of-principles-concerning-pes-planus-reasonable-hypothesis-no-67-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440856,"registerId":"F2021L00613-fast-fetch-1775956335633","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning pes planus (Reasonable Hypothesis) (No. 67 of 2021)","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\nPES PLANUS (Reasonable Hypothesis)\n\n(No. 67 of 2021)\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 May 2021\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 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 pes planus (Reasonable Hypothesis) (No. 67 of 2021).\n\n2 Commencement\n\n This instrument commences on 21 June 2021.\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 pes planus No. 45 of 2012 (Federal Register of Legislation No. F2012L01361) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 pes planus and death from pes planus.\n\nMeaning of pes planus\n\n(2) For the purposes of this Statement of Principles, pes planus:\n\n(a) means a substantial collapse of the medial longitudinal arch of the foot that results in either:\n\n(i) medical treatment; or\n\n(ii) symptoms of medial foot pain; and\n\n(b) includes congenital pes planus, developmental pes planus, acquired pes planus, flexible pes planus and rigid pes planus.\n\nNote 1: Pes planus is also known as flatfoot deformity and can occur with calcaneal valgus or forefoot abduction.\n\nNote 2: Medical treatment may include the use of orthotics.\n\n(3) While pes planus attracts ICD‑10‑AM code M21.4 or Q66.5, in applying this Statement of Principles the meaning of pes planus 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 pes planus\n\n(5) For the purposes of this Statement of Principles, pes planus, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's pes planus.\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 pes planus and death from pes planus 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 pes planus or death from pes planus with the circumstances of a person's relevant service:\n\n(1) having a fracture or osteonecrosis involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot before the clinical onset of pes planus;\n\nNote: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary. \n\n(2) having a dislocation of a joint or subluxation of a joint or joint instability involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot before the clinical onset of pes planus;\n\nNote: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary. \n\n(3) having a sprain, penetrating trauma or surgery to the ligaments involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot within the 3 months before the clinical onset of pes planus;\n\nNote: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.\n\n(4) having a strain, penetrating trauma or surgery involving the muscles or tendons that support the medial longitudinal arch of the affected foot within the 3 months before the clinical onset of pes planus;\n\n(5) having rupture or division of the plantar fascia of the affected foot before the clinical onset of pes planus;\n\n(6) having weakness or paralysis of the supinators of the affected foot at the time of the clinical onset of pes planus;\n\nNote: Examples of conditions that can give rise to weakness or paralysis of the foot supinator muscles include central or peripheral nervous system pathology, myopathy and tendonitis.\n\n(7) having spasticity or shortening of the pronators of the affected foot at the time of the clinical onset of pes planus;\n\nNote: Examples of conditions that can give rise to spasticity or shortening of the foot pronator muscles include central or peripheral nervous system pathology and myopathy.\n\n(8) having posterior tibialis tendinopathy at the time of the clinical onset of pes planus;\n\n(9) having a space occupying lesion limiting the ability of the affected foot to supinate at the time of the clinical onset of pes planus;\n\n(10) having arthritis or other destructive lesion of one or more of the joints of the tarsal or metatarsal bones of the medial longitudinal arch of the affected foot at the time of the clinical onset of pes planus;\n\nNote: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.\n\n(11) being obese at the time of the clinical onset of pes planus;\n\nNote: being obese is defined in the Schedule 1 - Dictionary.\n\n(12) being pregnant at the time of the clinical onset of pes planus;\n\n(13) having a fracture or osteonecrosis involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot before the clinical worsening of pes planus;\n\nNote: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary. \n\n(14) having a dislocation of a joint or subluxation of a joint or joint instability involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot before the clinical worsening of pes planus;\n\nNote: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary. \n\n(15) having a sprain, penetrating trauma or surgery to the ligaments involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot within the 3 months before the clinical worsening of pes planus;\n\nNote: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.\n\n(16) having a strain, penetrating trauma or surgery involving the muscles or tendons that support the medial longitudinal arch of the affected foot within the 3 months before the clinical worsening of pes planus;\n\n(17) having rupture or division of the plantar fascia of the affected foot before the clinical worsening of pes planus;\n\n(18) having weakness or paralysis of the supinators of the affected foot at the time of the clinical worsening of pes planus;\n\nNote: Examples of conditions that can give rise to weakness or paralysis of the foot supinator muscles include central or peripheral nervous system pathology, myopathy and tendonitis.\n\n(19) having spasticity or shortening of the pronators of the affected foot at the time of the clinical worsening of pes planus;\n\nNote: Examples of conditions that can give rise to spasticity or shortening of the foot pronator muscles include central or peripheral nervous system pathology and myopathy.\n\n(20) having posterior tibialis tendinopathy at the time of the clinical worsening of pes planus;\n\n(21) having a space occupying lesion limiting the ability of the affected foot to supinate at the time of the clinical worsening of pes planus;\n\n(22) having arthritis or other destructive lesion of one or more of the joints of the tarsal or metatarsal bones of the medial longitudinal arch of the affected foot at the time of the clinical worsening of pes planus;\n\nNote: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.\n\n(23) being obese at the time of the clinical worsening of pes planus;\n\nNote: being obese is defined in the Schedule 1 - Dictionary.\n\n(24) being pregnant at the time of the clinical worsening of pes planus;\n\n(25) running or jogging:\n\n(a) an average of at least 30 kilometres per week; and\n\n(b) for at least the 4 weeks before the clinical worsening of pes planus;\n\n(26) walking:\n\n(a) an average of at least 10 kilometres per week; and\n\n(b) while carrying loads of at least 15 kilograms; and\n\n(c) for at least the 4 weeks before the clinical worsening of pes planus;\n\n(27) inability to obtain appropriate clinical management for pes planus.\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(13) to 9(27) apply only to material contribution to, or aggravation of, pes planus where the person's pes planus 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 being obese means having a Body Mass Index (BMI) of 30 or greater.\n\nNote: BMI is also defined in the Schedule 1 - Dictionary.\n\n BMI means W/H2 where:\n\n(a) W is the person's weight in kilograms; and\n\n(b) H is the person's height in metres.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n pes planus—see subsection 7(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 tarsal or metatarsal bones of the medial longitudinal arch means the calcaneus, talus, navicular, cuneiforms and the first, second and third metatarsals.\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"},"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard replacement Statement of Principles maintaining the established framework for determining service connection of pes planus. It updates the 2012 version without expanding beyond the original purpose of providing medical criteria for veterans' compensation claims. The structure follows the standard RMA template with onset factors, worsening factors, and definitional schedule."},"complexity_factors":["27 distinct factual factors with specific temporal requirements (e.g., 'within 3 months', 'at least 4 weeks before')","Dual application structure: factors 1-12 for clinical onset, factors 13-27 for clinical worsening, with factor 27 applying to both","Cross-referencing mechanism in section 11 allowing incorporation of other Statements of Principles by reference","Defined terms in Schedule 1 including anatomical definitions ('tarsal or metatarsal bones of the medial longitudinal arch') and mathematical formula for BMI","Conditional logic in section 10(2) restricting factors 13-27 to aggravation cases where condition pre-existed service","Medical terminology requiring specialist knowledge (e.g., 'subluxation', 'supinators', 'posterior tibialis tendinopathy', 'space occupying lesion')"],"plain_english_summary":"This instrument sets the Repatriation Medical Authority’s medical criteria for linking pes planus (flat feet) to Australian Defence Force service, affecting current and former ADF members, veterans, peacekeepers and their families. It identifies 27 medical and activity-related factors (e.g. prior foot injury/surgery near symptom onset, obesity or pregnancy, heavy marching/running thresholds for worsening) that create a “reasonable hypothesis” of service connection. Its findings determine eligibility for treatment and compensation."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":true,"description":"This instrument repeals the 2012 Statement (s4) and replaces it with updated criteria that explicitly include death from pes planus (s7(5)), specified activity thresholds (s9(25)–(26)), and BMI-based obesity definitions (Schedule). Those elements indicate a change in the set of factors the Authority treats as raising a reasonable hypothesis. The source text itself does not provide a clause-by-clause comparison to the 2012 instrument, so a full determination of all scope differences requires side-by-side review of the prior Statement."},"complexity_factors":["Technical medical terminology and diagnostic concepts (e.g. medial longitudinal arch collapse, posterior tibialis tendinopathy, plantar fascia rupture) require expert interpretation (s7(2), s9(5), s9(8))","Temporal distinctions between factors before clinical onset and before clinical worsening create two different legal tests (s9(1)–(24); s10(2))","Activity-based quantitative thresholds (running ≥30 km/week; walking ≥10 km/week with ≥15 kg load for 4 weeks) impose measurement and evidentiary challenges (s9(25)–(26))","Cross-references to other Statements of Principles mean a factor may import another instrument’s terms, adding layered legal complexity (s11)","Definitions and numerical cut-offs are prescribed (BMI ≥30; BMI formula), requiring factual calculation (Schedule: being obese; BMI)","Inclusion of death from a terminal event broadens causal assessment to proximate or ultimate causes of death (s7(5); Schedule: terminal event)","Requirement that any listed factor be related to the person's relevant service introduces a nexus inquiry tied to service types defined in the instrument (s10(1); Schedule: relevant service)","Repeal and replacement of the 2012 Statement creates potential transition issues for existing claims and for comparing changed criteria (s4)"],"plain_english_summary":"This instrument sets the medical criteria the Repatriation Medical Authority will use to decide whether pes planus (flatfoot) or death from pes planus can reasonably be connected to a person’s military service for veterans’ entitlements. It lists specific medical findings, activity thresholds and circumstances (for example obesity, pregnancy, certain foot injuries, or heavy walking/running) that, if present and linked to relevant service, raise a reasonable hypothesis for entitlement claims."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-pes-planus-reasonable-hypothesis-no-67-of-2021","history":"/api/acts/statement-of-principles-concerning-pes-planus-reasonable-hypothesis-no-67-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-pes-planus-reasonable-hypothesis-no-67-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-pes-planus-reasonable-hypothesis-no-67-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-pes-planus-reasonable-hypothesis-no-67-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-pes-planus-reasonable-hypothesis-no-67-of-2021/documents"}}