{"id":"F2023L01142","name":"Statement of Principles concerning plantar fasciitis (Balance of Probabilities) (No. 83 of 2023)","slug":"statement-of-principles-concerning-plantar-fasciitis-balance-of-probabilities-no-83-of-2023","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442048,"registerId":"F2023L01142-fast-fetch-1775957172089","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning plantar fasciitis (Balance of Probabilities) (No. 83 of 2023)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nPLANTAR FASCIITIS (Balance of Probabilities)\n\n(No. 83 of 2023)\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 25 August 2023.\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 Terence Campbell AM
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 plantar fasciitis (Balance of Probabilities) (No. 83 of 2023).\n\n2 Commencement\n\n This instrument commences on 26 September 2023.\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 plantar fasciitis No. 52 of 2015 (Federal Register of Legislation No. F2015L00258) made under subsection 196B(3) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act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 plantar fasciitis and death from plantar fasciitis.\n\nMeaning of plantar fasciitis\n\n(2) For the purposes of this Statement of Principles, plantar fasciitis:\n\n(a) means a painful inflammatory or degenerative condition of the plantar fascia of the foot; and\n\n(b) excludes plantar fibromatosis.\n\nNote: Clinical manifestations typically include pain in the inferior heel that is worse with the first steps in the morning or after a period of inactivity. There may be tenderness of the inferior heel.\n\nDeath from plantar fasciitis\n\n(3) For the purposes of this Statement of Principles, plantar fasciitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's plantar fasciitis.\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 plantar fasciitis and death from plantar fasciitis 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, plantar fasciitis or death from plantar fasciitis is connected with the circumstances of a person's relevant service:\n\n(1) having trauma to the plantar aspect of the affected foot within the seven days before the clinical onset or clinical worsening of plantar fasciitis;\n\n(2) having an infection involving the plantar fascia at the time of the clinical onset or clinical worsening of plantar fasciitis;\n\n(3) running or jogging an average of at least 30 kilometres per week for at least the 2 months before the clinical onset or clinical worsening of plantar fasciitis;\n\n(4) undertaking exercise that involves repetitive weight bearing on the affected foot for:\n\n(a) a minimum intensity of 5 METS; and\n\n(b) for at least 4 hours per week; and\n\nfor at least the 2 months before the clinical onset or clinical worsening of plantar fasciitis;\n\nNote: MET is defined in the Schedule 1 - Dictionary.\n\nNote: Exercise that involves repetitive weight bearing on the affected foot includes marching, jumping, soccer, tennis, or dancing.\n\n(5) increasing the frequency, duration or intensity of weight bearing activity involving the affected foot:\n\n(a) by at least 200 percent; and\n\n(b) to a minimum intensity of 5 METs; and\n\n(c) for at least 2 hours per day;\n\nand within the seven days before the clinical onset or clinical worsening of plantar fasciitis;\n\nNote: MET is defined in the Schedule 1 – Dictionary\n\n \n\n(6) undergoing prolonged weight bearing on the affected foot while on a hard surface for at least five hours per day, on more days than not, for the 12 months before the clinical onset or clinical worsening of plantar fasciitis;\n\n(7) being overweight or obese at the time of the clinical onset or clinical worsening of plantar fasciitis;\n\nNote: being overweight or obese is defined in the Schedule 1 – Dictionary.\n\n(8) having a systemic arthritic disease at the time of the clinical onset or clinical worsening of plantar fasciitis;\n\nNote: systemic arthritic disease is defined in the Schedule 1 – Dictionary.\n\n(9) having an acquired biomechanical abnormality involving the affected foot before the clinical onset or clinical worsening of plantar fasciitis;\n\nNote: biomechanical abnormality is defined in the Schedule 1 – Dictionary.\n\n(10) wearing footwear with inadequate cushioning during weight bearing exercise which involves the affected foot within the seven days before the clinical onset or clinical worsening of plantar fasciitis;\n\n(11) inability to obtain appropriate clinical management for plantar fasciitis before the clinical worsening of plantar fasciitis.\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 clinical worsening aspect of factors apply only to material contribution to, or aggravation of, plantar fasciitis where the person's plantar fasciitis 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 being overweight or obese means having a Body Mass Index (BMI) of 25 or greater.\n\nNote: BMI is defined in the Schedule 1 – Dictionary.\n\n biomechanical abnormality means injury or disease that has resulted in overpronation or underpronation, or decreased ankle or forefoot flexibility.\n\n BMI means W/H2 where:\n\n W is the person's weight in kilograms; and\n\n H is the person's height in metres.\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, or 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 other crystal-induced arthropathy means arthropathy resulting from the deposition of calcium hydroxyapatite or calcium oxalate.\n\n plantar fasciitis—see subsection 7(2).\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 defined in the Schedule 1 – Dictionay.\n\n systemic arthritic disease means:\n\n(a) ankylosing spondylitis;\n\n(b) enteropathic spondyloarthropathy (arthritis associated with inflammatory bowel disease);\n\n(c) psoriatic arthropathy;\n\n(d) reactive arthritis;\n\n(e) undifferentiated spondyloarthropathy;\n\n(f) gout;\n\n(g) pseudogout (calcium pyrophosphate dehydrate);\n\n(h) other crystal-induced arthropathy.\n\nNote: other crystal-induced arthropathy is 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"},"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 plantar fasciitis. It updates the 2015 version (No. 52 of 2015) with current medical evidence but does not expand beyond the original purpose of providing medical criteria for veterans' compensation claims. The scope remains tightly focused on the specific condition and its relationship to defined military service categories."},"complexity_factors":["11 distinct factors with specific temporal requirements (ranging from 7 days to 12 months)","Technical medical definitions requiring cross-referencing (MET, BMI, systemic arthritic disease with 8 sub-types)","Nested definitions: 'being overweight or obese' refers to BMI, which has its own mathematical formula","Dual application framework covering two different Acts (VEA and MRCA) with different service categories","Conditional logic in section 10(2) restricting 'clinical worsening' factors to pre-existing conditions not arising from service","Cross-reference mechanism in section 11 allowing incorporation of other Statements of Principles by reference","Precise quantitative thresholds (30km/week, 5 METS, 4 hours/week, 200% increase, 5 hours/day, BMI 25)"],"plain_english_summary":"This instrument updates the medical rules for deciding whether plantar fasciitis (and death caused by it) is attributable to service, replacing the 2015 version and applying a \"balance of probabilities\" test. It lists specific factors used to link the condition to military service.\n\nIt affects veterans and current/former defence members claiming under the Veterans' Entitlements Act 1986 and the Military Rehabilitation and Compensation Act 2004, and directly determines eligibility for compensation."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the Statement of Principles concerning plantar fasciitis No. 52 of 2015 (s4) and replaces it, and so changes the governing instrument for adjudicating related claims. The current text sets out the operative factors, definitions and temporal rules (ss7–11, Schedule 1). The instrument itself does not state whether the substantive coverage was expanded or narrowed compared with the repealed 2015 statement; determining that requires a side‑by‑side comparison with the earlier instrument."},"complexity_factors":["Legal causation standard is 'balance of probabilities' (s8) rather than a clinical certainty standard, affecting evidentiary framing.","Multiple quantified exposure thresholds require numeric proof: running ≥30 km/week for ≥2 months (s9(3)); MET intensity ≥5 and hours/week or hours/day requirements (s9(4)–(5)); prolonged weight bearing ≥5 hours/day for 12 months (s9(6)); BMI ≥25 (Schedule 1).","Temporal linkages and short windows complicate proof: events within seven days for trauma or footwear (s9(1), s9(10)); 2‑month qualifying period for many factors (s9(3)–(5)).","Applies both to primary causation and to 'clinical worsening' (aggravation) of pre‑existing plantar fasciitis, with different application rules (s10(2)).","Interplay with other Statements of Principles requires cross‑reference where factors overlap (s11).","Defined medical and technical terms in Schedule 1 (MET, BMI, systemic arthritic disease, biomechanical abnormality, terminal event) require clinical interpretation.","Administrative scope and application are limited to claims under VEA or MRCA (s5), concentrating decision power with the Repatriation Medical Authority (instrument as a whole).","Repeal of the 2015 statement and formal commencement date create transitional and administrative effects (s2, s4).","Inclusion of death from a terminal event contributed to by plantar fasciitis broadens potential claim outcomes (s7(3))."],"plain_english_summary":"This instrument sets the medical criteria the Repatriation Medical Authority uses to decide, on the balance of probabilities, whether plantar fasciitis (or death from it) is connected to a veteran’s or member’s service for VEA or MRCA claims. It lists specific, measurable risk and exposure factors (trauma, infection, running ≥30 km/week, MET‑based repetitive weight‑bearing, prolonged hard‑surface standing, BMI ≥25, systemic arthritic disease, biomechanical abnormalities, footwear, lack of treatment) and replaces the 2015 statement."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-plantar-fasciitis-balance-of-probabilities-no-83-of-2023","history":"/api/acts/statement-of-principles-concerning-plantar-fasciitis-balance-of-probabilities-no-83-of-2023/history","analysis":"/api/acts/statement-of-principles-concerning-plantar-fasciitis-balance-of-probabilities-no-83-of-2023/analysis","conflicts":"/api/acts/statement-of-principles-concerning-plantar-fasciitis-balance-of-probabilities-no-83-of-2023/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-plantar-fasciitis-balance-of-probabilities-no-83-of-2023/important-cases","documents":"/api/acts/statement-of-principles-concerning-plantar-fasciitis-balance-of-probabilities-no-83-of-2023/documents"}}