{"id":"F2023L00473","name":"Statement of Principles concerning plantar fibromatosis (Balance of Probabilities) (No. 22 of 2023)","slug":"statement-of-principles-concerning-plantar-fibromatosis-balance-of-probabilities-no-22-of-2023","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441819,"registerId":"F2023L00473-fast-fetch-1775957018816","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning plantar fibromatosis (Balance of Probabilities) (No. 22 of 2023)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 22.10.0\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nPLANTAR FIBROMATOSIS (Balance of Probabilities)\n\n(No. 22 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 24 April 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 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 plantar fibromatosis (Balance of Probabilities) (No. 22 of 2023).\n\n2 Commencement\n\n This instrument commences on 23 May 2023.\n\n3 Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4 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\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 plantar fibromatosis and death from plantar fibromatosis.\n\nMeaning of plantar fibromatosis\n\n(2) For the purposes of this Statement of Principles, plantar fibromatosis:\n\n(a) means a benign, progressive fibroproliferative disease of the plantar fascia and the digital fascia of the foot, which causes puckering and thickening of the plantar skin and nodule and cord formation in the fascia that may progress to contracture of the digits; and\n\n(b) excludes:\n\n(i) plantar fasciitis;\n\n(ii) plantar fascial tear;\n\n(iii) hyperplastic wound scarring; and\n\n(iv) soft tissue benign or malignant neoplasia.\n\nNote: plantar fibromatosis is also known as Ledderhose disease or morbus Ledderhose.\n\nDeath from plantar fibromatosis\n\n(3) For the purposes of this Statement of Principles, plantar fibromatosis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's plantar fibromatosis.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n7 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 fibromatosis and death from plantar fibromatosis 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\n8 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 fibromatosis or death from plantar fibromatosis is connected with the circumstances of a person's relevant service:\n\n(1) having alcohol use disorder at the time of the clinical onset of plantar fibromatosis;\n\n(2) having alcoholic liver cirrhosis at the time of the clinical onset of plantar fibromatosis;\n\n(3) having diabetes mellitus before the clinical onset of plantar fibromatosis;\n\n(4) having alcohol use disorder at the time of the clinical worsening of plantar fibromatosis;\n\n(5) having alcoholic liver cirrhosis at the time of the clinical worsening of plantar fibromatosis;\n\n(6) having diabetes mellitus before the clinical worsening of plantar fibromatosis;\n\n(7) inability to obtain appropriate clinical management for plantar fibromatosis.\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(4) to 8(7) apply only to material contribution to, or aggravation of, plantar fibromatosis where the person's plantar fibromatosis 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(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 5\n\n1 Definitions\n\nIn this instrument:\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n plantar fibromatosis—see subsection 6(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 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":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"The instrument defines the scope of a Statement of Principles for plantar fibromatosis and death from it for VEA/MRCA claims. It does not indicate any change to prior coverage or a departure from the statutory scheme; it merely establishes factors and application rules for connecting the condition to relevant service."},"complexity_factors":["Specialised medical definitions and exclusions for the condition (s.6(2))","Evidentiary standard set to 'balance of probabilities' (s.7)","Requirement that listed factors be causally linked to relevant service (s.9(1))","Different treatment for material contribution/aggravation versus causation (s.9(2))","Cross-reference to other Statements of Principles when factors overlap (s.10)","Operationalising 'inability to obtain appropriate clinical management' as a factor (s.8(7))","Interaction with two separate statutory schemes (VEA and MRCA) and their definitions of relevant service (ss.3–5, Schedule 1)"],"plain_english_summary":"This instrument, made by the Repatriation Medical Authority, sets when plantar fibromatosis (Ledderhose disease) or death from it can be accepted as connected to a person’s relevant military service for claims under the VEA and the MRCA on the balance of probabilities. It identifies a limited set of medical and care‑related factors that must be shown to be related to service; those findings determine entitlement to service‑related benefits and create verification and clinical‑evidence obligations for claimants and administrators."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains its original narrow scope. It addresses only plantar fibromatosis in the context of veterans' compensation, with no evidence of scope creep beyond the specific medical condition and the standard statutory framework for Statements of Principles."},"complexity_factors":["Short, single-purpose instrument (11 sections plus brief dictionary)","Only 7 defined terms in Schedule 1","Simple conditional structure: 'at least one factor must exist' with 7 enumerated factors","Minimal cross-referencing — only refers to other Statements of Principles in section 10 and standard definitions of MRCA/VEA","Clear delineation between 'clinical onset' and 'clinical worsening' factors in section 8","Single exception structure in section 9(2) limiting application of worsening factors to pre-existing conditions","No nested exceptions or recursive definitions"],"plain_english_summary":"This Statement of Principles sets the medical test for linking plantar fibromatosis (Ledderhose disease) to military service for veterans claiming under the Veterans’ Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004. It says the condition is service-related on the balance of probabilities if at least one factor — alcohol use disorder, alcoholic liver cirrhosis, diabetes, or inability to obtain proper treatment — was present and connected to its onset or worsening. Pre-existing cases only permit findings of worsened condition; plantar fasciitis and cancer are excluded."},"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-plantar-fibromatosis-balance-of-probabilities-no-22-of-2023","history":"/api/acts/statement-of-principles-concerning-plantar-fibromatosis-balance-of-probabilities-no-22-of-2023/history","analysis":"/api/acts/statement-of-principles-concerning-plantar-fibromatosis-balance-of-probabilities-no-22-of-2023/analysis","conflicts":"/api/acts/statement-of-principles-concerning-plantar-fibromatosis-balance-of-probabilities-no-22-of-2023/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-plantar-fibromatosis-balance-of-probabilities-no-22-of-2023/important-cases","documents":"/api/acts/statement-of-principles-concerning-plantar-fibromatosis-balance-of-probabilities-no-22-of-2023/documents"}}