{"id":"F2018L00190","name":"Statement of Principles concerning popliteal cyst (Balance of Probabilities) (No. 32 of 2018)","slug":"statement-of-principles-concerning-popliteal-cyst-balance-of-probabilities-no-32-of-2018","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439496,"registerId":"F2018L00190-fast-fetch-1775955503815","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning popliteal cyst (Balance of Probabilities) (No. 32 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\nPOPLITEAL CYST (Balance of Probabilities)\n\n(No. 32 of 2018)\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 2 March 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 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 popliteal cyst (Balance of Probabilities) (No. 32 of 2018).\n\n2 Commencement\n\n This instrument commences on 2 April 2018.\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 popliteal cyst and death from popliteal cyst.\n\nMeaning of popliteal cyst\n\n(2) For the purposes of this Statement of Principles, popliteal cyst means a swelling in the popliteal fossa due to enlargement of the gastrocnemius-semimembranosus bursa, where the swelling is associated with clinical manifestations.\n\nNote: Clinical manifestations of a popliteal cyst include a palpable swelling or mass behind the knee, posterior knee pain, knee stiffness, tightness in the popliteal region and limitation of range of motion of the affected knee joint. Pain and swelling may be worsened by prolonged standing or activity. Popliteal cysts may enlarge, dissect or rupture, sometimes resulting in compression or inflammation of adjacent structures.\n\n(3) While popliteal cyst attracts ICD‑10‑AM code M66.0 or M71.2, in applying this Statement of Principles the meaning of popliteal cyst 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 popliteal cyst\n\n(5) For the purposes of this Statement of Principles, popliteal cyst, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's popliteal cyst.\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 popliteal cyst and death from popliteal cyst 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, popliteal cyst or death from popliteal cyst is connected with the circumstances of a person's relevant service:\n\n(1) having an injury or disease which causes synovitis of the affected knee joint at the time of the clinical onset of popliteal cyst;\n\nNote: Examples of an injury or disease which can cause synovitis of the affected knee joint include:\n\n(a) an acute meniscal tear of the knee;\n\n(b) calcium pyrophosphate deposition disease (pseudogout);\n\n(c) dialysis-related amyloidosis;\n\n(d) gout;\n\n(e) internal derangement of the knee;\n\n(f) Lyme disease;\n\n(g) osteoarthritis;\n\n(h) pigmented villonodular synovitis;\n\n(i) psoriatic arthropathy;\n\n(j) reactive arthritis;\n\n(k) rheumatoid arthritis;\n\n(l) sarcoidosis; and\n\n(m) tuberculosis.\n\n(2) having a partial or total knee replacement before the clinical onset of popliteal cyst;\n\n(3) having an injury or disease which causes synovitis of the affected knee joint at the time of the clinical worsening of popliteal cyst;\n\nNote: Examples of an injury or disease which can cause synovitis of the affected knee joint include:\n\n(a) an acute meniscal tear of the knee;\n\n(b) calcium pyrophosphate deposition disease (pseudogout);\n\n(c) dialysis-related amyloidosis;\n\n(d) gout;\n\n(e) internal derangement of the knee;\n\n(f) Lyme disease;\n\n(g) osteoarthritis;\n\n(h) pigmented villonodular synovitis;\n\n(i) psoriatic arthropathy;\n\n(j) reactive arthritis;\n\n(k) rheumatoid arthritis;\n\n(l) sarcoidosis; and\n\n(m) tuberculosis.\n\n(4) having a partial or total knee replacement before the clinical worsening of popliteal cyst;\n\n(5) for clinical worsening of a popliteal cyst manifesting as rupture of a popliteal cyst only, undertaking physical activity at a minimum intensity of five METS at the time of the clinical worsening of popliteal cyst;\n\nNote: MET is defined in the Schedule 1 - Dictionary. \n\n(6) inability to obtain appropriate clinical management for popliteal cyst.\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(3) to 8(6) apply only to material contribution to, or aggravation of, popliteal cyst where the person's popliteal cyst 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 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, 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 popliteal cyst—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_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 instrument appears to maintain its original scope as a specific medical determination for a single condition (popliteal cyst) under the Repatriation Medical Authority's statutory framework. It follows the standard template for Statements of Principles without evident scope creep."},"complexity_factors":["Moderate cross-referencing between the main instrument and Schedule 1 (Dictionary)","Nested conditional logic in section 8 with six alternative factors, some with sub-conditions (e.g., factor 5 applies only to rupture cases)","Dual legislative framework application (VEA and MRCA) requiring understanding of different service types defined in the Dictionary","Technical medical terminology requiring definition (synovitis, popliteal fossa, gastrocnemius-semimembranosus bursa, METS)","Specific reference to external classification system (ICD-10-AM Tenth Edition) with precise edition and ISBN","Distinction between clinical onset and clinical worsening with different applicable factors","Incorporation by reference of other Statements of Principles (section 10)"],"plain_english_summary":"This Statement of Principles sets the medical test for linking a popliteal (Baker’s) cyst or death from it to Australian military service under the VEA and MRCA, using the balance‑of‑probabilities standard. It applies to veterans and defence members and guides DVA decision‑makers.\n\nA claim requires at least one listed service‑related factor (e.g., concurrent inflammatory knee disease, rupture during moderate‑intensity activity, or lack of appropriate treatment); pre‑existing cysts are compensable only if worsened in service."},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"This Statement does not expand or contract the statutory classes of claimants; it provides medical causation criteria to be applied to claims under section 120B of the VEA and section 339 of the MRCA (s 4). It defines the condition, required linking factors and how death is treated (s 6, s 8), and defers to other Statements where underlying diseases are already covered (s 10)."},"complexity_factors":["Medical specificity and clinical judgement required (definition and clinical manifestations in s 6(2) and note) — evidence must show popliteal cyst as defined, not just an ICD code.","Timing and causal linkage requirements: factors must exist at clinical onset or clinical worsening and be related to relevant service (ss 8, 9).","Multiple possible causal factors listed (synovitis from many diseases, knee replacement, activity, access to management) create mixed-cause assessments (s 8 and associated notes).","Cross-references to other Statements of Principles where an underlying injury/disease is covered elsewhere (s 10) require coordinative analysis across instruments.","Quantified physical-exertion threshold (≥5 METS) introduces a measurable but technical evidentiary standard for rupture-related worsening (s 8(5); Schedule 1).","Evidentiary burden for 'inability to obtain appropriate clinical management' is potentially high and fact-specific (s 8(6)).","Definition of death from popliteal cyst requires contribution to a terminal event, implicating proximate-cause and contributory-cause medical analysis (s 6(5); Schedule 1).","Application limited to specified claim types (s 4) and commencement date (s 2) — administrative scope is narrow and statute-tied."],"plain_english_summary":"This instrument sets the medical criteria used to decide whether a popliteal cyst (a swelling behind the knee) or death from it is connected to a person’s relevant military service. It applies to claims under the Veterans’ Entitlements Act and the Military Rehabilitation and Compensation Act and specifies required linking factors — for example knee synovitis, prior knee replacement, certain physical activity at rupture, or lack of appropriate clinical management — that must be tied to the person’s relevant service before entitlements apply."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-popliteal-cyst-balance-of-probabilities-no-32-of-2018","history":"/api/acts/statement-of-principles-concerning-popliteal-cyst-balance-of-probabilities-no-32-of-2018/history","analysis":"/api/acts/statement-of-principles-concerning-popliteal-cyst-balance-of-probabilities-no-32-of-2018/analysis","conflicts":"/api/acts/statement-of-principles-concerning-popliteal-cyst-balance-of-probabilities-no-32-of-2018/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-popliteal-cyst-balance-of-probabilities-no-32-of-2018/important-cases","documents":"/api/acts/statement-of-principles-concerning-popliteal-cyst-balance-of-probabilities-no-32-of-2018/documents"}}