{"id":"F2019L00629","name":"Statement of Principles concerning posterior adventitial heel bursitis (Reasonable Hypothesis) (No. 47 of 2019)","slug":"statement-of-principles-concerning-posterior-adventitial-heel-bursitis-reasonable-hypothesis-no-47-o","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440042,"registerId":"F2019L00629-fast-fetch-1775955830426","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning posterior adventitial heel bursitis (Reasonable Hypothesis) (No. 47 of 2019)","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\nPOSTERIOR ADVENTITIAL HEEL BURSITIS (Reasonable Hypothesis)\n\n(No. 47 of 2019)\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 26 April 2019\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 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 posterior adventitial heel bursitis (Reasonable Hypothesis) (No. 47 of 2019).\n\n2 Commencement\n\n This instrument commences on 27 May 2019.\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 heel bursitis No. 77 of 2010 (Federal Register of Legislation No. F2010L02316) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 posterior adventitial heel bursitis and death from posterior adventitial heel bursitis.\n\nMeaning of posterior adventitial heel bursitis\n\n(2) For the purposes of this Statement of Principles, posterior adventitial heel bursitis:\n\n(a) means inflammation of the superficial retro-Achilles bursa located between the skin and the distal Achilles tendon; and\n\n(b) is characterised by a painful and tender swelling of the posterior aspect of the heel; and\n\n(c) excludes retrocalcaneal bursitis and plantar calcaneal bursitis.\n\nNote: plantar calcaneal bursitis is defined in the Schedule 1 – Dictionary.\n\nDeath from posterior adventitial heel bursitis\n\n(3) For the purposes of this Statement of Principles, posterior adventitial heel bursitis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's posterior adventitial heel bursitis.\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 posterior adventitial heel bursitis and death from posterior adventitial heel 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\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 posterior adventitial heel bursitis or death from posterior adventitial heel bursitis with the circumstances of a person's relevant service:\n\n(1) wearing footwear that causes friction or pressure on the posterior aspect of the heel of the affected foot, at the time of the clinical onset of posterior adventitial heel bursitis;\n\n(2) having a Haglund deformity at the time of the clinical onset of posterior adventitial heel bursitis;\n\nNote: Haglund deformity is defined in the Schedule 1 - Dictionary. \n\n(3) wearing footwear that causes friction or pressure on the posterior aspect of the heel of the affected foot, at the time of the clinical worsening of posterior adventitial heel bursitis;\n\n(4) having a Haglund deformity at the time of the clinical worsening of posterior adventitial heel bursitis;\n\nNote: Haglund deformity is defined in the Schedule 1 - Dictionary. \n\n(5) inability to obtain appropriate clinical management for posterior adventitial heel bursitis.\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(3) to 9(5) apply only to material contribution to, or aggravation of, posterior adventitial heel bursitis where the person's posterior adventitial heel bursitis 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 Haglund deformity means an abnormality of the posterosuperior part of the calcaneus, where there is a bony enlargement at the attachment of the Achilles tendon.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n plantar calcaneal bursitis means inflammation of the adventitial bursa located on the inferior aspect of the calcaneus near the insertion of the plantar fascia, characterised by heel pain at the plantar surface of the heel, mild warmth and swelling.\n\n posterior adventitial heel bursitis—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 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":3,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Statements of Principles under the veterans' compensation scheme. It replaces a 2010 instrument concerning 'heel bursitis' with a more precisely defined condition ('posterior adventitial heel bursitis'), actually narrowing rather than expanding the scope. The document remains tightly focused on establishing the causal factors for a single specific medical condition in the context of military service claims."},"complexity_factors":["Short, focused instrument (approximately 1,500 words) dealing with a single medical condition","Only 7 defined terms in the Dictionary, all with clear medical or legislative meanings","Simple conditional structure: 5 alternative factors in section 9, only one of which must be satisfied","Minimal cross-referencing — primarily internal references to the Dictionary and one reference to other Statements of Principles in section 11","Clear delineation between 'clinical onset' and 'clinical worsening' factors in section 9","Single layer of exception: explicit exclusion of retrocalcaneal and plantar calcaneal bursitis in section 7(2)(c)","Straightforward application provision linking to specific sections of two principal Acts (VEA and MRCA)"],"plain_english_summary":"This instrument sets when current and former Australian Defence Force members can claim compensation for posterior adventitial heel bursitis. It uses the “reasonable hypothesis” test — a presumptive, service‑friendly standard — so the condition is treated as plausibly service‑related if factors like footwear rubbing the heel, a Haglund deformity, or lack of access to proper treatment were present when it began or worsened. It replaces a 2010 version and narrows coverage to this specific heel bursitis."},"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":true,"description":"The instrument expressly repeals the earlier Statement of Principles concerning heel bursitis (No. 77 of 2010) (s4) and replaces it with a focused statement that defines posterior adventitial heel bursitis, lists the limited factors that can raise a reasonable hypothesis linking the condition to relevant service, and sets rules on aggravation and cross-application of other Statements (ss7–11). It applies to claims under the VEA and the MRCA (s5)."},"complexity_factors":["Technical medical definitions and exclusions (posterior adventitial heel bursitis defined; excludes retrocalcaneal and plantar calcaneal bursitis) (s7, Schedule 1)","Narrow, conditional linking rules requiring a factor to be related to relevant service (s9, s10)","Cross-reference to other Statements of Principles where factors overlap, affecting application (s11)","Statutory interaction with two Acts (VEA and MRCA) and relevant-service categories, requiring benefit-law interpretation (s3, s5, Schedule 1)","Replacement of prior statement (repeal) requiring comparison to earlier instrument for claims spanning the change (s4)"],"plain_english_summary":"This instrument sets out the medical test the Repatriation Medical Authority uses to decide when posterior adventitial heel bursitis (a defined inflammation at the back of the heel) can be reasonably linked to a person’s military service for claims under the Veterans’ Entitlements Act 1986 or the Military Rehabilitation and Compensation Act 2004 (ss3–5,7). It lists specific linking factors — for example footwear causing friction, a Haglund deformity, or inability to obtain appropriate clinical management — explains when aggravation applies, and repeals the 2010 Statement (ss9–11,4)."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-posterior-adventitial-heel-bursitis-reasonable-hypothesis-no-47-o","history":"/api/acts/statement-of-principles-concerning-posterior-adventitial-heel-bursitis-reasonable-hypothesis-no-47-o/history","analysis":"/api/acts/statement-of-principles-concerning-posterior-adventitial-heel-bursitis-reasonable-hypothesis-no-47-o/analysis","conflicts":"/api/acts/statement-of-principles-concerning-posterior-adventitial-heel-bursitis-reasonable-hypothesis-no-47-o/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-posterior-adventitial-heel-bursitis-reasonable-hypothesis-no-47-o/important-cases","documents":"/api/acts/statement-of-principles-concerning-posterior-adventitial-heel-bursitis-reasonable-hypothesis-no-47-o/documents"}}