{"id":"F2020L00482","name":"Statement of Principles concerning sprain and strain (Reasonable Hypothesis) (No. 27 of 2020)","slug":"statement-of-principles-concerning-sprain-and-strain-reasonable-hypothesis-no-27-of-2020","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440458,"registerId":"F2020L00482-fast-fetch-1775956070564","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning sprain and strain (Reasonable Hypothesis) (No. 27 of 2020)","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\nSPRAIN AND STRAIN (Reasonable Hypothesis)\n\n(No. 27 of 2020)\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 24 April 2020\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 sprain and strain (Reasonable Hypothesis) (No. 27 of 2020).\n\n2 Commencement\n\n This instrument commences on 25 May 2020.\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 sprain and strain No. 94 of 2011 (Federal Register of Legislation No. F2011L01726) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act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 sprain and strain and death from sprain and strain.\n\nMeaning of sprain\n\n(2) For the purposes of this Statement of Principles, sprain:\n\n(a) means an injury involving the tearing or stretching of one or more joint ligaments, associated with the onset of pain and tenderness at that site within the 24 hours following the injury; and\n\n(b) includes complete tear or rupture of a ligament; and\n\n(c) excludes recurrent sprain due to joint instability.\n\nMeaning of strain\n\n(3) For the purposes of this Statement of Principles, strain:\n\n(a) means an injury involving the tearing or stretching of a muscle or tendon, associated with the onset of pain and tenderness at that site within the 24 hours following the injury; and\n\n(b) includes complete tear or rupture of a muscle or tendon; and\n\n(c) excludes drug-induced disease of tendons or muscles.\n\nDeath from sprain and strain\n\n(4) For the purposes of this Statement of Principles, sprain or strain, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's sprain or strain.\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 sprain or strain and death from sprain or strain 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 sprain or strain or death from sprain or strain with the circumstances of a person's relevant service:\n\n(1) experiencing a significant physical force applied to or through the affected joint, at the time of the clinical onset of a sprain to that joint ligament;\n\nNote: Examples of activities and circumstances involving significant physical force applied to or through the affected joint include falls, collisions, lifting weights, running, jumping or stepping down from a height, throwing objects and climbing.\n\n(2) forceful stretching or high intensity use of a muscle or tendon at the time of the clinical onset of a strain to that muscle or tendon;\n\nNote: Examples of activities and circumstances involving forceful stretching or high intensity use of a muscle or tendon include lifting weights, push ups, pull ups, throwing objects, running, kicking, jumping and climbing.\n\n(3) experiencing a significant physical force applied to or through the affected joint, at the time of the clinical worsening of a sprain to that joint ligament;\n\nNote: Examples of activities and circumstances involving significant physical force applied to or through the affected joint include falls, collisions, lifting weights, running, jumping or stepping down from a height, throwing objects and climbing.\n\n(4) forceful stretching or high intensity use of a muscle or tendon at the time of the clinical worsening of a strain to that muscle or tendon;\n\nNote: Examples of activities and circumstances involving forceful stretching or high intensity use of a muscle or tendon include lifting weights, push ups, pull ups, throwing objects, running, kicking, jumping and climbing.\n\n(5) inability to obtain appropriate clinical management for sprain or strain.\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, sprain or strain where the person's sprain or strain 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 MRCA means the Military Rehabilitation and Compensation Act 2004.\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 sprain—see subsection 7(2).\n\n strain—see subsection 7(3).\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":"The instrument maintains its original narrow scope. It is a specific medical determination for a single condition (sprain and strain) under the reasonable hypothesis standard, consistent with the Repatriation Medical Authority's statutory function since 1994. The 2020 version updates the 2011 predecessor without expanding into new areas of compensation or eligibility."},"complexity_factors":["Short, focused instrument (approximately 1,500 words)","Only 6 defined terms in the Dictionary (MRCA, relevant service, sprain, strain, terminal event, VEA)","Clear, numbered structure with straightforward conditional logic (\"at least one of the following factors\")","Minimal cross-referencing — only internal references to the Dictionary and one reference to other Statements of Principles","Simple binary exclusions (recurrent sprain excluded, drug-induced disease excluded)","No nested exceptions or complex temporal calculations","Plain language examples provided in notes (falls, collisions, lifting weights, etc.)"],"plain_english_summary":"This rulebook sets the test for whether Australian Defence Force members, veterans, peacekeepers and their families can get compensation or treatment for sprains (ligaments) and strains (muscles/tendons). It applies the \"reasonable hypothesis\" standard to assess a plausible medical link between service and injury.\n\nIts outcome decides access to DVA medical care, compensation and death claims where a sprain/strain contributed, and updates the earlier 2011 guidance to align with current medical understanding."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the 2011 Statement of Principles (s4) and restates criteria, notably by explicitly including death contributed to by sprain/strain (s7(4)), adding inability to obtain appropriate clinical management as a factor (s9(5)), and clarifying inclusions/exclusions for sprain and strain (s7(2)–(3)). It therefore refines and narrows or clarifies aspects of scope and evidential pathways compared with the prior instrument, while remaining applicable to VEA/MRCA claims (s5)."},"complexity_factors":["Precise medical definitions and a short timing rule (onset within 24 hours) for sprain and strain creating bright-line clinical thresholds (s7(2)–(3)).","Inclusions and exclusions that narrow scope (complete tears included; recurrent sprain and drug‑induced tendon/muscle disease excluded) which affect eligibility assessments (s7(2)(b),(c); s7(3)(b),(c)).","Use of the legal standard 'reasonable hypothesis' (low evidentiary threshold) which requires interpretive judgment by decision‑makers (s9 heading & s8 context).","Five alternative causal/aggravation factors (including inability to obtain appropriate clinical management) that can each independently raise the reasonable hypothesis (s9(1)–(5)).","Relationship-to-service rules distinguishing injury arising in service from pre‑existing conditions aggravated by service, limiting application of some factors (s10(1)–(2)).","Cross‑references to other Statements of Principles and replacement of the 2011 instrument, which require administrators to reconcile overlapping SOPs (s11; s4).","Application limited to claims under specific statutory provisions (section 120A VEA and section 338 MRCA), tying the medical criteria to benefit decision processes (s5)."],"plain_english_summary":"This Statement of Principles sets the medical criteria the Repatriation Medical Authority uses to determine whether a sprain or strain (and death contributed to them) can reasonably be linked to a veteran’s relevant service, replacing the 2011 instrument. It applies to claims under the VEA and MRCA, names objective clinical features (tears/stretching with onset within 24 hours and specific exclusions) and lists five alternative factors that, if established, raise a reasonable hypothesis connecting the condition to service."},"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"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-sprain-and-strain-reasonable-hypothesis-no-27-of-2020","history":"/api/acts/statement-of-principles-concerning-sprain-and-strain-reasonable-hypothesis-no-27-of-2020/history","analysis":"/api/acts/statement-of-principles-concerning-sprain-and-strain-reasonable-hypothesis-no-27-of-2020/analysis","conflicts":"/api/acts/statement-of-principles-concerning-sprain-and-strain-reasonable-hypothesis-no-27-of-2020/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-sprain-and-strain-reasonable-hypothesis-no-27-of-2020/important-cases","documents":"/api/acts/statement-of-principles-concerning-sprain-and-strain-reasonable-hypothesis-no-27-of-2020/documents"}}