Reference Determination Content
Suggested draft · fictitious patient
Left Hip - Labral Scarring (labral Tear)
Evidence
The evidence that I have considered in making this decision includes:
- Formal Claim with supporting statements;
- A Statement of your Service from the Department of Defence;
- Copies of your Service Medical Records.
- A Diagnostic Assessment by Dr Thomas Perkins, General Practitioner, Veterans Health Centre, dated 14 October 2025;
- A Diagnosis Form (D9287) by Dr Thomas Perkins, General Practitioner, Veterans Health Centre, dated 14 October 2025;
- A pre-deployment medical examination by the medical officer, Garrison health centre, dated 12 December 2016;
- Force protection training records by the iraq, dated 28 April 2017;
- A treatment record and ultrasound reports by the medical officer, Role 2 facility, Iraq, dated 30 May 2017;
- An aeromedical evacuation record by the aeromedical evacuation team, dated 14 June 2017;
- A postnatal and outpatient health record by the medical officer, Garrison health centre, dated 21 July 2017;
- An MR arthrogram left hip by the radiologist, dated 16 November 2017;
- A specialist consultation by the orthopaedic hip surgeon, dated 20 November 2017;
- An outpatient health record by the medical officer, Garrison health centre, dated 23 April 2018;
- An MRI left hip by the radiologist, dated 3 May 2018;
- An operation report by the orthopaedic hip surgeon, dated 15 October 2018.
Your service
I have identified that you have the following service:
Australian Defence Force service between :
22 July 2012 and 18 January 2022
Left Hip - Labral Scarring (labral Tear)
You have stated that your condition was caused by:
- having a significant physical force applied to or through the affected shoulder joint or the affected hip joint at the time of clinical onset
- performing forceful and repetitive motions of the affected shoulder joint or the affected hip joint, involving extremes of the normal range of motion, for at least 4 hours per week for the 1 month immediately preceding clinical onset
- being in the third trimester of pregnancy within the 1 week before clinical onset of labral tear of the hip joint
Diagnosis: Labral Scarring (labral Tear)
Basis of diagnosis: The diagnosis was made in the Diagnostic Assessment by Dr Thomas Perkins dated 14 October 2025, and is supported by a specialist consultation by the orthopaedic hip surgeon, dated 20 November 2017.
I am satisfied this is the appropriate diagnosis.
In determining your claim for this condition, I have applied the SOP:
Statement of Principles concerning Labral Tear of the Hip and Shoulder (Reasonable Hypothesis) (No. 33 of 2026)
which sets out the factors that can connect the condition with service.
I am satisfied that you have met the following factor:
- having a significant physical force applied to or through the affected shoulder joint or the affected hip joint at the time of clinical onset
- performing forceful and repetitive motions of the affected shoulder joint or the affected hip joint, involving extremes of the normal range of motion, for at least 4 hours per week for the 1 month immediately preceding clinical onset
- being in the third trimester of pregnancy within the 1 week before clinical onset of labral tear of the hip joint
I have noted your contention as to the cause of this condition. The available evidence indicates, I have noted your contention to the cause of your condition. Your service medical records indicate that you presented to the health facility with sudden severe pain deep in the left groin with a painful click and could not bear weight on 30 May 2017.
The diagnosis meets the Statement of Principles requirements. You had relevant symptoms, acute groin pain with clicking and later catching and locking, and corresponding clinical signs, a painful click and pain on flexion, adduction and internal rotation, recorded at the Role 2 facility on 30 May 2017 and on later review.
This has then led to further investigations and the diagnosis of your condition of Labral Scarring (labral Tear). I have accepted your condition of Labral Scarring (labral Tear).
Having considered your service records and the available medical evidence, I am satisfied the SOP is met and that this condition is related to your wartime service.
I have therefore accepted that this condition is related to your service with effect from 30 May 2017.
Left Hip - Labral Scarring (labral Tear) (Worsening)
Evidence
The evidence that I have considered in making this decision includes:
- Formal Claim with supporting statements;
- A Statement of your Service from the Department of Defence;
- Copies of your Service Medical Records.
- A Diagnostic Assessment by Dr Thomas Perkins, General Practitioner, Veterans Health Centre, dated 14 October 2025;
- A Diagnosis Form (D9287) by Dr Thomas Perkins, General Practitioner, Veterans Health Centre, dated 14 October 2025;
- A pre-deployment medical examination by the medical officer, Garrison health centre, dated 12 December 2016;
- Force protection training records by the iraq, dated 28 April 2017;
- A treatment record and ultrasound reports by the medical officer, Role 2 facility, Iraq, dated 30 May 2017;
- An aeromedical evacuation record by the aeromedical evacuation team, dated 14 June 2017;
- A postnatal and outpatient health record by the medical officer, Garrison health centre, dated 21 July 2017;
- An MR arthrogram left hip by the radiologist, dated 16 November 2017;
- A specialist consultation by the orthopaedic hip surgeon, dated 20 November 2017;
- An outpatient health record by the medical officer, Garrison health centre, dated 23 April 2018;
- An MRI left hip by the radiologist, dated 3 May 2018;
- An operation report by the orthopaedic hip surgeon, dated 15 October 2018.
Your service
I have identified that you have the following service:
Australian Defence Force service between :
22 July 2012 and 18 January 2022
Left Hip - Labral Scarring (labral Tear) (Worsening)
You have stated that the worsening of your condition was caused by:
- inability to obtain appropriate clinical management for labral tear of the hip and shoulder before clinical worsening
Diagnosis: Labral Scarring (labral Tear) (Worsening)
Basis of diagnosis: The diagnosis was made in the Diagnostic Assessment by Dr Thomas Perkins dated 14 October 2025, and is supported by a specialist consultation by the orthopaedic hip surgeon, dated 20 November 2017.
I am satisfied this is the appropriate diagnosis.
In determining your claim for this condition, I have applied the SOP:
Statement of Principles concerning Labral Tear of the Hip and Shoulder (Balance of Probabilities) (No. 34 of 2026)
which sets out the factors that can connect the condition with service.
I am satisfied that you have met the following factor:
- inability to obtain appropriate clinical management for labral tear of the hip and shoulder before clinical worsening
I have noted your contention as to the cause of this condition. The available evidence indicates, I have noted your contention to the cause of your condition. Your service medical records indicate that you presented to the health facility with sudden severe pain deep in the left groin with a painful click and could not bear weight on 30 May 2017.
The diagnosis meets the Statement of Principles requirements. You had relevant symptoms, acute groin pain with clicking and later catching and locking, and corresponding clinical signs, a painful click and pain on flexion, adduction and internal rotation, recorded at the Role 2 facility on 30 May 2017 and on later review.
After the condition arose, it was worsened during your service. Appropriate management of an acute traumatic labral tear with mechanical symptoms is prompt MR arthrography and orthopaedic review, protected weight bearing, and early arthroscopic repair when symptoms persist.
This has then led to further investigations and the diagnosis of your condition of Labral Scarring (labral Tear) (Worsening). I have accepted your condition of Labral Scarring (labral Tear) (Worsening).
Having considered your service records and the available medical evidence, I am satisfied the SOP is met and that the worsening of this condition is related to your peacetime service.
I have therefore accepted that the worsening of this condition is related to your service with effect from 23 April 2018.
