Reference Determination Content
Suggested draft · fictitious patient
Left Hip - Labral Tear with Tendinosis
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 11 November 2025;
- A Diagnosis Form (D9287) by Dr Thomas Perkins, General Practitioner, Veterans Health Centre, dated 11 November 2025;
- A pre-deployment medical examination by the medical officer, Garrison health centre, dated 20 August 2012;
- An antenatal review and ultrasound report by the contingent medical officer, Sinai, dated 18 November 2012;
- Stores work records by the supervisor, contingent stores, dated 25 January 2013;
- A treatment record by the contingent medical officer, Sinai, dated 27 February 2013;
- A repatriation medical summary by the contingent medical officer, dated 8 March 2013;
- An MR arthrogram left hip by the radiologist, dated 22 August 2013;
- A specialist consultation by the orthopaedic hip surgeon, dated 5 September 2013;
- An outpatient health record by the medical officer, Garrison health centre, dated 10 March 2014;
- An MRI left hip by the radiologist, dated 18 March 2014;
- A specialist consultation by the sports physician, dated 24 March 2014;
- An operation report by the orthopaedic hip surgeon, dated 22 September 2014.
Your service
I have identified that you have the following service:
Australian Defence Force service between :
17 March 2003 and 25 November 2020
Left Hip - Labral Tear with Tendinosis
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 Tear with Tendinosis
Basis of diagnosis: The diagnosis was made in the Diagnostic Assessment by Dr Thomas Perkins dated 11 November 2025, and is supported by a specialist consultation by the orthopaedic hip surgeon, dated 5 September 2013.
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, tearing pain deep in the left groin with a click on moving the hip, pain over the outside of the hip, and difficulty walking on 27 February 2013.
The diagnosis meets the Statement of Principles requirements. You had relevant symptoms of acute groin pain with clicking, later with locking, and corresponding clinical signs of pain on flexion, adduction and internal rotation and a painful click, recorded by the contingent medical officer on 27 February 2013 and by the hip surgeon on 5 September 2013.
This has then led to further investigations and the diagnosis of your condition of Labral Tear with Tendinosis. I have accepted your condition of Labral Tear with Tendinosis.
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 27 February 2013.
Left Hip - Labral Tear with Tendinosis (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 11 November 2025;
- A Diagnosis Form (D9287) by Dr Thomas Perkins, General Practitioner, Veterans Health Centre, dated 11 November 2025;
- A pre-deployment medical examination by the medical officer, Garrison health centre, dated 20 August 2012;
- An antenatal review and ultrasound report by the contingent medical officer, Sinai, dated 18 November 2012;
- Stores work records by the supervisor, contingent stores, dated 25 January 2013;
- A treatment record by the contingent medical officer, Sinai, dated 27 February 2013;
- A repatriation medical summary by the contingent medical officer, dated 8 March 2013;
- An MR arthrogram left hip by the radiologist, dated 22 August 2013;
- A specialist consultation by the orthopaedic hip surgeon, dated 5 September 2013;
- An outpatient health record by the medical officer, Garrison health centre, dated 10 March 2014;
- An MRI left hip by the radiologist, dated 18 March 2014;
- A specialist consultation by the sports physician, dated 24 March 2014;
- An operation report by the orthopaedic hip surgeon, dated 22 September 2014.
Your service
I have identified that you have the following service:
Australian Defence Force service between :
17 March 2003 and 25 November 2020
Left Hip - Labral Tear with Tendinosis (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 Tear with Tendinosis (Worsening)
Basis of diagnosis: The diagnosis was made in the Diagnostic Assessment by Dr Thomas Perkins dated 11 November 2025, and is supported by a specialist consultation by the orthopaedic hip surgeon, dated 5 September 2013.
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, tearing pain deep in the left groin with a click on moving the hip, pain over the outside of the hip, and difficulty walking on 27 February 2013.
The diagnosis meets the Statement of Principles requirements. You had relevant symptoms of acute groin pain with clicking, later with locking, and corresponding clinical signs of pain on flexion, adduction and internal rotation and a painful click, recorded by the contingent medical officer on 27 February 2013 and by the hip surgeon on 5 September 2013.
After the condition arose, it was worsened during your service. Appropriate management of an acute traumatic labral tear with mechanical symptoms is early imaging, physiotherapy and protected loading, orthopaedic review, and arthroscopic repair when symptoms persist.
This has then led to further investigations and the diagnosis of your condition of Labral Tear with Tendinosis (Worsening). I have accepted your condition of Labral Tear with Tendinosis (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 10 March 2014.
