Reference Determination Content
Suggested draft · fictitious patient
Lumbar Strain and Spondylosis
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 August 2025;
- A Diagnosis Form (D9287) by Dr Thomas Perkins, General Practitioner, Veterans Health Centre, dated 11 August 2025;
- A pre-deployment health assessment by the medical officer, Garrison health centre, dated 2 March 2010;
- A deployed health record by the regimental medical officer, Afghanistan, dated 25 August 2010;
- A deployed health record by the regimental medical officer, Afghanistan, dated 10 September 2010;
- A physiotherapy assessment by the physiotherapist, Garrison health centre, dated 15 February 2011;
- An X-ray lumbar spine report by the radiologist, dated 15 February 2011;
- A deployed health record by the medical officer, Iraq, dated 9 September 2015;
- An MRI lumbar spine report by the radiologist, dated 18 February 2016;
- A specialist consultation by the sports physician, dated 18 February 2016;
- A medical employment classification review by the senior medical officer, dated 20 November 2017.
Your service
I have identified that you have the following service:
Australian Defence Force service between :
14 July 1998 and 3 March 2019
Lumbar Strain and Spondylosis
You have stated that your condition was caused by:
- 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; or through the affected joint include falls, collisions, lifting weights, running, jumping or stepping down from a height, throwing objects and climbing
- 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
Diagnosis: Lumbar Strain and Spondylosis
Basis of diagnosis: The diagnosis was made in the Diagnostic Assessment by Dr Thomas Perkins dated 11 August 2025, and is supported by a deployed health record by the regimental medical officer, Afghanistan, dated 25 August 2010.
I am satisfied this is the appropriate diagnosis.
In determining your claim for this condition, I have applied the SOP:
Statement of Principles concerning Sprain and Strain (Reasonable Hypothesis) (No. 27 of 2020)
which sets out the factors that can connect the condition with service.
I am satisfied that you have met the following factor:
- 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; or through the affected joint include falls, collisions, lifting weights, running, jumping or stepping down from a height, throwing objects and climbing
- 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
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 left low back pain with spasm, difficulty straightening, pain on lifting, bending and twisting, and stiffness after rest on 25 August 2010.
The lumbar strain and sprain were diagnosed clinically by the regimental medical officer on 25 August 2010 on the history of an acute lifting injury with a twisting fall and examination findings of left paraspinal spasm, left facet joint tenderness and painful restricted flexion. This meets the Statement of Principles definitions of a strain, an acute injury to a muscle or tendon, and a sprain, an acute injury to a joint ligament.
This has then led to further investigations and the diagnosis of your condition of Lumbar Strain and Spondylosis. I have accepted your condition of Lumbar Strain and Spondylosis.
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 25 August 2010.
Lumbar Strain and Spondylosis (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 August 2025;
- A Diagnosis Form (D9287) by Dr Thomas Perkins, General Practitioner, Veterans Health Centre, dated 11 August 2025;
- A pre-deployment health assessment by the medical officer, Garrison health centre, dated 2 March 2010;
- A deployed health record by the regimental medical officer, Afghanistan, dated 25 August 2010;
- A deployed health record by the regimental medical officer, Afghanistan, dated 10 September 2010;
- A physiotherapy assessment by the physiotherapist, Garrison health centre, dated 15 February 2011;
- An X-ray lumbar spine report by the radiologist, dated 15 February 2011;
- A deployed health record by the medical officer, Iraq, dated 9 September 2015;
- An MRI lumbar spine report by the radiologist, dated 18 February 2016;
- A specialist consultation by the sports physician, dated 18 February 2016;
- A medical employment classification review by the senior medical officer, dated 20 November 2017.
Your service
I have identified that you have the following service:
Australian Defence Force service between :
14 July 1998 and 3 March 2019
Lumbar Strain and Spondylosis (Worsening)
You have stated that the worsening of your condition was caused by:
- 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; Statement of Principles concerning 4 of 6 or through the affected joint include falls, collisions, lifting weights, running, jumping or stepping down from a height, throwing objects and climbing
- 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
- inability to obtain appropriate clinical management for sprain or strain
Diagnosis: Lumbar Strain and Spondylosis (Worsening)
Basis of diagnosis: The diagnosis was made in the Diagnostic Assessment by Dr Thomas Perkins dated 11 August 2025, and is supported by a deployed health record by the regimental medical officer, Afghanistan, dated 25 August 2010.
I am satisfied this is the appropriate diagnosis.
In determining your claim for this condition, I have applied the SOP:
Statement of Principles concerning Sprain and Strain (Reasonable Hypothesis) (No. 27 of 2020)
which sets out the factors that can connect the condition with service.
I am satisfied that you have met the following factor:
- 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; Statement of Principles concerning 4 of 6 or through the affected joint include falls, collisions, lifting weights, running, jumping or stepping down from a height, throwing objects and climbing
- 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
- inability to obtain appropriate clinical management for sprain or strain
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 left low back pain with spasm, difficulty straightening, pain on lifting, bending and twisting, and stiffness after rest on 25 August 2010.
The lumbar strain and sprain were diagnosed clinically by the regimental medical officer on 25 August 2010 on the history of an acute lifting injury with a twisting fall and examination findings of left paraspinal spasm, left facet joint tenderness and painful restricted flexion. This meets the Statement of Principles definitions of a strain, an acute injury to a muscle or tendon, and a sprain, an acute injury to a joint ligament.
After the condition arose, it was worsened during your service. On warlike service in Iraq on 9 September 2015 you were thrown from a vehicle tray onto hard ground during a force protection move. In the same fall on warlike service in Iraq the lumbar muscles were forcibly stretched and then used at high intensity to recover equipment. On warlike service in Afghanistan in 2010 and Iraq in 2015 no physiotherapy was available and operational demands kept you on heavy duties.
This has then led to further investigations and the diagnosis of your condition of Lumbar Strain and Spondylosis (Worsening). I have accepted your condition of Lumbar Strain and Spondylosis (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 wartime service.
I have therefore accepted that the worsening of this condition is related to your service with effect from 9 September 2015.
