Reference Determination Content
Suggested draft · fictitious patient
Right Foot - Heel Abrasion
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 diving medical examination by the medical officer, naval health centre, dated 12 February 2003;
- A field treatment record by the team medic, dated 27 March 2003;
- A field treatment record by the team medic, dated 28 March 2003;
- A field treatment record and transfer request by the team medic, dated 30 March 2003;
- A ship's medical record and wound swab by the ship's medical officer, dated 31 March 2003;
- A ship's medical record by the ship's medical officer, dated 22 April 2003;
- An outpatient health record by the medical officer, naval health centre, dated 14 June 2004.
Your service
I have identified that you have the following service:
Australian Defence Force service between :
10 February 1996 and 9 March 2009
Right Foot - Heel Abrasion
You have stated that your condition was caused by:
- having direct physical trauma to the affected site at the time of the cut, stab, abrasion or laceration
Diagnosis: Heel Abrasion
Basis of diagnosis: The diagnosis was made in the Diagnostic Assessment by Dr Thomas Perkins dated 14 October 2025, and is supported by a field treatment record by the team medic, dated 27 March 2003.
I am satisfied this is the appropriate diagnosis.
In determining your claim for this condition, I have applied the SOP:
Statement of Principles concerning Cut, Stab, Abrasion and Laceration (Reasonable Hypothesis) (No. 37 of 2025)
which sets out the factors that can connect the condition with service.
I am satisfied that you have met the following factor:
- having direct physical trauma to the affected site at the time of the cut, stab, abrasion or laceration
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 sharp pain and bleeding from the raw skin of the right heel, with pain on walking and on putting on fins and booties on 27 March 2003.
The diagnosis is based on the scraping of the right heel against a barnacle-encrusted ladder on 27 March 2003, and on the team medic's record that day of a 4 by 3 cm deep abrasion of the right heel with embedded shell fragments and grit. This meets the Statement of Principles definition of an abrasion as an injury that interrupts the continuity of the epidermis and causes a wound.
This has then led to further investigations and the diagnosis of your condition of Heel Abrasion. I have accepted your condition of Heel Abrasion.
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 March 2003.
Right Foot - Heel Abrasion (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 diving medical examination by the medical officer, naval health centre, dated 12 February 2003;
- A field treatment record by the team medic, dated 27 March 2003;
- A field treatment record by the team medic, dated 28 March 2003;
- A field treatment record and transfer request by the team medic, dated 30 March 2003;
- A ship's medical record and wound swab by the ship's medical officer, dated 31 March 2003;
- A ship's medical record by the ship's medical officer, dated 22 April 2003;
- An outpatient health record by the medical officer, naval health centre, dated 14 June 2004.
Your service
I have identified that you have the following service:
Australian Defence Force service between :
10 February 1996 and 9 March 2009
Right Foot - Heel Abrasion (Worsening)
You have stated that the worsening of your condition was caused by:
- inability to obtain appropriate clinical management for cut, stab, abrasion or laceration before clinical worsening
Diagnosis: Heel Abrasion (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 field treatment record by the team medic, dated 27 March 2003.
I am satisfied this is the appropriate diagnosis.
In determining your claim for this condition, I have applied the SOP:
Statement of Principles concerning Cut, Stab, Abrasion and Laceration (Reasonable Hypothesis) (No. 37 of 2025)
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 cut, stab, abrasion or laceration 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 sharp pain and bleeding from the raw skin of the right heel, with pain on walking and on putting on fins and booties on 27 March 2003.
The diagnosis is based on the scraping of the right heel against a barnacle-encrusted ladder on 27 March 2003, and on the team medic's record that day of a 4 by 3 cm deep abrasion of the right heel with embedded shell fragments and grit. This meets the Statement of Principles definition of an abrasion as an injury that interrupts the continuity of the epidermis and causes a wound.
After the condition arose, it was worsened during your service. On warlike service in southern Iraq from 27 to 30 March 2003 operational demands kept you diving twice a day in contaminated harbour water because no relief diver was available, the wound could not be kept dressed or dry, and antibiotics could not be delivered to the team until 31 March 2003.
This has then led to further investigations and the diagnosis of your condition of Heel Abrasion (Worsening). I have accepted your condition of Heel Abrasion (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 30 March 2003.
