Epicondylitis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 5 of 2023

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting epicondylitis or death from epicondylitis with the circumstances of a person's relevant service:

1. (1)
   performing forceful activities with the hand or forearm on the affected side, in combination with: (a) repetitive activities with the hand or forearm on the affected side; or (b) sustained activities with the hand or forearm on the affected side; for at least 1 hour per day, on more days than not, over a period of at least the 4 weeks before the clinical onset of epicondylitis;

   Note: Performing forceful and repetitive or forceful and sustained activities with the hand or forearm can occur as compensation for disability in the contralateral upper limb (including epicondylitis or amputation), or with manual wheelchair use. Activities with the hand or forearm involve bending or straightening of the elbow; rotation, pronation, supination, twisting or screwing motion of the forearm; and flexion, extension or bending of the wrist or hand.

2. (2)
   using a hand-held computer mouse on the affected side for at least 20 hours per week in the 6 months before the clinical onset of epicondylitis;
3. (3)
   having a sudden alteration of loading pattern as specified for a continuous period of at least 1 hour, within the 3 days before the clinical onset of epicondylitis;

   Note: having a sudden alteration of loading pattern as specified is defined in the Schedule 1 - Dictionary.

4. (4)
   taking a fluoroquinolone antibiotic within the 14 days before the clinical onset of epicondylitis;

   Note: Examples of fluoroquinolone antibiotics include ciprofloxacin, moxifloxacin, norfloxacin and ofloxacin.

5. (5)
   having spondyloarthritis at the time of the clinical onset of epicondylitis;

   Note: spondyloarthritis is defined in the Schedule 1 - Dictionary.

6. (6)
   performing forceful activities with the hand or forearm on the affected side, in combination with: (a) repetitive activities with the hand or forearm on the affected side; or (b) sustained activities with the hand or forearm on the affected side; for at least 1 hour per day, on more days than not, over a period of at least the 4 weeks before the clinical worsening of epicondylitis;

   Note: Performing forceful and repetitive or forceful and sustained activities with the hand or forearm can occur as compensation for disability in the contralateral upper limb (including epicondylitis or amputation), or with manual wheelchair use. Activities with the hand or forearm involve bending or straightening of the elbow; rotation, pronation, supination, twisting or screwing motion of the forearm; and flexion, extension or bending of the wrist or hand.

7. (7)
   using a hand-held computer mouse on the affected side for at least 20 hours per week in the 6 months before the clinical worsening of epicondylitis;
8. (8)
   having a sudden alteration of loading pattern as specified for a continuous period of at least 1 hour, within the 3 days before the clinical worsening of epicondylitis;

   Note: having a sudden alteration of loading pattern as specified is defined in the Schedule 1 - Dictionary.

9. (9)
   taking a fluoroquinolone antibiotic within the 14 days before the clinical worsening of epicondylitis;

   Note: Examples of fluoroquinolone antibiotics include ciprofloxacin, moxifloxacin, norfloxacin and ofloxacin.

10. (10)
    having spondyloarthritis at the time of the clinical worsening of epicondylitis;

    Note: spondyloarthritis is defined in the Schedule 1 - Dictionary.

11. (11)
    inability to obtain appropriate clinical management for epicondylitis;

Aggravation-only factors: the factors in subsections 9(6) to 9(11) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.