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Statement of Principles

Joint instability — DVA SoP factors

Every factor in the Repatriation Medical Authority Statement of Principles for Joint instability. DVA can only accept a claim for Joint instability if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

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Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

Joint instability

RH No. 57 of 201925 factors

Meaning of joint instability: For the purposes of this Statement of Principles, joint instability: (a) means an acquired lack of stability of a joint due to damage to or abnormality of the stabilising structures of that joint, manifesting as recurrent subluxation, recurrent dislocation or recurrent sprain; and (b) includes joints with an internal joint prosthesis; and (c) excludes spondylolisthesis, and the loosening or migration of the fixation component of an internal joint prosthesis. (3) While joint instability attracts ICD-10-AM code M22.0, M22.1, M23.5, M24.2, M24.4, M25.3, M43.3, M43.4, M43.5, M53.2 or T84.0, in applying this Statement of Principles the meaning of joint instability is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.

Reasonable Hypothesis (RH) — Statement of Principles No. 57 of 2019

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 joint instability or death from joint instability with the circumstances of a person's relevant service:

  1. (1)
    having physical trauma to the affected joint at the time of the clinical onset of joint instability;

    Note: Examples of activities and circumstances involving trauma to the affected joint include, but are not limited to, falls, collisions, lifting weights, push ups, pull ups, throwing objects, seizure and electrical injury.

  2. (2)
    having a dislocation or subluxation of the affected joint before the clinical onset of joint instability;
  3. (3)
    having a sprain of the affected joint before the clinical onset of joint instability;
  4. (4)
    having damage to a soft tissue structure as specified before the clinical onset of joint instability;

    Note: soft tissue structure as specified is defined in the Schedule 1 - Dictionary.

  5. (5)
    having a fracture or bony abnormality involving the articulating surfaces of the affected joint before the clinical onset of joint instability;

    Note: Examples of conditions which can cause a bony abnormality include, but are not limited to, osteonecrosis, dysbaric osteonecrosis and femoroacetabular impingement.

  6. (6)
    having a disease process as specified affecting the normal structural or functional relationship between the articulating surfaces of the affected joint at the time of the clinical onset of joint instability;

    Note: disease process as specified is defined in the Schedule 1 - Dictionary.

  7. (7)
    being pregnant within the six weeks before the clinical onset of joint instability;
  8. (8)
    for temporomandibular joint instability only, undertaking an activity or undergoing a medical procedure that involves wide opening of the mouth at the time of the clinical onset of joint instability;

    Note: Examples of activities which may involve wide mouth opening include, but are not limited to, yawning, laughing, vomiting, coughing, and chewing large pieces of food.

    Note: Examples of medical procedures that involve wide mouth opening include, but are not limited to, dental procedures, direct laryngoscopy, and intravenous administration of medications which cause drug-induced yawning.

  9. (9)
    for total hip prosthesis joint instability only, having lumbar spondylosis, lumbar intervertebral disc prolapse, lumbar spondylolisthesis, lumbar spinal stenosis or lumbar spinal fusion at the time of the clinical onset of joint instability;
  10. (10)
    for total hip joint prosthesis joint instability only, being obese at the time of the clinical onset of joint instability;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  11. (11)
    for tibiofemoral joint instability only, being severely obese at the time of the clinical onset of joint instability;

    Note: being severely obese is defined in the Schedule 1 - Dictionary.

  12. (12)
    for total knee joint prosthesis joint instability only, having morbid obesity at the time of the clinical onset of joint instability;
  13. (13)
    for elbow joint instability only, having more than three local glucocorticoid injections for epicondylitis before the clinical onset of joint instability;
  14. (14)
    having physical trauma to the affected joint at the time of the clinical worsening of joint instability;

    Note: Examples of activities and circumstances involving trauma to the affected joint include, but are not limited to, falls, collisions, lifting weights, push ups, pull ups, throwing objects, seizure and electrical injury.

  15. (15)
    having damage to a soft tissue structure as specified before the clinical worsening of joint instability;

    Note: soft tissue structure as specified is defined in the Schedule 1 - Dictionary.

  16. (16)
    having a fracture or bony abnormality involving the articulating surfaces of the affected joint before the clinical worsening of joint instability;

    Note: Examples of conditions which can cause a bony abnormality include, but are not limited to, osteonecrosis, dysbaric osteonecrosis and femoroacetabular impingement.

  17. (17)
    having a disease process as specified affecting the normal structural or functional relationship between the articulating surfaces of the affected joint at the time of the clinical worsening of joint instability;

    Note: disease process as specified is defined in the Schedule 1 - Dictionary.

  18. (18)
    being pregnant within the six weeks before the clinical worsening of joint instability;
  19. (19)
    for temporomandibular joint instability only, undertaking an activity or undergoing a medical procedure that involves wide opening of the mouth at the time of the clinical worsening of joint instability;

    Note: Examples of activities which may involve wide mouth opening include, but are not limited to, yawning, laughing, vomiting, coughing, and chewing large pieces of food.

    Note: Examples of medical procedures that involve wide mouth opening include, but are not limited to, dental procedures, direct laryngoscopy, and intravenous administration of medications which cause drug-induced yawning.

  20. (20)
    for total hip prosthesis joint instability only, having lumbar spondylosis, lumbar intervertebral disc prolapse, lumbar spondylolisthesis, lumbar spinal stenosis or lumbar spinal fusion at the time of the clinical worsening of joint instability;
  21. (21)
    for total hip joint prosthesis joint instability only, being obese at the time of the clinical worsening of joint instability;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  22. (22)
    for tibiofemoral joint instability only, being severely obese at the time of the clinical worsening of joint instability;

    Note: being severely obese is defined in the Schedule 1 - Dictionary.

  23. (23)
    for total knee joint prosthesis joint instability only, having morbid obesity at the time of the clinical worsening of joint instability;
  24. (24)
    for elbow joint instability only, having more than three local glucocorticoid injections for epicondylitis before the clinical worsening of joint instability;
  25. (25)
    inability to obtain appropriate clinical management for joint instability;

Aggravation-only factors: the factors in subsections 9(14) to 9(25) 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.

A VHC Diagnostic Assessment addresses each of these factors one by one against your service record and clinical history. See how a VHC DVA claim works, see all fees ($600 + GST per stage) or book an appointment.

Accepted — what is it worth?

A Statement of Principles decides one thing only: whether DVA accepts liability for joint instability. It says nothing about how much you are paid. Compensation is worked out separately, from impairment points under the GARP — so a condition can be accepted and still rate few points, or rate more than you expect once it is combined with everything else on your file.

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Presumptive liability · from 1 July 2026

Joint instability may be accepted without proving the link to service

Joint instability is listed in Part 2 of the determination as attributable to defence service, provided the criteria below are met.

  • Qualifying service: Any defence service.
    Onset: during the qualifying service.

A diagnosis is still required, and the presumption may not apply where there is clear evidence of a cause other than service. "Onset" means when an injury was sustained, or when all the signs and symptoms of a disease were first present — not the date of diagnosis. Applies to claims made on or after 1 July 2026.

How presumptive liability works →

Part of DVA Claims — Bones & joints — every Statement of Principles covering the bones and joints.

Others in this area:

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Dr Thomas Perkins, Veterans Health Centre

Reviewed by Dr Thomas Perkins

Founding doctor, Veterans Health Centre · former RAAF aviation medical officer · 13 years working exclusively with ADF members and veterans. Full profile →