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Statement of Principles

Morton metatarsalgia — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Morton metatarsalgia. DVA can only accept a claim for Morton metatarsalgia 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.

Morton metatarsalgia

RH No. 77 of 2019 · BoP No. 78 of 201922 factors

Meaning of morton metatarsalgia: For the purposes of this Statement of Principles, Morton metatarsalgia: (a) means an entrapment or irritation of the interdigital plantar nerve between the metatarsal heads, causing an acquired neuropathy; and (b) excludes peripheral neuropathy.

Reasonable Hypothesis (RH) — Statement of Principles No. 77 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 Morton metatarsalgia or death from Morton metatarsalgia with the circumstances of a person's relevant service:

  1. (1)
    wearing footwear which compresses the affected forefoot or increases the pressure on the ball of the affected foot, or has a high heel, for at least four hours per day on more days than not, for at least the one year before the clinical onset of Morton metatarsalgia;
  2. (2)
    having an injury to the foot which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, within the one year before the clinical onset of Morton metatarsalgia;
  3. (3)
    undergoing surgery to the foot which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, within the one year before the clinical onset of Morton metatarsalgia;
  4. (4)
    having a deformity of the affected foot from the specified list of deformities of the foot, which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, at the time of the clinical onset of Morton metatarsalgia;

    Note: specified list of deformities of the foot is defined in the Schedule 1 - Dictionary.

  5. (5)
    having an inflammatory arthritis which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, at the time of the clinical onset of Morton metatarsalgia;
  6. (6)
    wearing footwear which compresses the affected forefoot or increases the pressure on the ball of the affected foot, or has a high heel, for at least four hours per day on more days than not, for at least the one year before the clinical worsening of Morton metatarsalgia;
  7. (7)
    having an injury to the foot which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, within the one year before the clinical worsening of Morton metatarsalgia;
  8. (8)
    undergoing surgery to the foot which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, within the one year before the clinical worsening of Morton metatarsalgia;
  9. (9)
    having a deformity of the affected foot from the specified list of deformities of the foot, which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, at the time of the clinical worsening of Morton metatarsalgia;

    Note: specified list of deformities of the foot is defined in the Schedule 1 - Dictionary.

  10. (10)
    having an inflammatory arthritis which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, at the time of the clinical worsening of Morton metatarsalgia;
  11. (11)
    inability to obtain appropriate clinical management for Morton metatarsalgia;

Aggravation-only factors: the factors in subsections 9(6) to (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.

Balance of Probabilities (BoP) — Statement of Principles No. 78 of 2019

11 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, Morton metatarsalgia or death from Morton metatarsalgia is connected with the circumstances of a person's relevant service:

  1. (1)
    wearing footwear which compresses the affected forefoot or increases the pressure on the ball of the affected foot, or has a high heel, for at least four hours per day on more days than not, for at least the two years before the clinical onset of Morton metatarsalgia;
  2. (2)
    having an injury to the foot which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, within the six months before the clinical onset of Morton metatarsalgia;
  3. (3)
    undergoing surgery to the foot which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, within the six months before the clinical onset of Morton metatarsalgia;
  4. (4)
    having a deformity of the affected foot from the specified list of deformities of the foot, which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, at the time of the clinical onset of Morton metatarsalgia;

    Note: specified list of deformities of the foot is defined in the Schedule 1 - Dictionary.

  5. (5)
    having an inflammatory arthritis which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, at the time of the clinical onset of Morton metatarsalgia;
  6. (6)
    wearing footwear which compresses the affected forefoot or increases the pressure on the ball of the affected foot, or has a high heel, for at least four hours per day on more days than not, for at least the two years before the clinical worsening of Morton metatarsalgia;
  7. (7)
    having an injury to the foot which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, within the six months before the clinical worsening of Morton metatarsalgia;
  8. (8)
    undergoing surgery to the foot which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, within the six months before the clinical worsening of Morton metatarsalgia;
  9. (9)
    having a deformity of the affected foot from the specified list of deformities of the foot, which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, at the time of the clinical worsening of Morton metatarsalgia;

    Note: specified list of deformities of the foot is defined in the Schedule 1 - Dictionary.

  10. (10)
    having an inflammatory arthritis which damages or compresses the interdigital plantar nerve within the affected intermetatarsal space, at the time of the clinical worsening of Morton metatarsalgia;
  11. (11)
    inability to obtain appropriate clinical management for Morton metatarsalgia;

Aggravation-only factors: the factors in subsections 9(6) to (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.

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.

About Dr Thomas Perkins

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Founding doctor of the Veterans Health Centre in Ipswich, Queensland, and one of Australia's most experienced practitioners in veterans' medicolegal medicine.

Dr Perkins has spent more than thirteen years working exclusively with current and former ADF members — treating their conditions, writing their reports and navigating the DVA system alongside them. With over 100,000 claims submitted and 2,000 Permanent Impairment Assessments completed, he has seen precisely what separates an accepted claim from a rejected one at every level, from initial liability to the Veterans' Review Board.

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