Pes planus — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 67 of 2021

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 pes planus or death from pes planus with the circumstances of a person's relevant service:

1. (1)
   having a fracture or osteonecrosis involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot before the clinical onset of pes planus;

   Note: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.

2. (2)
   having a dislocation of a joint or subluxation of a joint or joint instability involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot before the clinical onset of pes planus;

   Note: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.

3. (3)
   having a sprain, penetrating trauma or surgery to the ligaments involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot within the 3 months before the clinical onset of pes planus;

   Note: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.

4. (4)
   having a strain, penetrating trauma or surgery involving the muscles or tendons that support the medial longitudinal arch of the affected foot within the 3 months before the clinical onset of pes planus;
5. (5)
   having rupture or division of the plantar fascia of the affected foot before the clinical onset of pes planus;
6. (6)
   having weakness or paralysis of the supinators of the affected foot at the time of the clinical onset of pes planus;

   Note: Examples of conditions that can give rise to weakness or paralysis of the foot supinator muscles include central or peripheral nervous system pathology, myopathy and tendonitis.

7. (7)
   having spasticity or shortening of the pronators of the affected foot at the time of the clinical onset of pes planus;

   Note: Examples of conditions that can give rise to spasticity or shortening of the foot pronator muscles include central or peripheral nervous system pathology and myopathy.

8. (8)
   having posterior tibialis tendinopathy at the time of the clinical onset of pes planus;
9. (9)
   having a space occupying lesion limiting the ability of the affected foot to supinate at the time of the clinical onset of pes planus;
10. (10)
    having arthritis or other destructive lesion of one or more of the joints of the tarsal or metatarsal bones of the medial longitudinal arch of the affected foot at the time of the clinical onset of pes planus;

    Note: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.

11. (11)
    being obese at the time of the clinical onset of pes planus;

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

12. (12)
    being pregnant at the time of the clinical onset of pes planus;
13. (13)
    having a fracture or osteonecrosis involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot before the clinical worsening of pes planus;

    Note: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.

14. (14)
    having a dislocation of a joint or subluxation of a joint or joint instability involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot before the clinical worsening of pes planus;

    Note: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.

15. (15)
    having a sprain, penetrating trauma or surgery to the ligaments involving one or more tarsal or metatarsal bones of the medial longitudinal arch of the affected foot within the 3 months before the clinical worsening of pes planus;

    Note: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.

16. (16)
    having a strain, penetrating trauma or surgery involving the muscles or tendons that support the medial longitudinal arch of the affected foot within the 3 months before the clinical worsening of pes planus;
17. (17)
    having rupture or division of the plantar fascia of the affected foot before the clinical worsening of pes planus;
18. (18)
    having weakness or paralysis of the supinators of the affected foot at the time of the clinical worsening of pes planus;

    Note: Examples of conditions that can give rise to weakness or paralysis of the foot supinator muscles include central or peripheral nervous system pathology, myopathy and tendonitis.

19. (19)
    having spasticity or shortening of the pronators of the affected foot at the time of the clinical worsening of pes planus;

    Note: Examples of conditions that can give rise to spasticity or shortening of the foot pronator muscles include central or peripheral nervous system pathology and myopathy.

20. (20)
    having posterior tibialis tendinopathy at the time of the clinical worsening of pes planus;
21. (21)
    having a space occupying lesion limiting the ability of the affected foot to supinate at the time of the clinical worsening of pes planus;
22. (22)
    having arthritis or other destructive lesion of one or more of the joints of the tarsal or metatarsal bones of the medial longitudinal arch of the affected foot at the time of the clinical worsening of pes planus;

    Note: tarsal or metatarsal bones of the medial longitudinal arch is defined in the Schedule 1 - Dictionary.

23. (23)
    being obese at the time of the clinical worsening of pes planus;

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

24. (24)
    being pregnant at the time of the clinical worsening of pes planus;
25. (25)
    running or jogging: (a) an average of at least 30 kilometres per week; and (b) for at least the 4 weeks before the clinical worsening of pes planus;
26. (26)
    walking: (a) an average of at least 10 kilometres per week; and (b) while carrying loads of at least 15 kilograms; and (c) for at least the 4 weeks before the clinical worsening of pes planus;
27. (27)
    inability to obtain appropriate clinical management for pes planus;

Aggravation-only factors: the factors in subsections 9(13) to 9(27) 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.