Damage to a soft tissue structure as specified

In the SOPs for joint instability the requirement is having damage to a soft tissue structure as specified, at the time of clinical onset or clinical worsening.

The RMA has defined a soft tissue structure as specified to mean:

"a tendon, ligament or fibrocartilaginous structure that contributes to joint stability in the affected joint"

There is no definition given for damage, so this can include injury or damage as a result of a disease process.

General Information

• ligament:  Joints occur where two bones meet.  Most of the joints in the body are freely moving joints called synovial joints.  Ligaments are elastic bands of tissue that attach to the bones and form a joint.  Ligaments provide stability and strength to the joint by restricting movement and holding the bones in place, and thereby facilitate bending, jumping and stretching.
• tendon:  Muscles contract (shorten) to bring the ends closer together and relax (lengthen) to let the ends move apart.  Muscles are attached to bones by cord-like extensions called tendons.  In adolescents, tendons attach to a growthplate called an apopyses, and the area where the tendon attaches may be weaker than the tendon itself.  In adults, where the growthplate fuses the tendon is weaker than the bone.
• fibrocartilaginous structure:  Some joints contain this tough, flexible and elastic type of cartilage.  It is found in the midline pelvic joint (pubic symphysis), intervertebral discs, and the covering of intervertebral discs (annulus fibrosus), menisci, and temporomandibular joints.

Establishing the onset of the damage

The history of the damage to the soft tissue structure that resulted in the joint instability should have been noted on the medical records, although medical attention may not have been sought immediately.  Therefore, a reliable history of an injury or damage to the joint that meets the relevant description at the time of the onset of the joint instability will generally be accepted unless there is contradictory evidence.  If the evidence is unclear, seek medical advice.

Last reviewed for CCPS 16 June 2014.

Investigative Documents

Preliminary questions [42061]

42062 the veteran had the damage to a soft tissue structure as defined in the statement of principles.

42063 the veteran had the damage to a soft tissue structure as specified at side and site of the body at some time.

42064  the veteran has established the causal connection between the damage to a soft tissue structure as specified and VEA service for joint instability.

42066   the veteran has established the causal connection between the damage to a soft tissue structure as specified and VEA service for the clinical onset of joint instability.

42069  the veteran has established the causal connection between the damage to a soft tissue structure as specified and operational service for the clinical onset of joint instability.

or

42070  the veteran has established the causal connection between the damage to a soft tissue structure as specified and eligible service for the clinical onset of joint instability.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

42068   the veteran has established the causal connection between the damage to a soft tissue structure as specified and VEA service for the clinical worsening of joint instability.

42071  the veteran has established the causal connection between the damage to a soft tissue structure as specified and operational service for the clinical worsening of joint instability.

or

42072  the veteran has established the causal connection between the damage to a soft tissue structure as specified and eligible service for the clinical worsening of joint instability.

Clinical onset and operational service [42069]

42073 on operational service, the veteran had the damage to a soft tissue structure as specified to side and site of the body.

42074 on operational service, the veteran had the damage to a soft tissue structure as specified to side and site of the body at the time of clinical onset of the joint instability.

42075 the damage to a soft tissue structure as specified, at the time of clinical onset of the joint instability, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.

or

42076 the veteran had the damage to a soft tissue structure as specified to side and site of the body due to an illness or injury which is identifiable.

42077 as a consequence of the identified illness or injury, the veteran had the damage to a soft tissue structure as specified, to the side and site of the body, at the time of the clinical onset of joint instability.

42078  the identified illness or injury, which caused the damage to a soft tissue structure as specified affecting side and site of the body, is causally related to operational service.

Clinical onset and eligible service [42070]

42079 on eligible service, the veteran had the damage to a soft tissue structure as specified at side and site of the body.

42080 the veteran had the damage to a soft tissue structure as specified at side and site of the body, during eligible service, as a casual result of eligible service.

42081 the veteran had the damage to a soft tissue structure as specified at side and site of the body, during eligible service, as a casual result of eligible service, at the time of the clinical onset of joint instability.

42082 the damage to a soft tissue structure as specified, at the time of clinical onset of the joint instability, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.

or

42076 the veteran had the damage to a soft tissue structure as specified to side and site of the body due to an illness or injury which is identifiable.

42077 as a consequence of the identified illness or injury, the veteran had the damage to a soft tissue structure as specified, to the side and site of the body, at the time of the clinical onset of joint instability.

42083  the identified illness or injury, which caused the damage to a soft tissue structure as specified affecting side and site of the body, is causally related to eligible service.

Clinical worsening and operational service [42071]

42073 on operational service, the veteran had the damage to a soft tissue structure as specified to side and site of the body.

42084 the veteran had the damage to a soft tissue structure as specified at side and site of the body, during operational service, as a casual result of operational service.

42085 the veteran had the damage to a soft tissue structure as specified at side and site of the body, during operational service, as a casual result of operational service, at the time of the clinical worsening of joint instability.

42086 the damage to a soft tissue structure as specified, at the time of clinical worsening of the joint instability, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.

or

42076 the veteran had the damage to a soft tissue structure as specified to side and site of the body due to an illness or injury which is identifiable.

42087 as a consequence of the identified illness or injury, the veteran had the damage to a soft tissue structure to side and site of the body at the time of the clinical worsening of joint instability.

42078  the identified illness or injury, which caused the damage to a soft tissue structure as specified affecting side and site of the body, is causally related to operational service.

42088 the clinical onset of the joint instability occurred prior to that part of operational service to which the identified illness or injury, as a consequence of which the veteran had damage to a soft tissue as specified to side and site of the body, is causally related.

Clinical worsening and eligible service [42072]

42079 on eligible service, the veteran had the damage to a soft tissue structure as specified at side and site of the body.

42080 the veteran had the damage to a soft tissue structure as specified at side and site of the body, during eligible service, as a casual result of eligible service.

42089 the veteran had the damage to a soft tissue structure as specified at side and site of the body, during eligible service, as a casual result of eligible service, at the time of the clinical worsening of joint instability.

42090 the damage to a soft tissue structure as specified, at the time of clinical worsening of the joint instability, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.

or

42076 the veteran had the damage to a soft tissue structure as specified to side and site of the body due to an illness or injury which is identifiable.

42087 as a consequence of the identified illness or injury, the veteran had the damage to a soft tissue structure to side and site of the body at the time of the clinical worsening of joint instability.

42083  the identified illness or injury, which caused the damage to a soft tissue structure as specified affecting side and site of the body, is causally related to eligible service.

42091 the clinical onset of the joint instability occurred prior to that part of eligible service to which the identified illness or injury, as a consequence of which the veteran had damage to a soft tissue structure as specified to side and site of the body, is causally related.