Internal Derangement of the Knee

This guide covers what DVA looks for when assessing this condition, including the relevant Statement of Principles factors, the evidence you should gather, and common preparation tips. Expand each section for more detail.

You are reviewing the condition-specific guidance to understand what evidence and preparation DVA expects.

Physical EligibleVETS Act 2026

Also known as: Knee Injury (Internal Derangement)Internal derangement of the knee is a chronic knee disorder caused by structural damage to the ligaments or meniscus inside the knee joint. This includes torn meniscus, torn cruciate ligaments (ACL, PCL), and torn collateral ligaments (MCL, LCL). It is very common among veterans due to physical training, sports, operational activities, and traumatic knee injuries during service. SoP 7 and 8 of 2019. Note: this guide covers structural knee damage from ligament or meniscus injury only. It does not cover osteoarthritis of the knee (which is a separate degenerative condition with its own SoP) or degenerative meniscal tears. If you have a knee sprain or strain that has not progressed to a chronic knee disorder, the sprain and strain guide may be more appropriate.

Provisional Access to Medical Treatment ()Internal derangement of the knee is on the PAMT list. You may be able to get treatment while your claim is being assessed.

DVA uses Statements of Principles () from the Repatriation Medical Authority to determine whether a condition can be linked to service. For Knee Injury (Internal Derangement), DVA generally considers the following factors:

Having a sprain involving a ligament of the affected knee within one year before the condition started — examples include twisting injuries, falls, collisions, and landing from jumps
Having an acute meniscal tear of the affected knee within one year before the condition started
Worsening: having a sprain involving a knee ligament within one year before the condition worsened
Worsening: having an acute meniscal tear within one year before the condition worsened
Not being able to get appropriate treatment for the knee condition before it worsened

Reference: SoP No. 7 of 2019 (Reasonable Hypothesis) / SoP No. 8 of 2019 (Balance of Probabilities). RH applies to operational/warlike service; BoP applies to peacetime service. Verify at rma.gov.au.Source: rma.gov.au — verify this directly with DVA for your circumstances.

DVA uses two different standards of proof depending on your type of service. Understanding which applies to you can help you prepare your evidence.

Reasonable Hypothesis (RH)Applies to: operational, warlike, or non-warlike serviceUnder the Reasonable Hypothesis standard (operational/warlike/non-warlike service), DVA generally considers that a knee sprain or acute meniscal tear during service — with clinical onset of chronic knee derangement within one year — is sufficient to raise a reasonable hypothesis.

Balance of Probabilities (BoP)Applies to: peacetime serviceUnder the Balance of Probabilities standard (peacetime service), DVA generally considers that the veteran must show it is more likely than not that the internal derangement of the knee was caused by a knee sprain or acute meniscal tear during service.

In plain EnglishIf you had operational or warlike service, the Reasonable Hypothesis (RH) standard applies — this is a lower threshold. If your service was peacetime only, the stricter Balance of Probabilities (BoP) standard applies. SoP instruments are updated periodically by the RMA. Always verify the current instrument at rma.gov.au/sops.

Benefit of the doubt: DVA is legally required to give you the benefit of the doubt if evidence is evenly balanced (s119 , s335 ). Learn more

DVA generally considers the standard of proof based on your service type. Verify this directly with DVA or a qualified advocate.

Required

Clinical diagnosis of internal derangement of the kneeA diagnosis from your GP, orthopaedic surgeon, or sports medicine doctor confirming internal derangement of the knee. MRI is commonly used to confirm meniscal or ligament damage.How to get it: See your GP and describe your knee symptoms. Ask for a referral for MRI if not already done.Estimated time: 2-4 weeks

Service records showing the knee injury or physical demandsDocumentation of the event that caused the knee injury — training accident, operational activity, sport, or physical training during service.How to get it: Request from Defence Archives: 1800 333 362. Allow 6-8 weeks. Check MyService first.Estimated time: 4-8 weeks

Medical nexus report linking the knee condition to serviceA written opinion from your doctor stating that your internal derangement of the knee was caused or contributed to by a specific knee injury or activity during service.How to get it: Ask your treating doctor: "Can you provide a written statement linking my knee condition to the injury or physical demands I experienced during my military service?"Estimated time: 2-4 weeks

Personal statement describing the knee injury and its impactYour own written account of how the injury happened, the treatment you received, and how the knee condition has affected you since.How to get it: Write this yourself in plain language. Describe the injury event, symptoms, and current limitations.

Buddy or witness statementA statement from someone who witnessed the knee injury or can describe the physical demands of the activity that caused it.How to get it: Ask a former colleague. Form D2141 (Statement in Support of Claim) can be used.

Tips for this condition

The SoP factors require a knee sprain or acute meniscal tear within one year before the chronic condition started — describe the specific injury event clearly
If the injury happened during sport, physical training, or operational activity, provide as much detail as possible about what happened
MRI evidence is very helpful — it shows exactly what structural damage exists in the knee
If both knees are affected, claim each side separately
This guide is for chronic structural damage to the knee. If your knee problem is degenerative wear (osteoarthritis), use our osteoarthritis guide instead
If you had an acute knee sprain that resolved without chronic damage, the sprain and strain guide may be more appropriate

Medical nexus statement (from your doctor)

A medical opinion linking your internal derangement of the knee to a specific knee injury during service.

What to ask your doctor

I am making a DVA claim for internal derangement of the knee. I injured my knee during [specific activity] while serving. Could you write a report linking my knee condition to this injury?

Personal statement (your own words)

Describe the injury event, when it happened during service, what treatment you received, and how the knee condition affects you now.

Suggested structure

The specific event or activity that caused the knee injury
Which knee was injured (left, right, or both)
When the injury happened — date or approximate period
What happened — twisting, fall, collision, landing, etc.
Immediate symptoms — pain, swelling, locking, giving way
Treatment received at the time — sick parade, medical centre, hospital
Whether the knee improved or became a chronic problem
Current impact on your daily life — difficulty walking, stairs, kneeling, sport

Common mistakes to avoid

✗Being vague about the injury event
✗Not specifying which knee
✗Not mentioning ongoing symptoms and limitations

Mistakes veterans commonly make when claiming for Knee Injury (Internal Derangement), and how to avoid them.

Confusing internal derangement with knee osteoarthritisAsk your doctor whether your knee condition is structural damage (torn meniscus or ligament) or degenerative wear (osteoarthritis). If it is degenerative, use the osteoarthritis guide. If you have both, you may be able to claim each separately.

Not describing the specific injury event that caused the knee damageDescribe exactly what happened: the activity, how you injured your knee, and when the pain and swelling started.

Not getting an MRI to confirm the structural damageAsk your GP for a referral for knee MRI before lodging your claim. The MRI report provides objective evidence of the damage.

Treatments DVA may cover

Physiotherapy and knee rehabilitation
Knee bracing and supportive devices
Anti-inflammatory medication and pain management
Arthroscopic surgery for meniscal repair or reconstruction
Ligament reconstruction surgery (ACL, PCL)
Post-surgical rehabilitation program

Next steps to consider

If your condition is permanent and stable, consider a Permanent Impairment claim
If both knees are affected, claim each side separately
Consider claiming osteoarthritis of the knee as a secondary condition if degenerative changes have developed as a result of the structural damage
If the knee injury has affected your ability to work, check eligibility for Incapacity Payments

Actual entitlements depend on individual DVA assessment. This is indicative only.

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Official + GuidanceVerified March 2026

This page combines official DVA information with platform-authored guidance. Official sources are cited where applicable.

SoP factors sourced from RMA. Guidance text explains official processes in plain language.

RMA — Statements of Principles

This is a guide onlyThis information is a free guide. It is not legal advice, medical advice, or financial advice. Always verify with DVA directly or with a qualified advocate before lodging a claim.

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Internal Derangement of the Knee

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