Reasonable Hypothesis [1] | 37 of 2018 |
Balance of Probabilities [2] | 38 of 2018 |
SOP Bulletin 202 [3]
A tension-type headache is a headache that is mild to moderate in intensity, bilateral, non-throbbing, and without other associated features. Infrequent, episodic tension-type headache occurs in almost the entire population and is not a disease. Tension-type headaches only warrant designation as a disease if they have an underlying basis, are of sufficient frequency and severity, and cause significant distress or impairment, warranting medical management.
For the diagnosis to be made the criteria in the SOP definition concerning: frequency and duration; clinical features; and level of distress or impairment must be met. Additionally, if the headaches are isolated episodes triggered by physiological stress (e.g. eye strain from too much close work, dehydration, acute psychological stress, fatigue) or extraneous agents (e.g. alcohol, odours/scents, food) then they are excluded and do not count towards meeting the diagnostic criteria. Evidence of an underlying headache disorder (and not just episodic headaches with identifiable acute triggers) should be available in order for the diagnosis to be confirmed. Specialist opinion will generally not be required.
The relevant medical specialist is a neurologist.
* another SOP applies
Tension-type headaches that are claimed to have commenced or worsened in association with head or neck trauma come under the tension-type headache SOP. A factor for concussion or moderate to severe head injury has been added to the current RH SOP.
A diagnosis of "post-traumatic headaches" should not be made.
The RMA has formally investigated whether head or neck trauma is a cause of headache. They have not issued separate SOPs for "post-traumatic headache". They have concluded that head trauma is not a cause of migraine but is a cause of cluster headache and tension-type headache at the RH standard of proof.
Any claims for "post-traumatic headaches" should be determined using the tension-type headache, migraine or cluster headache SOP, depending on the clinical presentation. The exception is if the headaches are due to a demonstrable structural abnormality (eg. subdural haematoma), in which case that abnormality should be diagnosed.
Episodic tension-type headaches are likely to have been occurring since childhood. A change to the pattern of headaches relating to frequency, occurrence without acute triggers, or onset of some underlying cause, may indicate a clinical onset of tension-type headaches as a disease.
Clinical worsening would generally be evidenced by a sustained increase in the frequency or severity of headaches.
Place holder node for Rulebase for tension-type headache
Tension-type headache - Inability to obtain appropriate clinical management for tension-type headache Factor
Last reviewed for CCPS 23 November 1999.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [11470]
11472 [6] the clinical onset of tension-type headache occurred after the end of the veteran's last period of VEA service. the veteran's tension-type headache permanently worsened. the veteran was unable to obtain appropriate clinical management for tension-type headache at some time.
11475 [9] the inability to obtain appropriate clinical management for tension-type headache contributed to the clinical worsening of the condition under consideration. 11477 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for tension-type headache and VEA service for the clinical worsening of tension-type headache. 11480 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for tension-type headache and operational service for the clinical worsening of tension-type headache. or 11481 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for tension-type headache and eligible service for the clinical worsening of tension-type headache. Clinical worsening and operational service [11480] or 11488 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for tension-type headache is causally related to operational service. [14] [15] Clinical worsening and eligible service [11481] or 11489 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for tension-type headache is causally related to eligible service. [14] [15]
Links
[1] http://www.rma.gov.au/assets/SOP/2018/037.pdf
[2] http://www.rma.gov.au/assets/SOP/2018/038.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20202.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/64178%23comment-form
[5] https://clik.dva.gov.au/ccpsother-31
[6] https://clik.dva.gov.au/node/72051
[7] clikpopup://CCPS/Reject/OnsetAfterService
[8] clikpopup://CCPS/Reject/NoPermanentWorsening
[9] https://clik.dva.gov.au/acm-0
[10] clikpopup://CCPS/ACM/NoContribution
[11] clikpopup://CCPS/ACM/NotOpService
[12] clikpopup://CCPS/ACM/NotOperDuties
[13] clikpopup://CCPS/rejectwilful
[14] clikpopup://CCPS/ACM/NoIllness
[15] clikpopup://CCPS/reject11488,11489No
[16] clikpopup://CCPS/Tension-type headache/ACM - onset prior to operational service
[17] clikpopup://CCPS/ACM/OnsetFailOper
[18] clikpopup://CCPS/ACM/NotEligService
[19] clikpopup://CCPS/ACM/NotEligDuties
[20] clikpopup://CCPS/Tension-type headache/ACM - onset prior to eligible service
[21] clikpopup://CCPS/ACM/OnsetFailElig