Reasonable Hypothesis SOP [1] | 7 of 2018 as amended |
Balance of Probabilities SOP [1] | 8 of 2018 as amended |
SOP Bulletin 213 [2]
ICD Coding
Typically, migraine is an episodic headache disorder, usually manifesting as a severe, unilateral, throbbing headache, generally associated with nausea and/or light and sound sensitivity. There are a number of variants of migraine and a headache is not always present.
The diagnosis is made clinically, based on the patient history, and can be made by a GP. There are no specific diagnostic tests.
The relevant medical specialist is a neurologist.
* another SOP applies
# non-SOP condition
Migraines that are claimed to have commenced or worsened in association with head or neck trauma come under the migraine SOP. A diagnosis of post-traumatic headaches/migraines 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 headaches”. They have concluded that head trauma is a cause of migraine, at the RH level only.
Claims for “post-traumatic headache” 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.
Clinical onset will be based on the history and date from the first episode that is consistent with having migraine.
Clinical worsening has been defined in the migraine SOP. It is still necessary when determining claims to consider whether there has been worsening of the condition, over and above the normal course of the disease, and arising due to relevant service rendered after the onset of the condition.
Place holder node for Rulebase for migraine
Migraine - Inability to obtain appropriate clinical management for migraine Factor
Last reviewed for CCPS 12 May 2010.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [15965] 11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7334 [5] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 [8] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration. 11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration. 11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration. or 11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration. Clinical worsening and operational service [11235] or 7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [13] [14] Clinical worsening and eligible service [11236] or 7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [13] [14]
Migraine - Treatment with glyceryl trinitrate or isosorbide mononitrate Factor
Last reviewed for CCPS 12 May 2010.
Preliminary questions [41373]
41374 [21] there is some evidence that treatment with glyceryl trinitrate or isosorbide mononitrate may be a factor in the worsening of the condition under consideration.
41378 [21] the veteran has undergone treatment with glyceryl trinitrate or isosorbide mononitrate at some time. the veteran underwent treatment with glyceryl trinitrate or isosorbide mononitrate for treatment of an illness or injury which is identifiable. the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. for treatment of the identified illness or injury, the veteran underwent treatment with glyceryl trinitrate or isosorbide mononitrate at the time of the clinical worsening of migraine. 41377 — the veteran has established the causal connection between treatment with glyceryl trinitrate or isosorbide mononitrate and VEA service for the clinical worsening of migraine. 41375 — the veteran has established the causal connection between treatment with glyceryl trinitrate or isosorbide mononitrate and operational service for the clinical worsening of migraine. or 41376 — the veteran has established the causal connection between treatment with glyceryl trinitrate or isosorbide mononitrate and eligible service for the clinical worsening of migraine. Clinical worsening and operational service [41375] 41381 — the identified illness or injury, for which the veteran underwent treatment with glyceryl trinitrate or isosorbide mononitrate, is causally related to operational service. [24] [25] Clinical worsening and eligible service [41376] 41382 — the identified illness or injury, for which the veteran underwent treatment with glyceryl trinitrate or isosorbide mononitrate, is causally related to eligible service. [27] [25]
Links
[1] http://www.rma.gov.au/sops/condition/migraine
[2] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20213.pdf
[3] https://clik.dva.gov.au/user/login?destination=comment/reply/63854%23comment-form
[4] https://clik.dva.gov.au/ccpsother-31
[5] https://clik.dva.gov.au/node/69482
[6] clikpopup://CCPS/Reject/OnsetAfterService
[7] clikpopup://CCPS/Reject/NoPermanentWorsening
[8] clikpopup://CCPS/Migraine/ACM - contributed to worsening
[9] clikpopup://CCPS/ACM/NoContribution
[10] clikpopup://CCPS/ACM/NotOpService
[11] clikpopup://CCPS/ACM/NotOperDuties
[12] clikpopup://CCPS/rejectwilful
[13] clikpopup://CCPS/ACM/NoIllness
[14] clikpopup://CCPS/reject7390,7391No
[15] clikpopup://CCPS/Migraine/ACM - onset prior to operational service
[16] clikpopup://CCPS/ACM/OnsetFailOper
[17] clikpopup://CCPS/ACM/NotEligService
[18] clikpopup://CCPS/ACM/NotEligDuties
[19] clikpopup://CCPS/Migraine/ACM - onset prior to eligible service
[20] clikpopup://CCPS/ACM/OnsetFailElig
[21] https://clik.dva.gov.au/ccpsf030rc-2
[22] https://clik.dva.gov.au/reasons-decision-37
[23] clikpopup://CCPS/reject41379No
[24] clikpopup://CCPS/reject41380No
[25] clikpopup://CCPS/reject41381,41382No
[26] clikpopup://CCPS/Underwent treatment with glyceryl trinitrate or isosorbide mononitrate occurring prior to operational is causally related
[27] clikpopup://CCPS/reject41383No
[28] clikpopup://CCPS/Underwent treatment with glyceryl trinitrate or isosorbide mononitrate occurring prior to eligible is causally related
[29] clikpopup://CCPS/reject41384No