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23.6 Hearing Loss

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23.6 Hearing Loss

In this section

23.6.1 Liability for hearing loss

23.6.2  Date of injury for diseases and injuries

23.6.3  Investigation of claims

23.6.4 Claims under predecessor Acts

23.6.5  Claims with any period of service after 1 July 2004

 

There are two main types of deafness resulting from workplace exposure:

Noise induced or sensorineural hearing loss usually occurs after a period of extended exposure to noise. Examples include prolonged exposure to loud noises like aircraft engines or gunfire. Audiograms will reveal higher level frequencies are generally affected first then eventually the lower level frequencies.

Noise induced hearing loss is generally assessed under the disease provisions of the DRCA.

Noise or acoustic trauma, can occur if a person is exposed to an intense or explosive sound. Audiogram readings could show a high or low frequency loss, or an across all frequency loss.

If hearing loss is caused by a specific incident (for example, barotrauma or head injury), it should be treated as an injury. This should be supported by medical evidence stating when the incident occurred.

There are of course other medical conditions or injuries that can result in hearing loss. Normal investigation procedures would be followed during examination of claims based on those conditions or incidents.

 

23.6.1 Liability for hearing loss

In December 2017 the Military Rehabilitation and Compensation Committee agreed to a policy review for noise induced hearing loss which would align, where possible, the policy in place for claiming and assessing under DRCA and VEA/MRCA.

Previously, the policy approach was that deterioration in hearing loss subsequent to cessation of military employment is non-compensable. This was based on previous advice that once a person is removed from noise exposure (in Commonwealth employment), any damage previously done by noise trauma would not get any worse. This is no longer the policy.

Under the VEA and MRCA streamlining process, it is recognised that on the balance of probabilities all military personnel will meet the requirements of at least one of the Statement of Principles factors for sensorineural hearing loss. The same can also be said of claimants under DRCA, that in their military service they would have experienced conditions likely to cause hearing loss.

From May 2018, the delegate may accept a claim for any hearing loss that is not associated with age-related hearing loss, and provided there is evidence of relevant service and exposure or trauma. There is no requirement to further investigate or apportion any contributory hearing loss to factors other than age-related hearing loss.

 

23.6.2 Date of injury for diseases and injuries

Diseases

When hearing loss is attributed to extended exposure to excessive noise, as is the case for noise induced or sensorineural hearing loss, it should be treated as a disease. Under s7(4) of the DRCA, the date of injury for diseases is:

For the purposes of this Act, an employee shall be taken to have sustained an injury, being a disease, or an aggravation of a disease, on the day when:

(a) the employee first sought medical treatment for the disease, or aggravation; or

(b) the disease or aggravation resulted in the death of the employee or first resulted in the incapacity for work, or impairment of the employee;

whichever happens first.

Given the nature of hearing loss, there will generally be no need to consider death or incapacity. Therefore, a delegate should establish when a person was first impaired or sought medical treatment for the hearing loss.

What is medical treatment?

For the purposes of determining the date of disease for hearing loss claims, medical treatment may include hearing assessments (such as audiograms), as well as consultations with doctors. An employee has ‘sought medical treatment’ regardless of whether or not treatment was provided.

What is impairment?

Subsection 4(1) defines impairment as ‘the loss, the loss of the use, or the damage or malfunction, of any part of the body or of any bodily system or function or part of such system or function’.

The nature of noise-induced hearing loss is that the hair cells in the cochlea of the inner ear are damaged over time as a result of temporary or repeated exposure to a noisy environment. The signs and symptoms of the disease are there from the date of first exposure – even if the person has not yet realised this. However, the date of impairment for hearing loss can also be the date of last noise exposure i.e. the date of discharge. It is up to the delegate to decide which date is most appropriate.

Injury

In the case of noise or acoustic trauma, the appropriate date is the date when the event causing the injury or aggravation occurred.

23.6.3 Investigation of claims

The investigation of hearing loss claims should establish what level of an identified hearing loss is noise-induced, less the level of age-related hearing loss. There is no longer a requirement to request a Hearing Loss Supporting Statement to determine any potential hearing loss before or after service.

Hearing Tests

Hearing tests should usually show that there is a permanent shift to a hearing threshold of 25 decibels (db) or more at 500, 1000, 1500, 2000, 3000, 4000 or 6000 Hz.  However, this threshold is not a requirement under the DRCA and would not hold up to reconsideration or review if the claim was rejected on this basis.  Under the DRCA, any loss of hearing is a loss. This is one of the areas of differentiation between the DRCA and VEA/MRCA which are bound by the SoPs.

Where hearing tests already exist

Medical advice is that service audiograms may not meet appropriate standards for the diagnosis of hearing loss. This is due to the fact that bone conduction, which enables the differentiation of the type of hearing loss, is rarely available.  In addition, environmental conditions are not assured; proper hearing tests must be performed in a controlled environment and without noise exposure 24 hours prior. 

Where an audiogram already exists, and a client is willing to use it for the purposes of their liability claim and compensation assessment, then the pre-existing one may be used.

However, in all cases it is recommended that delegates refer claimants to Australian Hearing to conduct up-to-date and accurate audiograms to assess the level of compensable hearing loss. Early assessment at this stage of a person’s claim process would be beneficial in determining later compensation and support assessments.

Audiology referrals

The services of a reputable audiology service, such as Australian Hearing, should also be used when independent medical evidence regarding hearing loss claims is required. Within ISH, there is a standard letter package for use when referring claimants for assessment.

These providers, such as Australian Hearing, have the expertise to differentiate between noise-induced and age-related hearing loss.

23.6.4 Claims under predecessor Acts

Under the 1930 and 1971 Acts, liability claims must meet the relevant legislative tests of causation (CLIK 21.3).

Notice and claim requirements

The DRCA and its predecessor Acts require an employee to give notice in writing of an injury or loss of property as soon as practicable after the employee becomes aware of the injury and state that the Act does not apply in relation to the injury or loss if this requirement is not met.

In relation to all hearing loss claims, delegates may consider that proper notice has been given. Given what is known about the nature of service and hearing loss, the Commonwealth is not prejudiced by a late notice.

Therefore, delegates must not automatically reject a claim for hearing loss that has been lodged under DRCA or its predecessor Acts.

 

23.6.5 Claims with any period of service post 1 July 2004

Where hearing loss may relate to eligible service under the DRCA as well as defence service under the MRCA, then the Military Rehabilitation and Compensation (Consequential and Transitional Provisions) Act 2004 provide rules which govern the interaction of the two Acts (CLIK Chapter 12). The intention is that, where applicable, transitional claims should be brought under MRCA. 

In the case of hearing loss claims, where a client has both DRCA and MRCA service, a reasonable assumption can be made that MRCA service has materially contributed to the client’s hearing loss. As such, delegates are encouraged to take into account the totality of service and apply the transitional provisions to assess the claim under MRCA. This will have a more beneficial outcome for the client during the assessment of compensation payments.