AN03 TREATMENT OF HEARING TEST ANOMALIES FOR COMPENSATION PURPOSES

Advisory from Disability Compensation Branch

No 3/2003

This is an advisory note only.  Disability Compensation Branch and Legal Services Group have agreed this policy view.  It is not a Repatriation Commission Guideline or a Departmental Instruction.   The advice is not intended to conflict with the proper application of the Veterans' Entitlements Act 1986 or the judgements of the Courts.  It may be subject to change as a result of further interpretation by the Courts of the legislation.  Nevertheless it represents a considered view that should be taken into account by all delegates.

TREATMENT OF HEARING TEST ANOMALIES FOR COMPENSATION PURPOSES

Purpose

This Departmental Instruction is to advise staff of the Departmental approach to investigating:

•                          new claims for hearing loss; and
•                          applications for increase where hearing loss is an accepted disability.

Background

The need for this instruction follows instances of inconsistent results between audiograms obtained for claims investigations and later tests conducted for the provision of hearing aids.

Veterans may have genuine difficulty in providing consistent results. For example, tinnitus on the day of testing could mask the test tones and result in a higher measured hearing loss than is in fact the case.

Action

In order to prevent inaccurate disability pension assessments, the following course of action has been developed:

1. Hearing tests to be performed by audiologists rather than audiometrists

CCPS team managers should ensure that hearing test appointments are made with audiologists (or ENT specialists), rather than audiometrists.

Audiologists receive 6 years tertiary training and supervision to become accredited, compared with no requirement for formal qualifications in order to become an audiometrist. A fully trained audiologist would be aware of the need to test hearing thresholds using ascending and descending tones at varying frequencies and jumping randomly from ear to ear.

2. State Offices to liaise with audiologists regarding the possible need for repeat testing to demonstrate test/retest consistency

If audiologists are unsure of the accuracy of responses after a single testing, they should be encouraged to book a second or even a third test for the veteran on different days. Audiologists should be advised that DVA will support their efforts to obtain accurate results by guaranteeing payment for any repeat testing deemed necessary.

3. Veterans who produce inconsistent results after three tests should be sent for an ENT specialist consultation in order to rule out additional pathology

Referral letters for specialist appointments should enclose all audiograms. While ENT referrals may increase overall time taken to process for the cases involved, there are likely to be very few cases requiring specialist testing. Furthermore if DVA follows a nationally consistent approach in this matter, it is reasonable to expect that the number of cases needing multiple tests will reduce over time.

4. Cases where intent to defraud seems the most likely explanation should be dealt with on a case by case basis

The merits of initiating fraud procedures should be carefully weighed up against the disadvantages.

If measured differences between audiograms were such that the impairment rating dropped from, say, 42 to 38 points, then there would be no adjustment necessary. In both cases the impairment rating would be rounded to 40 points. Therefore any discrepancy would need to be a significant one in order to change the rate of pension. Veterans with a significant hearing loss would be unlikely to attempt to manipulate their test results.

In cases where the results of successive tests are widely discrepant and where a specialist has ruled out additional pathology, decision-makers should either:

• NIF the condition, on the grounds that any degree of hearing loss cannot be reliably quantified; or
• assign a NIL assessment.

If the case goes to Appeal, then the history of inconsistent results would be available to back up the primary decision.

Mark Johnson

Branch Head

Disability Compensation

September 2003