Reasonable Hypothesis SOP [1] | 084 of 2020 |
Balance of Probabilities SOP [2] | 085 of 2020 |
SOP Bulletin 217 [3]
Tinnitus is the perception of sound (often ringing) in the ear/s or head when no external physical source for the sound is present. Tinnitus is a symptom, not a disease in itself. However, for SOP purposes is treated as an injury or disease.
The critical feature of the tinnitus SOP definition is ‘persistence’. Though the tinnitus need not be present all the time, the tinnitus needs to, at a minimum, intermittently reoccur without an external stimulus for a period of at least three consecutive months.
The diagnosis relies on self-report of symptoms. Testing is possible to identify the frequency and loudness of the tinnitus and how effectively it can be masked. The routine investigation of tinnitus includes an audiogram.
The relevant medical specialist is an Ear, Nose and Throat surgeon.
*another SOP applies
The clinical onset will be when the symptoms first became persistent. This will be based on self-report.
The usual course for tinnitus is for it to persist but not worsen unless there is further damage to hearing, ongoing exposure to the cause of the tinnitus or the overlay of psychological factors, which can worsen the perception of the tinnitus. Conventional medical therapy is generally ineffective at reducing or abolishing the tinnitus. The aim of therapy is to alleviate distress associated with the tinnitus.
In some cases, it may be approriate to address claims for worsening as an impairment reassessment rather than an aggravation.
Exposure to a loud noise can produce a temporary episode of non-persistent tinnitus. Repeated exposures can produce repeated temporary bouts. Tinnitus should only be diagnosed where there are persistent or recurring symptoms without ongoing triggers.
The RMA has specified the following conditions as being sources of vascular sound proximal to the ear, capable of causing tinnitus:
Condition |
ICD-9 CM Code |
---|---|
acquired arteriovenous fistula |
437.3, 900 |
glomus jugulare tumour |
194.6 |
Paget's disease of the skull |
731.0 |
benign intracranial hypertension |
348.2 |
carotid stenosis/occlusion |
433 |
cerebral atherosclerosis |
437.0 |
intracranial aneurysm |
437.3 |
These are all serious medical conditions and should be recorded in the medical documents. You should seek medical advice if you are unsure whether or not the veteran has one of these conditions.
Investigative Documents
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Sources of Vascular Sound Proximal to the Ear - Tinnitus | MR9073.pdf [6] | MR9073.docx [7] |
13659 there is some evidence that a source of vascular sound proximal to the affected ear may be a factor in the development or worsening of the condition under consideration.
13107 the veteran has suffered from a source of vascular sound proximal to side and site of the body at some time.
13108 the source of vascular sound proximal to side and site of the body is an illness or injury which is identifiable.
13111 the veteran has established the causal connection between the source of vascular sound and VEA service for tinnitus.
13109 the veteran was suffering from the identified illness or injury, a source of vascular sound proximal to side and site of the body, at the time of the clinical onset of the condition under consideration.
13112 the veteran has established the causal connection between the source of vascular sound and VEA service for the clinical onset of tinnitus.
30405 the veteran has established the causal connection between the source of vascular sound and operational service for the clinical onset of tinnitus.
or
30406 the veteran has established the causal connection between the source of vascular sound and eligible service for the clinical onset of tinnitus.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
13110 the veteran was suffering from the identified illness or injury, a source of vascular sound proximal to side and site of the body, at the time of the clinical worsening of the condition under consideration.
13113 the veteran has established the causal connection between the source of vascular sound and VEA service for the clinical worsening of tinnitus.
30407 the veteran has established the causal connection between the source of vascular sound and operational service for the clinical worsening of tinnitus.
or
30408 the veteran has established the causal connection between the source of vascular sound and eligible service for the clinical worsening of tinnitus.
13114 the identified illness or injury, a source of vascular sound proximal to side and site of the body, is causally related to operational service.
13115 the identified illness or injury, a source of vascular sound proximal to side and site of the body, is causally related to eligible service.
13114 the identified illness or injury, a source of vascular sound proximal to side and site of the body, is causally related to operational service.
30409 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a source of vascular sound proximal to side and site of the body, is causally related.
13115 the identified illness or injury, a source of vascular sound proximal to side and site of the body, is causally related to eligible service.
30410 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a source of vascular sound proximal to side and site of the body, is causally related.
The RMA defines impulsive noise as "noise which is characterised by a sharp rise and a rapid decay in sound levels and is less than one second in duration."
An explosion (grenades, mines or bombs) or the firing of a rifle, handgun or shotgun are all examples of impulsive noise. The key feature is the sudden change in sound pressure occurring with a pulsed noise.
If a rifle, handgun or shotgun is fired right next to your ear the noise level will be about 160+ dB. Artillery fire at 500 feet is around 150 dB. Fireworks at 3 feet are around 160 dB. An air raid with bombs going off in close proximity is around 130 dB. For other noises it depends very much on distance from the source, and you may need to seek expert advice. Physical requirements, duties, and workplace hazards of specific military occupations provides information about the scope and nature of work undertaken in many military occupations, including those with high levels of noise exposure. Note also that exposure must have occurred whilst the person was not wearing adequate ear protection.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | A Condition that can Contribute to Tinnitus | CR9172.pdf [8] | CR9172.docx [9] |
13797 the veteran has been exposed to an impulsive noise of at least 130 dBA without adequate ear protection at some time.
13083 the veteran has established the causal connection between the impulsive noise exposure and VEA service for tinnitus.
13084 the veteran has established the causal connection between the impulsive noise exposure and VEA service for the clinical onset of tinnitus.
30371 the veteran has established the causal connection between the impulsive noise exposure and operational service for the clinical onset of tinnitus.
or
30372 the veteran has established the causal connection between the impulsive noise exposure and eligible service for the clinical onset of tinnitus.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
13085 the veteran has established the causal connection between the impulsive noise exposure and VEA service for the clinical worsening of tinnitus.
30373 the veteran has established the causal connection between the impulsive noise exposure and operational service for the clinical worsening of tinnitus.
or
30374 the veteran has established the causal connection between the impulsive noise exposure and eligible service for the clinical worsening of tinnitus.
13081 the veteran was exposed to an impulsive noise of at least 130 dBA without adequate ear protection within the 48 hours immediately before the clinical onset of the condition under consideration.
13086 on operational service, the veteran was exposed to an impulsive noise of at least 130 dBA without adequate ear protection within the 48 hours immediately before the clinical onset of the condition under consideration.
13089 the exposure to an impulsive noise of at least 130 dBA without adequate ear protection, on operational service, within the 48 hours immediately before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
13082 the veteran has been exposed to an impulsive noise of at least 140 dBA without adequate ear protection.
30375 the veteran was exposed to an impulsive noise of at least 140 dBA without adequate ear protection within the 48 hours immediately before the clinical onset of the condition under consideration.
13087 on eligible service, the veteran was exposed to an impulsive noise of at least 140 dBA without adequate ear protection within the 48 hours immediately before the clinical onset of the condition under consideration.
13088 in the course of eligible service duties, the veteran was exposed to an impulsive noise of at least 140 dBA without adequate ear protection within the 48 hours immediately before the clinical onset of the condition under consideration.
13090 the exposure to an impulsive noise of at least 140 dBA without adequate ear protection, on eligible service, within the 48 hours immediately before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
30376 the veteran was exposed to an impulsive noise of at least 130 dBA without adequate ear protection within the 48 hours immediately before the clinical worsening of the condition under consideration.
30377 on operational service, the veteran was exposed to an impulsive noise of at least 130 dBA without adequate ear protection within the 48 hours immediately before the clinical worsening of the condition under consideration.
30378 in the course of operational service duties, the veteran was exposed to an impulsive noise of at least 130 dBA without adequate ear protection within the 48 hours immediately before the clinical worsening of the condition under consideration.
30379 the exposure to an impulsive noise of at least 130 dBA without adequate ear protection, on operational service, within the 48 hours immediately before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
13082 the veteran has been exposed to an impulsive noise of at least 140 dBA without adequate ear protection.
30380 the veteran was exposed to an impulsive noise of at least 140 dBA without adequate ear protection within the 48 hours immediately before the clinical worsening of the condition under consideration.
30381 on eligible service, the veteran was exposed to an impulsive noise of at least 140 dBA without adequate ear protection within the 48 hours immediately before the clinical worsening of the condition under consideration.
30382 in the course of eligible service duties, the veteran was exposed to an impulsive noise of at least 140 dBA without adequate ear protection within the 48 hours immediately before the clinical worsening of the condition under consideration.
30383 the exposure to an impulsive noise of at least 140 dBA without adequate ear protection, on eligible service, within the 48 hours immediately before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | A Condition that can Contribute to Osteoarthritis |
|
|
The SOP requirement is "being exposed to noise of at least 85 dBA as an 8-hour time weighted average (TWA) with a 3-dB exchange rate…."
Essentially this means 85 dBA for a cumulative total of 8 hours a day, or exposure to greater levels of dBA for shorter periods per day. Many military occupations would meet this level of exposure. In general, if you are in an environment where you need to shout to be heard, the noise level of that environment is in a range that can damage hearing.
The loudness of a sound doubles for every 3dBA increase. Thus, a dishwasher rated at 58dBA is twice as loud as one rated at 55dBA. Working in an environment of 85dBA for 8 hours involves the same noise exposure as working in an environment of 88dBA for 4 hours, or 91dBA for 2 hours, or 94dBA for one hour, and so on.
Generally, the use of well fitted ear plugs and muffs combined will provide a 30dBA reduction in noise level.
The table of noise exposure levels and durations based on 3-dBA exchange rate forms part of the SOP and sets out the duration needed for each level of noise.
Some specific examples of relevant dBA levels in military settings include:
Further assistance with calculating noise levels for particular types of exposures may be obtained from:
*NB. This hotword contains an embedded table: Military occupations with heavy noise component. There is likely to be a high level of noise exposure – at least to the level of 85 dBA – on any given day, within the normal work environment, for all occupations listed therein.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Exposure to High Noise Levels - Tinnitus | CR9175.pdf [10] | CR9175.docx [11] |
30447 the veteran has been exposed to high noise levels as specified in the Statements of Principles without adequate ear protection at some time.
30448 the veteran has established the causal connection between the high noise exposure and VEA service for tinnitus.
30449 the veteran has established the causal connection between the high noise exposure and VEA service for the clinical onset of tinnitus.
30451 the veteran has established the causal connection between the high noise exposure and operational service for the clinical onset of tinnitus.
or
30452 the veteran has established the causal connection between the high noise exposure and eligible service for the clinical onset of tinnitus.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
30450 the veteran has established the causal connection between the high noise exposure and VEA service for the clinical worsening of tinnitus.
30453 the veteran has established the causal connection between the high noise exposure and operational service for the clinical worsening of tinnitus.
or
30454 the veteran has established the causal connection between the high noise exposure and eligible service for the clinical worsening of tinnitus.
30459 the veteran was exposed to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for 180 days at some time.
30455 the veteran was exposed to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for 180 days immediately before the clinical onset of the condition under consideration.
30456 operational service made a material contribution to the veteran's exposure to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for 180 days immediately before the clinical onset of the condition under consideration.
30466 the veteran was exposed to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for one year at some time.
30457 the veteran was exposed to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for one year immediately before the clinical onset of the condition under consideration.
30458 eligible service made a material contribution to the veteran's exposure to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for one year immediately before the clinical onset of the condition under consideration.
30459 the veteran was exposed to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for 180 days at some time.
30460 the veteran was exposed to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for 180 days immediately before the clinical worsening of the condition under consideration.
30463 the clinical onset of the condition under consideration occurred before the veteran's exposure to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for 180 days.
30461 operational service made a material contribution to the veteran's exposure to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for 180 days immediately before the clinical worsening of the condition under consideration.
30466 the veteran was exposed to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for one year at some time.
30464 the veteran was exposed to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for one year immediately before the clinical worsening of the condition under consideration.
30467 the clinical onset of the condition under consideration occurred before the veteran's exposure to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for one year.
30465 eligible service made a material contribution to the veteran's exposure to high noise levels as specified in the Statements of Principles for tinnitus without adequate ear protection for one year immediately before the clinical worsening of the condition under consideration.
Appropriate clinical management of tinnitus involves treatment of the underlying cause of the tinnitus, which may then improve the tinnitus. Some patients benefit from use of a tinnitus masker, a device worn like a hearing aid that presents a noise more pleasant than the tinnitus. Electrical stimulation of the inner ear, as with a cochlear implant, often reduces the tinnitus, but is appropriate only for the profoundly deaf.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Inability to Obtain Appropriate Clinical Management | GQACM.pdf [12] | GQACM.docx [13] |
11109 the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7066 there is some evidence that an inability to obtain appropriate clinical management for the condition under consideration may be a factor in the worsening of the condition under consideration.
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
7378 the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 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.
7384 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service.
21084 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service, as a causal result of operational service.
7387 the veteran's inability to obtain appropriate clinical management for the condition under consideration during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.
or
7389 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.
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.
7392 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.
7385 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service.
7386 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service, as a causal result of eligible service.
7388 the veteran's inability to obtain appropriate clinical management for the condition under consideration during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.
or
7389 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.
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.
7393 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.
The RMA has defined an intracranial neoplasm as "a benign or malignant neoplasm affecting the brain, meninges, skull or cranial nerves." Basically this encompasses cancers or tumours, whether originating in the brain or spreading to the brain from a primary source elsewhere in the body. These are all serious medical conditions and should be recorded in the medical documents. You should seek medical advice if you are unsure whether or not the veteran has an intracranial neoplasm.
13660 there is some evidence that an intracranial neoplasm may be a factor in the development or worsening of the condition under consideration.
13118 the veteran has suffered from an intracranial neoplasm at some time.
13119 intracranial neoplasm means a neoplasm affecting the brain, meninges, skull or cranial nerves.
13121 the veteran has established the causal connection between the intracranial neoplasm and VEA service for tinnitus.
13120 the veteran was suffering from the identified illness or injury, an intracranial neoplasm, at the time of the clinical onset of the condition under consideration.
13122 the veteran has established the causal connection between the intracranial neoplasm and VEA service for the clinical onset of tinnitus.
30399 the veteran has established the causal connection between the intracranial neoplasm and operational service for the clinical onset of tinnitus.
or
30400 the veteran has established the causal connection between the intracranial neoplasm and eligible service for the clinical onset of tinnitus.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
30398 the veteran was suffering from the identified illness or injury, an intracranial neoplasm, at the time of the clinical worsening of the condition under consideration.
13123 the veteran has established the causal connection between the intracranial neoplasm and VEA service for the clinical worsening of tinnitus.
30401 the veteran has established the causal connection between the intracranial neoplasm and operational service for the clinical worsening of tinnitus.
or
30402 the veteran has established the causal connection between the intracranial neoplasm and eligible service for the clinical worsening of tinnitus.
13124 the identified illness or injury, an intracranial neoplasm, is causally related to operational service.
13125 the identified illness or injury, an intracranial neoplasm, is causally related to eligible service.
13124 the identified illness or injury, an intracranial neoplasm, is causally related to operational service.
30403 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, an intracranial neoplasm, is causally related.
13125 the identified illness or injury, an intracranial neoplasm, is causally related to eligible service.
30404 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, an intracranial neoplasm, is causally related.
In the Statement of Principles for Meniere's disease the RMA has defined this to mean:
"a clinical condition characterised by recurrent attacks of episodic vertigo often associated with:
This definition excludes labyrinthitis, vertigo of central origin and other unspecified vertiginous syndromes."
It has its onset most frequently in the fifth decade of life, although younger adults and the elderly are not spared.
Usually only one ear is affected, although in a small number of cases both ears are involved. Tinnitus and/or deafness may be absent during the initial attack[s] of vertigo, but they invariably appear as the disease progresses and are increased in severity during an acute attack. With milder forms of the condition, the patient may complain more of head discomfort, slight instability, and difficulty in concentration than of vertigo and may be considered to be anxious or depressed. Usually the deafness is unilateral and progressive, and when it is complete, the vertiginous attacks cease. However, the course is variable. Audiometry, particularly in the early stages of the disease, shows hearing thresholds elevated more in lower than in higher frequencies - the reverse usually applies for sensorineural hearing loss.
13662 there is some evidence that Meniere's disease may be a factor in the development or worsening of the condition under consideration.
13135 the veteran has suffered from Meniere's disease at some time.
13138 the veteran has established the causal connection between the Meniere's disease and VEA service for the condition under consideration.
13137 the veteran was suffering from Meniere's disease at the time of the clinical onset of the condition under consideration.
13139 the veteran has established the causal connection between the Meniere's disease and VEA service for the clinical onset of the condition under consideration.
30385 the veteran has established the causal connection between the Meniere's disease and operational service for the clinical onset of the condition under consideration.
or
30386 the veteran has established the causal connection between the Meniere's disease and eligible service for the clinical onset of the condition under consideration.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
30384 the veteran was suffering from Meniere's disease at the time of the clinical worsening of the condition under consideration.
13140 the veteran has established the causal connection between the Meniere's disease and VEA service for the clinical worsening of the condition under consideration.
30387 the veteran has established the causal connection between the Meniere's disease and operational service for the clinical worsening of the condition under consideration.
or
30388 the veteran has established the causal connection between the Meniere's disease and eligible service for the clinical worsening of the condition under consideration.
17520 the Meniere's disease is causally related to operational service.
17521 the Meniere's disease is causally related to eligible service.
17520 the Meniere's disease is causally related to operational service.
30389 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the Meniere's disease is causally related.
17521 the Meniere's disease is causally related to eligible service.
30390 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the Meniere's disease is causally related.
If a veteran or member had otitic barotrauma he or she would have needed significant medical attention at that time. Such medical treatment would normally be recorded in doctors' notes and/or hospital records. However, these records may have been destroyed or can no longer be obtained. Therefore, if there is a reliable history of appropriate medical treatment at a particular time, this generally will be accepted, unless there is contradictory evidence. Seek medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to otitic barotrauma rather than to some other condition.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Otitic Barotruama | CR9182.pdf [14] | CR9182.docx [15] |
Medical Report | Otitic Barotruama | MR9256.pdf [16] | MR9256.docx [17] |
15304 there is some evidence that otitic barotrauma may be a factor in the development or worsening of the condition under consideration.
14635 the veteran has suffered from otitic barotrauma at some time.
30593 the veteran has established the causal connection between the otitic barotrauma and VEA service for the condition under consideration.
30594 the veteran has established the causal connection between the otitic barotrauma and VEA service for the clinical onset of the condition under consideration.
30596 the veteran has established the causal connection between the otitic barotrauma and operational service for the clinical onset of the condition under consideration.
or
30597 the veteran has established the causal connection between the otitic barotrauma and eligible service for the clinical onset of the condition under consideration.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
30595 the veteran has established the causal connection between the otitic barotrauma and VEA service for the clinical worsening of the condition under consideration.
30598 the veteran has established the causal connection between the otitic barotrauma and operational service for the clinical worsening of the condition under consideration.
or
30599 the veteran has established the causal connection between the otitic barotrauma and eligible service for the clinical worsening of the condition under consideration.
30600 on operational service, the veteran suffered at least one episode of otitic barotrauma.
30601 on operational service, the veteran suffered at least one episode of otitic barotrauma within the 30 days immediately before the clinical onset of the condition under consideration.
30602 the episode of otitic barotrauma on operational service within the 30 days immediately before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
30603 on eligible service, the veteran suffered at least one episode of otitic barotrauma.
30604 as a causal result of eligible service, the veteran suffered at least one episode of otitic barotrauma.
30605 as a causal result of eligible service, the veteran suffered at least one episode of otitic barotrauma within the 30 days immediately before the clinical onset of the condition under consideration.
30606 the episode of otitic barotrauma on eligible service within the 30 days immediately before the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
30600 on operational service, the veteran suffered at least one episode of otitic barotrauma.
30607 as a causal result of operational service, the veteran suffered at least one episode of otitic barotrauma.
30608 as a causal result of operational service, the veteran suffered at least one episode of otitic barotrauma within the 30 days immediately before the clinical worsening of the condition under consideration.
30609 the episode of otitic barotrauma on operational service within the 30 days immediately before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
30603 on eligible service, the veteran suffered at least one episode of otitic barotrauma.
30604 as a causal result of eligible service, the veteran suffered at least one episode of otitic barotrauma.
30610 as a causal result of eligible service, the veteran suffered at least one episode of otitic barotrauma within the 30 days immediately before the clinical worsening of the condition under consideration.
30611 the episode of otitic barotrauma on eligible service within the 30 days immediately before the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
In the Statement of Principles for Tinnitus the RMA has defined otosclerosis as "a primary disorder of the labyrinthine capsule, characterised by new bone formation commonly involving the footplate of the stapes." The stapes [also called the stirrup] is one of the 3 small bones in the middle ear which conduct vibrations from the tympanic membrane to the inner ear.
The tendency to otosclerosis is familial and it becomes clinically evident in the late teenage and early adult years. About 10% of affected persons develop hearing loss.
13661 there is some evidence that otosclerosis may be a factor in the development or worsening of the condition under consideration.
13127 the veteran has suffered from otosclerosis at some time.
13130 the veteran has established the causal connection between the otosclerosis and VEA service for tinnitus.
13129 the veteran was suffering from otosclerosis at the time of the clinical onset of the condition under consideration.
13131 the veteran has established the causal connection between the otosclerosis and VEA service for the clinical onset of tinnitus.
30392 the veteran has established the causal connection between the otosclerosis and operational service for the clinical onset of tinnitus.
or
30393 the veteran has established the causal connection between the otosclerosis and eligible service for the clinical onset of tinnitus.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
30391 the veteran was suffering from otosclerosis at the time of the clinical worsening of the condition under consideration.
13132 the veteran has established the causal connection between the otosclerosis and VEA service for the clinical worsening of tinnitus.
30394 the veteran has established the causal connection between the otosclerosis and operational service for the clinical worsening of tinnitus.
or
30395 the veteran has established the causal connection between the otosclerosis and eligible service for the clinical worsening of tinnitus.
30468 the otosclerosis is causally related to operational service.
30469 the otosclerosis is causally related to eligible service.
30468 the otosclerosis is causally related to operational service.
30396 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the otosclerosis is causally related.
30469 the otosclerosis is causally related to eligible service.
30397 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the otosclerosis is causally related.
Information about establishing the presence of sensorineural hearing loss is contained in the diagnostic protocol for Sensorineural hearing loss in the CCPS Research Library.
30578 the veteran has suffered from sensorineural hearing loss at some time.
30579 the veteran has established the causal connection between the sensorineural hearing loss and VEA service for tinnitus.
30580 the veteran was suffering from sensorineural hearing loss at the time of the clinical onset of the condition under consideration.
30581 the veteran has established the causal connection between the sensorineural hearing loss and VEA service for the clinical onset of tinnitus.
30584 the veteran has established the causal connection between the sensorineural hearing loss and operational service for the clinical onset of tinnitus.
or
30585 the veteran has established the causal connection between the sensorineural hearing loss and eligible service for the clinical onset of tinnitus.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
30582 the veteran was suffering from sensorineural hearing loss at the time of the clinical worsening of the condition under consideration.
30583 the veteran has established the causal connection between the sensorineural hearing loss and VEA service for the clinical worsening of tinnitus.
30586 the veteran has established the causal connection between the sensorineural hearing loss and operational service for the clinical worsening of tinnitus.
or
30587 the veteran has established the causal connection between the sensorineural hearing loss and eligible service for the clinical worsening of tinnitus.
30588 the sensorineural hearing loss is causally related to operational service.
30589 the sensorineural hearing loss is causally related to eligible service.
30588 the sensorineural hearing loss is causally related to operational service.
30590 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the sensorineural hearing loss is causally related.
30589 the sensorineural hearing loss is causally related to eligible service.
30591 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the sensorineural hearing loss is causally related.
In the Statement of Principles for Tinnitus the RMA defines trauma to the auditory apparatus as "injury to the tympanic membrane, ear ossicles, cochlea or acoustic nerve caused by trauma to the head."
Type | Title | PDF Format | Word Format |
---|---|---|---|
Claimant Report | Trauma to the Auditory Apparatus - Tinnitus | CR9173.pdf [18] | CR9173.docx [19] |
Medical Report | Trauma to the Auditory Apparatus - Tinnitus | MR9247.pdf [20] | MR9247.docx [21] |
13657 there is some evidence that trauma to the auditory apparatus may be a factor in the development or worsening of the condition under consideration.
13091 the veteran has suffered a trauma to the auditory apparatus at some time.
13094 the veteran has established the causal connection between the trauma to the auditory apparatus and VEA service for tinnitus.
13095 the veteran has established the causal connection between the trauma to the auditory apparatus and VEA service for the clinical onset of tinnitus.
30413 the veteran has established the causal connection between the trauma to the auditory apparatus and operational service for the clinical onset of tinnitus.
or
30414 the veteran has established the causal connection between the trauma to the auditory apparatus and eligible service for the clinical onset of tinnitus.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
13096 the veteran has established the causal connection between the trauma to the auditory apparatus and VEA service for the clinical worsening of tinnitus.
30415 the veteran has established the causal connection between the trauma to the auditory apparatus and operational service for the clinical worsening of tinnitus.
or
30416 the veteran has established the causal connection between the trauma to the auditory apparatus and eligible service for the clinical worsening of tinnitus.
13778 on operational service, the veteran suffered trauma to the auditory apparatus.
13093 on operational service, the veteran suffered trauma to the auditory apparatus at the time of the clinical onset of the condition under consideration.
13097 the trauma to the auditory apparatus on operational service at the time of the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
or
13098 the veteran suffered trauma to the auditory apparatus as a result of an illness or injury which is identifiable.
30417 as a result of the identified illness or injury, the veteran suffered trauma to the auditory apparatus at the time of the clinical onset of the condition under consideration.
30418 the identified illness or injury, which resulted in trauma to the auditory apparatus, is causally related to operational service.
30419 on eligible service, the veteran suffered trauma to the auditory apparatus.
30420 as a causal result of eligible service, the veteran suffered trauma to the auditory apparatus.
30421 as a causal result of eligible service, the veteran suffered trauma to the auditory apparatus at the time of the clinical onset of the condition under consideration.
30422 the trauma to the auditory apparatus on eligible service at the time of the clinical onset of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
or
13098 the veteran suffered trauma to the auditory apparatus as a result of an illness or injury which is identifiable.
30417 as a result of the identified illness or injury, the veteran suffered trauma to the auditory apparatus at the time of the clinical onset of the condition under consideration.
30423 the identified illness or injury, which resulted in trauma to the auditory apparatus, is causally related to eligible service.
13778 on operational service, the veteran suffered trauma to the auditory apparatus.
30424 as a causal result of operational service, the veteran suffered trauma to the auditory apparatus.
30425 as a causal result of operational service, the veteran suffered trauma to the auditory apparatus at the time of the clinical worsening of the condition under consideration.
30426 the trauma to the auditory apparatus on operational service at the time of the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
or
13098 the veteran suffered trauma to the auditory apparatus as a result of an illness or injury which is identifiable.
30427 as a result of the identified illness or injury, the veteran suffered trauma to the auditory apparatus at the time of the clinical worsening of the condition under consideration.
30418 the identified illness or injury, which resulted in trauma to the auditory apparatus, is causally related to operational service.
30428 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, which resulted in trauma to the auditory apparatus, is causally related.
30419 on eligible service, the veteran suffered trauma to the auditory apparatus.
30420 as a causal result of eligible service, the veteran suffered trauma to the auditory apparatus.
30429 as a causal result of eligible service, the veteran suffered trauma to the auditory apparatus at the time of the clinical worsening of the condition under consideration.
30430 the trauma to the auditory apparatus on eligible service at the time of the clinical worsening of the condition under consideration was due to the veteran's serious default, wilful act or serious breach of discipline.
or
13098 the veteran suffered trauma to the auditory apparatus as a result of an illness or injury which is identifiable.
30427 as a result of the identified illness or injury, the veteran suffered trauma to the auditory apparatus at the time of the clinical worsening of the condition under consideration.
30423 the identified illness or injury, which resulted in trauma to the auditory apparatus, is causally related to eligible service.
30431 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, which resulted in trauma to the auditory apparatus, is causally related.
Ototoxic drugs are drugs that have an adverse effect on the acoustic nerve or the organs of hearing or balance.
All these drugs are taken as a course of treatment ie prescribed by a doctor as a specified dose to be taken over a number of days (or perhaps weeks).
The RMA has specified the following list of ototoxic drugs as being capable of causing tinnitus or sensorineural hearing loss:
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Treatment with Ototoxic Drugs | MR9074.pdf [22] | MR9074.docx [23] |
13658 there is some evidence that treatment with an ototoxic drug may be a factor in the development or worsening of the condition under consideration.
13099 the veteran has undergone a course of treatment with an ototoxic drug from the list specified in the Statements of Principles within the year immediately before the clinical onset or worsening of the condition under consideration.
13101 the veteran underwent a course of treatment with an ototoxic drug from the list specified in the Statements of Principles within the year immediately before the clinical onset or worsening of the condition under consideration for an illness or injury which is identifiable.
13102 the veteran has established the causal connection between the treatment with an ototoxic drug and VEA service for the condition under consideration.
13100 for the identified illness or injury, the veteran underwent a course of treatment with an ototoxic drug from the list specified in the Statements of Principles within the year immediately before the clinical onset of the condition under consideration.
13103 the veteran has established the causal connection between the treatment with an ototoxic drug and VEA service for the clinical onset of the condition under consideration.
30433 the veteran has established the causal connection between the treatment with an ototoxic drug and operational service for the clinical onset of the condition under consideration.
or
30434 the veteran has established the causal connection between the treatment with an ototoxic drug and eligible service for the clinical onset of the condition under consideration.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
30432 for the identified illness or injury, the veteran underwent a course of treatment with an ototoxic drug from the list specified in the Statements of Principles within the year immediately before the clinical worsening of the condition under consideration.
13104 the veteran has established the causal connection between the treatment with an ototoxic drug and VEA service for the clinical worsening of the condition under consideration.
30435 the veteran has established the causal connection between the treatment with an ototoxic drug and operational service for the clinical worsening of the condition under consideration.
or
30436 the veteran has established the causal connection between the treatment with an ototoxic drug and eligible service for the clinical worsening of the condition under consideration.
13105 the identified illness or injury, for which the treatment with an ototoxic drug was undergone, is causally related to operational service.
13106 the identified illness or injury, for which the treatment with an ototoxic drug was undergone, is causally related to eligible service.
13105 the identified illness or injury, for which the treatment with an ototoxic drug was undergone, is causally related to operational service.
30437 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, for which the treatment with an ototoxic drug was undergone, is causally related.
13106 the identified illness or injury, for which the treatment with an ototoxic drug was undergone, is causally related to eligible service.
30438 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, for which the treatment with an ototoxic drug was undergone, is causally related.
Although sensorineural hearing loss or tinnitus may be caused or aggravated by taking salicylate derivatives or quinine derivatives, this effect of such drugs is characteristically reversible once the drug is discontinued. Therefore, the taking of salicylate or quinine derivatives is only a factor in the causation or aggravation of sensorineural hearing loss or tinnitus if the treatment with that drug could not be stopped or replaced by treatment with some other drug. This would not be the case if, for example, a person was taking aspirin for pain relief because other pain relieving medication (eg paracetamol) could be used.
Type | Title | PDF Format | Word Format |
---|---|---|---|
Medical Report | Salicylates or Quinine Derivatives | MR9100.pdf [24] | MR9100.docx [25] |
30470 there is some evidence that treatment with salicylate or quinine derivatives may be a factor in the development or worsening of the condition under consideration.
16722 the veteran was undergoing a course of treatment with salicylate or quinine derivatives at the time of the clinical onset or worsening of the condition under consideration.
16723 the veteran was undergoing a course of treatment with salicylate or quinine derivatives at the time of the clinical onset or worsening of the condition under consideration for an illness or injury which is identifiable.
16724 the identified illness or injury is a condition for which treatment with salicylate or quinine derivatives can be ceased or substituted.
16725 the veteran has established the causal connection between the treatment with salicylate or quinine derivatives and VEA service for the condition under consideration.
30439 for the identified illness or injury, the veteran was undergoing a course of treatment with salicylate or quinine derivatives, which were unable to be ceased or substituted, at the time of the clinical onset of the condition under consideration.
16726 the veteran has established the causal connection between the treatment with salicylate or quinine derivatives and VEA service for the clinical onset of the condition under consideration.
30441 the veteran has established the causal connection between the treatment with salicylate or quinine derivatives and operational service for the clinical onset of the condition under consideration.
or
30442 the veteran has established the causal connection between the treatment with salicylate or quinine derivatives and eligible service for the clinical onset of the condition under consideration.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
30440 for the identified illness or injury, the veteran was undergoing a course of treatment with salicylate or quinine derivatives, which were unable to be ceased or substituted, at the time of the clinical worsening of the condition under consideration.
16727 the veteran has established the causal connection between the treatment with salicylate or quinine derivatives and VEA service for the clinical worsening of the condition under consideration.
30443 the veteran has established the causal connection between the treatment with salicylate or quinine derivatives and operational service for the clinical worsening of the condition under consideration.
or
30444 the veteran has established the causal connection between the treatment with salicylate or quinine derivatives and eligible service for the clinical worsening of the condition under consideration.
16728 the identified illness or injury, for which the course of treatment with salicylate or quinine derivatives was undergone, is causally related to operational service.
16729 the identified illness or injury, for which the course of treatment with salicylate or quinine derivatives was undergone, is causally related to eligible service.
16728 the identified illness or injury, for which the course of treatment with salicylate or quinine derivatives was undergone, is causally related to operational service.
30445 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, for which the course of treatment with salicylate or quinine derivatives was undergone, is causally related.
16729 the identified illness or injury, for which the course of treatment with salicylate or quinine derivatives was undergone, is causally related to eligible service.
30446 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, for which the course of treatment with salicylate or quinine derivatives was undergone, is causally related.
Links
[1] http://www.rma.gov.au/assets/SOP/2020/6771bcea8c/084.pdf
[2] http://www.rma.gov.au/assets/SOP/2020/0c626d0107/085.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20217.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/64194%23comment-form
[5] http://www.rma.gov.au/SOP/alpha_ind/t.htm
[6] https://clik.dva.gov.au/system/files/media/MR9073_0.pdf
[7] https://clik.dva.gov.au/system/files/media/MR9073_0.docx
[8] https://clik.dva.gov.au/system/files/media/CR9172.pdf
[9] https://clik.dva.gov.au/system/files/media/CR9172.docx
[10] https://clik.dva.gov.au/system/files/media/CR9175.pdf
[11] https://clik.dva.gov.au/system/files/media/CR9175.docx
[12] https://clik.dva.gov.au/system/files/media/GQACM_8.pdf
[13] https://clik.dva.gov.au/system/files/media/GQACM_8.docx
[14] https://clik.dva.gov.au/system/files/media/CR9182_0.pdf
[15] https://clik.dva.gov.au/system/files/media/CR9182_0.docx
[16] https://clik.dva.gov.au/system/files/media/MR9256_2.pdf
[17] https://clik.dva.gov.au/system/files/media/MR9256_1.docx
[18] https://clik.dva.gov.au/system/files/media/CR9173.pdf
[19] https://clik.dva.gov.au/system/files/media/CR9173.docx
[20] https://clik.dva.gov.au/system/files/media/MR9247.pdf
[21] https://clik.dva.gov.au/system/files/media/MR9247.docx
[22] https://clik.dva.gov.au/system/files/media/MR9074_1.pdf
[23] https://clik.dva.gov.au/system/files/media/MR9074_1.docx
[24] https://clik.dva.gov.au/system/files/media/MR9100_1.pdf
[25] https://clik.dva.gov.au/system/files/media/MR9100_1.docx