Hyperacusis — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 27 of 2021

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting hyperacusis or death from hyperacusis with the circumstances of a person's relevant service:

1. (1)
   being exposed to a peak sound pressure level at the tympanic membrane of at least 140 dB(C) before the clinical onset of hyperacusis;

   Note: dB(C) is defined in the Schedule 1 - Dictionary.

2. (2)
   being exposed to a sound pressure level at the tympanic membrane of at least 85 dB(A) as an 8-hour time-weighted average (TWA) with a 3-dB exchange rate for a cumulative period of at least six months before the clinical onset of hyperacusis;

   Note: dB(A) and time-weighted average (TWA) with a 3-dB exchange rate are defined in the Schedule 1 - Dictionary.

3. (3)
   having sensorineural hearing loss at the time of the clinical onset of hyperacusis;
4. (4)
   having acoustic shock at the time of the clinical onset of hyperacusis;

   Note: acoustic shock is defined in the Schedule 1 - Dictionary.

5. (5)
   having an episode of otitic barotrauma within the 30 days before the clinical onset of hyperacusis;

   Note: Otitic barotrauma is also known as otic barotrauma.

6. (6)
   being exposed to an explosive blast within the 30 days before the clinical onset of hyperacusis;
7. (7)
   having concussion or moderate to severe traumatic brain injury within the 30 days before the clinical onset of hyperacusis;
8. (8)
   having blunt trauma to the head causing a fracture of the temporal bone within the 30 days before the clinical onset of hyperacusis;
9. (9)
   having stapedectomy or surgery involving the insular cortex or another part of the brain involved in central auditory processing within the 30 days before the clinical onset of hyperacusis;
10. (10)
    having an inner ear disorder of the affected ear from the specified list of inner ear disorders at the time of the clinical onset of hyperacusis;

    Note: specified list of inner ear disorders is defined in the Schedule 1 - Dictionary.

11. (11)
    having Meniere's disease at the time of the clinical onset of hyperacusis;
12. (12)
    having paralysis of the facial nerve on the affected side at the time of the clinical onset of hyperacusis;

    Note: The facial nerve is also known as the seventh cranial nerve.

    Note: Facial nerve paralysis is also known as Bell's palsy.

    Note: Conditions that can cause paralysis of the facial nerve include autoimmune disease, multiple sclerosis and viral infection.

13. (13)
    having a viral or bacterial infection from the specified list of viral or bacterial infections within the 30 days before the clinical onset of hyperacusis;

    Note: specified list of viral or bacterial infections is defined in the Schedule 1 - Dictionary.

14. (14)
    having dysfunction of the stapedius muscle or the tensor tympani muscle on the affected side at the time of the clinical onset of hyperacusis;
15. (15)
    having a middle cerebral artery aneurysm at the time of the clinical onset of hyperacusis;
16. (16)
    having a cerebrovascular accident within the 30 days before the clinical onset of hyperacusis;
17. (17)
    having multiple sclerosis at the time of the clinical onset of hyperacusis;
18. (18)
    undergoing withdrawal following long-term benzodiazepine use within the seven days before the clinical onset of hyperacusis;

    Note: long-term benzodiazepine use is defined in the Schedule 1 - Dictionary.

19. (19)
    being exposed to a peak sound pressure level at the tympanic membrane of at least 140 dB(C) before the clinical worsening of hyperacusis;

    Note: dB(C) is defined in the Schedule 1 - Dictionary.

20. (20)
    being exposed to a sound pressure level at the tympanic membrane of at least 85 dB(A) as an 8-hour time-weighted average (TWA) with a 3-dB exchange rate for a cumulative period of at least six months before the clinical worsening of hyperacusis;

    Note: dB(A) and time-weighted average (TWA) with a 3-dB exchange rate are defined in the Schedule 1 - Dictionary.

21. (21)
    having sensorineural hearing loss at the time of the clinical worsening of hyperacusis;
22. (22)
    having acoustic shock at the time of the clinical worsening of hyperacusis;

    Note: acoustic shock is defined in the Schedule 1 - Dictionary.

23. (23)
    having an episode of otitic barotrauma within the 30 days before the clinical worsening of hyperacusis;

    Note: Otitic barotrauma is also known as otic barotrauma.

24. (24)
    being exposed to an explosive blast within the 30 days before the clinical worsening of hyperacusis;
25. (25)
    having concussion or moderate to severe traumatic brain injury within the 30 days before the clinical worsening of hyperacusis;
26. (26)
    having blunt trauma to the head causing a fracture of the temporal bone within the 30 days before the clinical worsening of hyperacusis;
27. (27)
    having stapedectomy or surgery involving the insular cortex or another part of the brain involved in central auditory processing within the 30 days before the clinical worsening of hyperacusis;
28. (28)
    having an inner ear disorder of the affected ear from the specified list of inner ear disorders at the time of the clinical worsening of hyperacusis;

    Note: specified list of inner ear disorders is defined in the Schedule 1 - Dictionary.

29. (29)
    having Meniere's disease at the time of the clinical worsening of hyperacusis;
30. (30)
    having paralysis of the facial nerve on the affected side at the time of the clinical worsening of hyperacusis;

    Note: The facial nerve is also known as the seventh cranial nerve.

    Note: Facial nerve paralysis is also known as Bell's palsy.

    Note: Conditions that can cause paralysis of the facial nerve include autoimmune disease, multiple sclerosis and viral infection.

31. (31)
    having a viral or bacterial infection from the specified list of viral or bacterial infections within the 30 days before the clinical worsening of hyperacusis;

    Note: specified list of viral or bacterial infections is defined in the Schedule 1 - Dictionary.

32. (32)
    having dysfunction of the stapedius muscle or the tensor tympani muscle on the affected side at the time of the clinical worsening of hyperacusis;
33. (33)
    having a middle cerebral artery aneurysm at the time of the clinical worsening of hyperacusis;
34. (34)
    having a cerebrovascular accident within the 30 days before the clinical worsening of hyperacusis;
35. (35)
    having multiple sclerosis at the time of the clinical worsening of hyperacusis;
36. (36)
    undergoing withdrawal following long-term benzodiazepine use within the seven days before the clinical worsening of hyperacusis;

    Note: long-term benzodiazepine use is defined in the Schedule 1 - Dictionary.

37. (37)
    inability to obtain appropriate clinical management for hyperacusis;

Aggravation-only factors: the factors in subsections 8(19) to 8(37) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.