Sensorineural hearing loss — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 98 of 2019

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 sensorineural hearing loss or death from sensorineural hearing loss 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 sensorineural hearing loss;

   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 sensorineural hearing loss;

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

3. (3)
   being exposed to an explosive blast within the 30 days before the clinical onset of sensorineural hearing loss;
4. (4)
   being struck by lightning within the 30 days before the clinical onset of sensorineural hearing loss;
5. (5)
   having: (a) an episode of otitic barotrauma involving the affected ear; or (b) decompression sickness; within the 30 days before the clinical onset of sensorineural hearing loss;
6. (6)
   undergoing a course of treatment with a drug or a drug from a class of drugs from the specified list of drugs, within the one year before the clinical onset of sensorineural hearing loss; Compilation No. 1 Compilation date: 30/05/2022 Authorised Version F2022C00587 registered 31/05/2022;

   Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

7. (7)
   having received an ototopical medication as specified, directly into the inner ear, in the presence of tympanic membrane perforation or a patent tympanostomy tube (grommet), within the 30 days before the clinical onset of sensorineural hearing loss;

   Note: ototopical medication as specified is defined in the Schedule 1 - Dictionary.

8. (8)
   taking paracetamol or a nonsteroidal anti-inflammatory drug on an average of at least two days per week, for a continuous period of at least the one year before the clinical onset of sensorineural hearing loss;
9. (9)
   taking a cumulative total of at least 40 grams of aspirin, or having acute salicylate toxicity, within the 30 days before the clinical onset of sensorineural hearing loss;
10. (10)
    having a suppurative bacterial infection from the specified list of bacterial infections of the middle or inner ear, involving the affected side, within the 30 days before the clinical onset of sensorineural hearing loss;

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

11. (11)
    having an infection with a virus from the specified list of viruses, within the 30 days before the clinical onset of sensorineural hearing loss;

    Note: specified list of viruses is defined in the Schedule 1 - Dictionary.

12. (12)
    having viral labyrinthitis of the affected ear within the 30 days before the clinical onset of sensorineural hearing loss;
13. (13)
    having meningitis or encephalitis within the one year before the clinical onset of sensorineural hearing loss;
14. (14)
    having neurosyphilis before the clinical onset of sensorineural hearing loss;
15. (15)
    having tuberculosis of the meninges, middle ear or inner ear of the affected side, before the clinical onset of sensorineural hearing loss;
16. (16)
    having leprosy before the clinical onset of sensorineural hearing loss;
17. (17)
    having a disease from the specified list of bone diseases, affecting the petrous temporal bone or middle ear ossicles of the affected side, at the time of the clinical onset of sensorineural hearing loss;

    Note: specified list of bone diseases is defined in the Schedule 1 - Dictionary.

18. (18)
    having osteoporosis at the time of the clinical onset of sensorineural hearing loss; Compilation No. 1 Compilation date: 30/05/2022 Authorised Version F2022C00587 registered 31/05/2022;
19. (19)
    having a disease from the specified list of autoimmune diseases at the time of the clinical onset of sensorineural hearing loss;

    Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.

20. (20)
    having multiple sclerosis at the time of the clinical onset of sensorineural hearing loss;
21. (21)
    having diabetes mellitus at the time of the clinical onset of sensorineural hearing loss;
22. (22)
    having a disease from the specified list of haematological diseases at the time of the clinical onset of sensorineural hearing loss;

    Note: specified list of haematological diseases is defined in the Schedule 1 - Dictionary.

23. (23)
    having a cerebrovascular accident within the three months before the clinical onset of sensorineural hearing loss;
24. (24)
    having a lesion interrupting the supply of blood to the cochlea of the affected ear at the time of the clinical onset of sensorineural hearing loss;

    Note: Examples of lesions interrupting the supply of blood to the cochlea include, but are not limited to, thrombosis, haemorrhage or vasospasm of the vertebro-basilar circulation, and intralabyrinthine haemorrhage or infarction.

25. (25)
    having blunt trauma, penetrating trauma or surgery to the cochlea or auditory nerve of the affected side, within the five years before the clinical onset of sensorineural hearing loss;

    Note: Examples of trauma include, but are not limited to, temporal bone fracture and basilar skull fracture.

26. (26)
    having moderate to severe traumatic brain injury within the three months before the clinical onset of sensorineural hearing loss;
27. (27)
    having a benign or malignant neoplasm involving the affected auditory nerve or cochlea at the time of the clinical onset of sensorineural hearing loss;
28. (28)
    undergoing a course of therapeutic radiation for cancer, where the affected cochlea or auditory nerve was in the field of radiation, before the clinical onset of sensorineural hearing loss; Compilation No. 1 Compilation date: 30/05/2022 Authorised Version F2022C00587 registered 31/05/2022;
29. (29)
    inhaling, ingesting or having cutaneous contact with an agent from the specified list of chemical agents, for a cumulative period of at least 2 500 hours within a continuous period of five years, before the clinical onset of sensorineural hearing loss, and where that exposure has ceased, the clinical onset of sensorineural hearing loss has occurred within two years of cessation;

    Note: specified list of chemical agents is defined in the Schedule 1 - Dictionary.

30. (30)
    having: (a) a cobalt-containing metal-on-metal hip prosthesis; or (b) a serum cobalt concentration of at least 200 micrograms per litre; for at least four weeks before the clinical onset of sensorineural hearing loss;
31. (31)
    smoking at least ten pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of sensorineural hearing loss, and where smoking has ceased, the clinical onset of sensorineural hearing loss has occurred within five years of cessation;

    Note: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

32. (32)
    being exposed to second-hand smoke: (a) for at least 2 500 hours before the clinical onset of sensorineural hearing loss; and (b) where the first exposure to second-hand smoke commenced at least five years before the clinical onset of sensorineural hearing loss; and (c) where the last exposure to second-hand smoke occurred within the two years before the clinical onset of sensorineural hearing loss;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

33. (33)
    consuming an average of at least 100 grams of alcohol per day for at least the four years before the clinical onset of sensorineural hearing loss;

    Note: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.

34. (34)
    being obese for at least five years within the ten years before the clinical onset of sensorineural hearing loss; Compilation No. 1 Compilation date: 30/05/2022 Authorised Version F2022C00587 registered 31/05/2022;

    Note: being obese is defined in the Schedule 1 - Dictionary.

35. (35)
    having hypertension at the time of the clinical onset of sensorineural hearing loss;
36. (36)
    being exposed to a peak sound pressure level at the tympanic membrane of at least 140 dB(C) before the clinical worsening of sensorineural hearing loss;

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

37. (37)
    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 sensorineural hearing loss;

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

38. (38)
    being exposed to an explosive blast within the 30 days before the clinical worsening of sensorineural hearing loss;
39. (39)
    being struck by lightning within the 30 days before the clinical worsening of sensorineural hearing loss;
40. (40)
    having: (a) an episode of otitic barotrauma involving the affected ear; or (b) decompression sickness; within the 30 days before the clinical worsening of sensorineural hearing loss;
41. (41)
    undergoing a course of treatment with a drug or a drug from a class of drugs from the specified list of drugs, within the one year before the clinical worsening of sensorineural hearing loss;

    Note: specified list of drugs is defined in the Schedule 1 - Dictionary.

42. (42)
    having received an ototopical medication as specified, directly into the inner ear, in the presence of tympanic membrane perforation or a patent tympanostomy tube (grommet), within the 30 days before the clinical worsening of sensorineural hearing loss;

    Note: ototopical medication as specified is defined in the Schedule 1 - Dictionary.

43. (43)
    taking paracetamol or a nonsteroidal anti-inflammatory drug on an average of at least two days per week, for a continuous period of at least the one year before the clinical worsening of sensorineural hearing loss; Compilation No. 1 Compilation date: 30/05/2022 Authorised Version F2022C00587 registered 31/05/2022;
44. (44)
    taking a cumulative total of at least 40 grams of aspirin, or having acute salicylate toxicity, within the 30 days before the clinical worsening of sensorineural hearing loss;
45. (45)
    having a suppurative bacterial infection from the specified list of bacterial infections of the middle or inner ear, involving the affected side, within the 30 days before the clinical worsening of sensorineural hearing loss;

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

46. (46)
    having an infection with a virus from the specified list of viruses, within the 30 days before the clinical worsening of sensorineural hearing loss;

    Note: specified list of viruses is defined in the Schedule 1 - Dictionary.

47. (47)
    having viral labyrinthitis of the affected ear within the 30 days before the clinical worsening of sensorineural hearing loss;
48. (48)
    having meningitis or encephalitis within the one year before the clinical worsening of sensorineural hearing loss;
49. (49)
    having neurosyphilis before the clinical worsening of sensorineural hearing loss;
50. (50)
    having tuberculosis of the meninges, middle ear or inner ear of the affected side, before the clinical worsening of sensorineural hearing loss;
51. (51)
    having leprosy before the clinical worsening of sensorineural hearing loss;
52. (52)
    having a disease from the specified list of bone diseases, affecting the petrous temporal bone or middle ear ossicles of the affected side, at the time of the clinical worsening of sensorineural hearing loss;

    Note: specified list of bone diseases is defined in the Schedule 1 - Dictionary.

53. (53)
    having osteoporosis at the time of the clinical worsening of sensorineural hearing loss;
54. (54)
    having a disease from the specified list of autoimmune diseases at the time of the clinical worsening of sensorineural hearing loss;

    Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.

55. (55)
    having multiple sclerosis at the time of the clinical worsening of sensorineural hearing loss; Compilation No. 1 Compilation date: 30/05/2022 Authorised Version F2022C00587 registered 31/05/2022;
56. (56)
    having diabetes mellitus at the time of the clinical worsening of sensorineural hearing loss;
57. (57)
    having a disease from the specified list of haematological diseases at the time of the clinical worsening of sensorineural hearing loss;

    Note: specified list of haematological diseases is defined in the Schedule 1 - Dictionary.

58. (58)
    having a cerebrovascular accident within the three months before the clinical worsening of sensorineural hearing loss;
59. (59)
    having a lesion interrupting the supply of blood to the cochlea of the affected ear at the time of the clinical worsening of sensorineural hearing loss;

    Note: Examples of lesions interrupting the supply of blood to the cochlea include, but are not limited to, thrombosis, haemorrhage or vasospasm of the vertebro-basilar circulation, and intralabyrinthine haemorrhage or infarction.

60. (60)
    having blunt trauma, penetrating trauma or surgery to the cochlea or auditory nerve of the affected side within the five years before the clinical worsening of sensorineural hearing loss;

    Note: Examples of trauma include, but are not limited to, temporal bone fracture and basilar skull fracture.

61. (61)
    having moderate to severe traumatic brain injury within the three months before the clinical worsening of sensorineural hearing loss;
62. (62)
    having a benign or malignant neoplasm involving the affected auditory nerve or cochlea at the time of the clinical worsening of sensorineural hearing loss;
63. (63)
    undergoing a course of therapeutic radiation for cancer, where the affected cochlea or auditory nerve was in the field of radiation, before the clinical worsening of sensorineural hearing loss;
64. (64)
    inhaling, ingesting or having cutaneous contact with an agent from the specified list of chemical agents, for a cumulative period of at least 2 500 hours within a continuous period of five years, before the clinical worsening of sensorineural hearing loss, and where that exposure has ceased, the clinical worsening of sensorineural hearing loss has occurred within two years of cessation;

    Note: specified list of chemical agents is defined in the Schedule 1 - Dictionary.

65. (65)
    having: (a) a cobalt-containing metal-on-metal hip prosthesis; or (b) a serum cobalt concentration of at least 200 micrograms per litre; Compilation No. 1 Compilation date: 30/05/2022 Authorised Version F2022C00587 registered 31/05/2022 for at least four weeks before the clinical worsening of sensorineural hearing loss;
66. (66)
    smoking at least ten pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical worsening of sensorineural hearing loss, and where smoking has ceased, the clinical worsening of sensorineural hearing loss has occurred within five years of cessation;

    Note: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary.

67. (67)
    being exposed to second-hand smoke: (a) for at least 2 500 hours before the clinical worsening of sensorineural hearing loss; and (b) where the first exposure to second-hand smoke commenced at least five years before the clinical worsening of sensorineural hearing loss; and (c) where the last exposure to second-hand smoke occurred within the two years before the clinical worsening of sensorineural hearing loss;

    Note: being exposed to second-hand smoke is defined in the Schedule 1 - Dictionary.

68. (68)
    consuming an average of at least 100 grams of alcohol per day for at least the four years before the clinical worsening of sensorineural hearing loss;

    Note: Alcohol consumption is calculated utilising the Australian Standard of ten grams of alcohol per standard alcoholic drink.

69. (69)
    being obese for at least five years within the ten years before the clinical worsening of sensorineural hearing loss;

    Note: being obese is defined in the Schedule 1 - Dictionary.

70. (70)
    having hypertension at the time of the clinical worsening of sensorineural hearing loss;
71. (71)
    inability to obtain appropriate clinical management for sensorineural hearing loss;

Aggravation-only factors: the factors in subsections 9(36) to 9(71) 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.