{"id":"F2019L01093","name":"Statement of Principles concerning conductive hearing loss (Reasonable Hypothesis) (No. 81 of 2019)","slug":"statement-of-principles-concerning-conductive-hearing-loss-reasonable-hypothesis-no-81-of-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440205,"registerId":"F2019L01093-fast-fetch-1775955921840","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning conductive hearing loss (Reasonable Hypothesis) (No. 81 of 2019)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nCONDUCTIVE HEARING LOSS (Reasonable Hypothesis)\n\n(No. 81 of 2019)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 23 August 2019\n\n \n\n \n\n \n\n \n\n \n\n| The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:
|\n| --- |\n| 
Professor Nicholas Saunders AO
Chairperson
|\n\n\n \n\n \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n\n\n\n1 Name\n\nThis is the Statement of Principles concerning conductive hearing loss (Reasonable Hypothesis) (No. 81 of 2019).\n\n2 Commencement\n\n This instrument commences on 23 September 2019.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning conductive hearing loss No. 7 of 2011 (Federal Register of Legislation No. F2010L03255) made under subsection 196B(2) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n6 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about conductive hearing loss and death from conductive hearing loss.\n\nMeaning of conductive hearing loss\n\n(2) For the purposes of this Statement of Principles, conductive hearing loss:\n\n(a) means acquired hearing loss due to defective conduction of sound from the external environment to the inner ear, with a permanent shift to a hearing threshold level of 25 decibels (dB) or more in the frequency of 500, 1 000, 2 000, 3 000, 4 000 or 6 000 hertz (Hz), and an air-bone gap in the affected ear of:\n\n(i) at least 10 dB at three or more of these frequencies; or\n\n(ii) at least 15 dB at any one of these frequencies.\n\nNote 1: The hearing loss is related to defective conduction of sound through the external auditory canal, the tympanic membrane (ear drum), middle ear ossicles or the middle ear space.\n\nNote 2: air-bone gap is defined in the Schedule 1 – Dictionary.\n\nDeath from conductive hearing loss\n\n(3) For the purposes of this Statement of Principles, conductive hearing loss, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's conductive hearing loss.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that conductive hearing loss and death from conductive hearing loss can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.\n\n9 Factors that must exist\n\nAt least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting conductive hearing loss or death from conductive hearing loss with the circumstances of a person's relevant service:\n\n(1) having otosclerosis on the affected side at the time of the clinical onset of conductive hearing loss;\n\n(2) having a disease from the specified list of bone diseases, involving the conductive hearing apparatus of the affected side, at the time of the clinical onset of conductive hearing loss;\n\nNote: conductive hearing apparatus and specified list of bone diseases are defined in the Schedule 1 - Dictionary. \n\n(3) having osteoporosis at the time of the clinical onset of conductive hearing loss;\n\n(4) having an episode of otitic barotrauma involving the affected ear, within the seven days before the clinical onset of conductive hearing loss;\n\n(5) being exposed to a peak sound pressure level at the tympanic membrane of at least 140 dB(C), within the seven days before the clinical onset of conductive hearing loss;\n\nNote: dB(C) is defined in the Schedule 1 - Dictionary. \n\n(6) being exposed to an explosive blast within the seven days before the clinical onset of conductive hearing loss;\n\n(7) being struck by lightning within the seven days before the clinical onset of conductive hearing loss;\n\n(8) having blunt trauma, penetrating trauma or surgery, involving the conductive hearing apparatus of the affected ear, within the seven days before the clinical onset of conductive hearing loss;\n\nNote: conductive hearing apparatus is defined in the Schedule 1 - Dictionary. \n\n(9) having acquired, permanent narrowing or obstruction of the external auditory canal of the affected ear, at the time of the clinical onset of conductive hearing loss;\n\nNote 1: Examples of causes of narrowing or obstruction of the external auditory canal include, but are not limited to:\n\n(a) benign fibro-osseous lesion;\n\n(b) benign or malignant neoplasm;\n\n(c) chronic otitis externa;\n\n(d) exostosis of the external auditory canal;\n\n(e) granuloma; and\n\n(f) necrotising otitis externa.\n\nNote 2: exostosis of the external auditory canal is defined in the Schedule 1 – Dictionary.\n\n(10) having chronic otitis media, involving the middle ear of the affected side, at the time of the clinical onset of conductive hearing loss;\n\nNote: chronic otitis media is defined in the Schedule 1 - Dictionary. \n\n(11) having:\n\n(a) a benign or malignant neoplasm; or\n\n(b) other mass lesion;\n\ninvolving the middle ear of the affected side, at the time of the clinical onset of conductive hearing loss;\n\nNote: Examples of neoplasms or mass lesions involving the middle ear include, but are not limited to:\n\n(a) cholesteatoma;\n\n(b) granuloma; and\n\n(c) neuroendocrine adenoma.\n\n(12) having a disease from the specified list of autoimmune diseases, at the time of the clinical onset of conductive hearing loss;\n\nNote: specified list of autoimmune diseases is defined in the Schedule 1 – Dictionary.\n\n(13) undergoing a course of therapeutic radiation for cancer, where the conductive hearing apparatus of the affected side was in the field of radiation, before the clinical onset of conductive hearing loss;\n\nNote: conductive hearing apparatus is defined in the Schedule 1 – Dictionary.\n\n(14) having otosclerosis on the affected side at the time of the clinical worsening of conductive hearing loss;\n\n(15) having a disease from the specified list of bone diseases, involving the conductive hearing apparatus of the affected side, at the time of the clinical worsening of conductive hearing loss;\n\nNote: conductive hearing apparatus and specified list of bone diseases are defined in the Schedule 1 - Dictionary. \n\n(16) having osteoporosis at the time of the clinical worsening of conductive hearing loss;\n\n(17) having an episode of otitic barotrauma involving the affected ear, within the seven days before the clinical worsening of conductive hearing loss;\n\n(18) being exposed to a peak sound pressure level at the tympanic membrane of at least 140 dB(C), within the seven days before the clinical worsening of conductive hearing loss;\n\nNote: dB(C) is defined in the Schedule 1 - Dictionary. \n\n(19) being exposed to an explosive blast within the seven days before the clinical worsening of conductive hearing loss;\n\n(20) being struck by lightning within the seven days before the clinical worsening of conductive hearing loss;\n\n(21) having blunt trauma, penetrating trauma or surgery, involving the conductive hearing apparatus of the affected ear, within the seven days before the clinical worsening of conductive hearing loss;\n\nNote: conductive hearing apparatus is defined in the Schedule 1 - Dictionary. \n\n(22) having acquired, permanent narrowing or obstruction of the external auditory canal of the affected ear, at the time of the clinical worsening of conductive hearing loss;\n\nNote 1: Examples of causes of narrowing or obstruction of the external auditory canal include, but are not limited to:\n\n(a) benign fibro-osseous lesion;\n\n(b) benign or malignant neoplasm;\n\n(c) chronic otitis externa;\n\n(d) exostosis of the external auditory canal;\n\n(e) granuloma; and\n\n(f) necrotising otitis externa.\n\nNote 2: exostosis of the external auditory canal is defined in the Schedule 1 – Dictionary.\n\n(23) having chronic otitis media, involving the middle ear of the affected side, at the time of the clinical worsening of conductive hearing loss;\n\nNote: chronic otitis media is defined in the Schedule 1 - Dictionary. \n\n(24) having:\n\n(a) a benign or malignant neoplasm; or\n\n(b) other mass lesion;\n\ninvolving the middle ear of the affected side, at the time of the clinical worsening of conductive hearing loss;\n\nNote: Examples of neoplasms or mass lesions involving the middle ear include, but are not limited to:\n\n(a) cholesteatoma;\n\n(b) granuloma; and\n\n(c) neuroendocrine adenoma.\n\n(25) having a disease from the specified list of autoimmune diseases, at the time of the clinical worsening of conductive hearing loss;\n\nNote: specified list of autoimmune diseases is defined in the Schedule 1 – Dictionary.\n\n(26) undergoing a course of therapeutic radiation for cancer, where the conductive hearing apparatus of the affected side was in the field of radiation, before the clinical worsening of conductive hearing loss;\n\nNote: conductive hearing apparatus is defined in the Schedule 1 – Dictionary.\n\n(27) inability to obtain appropriate clinical management for conductive hearing loss.\n\n10 Relationship to service\n\n(1) The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.\n\n(2) The factors set out in subsections 9(14) to 9(27) apply only to material contribution to, or aggravation of, conductive hearing loss where the person's conductive hearing loss was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nIn this Statement of Principles:\n\n(1) if a factor referred to in section 9 applies in relation to a person; and\n\n(2) that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(2) of the VEA;\n\nthen the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\nair-bone gap means a difference between the air conduction and bone conduction thresholds, as measured by pure-tone audiometry.\n\nchronic otitis media means a chronic inflammation of the middle ear that is characterised by discharge from the middle ear through a perforated tympanic membrane that persists for at least six weeks.\n\nconductive hearing apparatus means the external auditory canal or middle ear, including the tympanic membrane (ear drum) and middle ear ossicles.\n\nconductive hearing loss—see subsection 7(2).\n\ndB(C) is the sound pressure level in decibels measured by a sound level meter using a type C electronic filter. The type C filter is used to measure peak or impact sound pressure levels.\n\nexostosis of the external auditory canal means abnormal bone growth within the external auditory ear canal caused by irritation from prolonged or repeated exposure to cold wind and water. It is also known as surfer's ear.\n\nfibrous dysplasia is a benign disorder that causes marrow fibrosis, abnormal matrix production, and stimulation of osteoclastic reabsorption.\n\nMRCA means the Military Rehabilitation and Compensation Act 2004.\n\nosteoma means a benign neoplasm in which a new piece of bone usually grows on another piece of bone.\n\nrelevant service means:\n\n(a) operational service under the VEA;\n\n(b) peacekeeping service under the VEA;\n\n(c) hazardous service under the VEA;\n\n(d) British nuclear test defence service under the VEA;\n\n(e) warlike service under the MRCA; or\n\n(f) non-warlike service under the MRCA.\n\nNote: MRCA and VEA are also defined in the Schedule 1 – Dictionary.\n\nspecified list of autoimmune diseases means:\n\n(a) chronic psoriasis\n\n(b) granulomatosis with polyangiitis (Wegener granulomatosis);\n\n(c) polyarteritis nodosa;\n\n(d) relapsing polychondritis;\n\n(e) rheumatoid arthritis; \n\n(f) systemic lupus erythematosus; or\n\n(g) systemic sclerosis.\n\n \n\nspecified list of bone diseases means:\n\n(a) acromegaly;\n\n(b) fibrous dysplasia;\n\n(c) osteoma;\n\n(d) osteonecrosis; or\n\n(e) Paget's disease of bone.\n\nNote: fibrous dysplasia and osteoma are also defined in the Schedule 1 – Dictionary.\n\nterminal event means the proximate or ultimate cause of death and includes the following:\n\n(a) pneumonia;\n\n(b) respiratory failure;\n\n(c) cardiac arrest;\n\n(d) circulatory failure; or\n\n(e) cessation of brain function.\n\nVEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument expressly repeals the earlier Statement of Principles concerning conductive hearing loss No. 7 of 2011 and substitutes a new Statement establishing updated definitions, thresholds and lists of causative factors. The instrument therefore alters the operative statement of scope and criteria that decision‑makers must apply; the text provided does not permit a precise comparison of whether specific elements are broadened or narrowed relative to the repealed instrument."},"complexity_factors":["Technical medical criteria (audiometric thresholds, air‑bone gap definitions and specific frequency requirements) increase specialist interpretation.","Multiple discrete causal factors (27 enumerated items) with temporal qualifiers (many limited to within seven days) raise evidentiary complexity.","Cross‑references to definitions in Schedule 1 and to other Statements of Principles require cross‑document reading.","Legal standard used is the administrative ‘reasonable hypothesis’ test, which is less rigid than proof on the balance of probabilities but requires medical linkage to relevant service.","Interaction rules (section 10) limiting some factors to material contribution or aggravation where condition pre‑existed service add conditional complexity.","Replaces a prior Statement (repeal), so practitioners must track legislative history and ensure they use the current instrument."],"plain_english_summary":"This instrument, made by the Repatriation Medical Authority, sets the medical criteria and causal factors that must exist to raise a “reasonable hypothesis” linking conductive hearing loss (and death from it) to a person’s relevant service under the Veterans' Entitlements Act or the Military Rehabilitation and Compensation Act. It specifies audiometric thresholds, time windows and a list of medical conditions, exposures and injuries that decision‑makers use when assessing veterans’ entitlement claims and related causation questions."},"kimi_summary":{"content_quality":"ok","complexity_score":5,"scope_assessment":{"changed":false,"description":"This instrument maintains the established scope of Statements of Principles under the veterans' compensation scheme. It replaces the 2011 version with updated medical factors but does not expand beyond the original purpose of determining service connection for conductive hearing loss. The structure (onset factors vs. worsening factors) and the linkage to existing service definitions remain consistent with the legislative framework established in the Veterans' Entitlements Act 1986 and Military Rehabilitation and Compensation Act 2004."},"complexity_factors":["27 distinct factors with specific temporal requirements (7-day windows for some factors)","14 defined terms in Schedule 1, including technical medical definitions (air-bone gap, dB(C), exostosis, fibrous dysplasia)","Two-tier structure distinguishing clinical onset (factors 1-13) from clinical worsening (factors 14-27)","Nested cross-references: factors refer to other Statements of Principles for diseases like autoimmune conditions or bone diseases","Precise audiometric thresholds requiring specialist medical measurement (25 dB, specific frequencies 500-6000 Hz, air-bone gap calculations)","Dual legislative framework application (VEA and MRCA) with different service definitions","Exception handling in section 10(2) limiting worsening factors to pre-existing conditions not arising from service"],"plain_english_summary":"This Statement of Principles sets the medical rules for deciding when a veteran’s conductive hearing loss is connected to service. It tells decision-makers and medical advisers what clinical thresholds and a “reasonable hypothesis” are required, and lists 27 qualifying factors (e.g. otosclerosis, blast exposure, chronic otitis media, barotrauma, trauma, radiation) with time limits and technical criteria. Its outcome determines veterans’ access to compensation, treatment and rehabilitation."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-conductive-hearing-loss-reasonable-hypothesis-no-81-of-2019","history":"/api/acts/statement-of-principles-concerning-conductive-hearing-loss-reasonable-hypothesis-no-81-of-2019/history","analysis":"/api/acts/statement-of-principles-concerning-conductive-hearing-loss-reasonable-hypothesis-no-81-of-2019/analysis","conflicts":"/api/acts/statement-of-principles-concerning-conductive-hearing-loss-reasonable-hypothesis-no-81-of-2019/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-conductive-hearing-loss-reasonable-hypothesis-no-81-of-2019/important-cases","documents":"/api/acts/statement-of-principles-concerning-conductive-hearing-loss-reasonable-hypothesis-no-81-of-2019/documents"}}