{"id":"F2021L00029","name":"Statement of Principles concerning hyperacusis (Balance of Probabilities) (No. 28 of 2021)","slug":"statement-of-principles-concerning-hyperacusis-balance-of-probabilities-no-28-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440745,"registerId":"F2021L00029-fast-fetch-1775956275250","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning hyperacusis (Balance of Probabilities) (No. 28 of 2021)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 22.10.0\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![RMA-Red](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nHYPERACUSIS  (Balance of Probabilities)\n\n(No. 28 of 2021)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n \n\nDated                                                           24 December 2020\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:<br> |\n| --- |\n| <br> <br>Professor Nicholas Saunders AO<br>Chairperson<br> |\n\n\n \n\n   \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Application\n\n5 Definitions\n\n6 Kind of injury, disease or death to which this Statement of Principles relates\n\n7 Basis for determining the factors\n\n8 Factors that must exist\n\n9 Relationship to service\n\n10 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 hyperacusis (Balance of Probabilities) (No. 28 of 2021).\n\n2               Commencement\n\n              This instrument commences on 25 January 2021.\n\n3               Authority\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n4               Application\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n5               Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n6               Kind of injury, disease or death to which this Statement of Principles relates\n\n(1)          This Statement of Principles is about hyperacusis and death from hyperacusis.\n\nMeaning of hyperacusis\n\n(2)          For the purposes of this Statement of Principles, hyperacusis:\n\n(a)          means a disorder of sound tolerance or perception in which there is increased sensitivity or decreased tolerance to certain everyday sounds at levels that would not disturb most individuals; and\n\n(b)           causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities; and\n\n(c)           must have persisted for at least three months.\n\nNote 1: The sounds may be perceived as uncomfortably loud, unpleasant, frightening or painful.\n\nNote 2: Sounds generated within the body may also cause hyperacusis.\n\nDeath from hyperacusis\n\n(3)          For the purposes of this Statement of Principles, hyperacusis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's hyperacusis.\n\nNote: terminal event is defined in the Schedule 1 - Dictionary.\n\n7               Basis for determining the factors\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that hyperacusis and death from hyperacusis can be related to relevant service rendered by veterans 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\n8               Factors that must exist\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, hyperacusis or death from hyperacusis is connected with the circumstances of a person's relevant service:\n\n(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;\n\nNote: dB(C) is defined in the Schedule 1 - Dictionary.\n\n(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 one year before the clinical onset of hyperacusis;\n\nNote: dB(A) and time-weighted average (TWA) with a 3-dB exchange rate are defined in the Schedule 1 - Dictionary.\n\n(3)          having acoustic shock at the time of the clinical onset of hyperacusis;\n\nNote: acoustic shock is defined in the Schedule 1 - Dictionary.\n\n(4)          having an episode of otitic barotrauma within the 30 days before the clinical onset of hyperacusis;\n\nNote: Otitic barotrauma is also known as otic barotrauma.\n\n(5)          being exposed to an explosive blast within the 30 days before the clinical onset of hyperacusis;\n\n(6)          having concussion or moderate to severe traumatic brain injury within the 30 days before the clinical onset of hyperacusis;\n\n(7)          having blunt trauma to the head causing a fracture of the temporal bone within the 30 days before the clinical onset of hyperacusis;\n\n(8)          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;\n\n(9)          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;\n\nNote: specified list of inner ear disorders is defined in the Schedule 1 - Dictionary.\n\n(10)      having Meniere's disease at the time of the clinical onset of hyperacusis;\n\n(11)      having paralysis of the facial nerve on the affected side at the time of the clinical onset of hyperacusis;\n\nNote 1: The facial nerve is also known as the seventh cranial nerve.\n\nNote 2: Facial nerve paralysis is also known as Bell's palsy.\n\nNote 3: Conditions that can cause paralysis of the facial nerve include autoimmune disease, multiple sclerosis and viral infection.\n\n(12)      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;\n\nNote: specified list of viral or bacterial infections is defined in the Schedule 1 - Dictionary.\n\n(13)      having dysfunction of the stapedius muscle or the tensor tympani muscle on the affected side at the time of the clinical onset of hyperacusis;\n\n(14)      having a cerebrovascular accident within the 30 days before the clinical onset of hyperacusis;\n\n(15)      having multiple sclerosis at the time of the clinical onset of hyperacusis;\n\n(16)      being exposed to a peak sound pressure level at the tympanic membrane of at least 140 dB(C) before the clinical worsening of hyperacusis;\n\nNote: dB(C) is defined in the Schedule 1 - Dictionary.\n\n(17)      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 one year before the clinical worsening of hyperacusis;\n\nNote: dB(A) and time-weighted average (TWA) with a 3-dB exchange rate are defined in the Schedule 1 - Dictionary.\n\n(18)      having acoustic shock at the time of the clinical worsening of hyperacusis;\n\nNote: acoustic shock is defined in the Schedule 1 - Dictionary.\n\n(19)      having an episode of otitic barotrauma within the 30 days before the clinical worsening of hyperacusis;\n\nNote: Otitic barotrauma is also known as otic barotrauma.\n\n(20)      being exposed to an explosive blast within the 30 days before the clinical worsening of hyperacusis;\n\n(21)      having concussion or moderate to severe traumatic brain injury within the 30 days before the clinical worsening of hyperacusis;\n\n(22)      having blunt trauma to the head causing a fracture of the temporal bone within the 30 days before the clinical worsening of hyperacusis;\n\n(23)      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;\n\n(24)      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;\n\nNote: specified list of inner ear disorders is defined in the Schedule 1 - Dictionary.\n\n(25)      having Meniere's disease at the time of the clinical worsening of hyperacusis;\n\n(26)      having paralysis of the facial nerve on the affected side at the time of the clinical worsening of hyperacusis;\n\nNote 1: The facial nerve is also known as the seventh cranial nerve.\n\nNote 2: Facial nerve paralysis is also known as Bell's palsy.\n\nNote 3: Conditions that can cause paralysis of the facial nerve include autoimmune disease, multiple sclerosis and viral infection.\n\n(27)      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;\n\nNote: specified list of viral or bacterial infections is defined in the Schedule 1 - Dictionary.\n\n(28)      having dysfunction of the stapedius muscle or the tensor tympani muscle on the affected side at the time of the clinical worsening of hyperacusis;\n\n(29)      having a cerebrovascular accident within the 30 days before the clinical worsening of hyperacusis;\n\n(30)      having multiple sclerosis at the time of the clinical worsening of hyperacusis;\n\n(31)      inability to obtain appropriate clinical management for hyperacusis.\n\n9               Relationship to service\n\n(1)          The existence in a person of any factor referred to in section 8, must be related to the relevant service rendered by the person.\n\n(2)          The factors set out in subsections 8(16) to 8(31) apply only to material contribution to, or aggravation of, hyperacusis where the person's hyperacusis was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n10           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 8 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(3) 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 5\n\n1               Definitions\n\nIn this instrument:\n\n                             acoustic shock means the development of acoustic shock symptoms within 30 days of being exposed to a brief, sudden, unexpected, loud sound.\n\nNote: acoustic shock symptoms is also defined in the Schedule 1 - Dictionary.\n\n                             acoustic shock symptoms means the acoustic shock symptoms identified in Work Health and Safety (Managing Noise and Preventing Hearing Loss at Work) Code of Practice 2015, including:\n\n(a)          a feeling of fullness in the ear;\n\n(b)          burning sensations or sharp pain around or in the ear;\n\n(c)          dizziness;\n\n(d)          hypervigilance;\n\n(e)          numbness, tingling or soreness down the side of face, neck or shoulder; and\n\n(f)           tinnitus.\n\nNote: The sounds associated with the development of acoustic shock symptoms include crackles, hisses, whistles, shrieks and high-pitched noises.\n\n                             dB(A) means the sound pressure level in decibels measured by a sound level meter using a type A electronic filter.\n\n                             dB(C) means 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\n                             hyperacusis—see subsection 6(2).\n\n                             MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                             relevant service means:\n\n(a)          eligible war service (other than operational service) under the VEA;\n\n(b)          defence service (other than hazardous service and British nuclear test defence service) under the VEA; or\n\n(c)          peacetime service under the MRCA.\n\nNote: MRCA and VEA are also defined in the Schedule 1 - Dictionary.             \n\n                             specified list of inner ear disorders means:\n\n(a)          lateral semicircular canal dysplasia;\n\n(b)          perilymphatic fistula;\n\n(c)          stapes hypermobility; or\n\n(d)          superior semicircular canal dehiscence.\n\n                             specified list of viral or bacterial infections means:\n\n(a)          neurosyphilis;\n\n(b)          Lyme disease;\n\n(c)          Orientia tsutsugamushi infection (scrub typhus); or\n\n(d)          Rickettsia prowazekii infection.\n\n                             terminal 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\n                               time-weighted average (TWA) with a 3-dB exchange rate means the time-weighted average noise exposure level calculated according to the following formulae and shown in the table:\n\n \n\nTWA = 10.0  Log(D/100) + 85\n\nwhere D = daily dose; and\n\nD = [C1/T1 + C2/T2 + …..+ Cn/Tn]  100\n\nwhere               Cn = total time of exposure at a specified noise level; and\n\nTn = exposure duration for which noise at this level becomes hazardous\n\n \n\nTable of noise exposure levels and\n\ndurations based on 3-dB(A) exchange rate\n\n- Duration, T Duration, T\n- ExposureLevel, L(dB(A)) Hours Minutes Seconds ExposureLevel, L(dB(A)) Hours Minutes Seconds\n- 80 25 24  106  3 45\n- 81 20 10  107  2 59\n- 82 16   108  2 22\n- 83 12 42  109  1 53\n- 84 10 5  110  1 29\n- 85 8   111  1 11\n- 86 6 21  112   56\n- 87 5 2  113   45\n- 88 4   114   35\n- 89 3 10  115   28\n- 90 2 31  116   22\n- 91 2   117   18\n- 92 1 35  118   14\n- 93 1 16  119   11\n- 94 1   120   9\n- 95  47 37 121   7\n- 96  37 48 122   6\n- 97  30  123   4\n- 98  23 49 124   3\n- 99  18 59 125   3\n- 100  15  126   2\n- 101  11 54 127   1\n- 102  9 27 128   1\n- 103  7 30 129   1\n- 104  5 57 130-140   <1\n- 105  4 43    \n\n\n                             Source: National Institute of Occupational Safety and Health 1998 Guidelines Publication No. 98-126\n\n                             VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":5,"scope_assessment":{"changed":false,"description":"This is a standard Repatriation Medical Authority Statement of Principles with typical scope for determining service connection of a specific medical condition. It follows the established template for such instruments without significant expansion beyond the original purpose of linking hyperacusis to military service."},"complexity_factors":["31 distinct causal factors with specific temporal requirements (30-day windows for many factors, one-year cumulative exposure for noise)","Dual structure covering both 'clinical onset' (factors 1-15) and 'clinical worsening' (factors 16-30) plus a standalone factor (31)","Extensive cross-referencing to other Statements of Principles via section 10","Technical medical and acoustic terminology requiring 12 defined terms in Schedule 1","Mathematical formula for time-weighted average noise exposure with accompanying data table","Nested definitions (e.g., 'acoustic shock' depends on 'acoustic shock symptoms' which references external Code of Practice)","Specific decibel thresholds and measurement standards (dB(A) vs dB(C)) requiring technical understanding"],"plain_english_summary":"This Statement of Principles sets the medical test for whether hyperacusis — persistent, distressing oversensitivity to everyday sounds — is connected to Australian military service, for claims under the Veterans' Entitlements Act and the Military Rehabilitation and Compensation Act. Using the \"balance of probabilities,\" it requires at least one of 31 service-related factors (e.g., high noise exposure, head/ear trauma, certain medical conditions) and defines hyperacusis as ≥3 months with significant impairment; death due to contributory hyperacusis is also covered."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"},"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":false,"description":"The instrument itself defines its scope: it applies to VEA s120B and MRCA s339 claims, covers hyperacusis and death from hyperacusis, and sets the evidentiary factors linking the condition to relevant service. The text does not indicate an expansion or contraction beyond those statutory claim types; it also expressly defers to other Statements of Principles where overlap exists (section 10)."},"complexity_factors":["Technical acoustic measurements and thresholds (peak 140 dB(C); 85 dB(A) 8‑hour TWA with 3 dB exchange rate) and requirement these apply at the tympanic membrane (section 8(1),(2); Schedule 1).","Detailed time windows and temporal linking (clinical onset vs clinical worsening; multiple 30‑day windows for different events) that affect causation findings (sections 6(2), 8(3)–8(31)).","Mathematical exposure calculation (TWA formula and table in Schedule 1) requiring occupational/noise exposure assessment and record evidence.","Multiple medical conditions and procedures listed as alternative causal or aggravating factors (inner ear disorders, Meniere's, concussion, surgeries, infections) requiring clinical proof (section 8; Schedule 1 lists).","Cross‑reference to other Statements of Principles for injuries/diseases covered elsewhere, creating dependence on external instruments (section 10).","Legal-standard interplay: application to claims under different statutes (VEA and MRCA), and the causation standard applied is balance of probabilities (sections 3–5, 7).","Potential evidentiary and implementation difficulty (e.g. demonstrating exposure at the tympanic membrane, establishing timing of clinical onset/worsening, or proving inability to obtain appropriate clinical management) that increases adjudicative discretion (sections 8, 9).","Definitions-heavy instrument: many specialised terms defined in Schedule 1 (acoustic shock, specified infections/disorders, terminal event, TWA), requiring medical and occupational expertise to interpret."],"plain_english_summary":"This Statement of Principles sets the medical and causal rules the Repatriation Medical Authority uses to decide, on the balance of probabilities, whether hyperacusis (and death to which it contributed) is connected with a person's military service for claims under the VEA or MRCA. It affects veterans and service members making entitlement claims: it specifies exposure thresholds, defined medical events and time limits that, if present and related to relevant service, establish a connection for decision‑making."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hyperacusis-balance-of-probabilities-no-28-of-2021","history":"/api/acts/statement-of-principles-concerning-hyperacusis-balance-of-probabilities-no-28-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-hyperacusis-balance-of-probabilities-no-28-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hyperacusis-balance-of-probabilities-no-28-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hyperacusis-balance-of-probabilities-no-28-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-hyperacusis-balance-of-probabilities-no-28-of-2021/documents"}}