{"id":"F2021L00028","name":"Statement of Principles concerning hyperacusis (Reasonable Hypothesis) (No. 27 of 2021)","slug":"statement-of-principles-concerning-hyperacusis-reasonable-hypothesis-no-27-of-2021","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":440744,"registerId":"F2021L00028-fast-fetch-1775956273047","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning hyperacusis (Reasonable Hypothesis) (No. 27 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\n\n \n\nStatement of Principles\n\nconcerning\n\nHYPERACUSIS (Reasonable Hypothesis)\n\n(No. 27 of 2021)\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 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:
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Professor Nicholas Saunders AO Chairperson
|\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 (Reasonable Hypothesis) (No. 27 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(2) of the Veterans' Entitlements Act 1986.\n\n4 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\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\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that hyperacusis and death from hyperacusis 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\n8 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 hyperacusis or death from hyperacusis 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 six months 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 sensorineural hearing loss at the time of the clinical onset of hyperacusis;\n\n(4) 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(5) 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(6) being exposed to an explosive blast within the 30 days before the clinical onset of hyperacusis;\n\n(7) having concussion or moderate to severe traumatic brain injury within the 30 days before the clinical onset of hyperacusis;\n\n(8) 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(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;\n\n(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;\n\nNote: specified list of inner ear disorders is defined in the Schedule 1 - Dictionary.\n\n(11) having Meniere's disease at the time of the clinical onset of hyperacusis;\n\n(12) 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(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;\n\nNote: specified list of viral or bacterial infections is defined in the Schedule 1 - Dictionary.\n\n(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;\n\n(15) having a middle cerebral artery aneurysm at the time of the clinical onset of hyperacusis;\n\n(16) having a cerebrovascular accident within the 30 days before the clinical onset of hyperacusis;\n\n(17) having multiple sclerosis at the time of the clinical onset of hyperacusis;\n\n(18) undergoing withdrawal following long-term benzodiazepine use within the seven days before the clinical onset of hyperacusis;\n\nNote: long-term benzodiazepine use is defined in the Schedule 1 - Dictionary.\n\n(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;\n\nNote: dB(C) is defined in the Schedule 1 - Dictionary.\n\n(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;\n\nNote: dB(A) and time-weighted average (TWA) with a 3-dB exchange rate are defined in the Schedule 1 - Dictionary.\n\n(21) having sensorineural hearing loss at the time of the clinical worsening of hyperacusis;\n\n(22) 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(23) 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(24) being exposed to an explosive blast within the 30 days before the clinical worsening of hyperacusis;\n\n(25) having concussion or moderate to severe traumatic brain injury within the 30 days before the clinical worsening of hyperacusis;\n\n(26) 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(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;\n\n(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;\n\nNote: specified list of inner ear disorders is defined in the Schedule 1 - Dictionary.\n\n(29) having Meniere's disease at the time of the clinical worsening of hyperacusis;\n\n(30) 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(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;\n\nNote: specified list of viral or bacterial infections is defined in the Schedule 1 - Dictionary.\n\n(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;\n\n(33) having a middle cerebral artery aneurysm at the time of the clinical worsening of hyperacusis;\n\n(34) having a cerebrovascular accident within the 30 days before the clinical worsening of hyperacusis;\n\n(35) having multiple sclerosis at the time of the clinical worsening of hyperacusis;\n\n(36) undergoing withdrawal following long-term benzodiazepine use within the seven days before the clinical worsening of hyperacusis;\n\nNote: long-term benzodiazepine use is defined in the Schedule 1 - Dictionary.\n\n(37) 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(19) to 8(37) 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(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 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 long-term benzodiazepine use means taking a benzodiazepine daily for at least three months.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n relevant 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\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":{"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":5,"scope_assessment":{"changed":false,"description":"The instrument does not broaden or narrow claimant categories; it specifies the medical and exposure criteria the Authority will treat as sufficient to raise a reasonable hypothesis connecting hyperacusis (and death from it) to relevant service. It applies to claims under the VEA and MRCA and clarifies evidentiary thresholds and definitions (see sections 4,6,8,9 and Schedule 1)."},"complexity_factors":["Numeric acoustic thresholds and measurement standards (peak ≥140 dB(C); 8-hour TWA ≥85 dB(A) with 3-dB exchange) (sections 8(1)-(2), 8(19)-(20); Schedule 1)","Multiple clinical and temporal criteria with short windows for causation or worsening (eg. 30-day and 7-day windows) (sections 8(5)-(8),(13),(16),(23)-(26),(36))","Wide range of medical conditions and procedures listed as factors (sensorineural hearing loss, acoustic shock, Meniere's, inner ear disorders, surgery, MS, etc.) (sections 8(3)-(18),(21)-(35); Schedule 1)","Interaction and cross-reference to other Statements of Principles for overlapping conditions (section 10)","Detailed technical calculation for time-weighted average exposure (TWA formula and table) in Schedule 1","Reliance on statutory \"reasonable hypothesis\" standard under VEA/MRCA and defined application scope (sections 3-4,7,9)"],"plain_english_summary":"This instrument sets the medical rules the Repatriation Medical Authority uses to decide whether hyperacusis (or death contributed to by it) can be reasonably linked to a veteran’s service. It lists objective exposure thresholds, clinical findings and time windows that, if present, raise a \"reasonable hypothesis\" for entitlement decisions. It affects veterans and serving members claiming benefits under the VEA or MRCA because it determines what medical and exposure evidence is sufficient to connect hyperacusis to service."},"kimi_summary":{"content_quality":"ok","complexity_score":5,"scope_assessment":{"changed":false,"description":"This Statement of Principles maintains its original scope as a medical determination instrument for a specific condition (hyperacusis) under the veterans' compensation scheme. It does not expand beyond its statutory purpose of establishing service connection factors for this particular auditory disorder."},"complexity_factors":["37 distinct factors with specific temporal requirements (30-day windows, 7-day windows, 6-month cumulative periods)","14 defined terms in Schedule 1, including nested definitions (acoustic shock refers to acoustic shock symptoms)","Mathematical formula for time-weighted average noise exposure with logarithmic calculation","Extensive cross-referencing to other Statements of Principles for conditions like sensorineural hearing loss, traumatic brain injury, and infections","Dual structure covering both clinical onset (factors 1-18) and clinical worsening (factors 19-37) with near-mirror provisions","Technical medical terminology requiring specialist knowledge (stapedius muscle, tensor tympani, insular cortex, perilymphatic fistula, semicircular canal dehiscence)","Acoustic measurement specifications (dB(A) vs dB(C), 3-dB exchange rates, peak vs time-weighted averages)","Conditional logic in section 9 restricting worsening claims to pre-existing conditions not arising from service"],"plain_english_summary":"This Statement of Principles sets the medical rules for deciding whether a veteran’s hyperacusis (abnormal sensitivity to everyday sounds, lasting ≥3 months) is connected to military service. It guides the Repatriation Medical Authority and DVA decision-makers and affects veterans, peacekeepers, and current/former defence members claiming compensation.\n\nConnection can be shown by one of 37 listed factors—examples include loud noise exposure, head or ear injury, certain inner‑ear disorders, infections, stroke, or benzodiazepine withdrawal—and must be related to service to grant benefits."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-hyperacusis-reasonable-hypothesis-no-27-of-2021","history":"/api/acts/statement-of-principles-concerning-hyperacusis-reasonable-hypothesis-no-27-of-2021/history","analysis":"/api/acts/statement-of-principles-concerning-hyperacusis-reasonable-hypothesis-no-27-of-2021/analysis","conflicts":"/api/acts/statement-of-principles-concerning-hyperacusis-reasonable-hypothesis-no-27-of-2021/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-hyperacusis-reasonable-hypothesis-no-27-of-2021/important-cases","documents":"/api/acts/statement-of-principles-concerning-hyperacusis-reasonable-hypothesis-no-27-of-2021/documents"}}