{"id":"F2005B01749","name":"Statement of Principles concerning sensorineural hearing loss No. 29 of 2001","slug":"statement-of-principles-concerning-sensorineural-hearing-loss-no-29-of-2001","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"repealed","isInForce":false,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":112188,"registerId":"commonwealth-F2005B01749-current","compilationNumber":null,"startDate":"2026-04-03","status":"Repealed","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning sensorineural hearing loss No. 29 of 2001","content":"Instrument No.29 of 2001\n\nRevocation and Determination\n\nof\n\nStatement of Principles\n\nconcerning\n\nSENSORINEURAL HEARING LOSS\n\nICD-10-AM CODES: H90.3, H90.4, H90.5\n\nVeterans’ Entitlements Act 1986\n\n1. The Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act):\n\n(a) revokes Instrument No.13 of 2001; and\n\n(b) determines in its place the following Statement of Principles.\n\nKind of injury, disease or death\n\n2. (a) This Statement of Principles is about sensorineural hearing loss and death from sensorineural hearing loss.\n\n(b) For the purposes of this Statement of Principles, “sensorineural hearing loss” means a permanent hearing threshold shift of 25 decibels (dB) or more, at 500, 1000, 1500, 2000, 3000 or 4000 hertz (Hz) due to a defect in the cochlea or the auditory nerve, attracting ICD-10-AM code H90.3, H90.4 or H90.5, but excluding congenital deafness.\n\nBasis for determining the factors\n\n3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that sensorineural hearing loss and death from sensorineural hearing loss can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces.\n\nFactors that must be related to service\n\n4. Subject to clause 6, at least one of the factors set out in clause 5 must be related to any relevant service rendered by the person.\n\nFactors\n\n5. The factors that 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 are:\n\n(a) being exposed to an impulsive noise of at least 130 dBA without adequate ear protection before the clinical onset of sensorineural hearing loss; or\n\n(b) being exposed to noise of at least 85 dBA as an 8-hour time-weighted average (TWA) with a 3‑dB exchange rate without adequate ear protection for a cumulative period of at least 180 days before the clinical onset of sensorineural hearing loss; or\n\n(c) undergoing a course of treatment with an ototoxic drug from the specified list within the year immediately before the clinical onset of sensorineural hearing loss; or\n\n(d) undergoing a course of salicylate or quinine derivatives, for a condition for which the drug cannot be ceased or substituted, at the time of the clinical onset of sensorineural hearing loss; or\n\n(e) suffering from suppurative labyrinthitis of the affected ear within the 30 days immediately before the clinical onset of sensorineural hearing loss; or\n\n(f) suffering from chronic suppurative otitis media on the affected side before the clinical onset of sensorineural hearing loss; or\n\n(g) suffering from Meniere’s disease at the time of the clinical onset of sensorineural hearing loss; or\n\n(h) suffering from a systemic immune mediated disorder at the time of the clinical onset of sensorineural hearing loss; or\n\n(j) suffering from leprosy with audiovestibular involvement of the affected ear before the clinical onset of sensorineural hearing loss; or\n\n(k) suffering from an acute vascular lesion involving the arteries supplying the cochlea of the affected ear at the time of the clinical onset of sensorineural hearing loss; or\n\n(m) suffering from a hyperviscosity syndrome within the 30 days immediately before the clinical onset of sensorineural hearing loss; or\n\n(n) suffering from an acute viral infection from the specified list of viruses within the 30 days immediately before the clinical onset of sensorineural hearing loss; or\n\n(o) suffering from bacterial meningitis before the clinical onset of sensorineural hearing loss; or\n\n(p) suffering from neurosyphilis before the clinical onset of sensorineural hearing loss; or\n\n(q) suffering from tuberculosis involving the temporal bone on the affected side before the clinical onset of sensorineural hearing loss; or\n\n(r) suffering from Paget’s disease of the skull at the time of the clinical onset of sensorineural hearing loss; or\n\n(s) suffering a head trauma causing:\n\n(i) ruptured ear drum of the affected ear,\n\n(ii) a perilymph fistula of the affected ear,\n\n(iii) fracture of the temporal bone of the affected side, or\n\n(iv) concussion\n\nwithin the five years immediately before the clinical onset of sensorineural hearing loss; or\n\n(t) suffering at least one episode of otitic barotrauma within the 30 days immediately before the clinical onset of sensorineural hearing loss; or\n\n(u) suffering from a neoplasm affecting the auditory apparatus on the affected side at the time of the clinical onset of sensorineural hearing loss; or\n\n(v) undergoing a course of therapeutic radiation to the head or neck region within the 18 months immediately before the clinical onset of sensorineural hearing loss; or\n\n(w) undergoing surgery to the middle ear, inner ear or posterior cranial fossa on the affected side before the clinical onset of sensorineural hearing loss; or\n\n(x) being exposed to an impulsive noise of at least 130 dBA without adequate ear protection before the clinical worsening of sensorineural hearing loss; or\n\n(y) being exposed to noise of at least 85 dBA as an 8-hr time-weighted average (TWA) with a 3‑dB exchange rate without adequate ear protection for a cumulative period of at least 180 days before the clinical worsening of sensorineural hearing loss; or\n\n(z) undergoing a course of treatment with an ototoxic drug from the specified list within the year immediately before the clinical worsening of sensorineural hearing loss; or\n\n(za) undergoing a course of salicylate or quinine derivatives, for a condition for which the drug cannot be ceased or substituted, at the time of the clinical worsening of sensorineural hearing loss; or\n\n(zb) suffering from suppurative labyrinthitis of the affected ear within the 30 days immediately before the clinical worsening of sensorineural hearing loss; or\n\n(zc) suffering from chronic suppurative otitis media on the affected side before the clinical worsening of sensorineural hearing loss; or\n\n(zd) suffering from Meniere’s disease at the time of the clinical worsening of sensorineural hearing loss; or\n\n(ze) suffering from a systemic immune mediated disorder at the time of the clinical worsening of sensorineural hearing loss; or\n\n(zf) suffering from leprosy with audiovestibular involvement of the affected ear before the clinical worsening of sensorineural hearing loss; or\n\n(zg) suffering from an acute vascular lesion involving the arteries supplying the cochlea of the affected ear at the time of the clinical worsening of sensorineural hearing loss; or\n\n(zh) suffering from a hyperviscosity syndrome within the 30 days immediately before the clinical worsening of sensorineural hearing loss; or\n\n(zj) suffering from an acute viral infection from the specified list of viruses within the 30 days immediately before the clinical worsening of sensorineural hearing loss; or\n\n(zk) suffering from bacterial meningitis before the clinical worsening of sensorineural hearing loss; or\n\n(zm) suffering from neurosyphilis before the clinical worsening of sensorineural hearing loss; or\n\n(zn) suffering from tuberculosis involving the temporal bone on the affected side before the clinical worsening of sensorineural hearing loss; or\n\n(zo) suffering from Paget’s disease of the skull at the time of the clinical worsening of sensorineural hearing loss; or\n\n(zp) suffering a head trauma causing:\n\n(i) ruptured ear drum of the affected ear,\n\n(ii) a perilymph fistula of the affected ear,\n\n(iii) fracture of the temporal bone of the affected side, or\n\n(iv) concussion\n\nwithin the five years immediately before the clinical worsening\n\nof sensorineural hearing loss; or\n\n(zq) suffering at least one episode of otitic barotrauma within the 30 days immediately before the clinical worsening of sensorineural hearing loss; or\n\n(zr) suffering from a neoplasm affecting the auditory apparatus on the affected side at the time of the clinical worsening of sensorineural hearing loss; or\n\n(zs) undergoing a course of therapeutic radiation to the head or neck region within the 18 months immediately before the clinical worsening of sensorineural hearing loss; or\n\n(zt) undergoing surgery to the middle ear, inner ear or posterior cranial fossa on the affected side before the clinical worsening of sensorineural hearing loss; or\n\n(zu) inability to obtain appropriate clinical management for sensorineural hearing loss.\n\nFactors that apply only to material contribution or aggravation\n\n6. Paragraphs 5(x) to 5(zu) apply only to material contribution to, or aggravation of, sensorineural hearing loss where the person’s sensorineural hearing loss was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70(5A)(d) of the Act refers.\n\nInclusion of Statements of Principles\n\n7. In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles.\n\nOther definitions\n\n8. For the purposes of this Statement of Principles:\n\n“a course of therapeutic radiation” means one or more fractions (treatment portions) of ionising radiation administered with the aim of achieving palliation or cure with gamma rays, x-rays, alpha particles or beta particles;\n\n“adequate ear protection” means a device which plugs the outer ear canal or which covers the outside of the ear so as to protect the wearer from harmful noise;\n\n“an ototoxic drug from the specified list” means one of the following:\n\n(a) \\-difluromethylornithine;\n\n(b) 6-amino nicotinamide;\n\n(c) Amikacin;\n\n(d) Bumetanide;\n\n(e) Cisplatin;\n\n(f) Erythromycin;\n\n(g) Ethacrynic acid;\n\n(h) Frusemide;\n\n(i) Gentamicin;\n\n(j) Kanamycin;\n\n(k) Misonidazole;\n\n(l) Neomycin;\n\n(m) Netilmicin;\n\n(n) Nitrogen Mustard;\n\n(o) Streptomycin;\n\n(p) Tobramycin;\n\n(q) Vancomycin;\n\n(r) Vinblastine;\n\n(s) Vincristine; or\n\n(t) Viomycin;\n\n“bacterial meningitis” means inflammation of the lining of the brain and spinal cord caused by bacteria;\n\n“chronic suppurative otitis media” means a recurrent or continuous infective disorder of the middle ear characterised by perforation of the tympanic membrane, aural discharge and hearing loss;\n\n“death from sensorineural hearing loss” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s sensorineural hearing loss;\n\n“hyperviscosity syndrome” means a disorder causing an increased viscosity of the blood;\n\n“ICD-10-AM code” means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), Second Edition, effective date of 1 July 2000, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 271 3;\n\n“impulsive noise” means noise which is characterised by a sharp rise and a rapid decay in sound levels and is less than one second in duration;\n\n“Meniere’s disease” means a clinical condition characterised by fluctuating hearing loss, tinnitus, a sense of fullness in the involved ear associated with recurring attacks of rotational vertigo of sudden onset, often associated with nausea and vomiting;\n\n“neoplasm affecting the auditory apparatus” means a primary or secondary neoplasm of the auditory nerve, inner ear, temporal bone, cerebellopontine angle or posterior cranial fossa;\n\n“Paget’s disease of the skull” (otherwise known as osteitis deformans) means a disease of bone marked by repeated episodes of bone resorption and new bone formation resulting in weakened deformed bones of increased mass of the skull;\n\n“perilymph fistula” means a leakage of perilymph fluid into the middle ear space from the inner ear due to the rupture of the membrane between the middle and inner ear at the oval or round window;\n\n“relevant service” means:\n\n(a) operational service; or\n\n(b) peacekeeping service; or\n\n(c) hazardous service;\n\n“specified list of viruses” means:\n\n(a) mumps virus;\n\n(b) measles virus;\n\n(c) rubella virus;\n\n(d) pertussis virus; or\n\n(e) varicella-zoster virus;\n\n“suppurative labyrinthitis” means inflammation of the labyrinth characterised by the presence of pus;\n\n“systemic immune mediated disorder” means one of the following:\n\n(a) Behçet’s syndrome;\n\n(b) Cogan’s syndrome;\n\n(c) periarteritis nodosa;\n\n(d) systemic lupus erythematosus; or\n\n(e) Wegener’s granulomatosis;\n\n“terminal event” means the proximate or ultimate cause of death and includes:\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“tuberculosis involving the temporal bone” means infection of the temporal bone with Mycobacterium tuberculosis;\n\n \n“time-weighted average (TWA) with 3‑dB exchange rate” means the time-weighted average noise exposure level calculated according to the following formulae and shown in the table:\n\nTWA = 10.0 x Log(D/100) + 85\n\nwhere D = daily dose; and\n\nD = \\[ C1/T1 + C2/T2 + …..+ Cn/Tn\\] x 100\n\nwhere Cn = total time of exposure at a specified noise level,\n\nTn = exposure duration for which noise at this level becomes hazardous\n\nTable of noise exposure levels and\n\ndurations based on 3-dBA exchange rate\n\n```html\n

Duration, T

Duration, T

Exposure

Level, L

(dBA)

Hours

Minutes

Seconds

Exposure

Level, L

(dBA)

Hours

Minutes

Seconds

80

25

24

106

3

45

81

20

10

107

2

59

82

16

108

2

22

83

12

42

109

1

53

84

10

5

110

1

29

85

8

111

1

11

86

6

21

112

56

87

5

2

113

45

88

4

114

35

89

3

10

115

28

90

2

31

116

22

91

2

117

18

92

1

35

118

14

93

1

16

119

11

94

1

120

9

95

47

37

121

7

96

37

48

122

6

97

30

123

4

98

23

49

124

3

99

18

59

125

3

100

15

126

2

101

11

54

127

1

102

9

27

128

1

103

7

30

129

1

104

5

57

130-140

<1

105

4

43

\n```\n\nSource: National Institute of Occupational Safety and Health 1998 Guidelines\n\nPublication No. 98-126\n\n \nApplication\n\n9. This Instrument applies to all matters to which section 120A of the Act applies.\n\nDated this Twenty-fourth day of May 2001\n\nThe Common Seal of the )\n\nRepatriation Medical Authority )\n\nwas affixed to this instrument )\n\nin the presence of: )\n\nKEN DONALD\n\nCHAIRMAN","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument expressly revokes Instrument No.13 of 2001 and replaces it with the new Statement of Principles (clause 1). It continues to apply to matters under s120A of the Veterans’ Entitlements Act (clause 9) but alters substantive content: it sets a specific audiometric definition (clause 2), updates and enumerates causal and aggravating factors with specified temporal limits (clause 5), and introduces interaction rules for pre‑existing conditions and other Statements (clauses 6–7)."},"complexity_factors":["Replacement of a prior instrument and formal application to s120A matters (clauses 1 and 9) creates administrative transition work.","Detailed medical definition with a quantitative threshold (permanent ≥25 dB shift at specified frequencies) and ICD‑10‑AM codes (clause 2) requires audiological evidence.","Long list of discrete causal and aggravating factors (clause 5) including noise, drugs, infections, trauma, surgery, neoplasms and systemic disorders increases factual complexity.","Different temporal windows for different factors (eg. within 30 days, 12 months, 18 months, 5 years) create multiple evidentiary timing rules (clause 5).","Separate regime for material contribution/aggravation where the condition pre‑exists service (clause 6) adds a conditional legal test and cross‑references to the Act.","Prescribed lists (ototoxic drugs, specified viruses, systemic immune disorders) and cross‑application of other Statements of Principles create layered dependency on external lists and other Determinations (clause 8; clause 7).","Technical noise‑exposure criteria including an impulsive 130 dBA threshold and an 8‑hour TWA calculation with a 3 dB exchange rate plus an extensive duration table require occupational‑noise measurement or reconstructive evidence (clause 5; definition of TWA in clause 8).","Definitions that require interpretation (eg. 'adequate ear protection', 'course of therapeutic radiation', 'terminal event') create room for administrative judgement and case‑by‑case medical assessment (clause 8).","The Repatriation Medical Authority’s statement that sound medical‑scientific evidence underpins the Determination (clause 3) signals evaluative discretion in applying the factors to individual claims."],"plain_english_summary":"This Determination (revoking Instrument No.13 of 2001) replaces the Statement of Principles for sensorineural hearing loss. It defines the medical threshold for the condition, excludes congenital deafness, and sets the specific service‑related factors and time limits that—if linked to a veteran’s relevant service—will raise a reasonable hypothesis that the hearing loss (or death from it) is connected to service. It applies to veterans, peacekeeping personnel and members of the Forces and governs assessment of claims under s120A of the Veterans’ Entitlements Act."},"kimi_summary":{"_metrics":{"model":"kimi-k2.5","source":"moonshot-realtime","completionTokens":2452},"content_quality":"ok","complexity_score":7,"scope_assessment":{"changed":false,"description":"The instrument maintains its original scope as a medical determination for veterans' compensation. It replaces Instrument No. 13 of 2001 with updated criteria but does not expand beyond establishing causation factors for sensorineural hearing loss in defence force personnel."},"complexity_factors":["21 separate causal factors for clinical onset and 22 for clinical worsening, each with specific timing windows (e.g., 'within 30 days', 'within 5 years')","Specialist medical terminology requiring clinical expertise (e.g., 'suppurative labyrinthitis', 'ototoxic drugs', 'perilymph fistula', 'hyperviscosity syndrome')","Mathematical logarithmic formula for calculating time-weighted average (TWA) noise exposure using 3-dB exchange rate","Extensive reference table with 50+ rows mapping noise levels (80–140 dBA) to maximum safe exposure durations in hours, minutes and seconds","15+ defined terms including specific lists of 20 ototoxic medications and 5 specified viruses","Cross-reference mechanism in clause 7 linking to other Statements of Principles for secondary conditions","Technical acoustic definitions distinguishing 'impulsive noise' (short, sharp sounds) from continuous noise exposure"],"plain_english_summary":"This law sets medical criteria for Australian veterans, peacekeepers and defence members to get compensation for sensorineural hearing loss (permanent inner-ear or nerve damage). It defines qualifying hearing loss levels and requires proof that service caused or materially worsened the condition — by specific factors such as high or prolonged noise exposure, ototoxic treatments, infections, head trauma, barotrauma or similar service-related events. It covers both onset during service and significant post‑service worsening."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-29-of-2001","history":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-29-of-2001/history","analysis":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-29-of-2001/analysis","conflicts":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-29-of-2001/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-29-of-2001/important-cases","documents":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-29-of-2001/documents"}}