{"id":"F2005B01750","name":"Statement of Principles concerning sensorineural hearing loss No. 30 of 2001","slug":"statement-of-principles-concerning-sensorineural-hearing-loss-no-30-of-2001","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"repealed","isInForce":false,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":112190,"registerId":"commonwealth-F2005B01750-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Repealed","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning sensorineural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. 30 of 2001","content":"Instrument No.30 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(3) of the Veterans’ Entitlements Act 1986 (the Act):\n\n(a) revokes Instrument No.14 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. On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that sensorineural hearing loss and death from sensorineural hearing loss can be related to relevant service rendered by veterans 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 exist before it can be said that, on the balance of probabilities, sensorineural hearing loss or death from sensorineural hearing loss is connected with the circumstances of a person’s relevant service are:\n\n(a) being exposed to an impulsive noise of at least 140 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 one year 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 140 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 one year 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 of the head 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) or 70(5)(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) eligible war service (other than operational service); or\n\n(b) defence service (other than 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 \n\nApplication\n\n9. This Instrument applies to all matters to which section 120B 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":"The instrument expressly revokes Instrument No.14 of 2001 and substitutes this Statement of Principles (cl.1). As replaced, the Statement sets specific diagnostic thresholds, enumerates detailed service‑related factors and clarifies when factors operate as material contribution or aggravation (cls 2,5,6). The text itself does not compare line‑by‑line to the revoked instrument, but by substituting a new Statement it changes the determinative framework that the Repatriation Medical Authority will apply to claims under section 120B of the Act (cl.1,9)."},"complexity_factors":["Technical medical definition and diagnostic threshold (permanent ≥25 dB loss at specified frequencies) (cl.2).","Large, detailed list of distinct causal and aggravating factors with varying time windows (e.g. 30 days, 1 year, 5 years, 18 months) (cl.5).","Two different legal tests: direct connection versus material contribution/aggravation and their conditional application (cl.6).","Complex acoustic exposure metric and calculation formula for time‑weighted average (TWA) with a 3 dB exchange rate plus a long table of exposure durations (\"TWA\" definition and table).","Specified lists (ototoxic drugs; viruses; systemic immune disorders) requiring cross‑checking of clinical records (cl.8).","Cross‑references to other Statements of Principles and to the Veterans’ Entitlements Act (application and interaction risk) (cls 7,9).","Administrative discretion: the Repatriation Medical Authority applies medical‑scientific evidence to causation decisions (cl.3)."],"plain_english_summary":"This instrument revokes Instrument No.14 of 2001 and replaces it with a Statement of Principles that defines \"sensorineural hearing loss\" (clinical threshold ≥25 dB at specified frequencies) and lists specific service‑related factors (noise exposures, ototoxic drugs, infections, trauma, surgery/radiation and others) that can establish a causal or aggravating link to relevant service (cls 1–5,8). It is the Repatriation Medical Authority’s test for deciding veterans’ entitlement claims under the Veterans’ Entitlements Act (cl.3,9). Who decides: the Authority (cl.1,3). Who benefits/pays: veterans’ claims under the Act where connection is found (cl.9)."},"kimi_summary":{"_metrics":{"model":"kimi-k2.5","source":"moonshot-realtime","completionTokens":2338},"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"The instrument maintains its original purpose of establishing medical criteria for determining liability for sensorineural hearing loss under the Veterans' Entitlements Act. While it revokes and replaces an earlier instrument (No.14 of 2001), it remains focused on the same specific disease and the same framework for connecting the condition to eligible service."},"complexity_factors":["42 separate factual factors listed (21 for clinical onset and 21 for clinical worsening) across subsections 5(a) to 5(zu)","20+ defined terms including technical medical conditions (e.g., 'suppurative labyrinthitis', 'perilymph fistula'), pharmacological agents, and specialized noise measurement terminology","Mathematical formulae for calculating time-weighted average (TWA) noise exposure with 3-dB exchange rate","Complex conditional logic in clause 6 restricting application of worsening factors to material contribution/aggravation scenarios only","Cross-references to ICD-10-AM medical classification codes and other Statements of Principles","Detailed noise exposure duration table containing 40+ data points mapping decibel levels to maximum exposure times in hours, minutes and seconds"],"plain_english_summary":"This Statement of Principles sets the medical rules for when Australian veterans and Defence Force members with eligible service can get compensation for sensorineural hearing loss (≥25 dB). It requires that at least one listed service‑related factor—examples include loud impulse or prolonged noise exposure, certain ear diseases, head trauma, ototoxic drugs, radiation, surgery, barotrauma, or meningitis—be more likely than not connected to the condition.\n\nIt covers both clinical onset and service‑related worsening and includes technical definitions and noise‑exposure calculations."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-30-of-2001","history":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-30-of-2001/history","analysis":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-30-of-2001/analysis","conflicts":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-30-of-2001/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-30-of-2001/important-cases","documents":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-30-of-2001/documents"}}