{"id":"F2010L03252","name":"Statement of Principles concerning sensorineural hearing loss No. 5 of 2011","slug":"statement-of-principles-concerning-sensorineural-hearing-loss-no-5-of-2011","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"repealed","isInForce":false,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":85476,"registerId":"commonwealth-F2010L03252-current","compilationNumber":null,"startDate":"2026-04-02","status":"Repealed","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning sensorineural hearing loss No. 5 of 2011","content":"Statement of Principles\n\nconcerning\n\nSENSORINEURAL HEARING LOSS\n\nNo. 5 of 2011\n\nfor the purposes of the\n\nVeterans’ Entitlements Act 1986\n\nand\n\nMilitary Rehabilitation and Compensation Act 2004\n\nTitle\n\n1. This Instrument may be cited as Statement of Principles concerning sensorineural hearing loss No. 5 of 2011.\n\nDetermination\n\n2. The Repatriation Medical Authority under subsection 196B(2) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):\n\n(a) revokes Instrument No. 29 of 2001 concerning sensorineural hearing loss; and\n\n(b) determines in its place this Statement of Principles.\n\nKind of injury, disease or death\n\n3. (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 shift to a hearing threshold level of 25 decibels (dB) or more, at 500, 1000, 1500, 2000, 3000, 4000 or 6000 hertz (Hz), due to a defect in the cochlea or the auditory nerve, but excluding congenital deafness.\n\nBasis for determining the factors\n\n4. 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 under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).\n\nFactors that must be related to service\n\n5. Subject to clause 7, at least one of the factors set out in clause 6 must be related to the relevant service rendered by the person.\n\nFactors\n\n6. The factor 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 is:\n\n(a) being exposed to a peak sound pressure level at the tympanic membrane of at least 140 dB(C), before the clinical onset of sensorineural hearing loss; or\n\n(b) 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 sensorineural hearing loss; or\n\n(c) experiencing otitic barotrauma involving the affected side, or decompression sickness, within the 30 days before the clinical onset of sensorineural hearing loss; or\n\n(d) undergoing a course of treatment with a drug or a drug from a class of drugs from the specified list within the one year before the clinical onset of sensorineural hearing loss; or\n\n(e) receiving a specified ototopical medication directly into the inner ear, in the presence of tympanic membrane perforation, before the clinical onset of sensorineural hearing loss; or\n\n(f) taking aspirin, paracetamol or a nonsteroidal anti-inflammatory drug more than twice per week, for at least the one year before the clinical onset of sensorineural hearing loss; or\n\n(g) having suppurative labyrinthitis of the affected ear within the 30 days before the clinical onset of sensorineural hearing loss; or\n\n(h) having chronic suppurative otitis media on the affected side before the clinical onset of sensorineural hearing loss; or\n\n(i) having an acute viral infection from the specified list of viruses within the 30 days before the clinical onset of sensorineural hearing loss; or\n\n(j) having meningitis within the 12 months before the clinical onset of sensorineural hearing loss; or\n\n(k) having neurosyphilis before the clinical onset of sensorineural hearing loss; or\n\n(l) having tuberculosis involving the temporal bone on the affected side before the clinical onset of sensorineural hearing loss; or\n\n(m) having diphtheria before the clinical onset of sensorineural hearing loss; or\n\n(n) having leprosy before the clinical onset of sensorineural hearing loss; or\n\n(o) having Meniere’s disease at the time of the clinical onset of sensorineural hearing loss; or\n\n(p) having Paget’s disease of bone, affecting the petrous temporal bone or middle ear ossicles, at the time of the clinical onset of sensorineural hearing loss; or\n\n(q) having a specified autoimmune disorder at the time of the clinical onset of sensorineural hearing loss; or\n\n(r) having multiple sclerosis at the time of the clinical onset of sensorineural hearing loss; or\n\n(s) having diabetes mellitus at the time of the clinical onset of sensorineural hearing loss; or\n\n(t) having a hyperviscosity syndrome for at least the 30 days before the clinical onset of sensorineural hearing loss; or\n\n(u) having a lesion interrupting the supply of blood to the cochlea of the affected ear at the time of the clinical onset of sensorineural hearing loss; or\n\n(v) having structural injury or physiological disruption to the inner ear or the auditory nerve as a result of blunt trauma, penetrating trauma or surgery, within the five years before the clinical onset of sensorineural hearing loss; or\n\n(w) having a neoplasm that involves the auditory nerve or the inner ear at the time of the clinical onset of sensorineural hearing loss; or\n\n(x) undergoing a course of therapeutic radiation to the head or neck region within the 18 months before the clinical onset of sensorineural hearing loss; or\n\n(y) inhaling, ingesting or having cutaneous contact with a specified organic solvent, on more days than not for a continuous period of at least four years before the clinical onset of sensorineural hearing loss, and where that exposure has ceased, the clinical onset of sensorineural hearing loss occurred within two years after cessation; or\n\n(z) inhaling, ingesting or having cutaneous contact with lead or emissions containing lead, for a cumulative period of at least 7000 hours, before the clinical onset of sensorineural hearing loss, and where that exposure has ceased, the clinical onset of sensorineural hearing loss occurred within two years after cessation; or\n\n(aa) smoking at least 20 pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of sensorineural hearing loss, and where smoking has ceased, the clinical onset of sensorineural hearing loss has occurred within five years after cessation; or\n\n(bb) consuming an average of at least 100 grams of alcohol per day for at least the four years before the clinical onset of sensorineural hearing loss; or\n\n(cc) being vaccinated with the measles-mumps vaccine within the 90 days before the clinical onset of sensorineural hearing loss; or\n\n(dd) being exposed to a peak sound pressure level at the tympanic membrane of at least 140 dB(C), before the clinical worsening of sensorineural hearing loss; or\n\n(ee) 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 sensorineural hearing loss; or\n\n(ff) experiencing otitic barotrauma involving the affected side, or decompression sickness, within the 30 days before the clinical worsening of sensorineural hearing loss; or\n\n(gg) undergoing a course of treatment with a drug or a drug from a class of drugs from the specified list within the one year before the clinical worsening of sensorineural hearing loss; or\n\n(hh) receiving a specified ototopical medication directly into the inner ear, in the presence of tympanic membrane perforation, before the clinical worsening of sensorineural hearing loss; or\n\n(ii) taking aspirin, paracetamol or a nonsteroidal anti-inflammatory drug more than twice per week, for at least the one year before the clinical worsening of sensorineural hearing loss; or\n\n(jj) having suppurative labyrinthitis of the affected ear within the 30 days before the clinical worsening of sensorineural hearing loss; or\n\n(kk) having chronic suppurative otitis media on the affected side before the clinical worsening of sensorineural hearing loss; or\n\n(ll) having an acute viral infection from the specified list of viruses within the 30 days before the clinical worsening of sensorineural hearing loss; or\n\n(mm) having meningitis within the 12 months before the clinical worsening of sensorineural hearing loss; or\n\n(nn) having neurosyphilis before the clinical worsening of sensorineural hearing loss; or\n\n(oo) having tuberculosis involving the temporal bone on the affected side before the clinical worsening of sensorineural hearing loss; or\n\n(pp) having diphtheria before the clinical worsening of sensorineural hearing loss; or\n\n(qq) having leprosy before the clinical worsening of sensorineural hearing loss; or\n\n(rr) having Meniere’s disease at the time of the clinical worsening of sensorineural hearing loss; or\n\n(ss) having Paget’s disease of bone, affecting the petrous temporal bone or middle ear ossicles, at the time of the clinical worsening of sensorineural hearing loss; or\n\n(tt) having a specified autoimmune disorder at the time of the clinical worsening of sensorineural hearing loss; or\n\n(uu) having multiple sclerosis at the time of the clinical worsening of sensorineural hearing loss; or\n\n(vv) having diabetes mellitus at the time of the clinical worsening of sensorineural hearing loss; or\n\n(ww) having a hyperviscosity syndrome for at least the 30 days before the clinical worsening of sensorineural hearing loss; or\n\n(xx) having a lesion interrupting the supply of blood to the cochlea of the affected ear at the time of the clinical worsening of sensorineural hearing loss; or\n\n(yy) having structural injury or physiological disruption to the inner ear or the auditory nerve as a result of blunt trauma, penetrating trauma or surgery, within the five years before the clinical worsening of sensorineural hearing loss; or\n\n(zz) having a neoplasm that involves the auditory nerve or the inner ear at the time of the clinical worsening of sensorineural hearing loss; or\n\n(aaa) undergoing a course of therapeutic radiation to the head or neck region within the 18 months before the clinical worsening of sensorineural hearing loss; or\n\n(bbb) inhaling, ingesting or having cutaneous contact with a specified organic solvent, on more days than not for a continuous period of at least four years before the clinical worsening of sensorineural hearing loss, and where that exposure has ceased, the clinical worsening of sensorineural hearing loss occurred within two years after cessation; or\n\n(ccc) inhaling, ingesting or having cutaneous contact with lead or emissions containing lead, for a cumulative period of at least 7000 hours, before the clinical worsening of sensorineural hearing loss, and where that exposure has ceased, the clinical worsening of sensorineural hearing loss occurred within two years after cessation; or\n\n(ddd) smoking at least 20 pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical worsening of sensorineural hearing loss, and where smoking has ceased, the clinical worsening of sensorineural hearing loss has occurred within five years after cessation; or\n\n(eee) consuming an average of at least 100 grams of alcohol per day for at least the four years before the clinical worsening of sensorineural hearing loss; or\n\n(fff) being vaccinated with the measles-mumps vaccine within the 90 days before the clinical worsening of sensorineural hearing loss; or\n\n(ggg) inability to obtain appropriate clinical management for sensorineural hearing loss.\n\n \nFactors that apply only to material contribution or aggravation\n\n7. Paragraphs 6(dd) to 6(ggg) 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.\n\nInclusion of Statements of Principles\n\n8. 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 as in force from time to time.\n\nOther definitions\n\n9. 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\"a drug or a drug from a class of drugs from the specified list\" means:\n\n(a) \\-difluoromethylornithine (eflornithine);\n\n(b) aminoglycoside antibiotics;\n\n(c) antineoplastic agents as specified;\n\n(d) carbamazepine;\n\n(e) loop diuretics;\n\n(f) macrolide antibiotics;\n\n(g) phosphodiesterase 5 inhibitors, including sildenafil (Viagra); or\n\n(h) quinine derivatives;\n\n\"a hyperviscosity syndrome\" means a disorder causing an increased viscosity of the blood, including leukaemia, polycythaemia or macroglobulinaemia;\n\n\"a specified autoimmune disorder\" means one of the following:\n\n(a) Behçet’s syndrome;\n\n(b) Cogan’s syndrome;\n\n(c) immune thrombocytopaenic purpura;\n\n(d) inflammatory myopathies, e.g., dermatomyositis, polymyositis, inclusion-body myositis;\n\n(e) microscopic polyangiitis;\n\n(f) polyarteritis nodosa;\n\n(g) relapsing polychondritis;\n\n(h) rheumatoid arthritis;\n\n(i) Sjogren’s syndrome;\n\n(j) Susac’s syndrome;\n\n(k) systemic lupus erythematosus;\n\n(l) systemic sclerosis (scleroderma); or\n\n(m) Wegener’s granulomatosis;\n\n\"a specified ototopical medication\" means ear drops containing agents from the following list:\n\n(a) acetic acid;\n\n(b) chloramphenicol;\n\n(c) chlorhexidine;\n\n(d) chloromycetin;\n\n(e) cresylate;\n\n(f) ethanol;\n\n(g) gentian violet;\n\n(h) povidone iodine; or\n\n(i) salicylates;\n\n\"a specified organic solvent\" means:\n\n(a) allyl benzene;\n\n(b) α-methylstyrene;\n\n(c) carbon disulphide;\n\n(d) dimethylacetamide;\n\n(e) ethyl benzene;\n\n(f) naphthalene;\n\n(g) n\\-hexane;\n\n(h) n\\-propylbenzene;\n\n(i) p\\-xylene;\n\n(j) styrene;\n\n(k) toluene;\n\n(l) trichloroethylene; or\n\n(m) trans-β-methylstyrene;\n\n\"alcohol\" is measured by the alcohol consumption calculations utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink;\n\n\"antineoplastic agents as specified\" means:\n\n(a) carboplatin;\n\n(b) cisplatin;\n\n(c) daunorubicin derivatives;\n\n(d) erlotinib;\n\n(e) 5-flourouracil (5-FU);\n\n(f) fotemustine;\n\n(g) imatinib;\n\n(h) misonidazole;\n\n(i) nitrogen mustard compounds;\n\n(j) oxaliplatin; or\n\n(k) vinca alkaloids, including vinblastine or vincristine;\n\n\"chronic suppurative otitis media\" means a recurrent or continuous infective disorder of the middle ear characterised by perforation of the tympanic membrane and aural discharge;\n\n\"dB(A)\" means A-weighted sound pressure level in decibels, where\n\nA-weighting is a standardised frequency response used in sound measuring instruments;\n\n\"dB(C)\" means C-weighted sound pressure level in decibels, where\n\nC-weighting is a standardised frequency response used in sound measuring instruments;\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\"meningitis\" means inflammation of the lining of the brain, which may be of bacterial, viral, fungal or parasitic origin;\n\n\"neurosyphilis\" means inflammation of the central nervous system as a manifestation of syphilis;\n\n\"pack-years of cigarettes, or the equivalent thereof in other tobacco products\" means a calculation of consumption where one pack-year of cigarettes equals twenty tailor-made cigarettes per day for a period of one calendar year, or 7300 cigarettes. One tailor-made cigarette approximates one gram of tobacco or one gram of cigar or pipe tobacco by weight. One pack-year of tailor-made cigarettes equates to 7300 cigarettes, or 7.3 kilograms of smoking tobacco by weight. Tobacco products means either cigarettes, pipe tobacco or cigars smoked, alone or in any combination;\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) warlike service under the MRCA; or\n\n(e) non-warlike service under the MRCA;\n\n\"specified list of viruses\" means:\n\n(a) measles virus;\n\n(b) mumps virus; or\n\n(c) varicella-zoster virus;\n\n \n\"suppurative labyrinthitis\" means inflammation of the inner ear characterised by the presence of pus;\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\"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\n \n\nTable of noise exposure levels and\n\ndurations based on 3-dB(A) exchange rate\n\n```html\n

Duration, T

Duration, T

Exposure

Level, L

(dB(A))

Hours

Minutes

Seconds

Exposure

Level, L

(dB(A))

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\nApplication\n\n10. This Instrument applies to all matters to which section 120A of the VEA or section 338 of the MRCA applies.\n\n \nDate of effect\n\n11. This Instrument takes effect from 5 January 2011.\n\nDated this fourteenth day of December 2010\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\nCHAIRPERSON","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":7,"scope_assessment":{"changed":false,"description":"This Instrument expressly revokes Instrument No. 29 of 2001 and replaces it (clause 2) but, on its face, applies to the same statutory hooks — matters under section 120A of the VEA and section 338 of the MRCA (clause 10). The text does not itself identify any expansion or contraction of the statutory scope; any substantive comparison with the revoked instrument cannot be made from this document alone."},"complexity_factors":["Extensive list of alternative causation and aggravation factors spanning (clause 6(a)–6(ggg)), creating many discrete pathways to entitlement.","Technical acoustic metrics and calculation method (definitions and TWA formula; noise exposure table) requiring specialist interpretation.","Multiple precise temporal windows and exposure-duration requirements (e.g. 30 days, 12 months, 4 years, 7000 cumulative hours) across different factors.","Detailed defined-term lists (drugs, organic solvents, autoimmune disorders, ototopical medications, antineoplastic agents) in clause 9.","Distinction between factors that establish initial causation and those limited to material contribution/aggravation (clause 7).","Cross-reference mechanism to other Statements of Principles (clause 8) that can import further technical criteria.","Legal cross-links to two statutes (application to matters under s120A VEA and s338 MRCA) requiring procedural integration (clause 10)."],"plain_english_summary":"This Instrument sets the medical criteria the Repatriation Medical Authority uses to decide whether sensorineural hearing loss (and death from it) can be connected to a person’s military service under the VEA and MRCA. It prescribes objective thresholds (noise levels/durations), medical conditions, drugs, toxic exposures and time‑windows that, if present before onset or worsening, raise a reasonable hypothesis of service connection. It affects veterans, current and former service members, medical assessors and claims administrators."},"kimi_summary":{"_metrics":{"model":"kimi-k2.5","source":"moonshot-realtime","completionTokens":2192},"content_quality":"ok","complexity_score":7,"scope_assessment":{"changed":false,"description":"This instrument updates and replaces Instrument No. 29 of 2001 concerning the same medical condition. While the specific scientific factors and exposure thresholds have been revised based on contemporary medical evidence, the scope remains strictly limited to establishing criteria for determining service-relatedness of sensorineural hearing loss under veterans' compensation legislation."},"complexity_factors":["Bifurcated structure with parallel lists for 'clinical onset' (factors a-cc) versus 'clinical worsening' (factors dd-ggg)","Mathematical logarithmic formula for calculating time-weighted average (TWA) noise exposure with 3-dB exchange rate","Detailed lookup table correlating 40+ decibel exposure levels (80-140 dB) to precise maximum safe durations in hours, minutes, and seconds","27 defined terms including complex calculations like 'pack-years' (7300 cigarettes = 7.3kg tobacco) and specific drug classifications","Conditional limitation in clause 7 restricting factors (dd) to (ggg) to material contribution/aggravation cases only","Incorporation by reference of other Statements of Principles (clause 8) creating nested cross-referencing requirements","Highly technical medical terminology (e.g., 'suppurative labyrinthitis', 'hyperviscosity syndrome', 'ototopical medication', 'neurosyphilis')"],"plain_english_summary":"This Statement of Principles by the Repatriation Medical Authority sets the medical criteria used to decide if Australian veterans or Defence members can get compensation for sensorineural hearing loss. A claimant must raise a “reasonable hypothesis” that one or more listed service-related factors (noise, trauma, disease/infection, chemicals, medications, or heavy smoking/alcohol) caused onset or worsening of their hearing loss. It replaces the 2001 instrument and applies to claims under the VEA and MRCA."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-5-of-2011","history":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-5-of-2011/history","analysis":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-5-of-2011/analysis","conflicts":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-5-of-2011/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-5-of-2011/important-cases","documents":"/api/acts/statement-of-principles-concerning-sensorineural-hearing-loss-no-5-of-2011/documents"}}