DECIDED BY: Marafioti; Shartal; Jago DATE: 20/02/98 ACT: WCA BOARD DIRECTIVES AND GUIDELINES: Operational Policy Manual, Document No.

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1 SUMMARY DECISION NO. 1092/97 Tinnitus; Board Directives and Guidelines (tinnitus). The worker appealed a decision of the Hearings Officer denying entitlement for tinnitus in the left ear. The worker had an accepted claim for hearing loss. There was supportive medical evidence. Board policy did not require that the tinnitus be bilateral. The appeal was allowed. [6 pages] DECIDED BY: Marafioti; Shartal; Jago DATE: 20/02/98 ACT: WCA BOARD DIRECTIVES AND GUIDELINES: Operational Policy Manual, Document No

2 WORKERS COMPENSATION APPEALS TRIBUNAL DECISION NO. 1092/97 [1] This appeal was heard in Toronto on May 22, 1997, by a Tribunal Panel consisting of: V. Marafioti: Vice-Chair, W.D. Jago : Member representative of employers, S. Shartal : Member representative of workers. THE APPEAL PROCEEDINGS [2] The worker appeals the decision of the Hearings Officer M. De Marco, dated May 8, That decision denied the worker entitlement for tinnitus and a permanent impairment award for her noiseinduced hearing loss. [3] The appeal was conducted by way of written submissions. The worker is represented by Eddy Grisolia, Office of the Worker Adviser. The employer is represented by W.F. (Bill) Madill, Manager, Human Resources, Central Region. THE EVIDENCE [4] The Panel considered the following: Exhibit #1: Case Description; Exhibit #2: Addendum #1 to the Case Description dated May 8, [5] No oral testimony was heard. Written submissions were made by the worker s representative. THE ISSUE [6] The issue for the Panel to determine is whether the worker is entitled to benefits for tinnitus. THE PANEL S REASONS (i) Background [7] The evidence in this claim clearly establishes that there was exposure to sufficient industrial noise to consider acceptance of a claim for hearing loss due to exposure to industrial noise. The Board determined that the audiograms established that the hearing loss in each ear was not sufficient to grant entitlement for a permanent disability. A report from the worker s physician Dr. P.S. Wade, regarding her ears indicates a history of complaint of tinnitus and hearing loss in the left ear since the early 1980s. The Unit Medical Adviser reviewed the documentation with regards to the tinnitus. The Adviser concluded that the medical reports indicated that the complaint of tinnitus was unilateral to the left ear only and the condition was not severe to warrant benefits.

3 Page: 2 [8] The Decision Review Specialist concluded on March 27, 1991, that the tinnitus reported by the attending physician is confined to the left ear and was not described as severe. According to the Specialist the complaint of tinnitus does not meet the requirements of bilateral, continuous, and severe and therefore entitlement was denied. The Hearings Officer concluded that upon review of Dr. Wade s report, as follows: (ii) Initial audiometric testing revealed a mild bilateral sensorineural hearing loss, associated with a noise-induced etiology, however, the degree of a hearing loss is not felt to be sufficient to warrant the granting of a permanent impairment award. Any deterioration in the hearing loss cannot be related to the worker s work exposure as [the worker] has not been exposed to hazardous noise in the employment since It is apparent the tinnitus involves solely the left ear and as Board policy suggests, the condition must be bilateral, continuous and severe. Thus, there is no basis for allowance. The law and policy [9] Entitlement criteria for pre-1990 tinnitus are set out in Board Operational Policy Document # It states that the Board accepts entitlement for occupational noise-induced tinnitus if it is the result of exposure to hazardous noise through employment in Ontario and if all the following circumstances exist: there is an accepted claim for occupational noise-induced hearing loss, and there is a clear and adequate history of two or more years of continuous and severe tinnitus, and the condition has been confirmed by a specialist with facilities for testing tinnitus. [10] The policy goes on to state that permanent disability awards for tinnitus do not usually exceed 2%, except under unusual circumstances. It concludes by advising that claims not meeting the above circumstances will be adjudicated on the real merits and justice of the case. [11] In order to determine the date of a tinnitus claim, Board Operational Policy Document # states that the accident date for tinnitus is the date of first documented evidence for severe, continuous tinnitus. Substantively, the entitlement criteria for post-1990 tinnitus claims are similar to the pre-1990 criteria. (iii) The submissions (a) The worker s submissions [12] The worker requests entitlement for her tinnitus condition as a result of noise exposure at work. The representative noted the Hearings Officer decision and the reports from Dr. Wade dated November 20, 1995, and March 4, 1996, which, he submits, indicated that the worker s tinnitus is related to noise exposure at work. The representative noted that the worker s testimony at the Board hearing was that the tinnitus was present in both ears. Mr. Grisolia, submits that according to Dr. Wade in his report of March 4, 1996, the condition does not need to be bilateral for entitlement to be established.

4 Page: 3 [13] The worker s representative noted WCB Policy Documents # and # which outlines the criteria for entitlement for tinnitus. Mr. Grisolia submits that the policy does not indicate that the worker s condition must be bilateral. [14] Mr. Grisolia notes that the WCB has accepted the worker s claim for hearing loss. The representative notes that there is a history of tinnitus going back to the early 1980s. [15] In summary, the worker s representative submits that the worker has met the requirements set out in Board policy for entitlement for her tinnitus condition. (b) The employer s submissions [16] Mr. Madill in a letter dated April 2, 1997, submits that the employer is in complete agreement with the Worker s Compensation Board s decision regarding this claim. The employer submits that any deterioration in the hearing loss cannot be related to the worker s work exposure as the worker has not been employed by this employer and not exposed to hazardous noise since In addition, the employer notes that the hearing loss is not sufficient to warrant a permanent impairment award. (iv) The Panel s conclusions [17] The claim for this worker, relevant to the issue at hand, was accepted by the WCB for noise-induced hearing loss. The record indicates that the worker was employed with this employer from 1965 through to May The medical evidence indicates that the worker suffered a hearing loss under 35 decibels in each ear, therefore the WCB awarded health care benefits only. [18] The Panel notes that the WCB allowed for the hearing loss due to hazardous noise exposure within the employment under the criteria established. The criteria indicates that the worker must have been subjected to a noise level of 90 decibels or greater for an eight hour period per day, for at least five years or the equivalent. In addition, the loss of hearing in both ears must be 25 decibels or greater, before a claim is allowed for heath care benefits. The Board has established in their criteria that if the loss of hearing is 35 decibels or greater in one ear and at least 25 decibels in the other ear, and if the pattern of hearing loss is consistent with occupational noise exposure, the claim is allowed for health care benefits plus a permanent disability award. [19] The Board policy indicates that entitlements will be extended to the worker for occupational noise-induced tinnitus when it is the result of exposure to hazardous noise through employment and when all the following circumstances are present:

5 Page: 4 (i) There is an accepted claim for occupational noise-induced hearing loss. (ii) There is a clear and adequate history of two or more years of bilateral continuous and severe tinnitus. (iii) The condition has been confirmed by a specialist with facilities for testing tinnitus. [20] A permanent disability award for tinnitus shall not exceed 2%. [21] The Hearings Officer noted that entitlement is extended for occupational noise-induced tinnitus as a result of exposure to hazardous noise in one s employment provided that there is a clear and adequate history of two or more years of bilateral continuous and severe tinnitus and the condition must be confirmed medically. [22] The Panel accepts that the worker suffers from occupationally induced hearing loss and entitlement for hearing loss due to the exposure. The Panel notes that Dr. Wade s reports beginning with that of September 5, 1989, indicates a history of complaint of tinnitus and hearing loss in the left ear since the early 1980s. [23] The Panel is satisfied that the worker s tinnitus is causally related to her industrial noise exposure with the accident employer. The Panel is satisfied that the noise exposure at work was a significant cause of the worker s tinnitus. The Panel in particular was persuaded by the supporting medical reports of Dr. Wade which essentially indicated that the worker s tinnitus is causally related to her industrial noise exposure with the accident employer. [24] Dr. Wade wrote in his letter to Dr. Hussain dated September 5, 1989, as follows:... She s also complaining of tinnitus and a hearing loss in that ear since the early 1980 s. She has worked in a factory which was very noisy from 1965 to [25] In a letter dated November 20, 1995, Dr. Wade wrote: I mentioned that since Tinnitus is often associated with noise exposure her present cause of Tinnitus is likely related to just that.... Regarding her entitlement for Tinnitus I think that it is quite conceivable that the Tinnitus that she is experiencing is related to her 20 years of noise exposure in that very noisy factory. [26] Dr. Wade wrote on March 4, 1996:... Tinnitus from noise induced hearing loss does not necessarily have to be bilateral, and in my experience is often unilateral.

6 Page: 5 THE DECISION [27] The Panel is satisfied that the worker s tinnitus is causally related to her industrial noise exposure with the accident employer and as a result, the worker is entitled to benefits. DATED: February 20, 1998 SIGNED: V. Marafioti, W.D. Jago, S. Shartal

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