Hearing injury claim
Hearing loss after a motor accident
A side-window impact, airbag deployment, skull or temporal-bone trauma, or a sudden pressure event can damage the outer, middle or inner ear. The CTP assessment is not based on how loud sounds seem subjectively. It uses permanent binaural hearing impairment measured under the Motor Accident Guidelines and then converted to whole person impairment.
Accident mechanism and diagnosis
How can this injury happen in a motor accident?
Side impact or direct head strike
Contact with a window, pillar, helmet or road surface can injure the ear canal, ossicles, cochlea, auditory nerve or temporal bone.
Airbag or explosive noise exposure
A close airbag deployment or other intense impulse noise may cause acoustic trauma, tympanic membrane injury or sensorineural hearing loss.
Skull fracture or traumatic brain injury
A temporal-bone fracture, haemorrhage or central auditory injury may produce hearing loss with tinnitus, vertigo or facial nerve signs.
The injuries that may actually occur
- tympanic membrane perforation or middle-ear injury
- conductive hearing loss from ossicular disruption or fluid
- sensorineural hearing loss from cochlear or auditory nerve trauma
- mixed hearing loss where conductive and sensorineural components coexist
- hearing loss associated with temporal-bone fracture or brain injury
Symptoms and functional effects to document
- reduced hearing in one or both ears
- difficulty following speech in background noise
- sound distortion, fullness or sensitivity
- tinnitus occurring with accident-caused hearing loss
- work, safety or communication problems linked to the measured loss
Urgent health warning
Sudden hearing loss, fluid or blood from the ear, severe vertigo, facial weakness or neurological symptoms after a crash require prompt medical assessment.
Medical evidence
What tests and findings matter?
The file should identify the anatomical diagnosis, the date hearing changed and the permanent audiological result. Pre-accident audiograms, occupational noise history and age-related correction can be important when causation is disputed.
| Test or record | What it can establish | What it cannot establish alone |
|---|---|---|
| Pure-tone audiogram | Measures air and bone conduction thresholds in a suitable sound-attenuated environment using an audiometer calibrated to current Australian standards. | A screening test, uncalibrated device or test completed with hearing aids does not satisfy the prescribed sensitivity evaluation. |
| Speech audiometry and tympanometry | May help distinguish conductive, cochlear and neural patterns and test whether the pure-tone result is clinically coherent. | These tests do not replace the prescribed binaural hearing calculation. |
| ENT examination and imaging | Can document perforation, ossicular damage, temporal-bone fracture, middle-ear disease or another anatomical cause. | An anatomical finding does not set the hearing WPI without permanent hearing measurement. |
| Earlier audiograms and noise history | Help separate pre-existing hearing loss, presbyacusis and accident-related change. | Age or noise exposure should not be assumed to explain the loss without evidence. |
A separate legal classification
Threshold injury is not the same as WPI
A diagnosed structural ear, auditory nerve or permanent hearing injury may be more than a soft tissue injury. Ear noise, blocked-ear sensation or subjective hearing difficulty without a supported injury still requires careful classification. Threshold injury and the later binaural WPI calculation are separate questions.
A non-threshold classification does not set a WPI percentage. Conversely, a low or zero WPI assessment does not necessarily decide the threshold-injury classification. Physical and psychiatric WPI are assessed separately and cannot be combined to determine whether impairment is greater than 10%.
Motor Accident Guidelines Part 6
How is permanent impairment assessed?
Clauses 6.181-6.186 replace the AMA4 hearing method with the current CTP method. Permanent loss is calculated as binaural hearing impairment using the 1988 National Acoustics Laboratory tables, with the prescribed presbyacusis correction, and AMA4 Chapter 9 Table 3 then converts the binaural result to WPI.
| Assessment issue | CTP method | Important limit |
|---|---|---|
| Is the hearing loss permanent? | The assessor reviews serial audiograms, treatment and stability before rating. | Temporary conductive loss from fluid, swelling or a healing perforation should not be rated as permanent. |
| What percentage hearing loss exists? | Use the 1988 NAL procedure for binaural hearing impairment with presbyacusis correction. | The poorer ear is not converted directly to WPI and unilateral symptoms are not simply doubled. |
| How is WPI obtained? | Convert the final binaural hearing impairment with AMA4 Chapter 9 Table 3, page 228. | Hearing aids are not worn during hearing-sensitivity evaluation. |
Verified Guidelines example or rule
Clause 6.186 gives this example: a person aged 50 with total unilateral right-ear loss and no left-ear loss has 17% binaural hearing impairment, less 0% presbyacusis correction, which converts to 6% WPI. It is a Guidelines example, not a shortcut for other audiograms.
What may result in 0% or no assessable WPI?
- a temporary hearing change that resolves with treatment
- subjective difficulty with no supported permanent binaural loss
- a binaural result that converts to 0% WPI under Table 3
- hearing loss wholly explained by a verified pre-accident condition after proper assessment
What may support a higher assessment if verified?
- greater permanent loss across the prescribed frequencies in both ears
- a supported accident-related worsening over documented pre-accident hearing
- permanent severe tinnitus where clause 6.180 is also satisfied
- a separate accident-caused facial, vestibular or neurological impairment assessed by its proper method
Combination and overlap rules
- Tinnitus is not a standalone WPI rating: clause 6.180 permits an addition to binaural hearing impairment only where both hearing loss and tinnitus are accident-caused.
- Vestibular impairment is assessed separately under clauses 6.187-6.188 and requires objective vestibular dysfunction.
- Pain receives no separate AMA4 Chapter 15 allowance under clause 6.38.
What does not establish impairment by itself?
- saying one ear feels blocked or muffled
- one online or workplace screening result
- tinnitus without accident-caused hearing loss
- an ENT diagnosis without the permanent binaural calculation
Crash-specific examples
Airbag deployment with a perforated eardrum
The early ENT record proves the injury, but WPI depends on the permanent post-treatment audiogram. If hearing returns to the pre-accident level, the perforation may leave no hearing WPI.
Side impact with unilateral sensorineural loss
A calibrated audiogram, ENT opinion and earlier hearing records help establish causation. The result is still converted through the binaural method; unilateral total loss does not equal total hearing WPI.
Claim file preparation
Evidence checklist
Practical next steps
What should you do next with a hearing loss after a motor accident claim?
Start with the insurer's most recent written decision and identify what is actually disputed: treatment, weekly payments or work capacity, threshold injury, permanent impairment, causation, or damages. These are separate questions and may require different evidence and review procedures. Record the date of the decision and every review deadline shown before gathering further material.
- 01
Preserve the claim and the decision under review
Keep the claim number, accident date, insurer letter, certificate of fitness and any internal review or Personal Injury Commission correspondence together. Do not assume that a treatment approval or payment of statutory benefits decides fault, damages eligibility or WPI.
- 02
Obtain evidence that answers the disputed issue
For this injury, the useful starting material includes ambulance and emergency records describing head or ear trauma and ENT reports and otoscopic findings. Clinical testing may include Pure-tone audiogram and Speech audiometry and tympanometry. Ask the treating practitioner to record the diagnosis, accident causation, objective findings, treatment response and current functional limits rather than symptoms alone.
- 03
Use the correct review process
Compare the insurer's reasons with the records it relied on. A threshold-injury decision, treatment refusal, weekly-payment decision and WPI assessment do not all follow the same review process. The decision letter should identify available internal review or dispute steps and the applicable deadline.
If the decision, medical material or deadline is unclear, send the key documents for a focused review before lodging a broad objection. See the CTP disputes guide or contact NSW CTP Claim. Advice depends on the facts, evidence and current law; a review cannot guarantee a claim outcome.
Assessment source
Hearing loss assessment under the NSW CTP Guidelines
Assessment source: Motor Accident Guidelines Part 6, clauses 6.177-6.186; 1988 National Acoustics Laboratory hearing-loss tables; AMA4 Chapter 9, Table 3 (page 228).
Threshold injury: A structural ear or auditory injury may be non-threshold, but the anatomical diagnosis and legal definition must be established separately from WPI.
What the assessor checks
- permanence before rating
- calibrated pure-tone thresholds without hearing aids
- binaural hearing impairment under the NAL method
- presbyacusis correction and Table 3 WPI conversion
What does not establish the result by itself
- subjective hearing difficulty
- tinnitus alone
- an uncalibrated screening result
- a diagnosis without the binaural calculation
Official sources
Related NSW CTP guides
Free claim check
Review the diagnosis, insurer decision and evidence together
Send the accident date, insurer decision, relevant hospital or specialist reports, and any deadline shown. NSW CTP Claim is a specialised service of Stephen Young Lawyers. Legal services are provided by Stephen Young Lawyers.
Frequently asked questions
- Is hearing loss in one ear assessed as if both ears are lost?
- No. The Guidelines require a binaural hearing impairment calculation. The measured loss in each ear contributes to that prescribed result, which is then converted to WPI.
- Can I wear hearing aids during the audiogram used for WPI?
- No. Clause 6.183 says hearing aids must not be used during evaluation of hearing sensitivity.
- Does an eardrum perforation automatically produce WPI?
- No. It may heal without permanent hearing impairment. The permanent audiological and clinical outcome is what matters.
- Can pre-existing industrial deafness be deducted?
- Only on proper evidence. Earlier audiograms and the prescribed age correction can help separate pre-existing loss from accident-related change.
- Is hearing WPI the same as threshold injury?
- No. Threshold classification and permanent impairment are separate legal and medical questions.