Ear injury claim
Tinnitus after a motor accident
Tinnitus is ringing, buzzing, hissing or another sound perceived without an external source. It may follow acoustic trauma, a head strike, temporal-bone injury or inner-ear damage. Under the NSW CTP Guidelines, tinnitus is not rated by itself: clause 6.180 only permits assessment when permanent tinnitus and hearing loss are both caused by the motor accident.
Accident mechanism and diagnosis
How can this injury happen in a motor accident?
Airbag or impulse noise
A close, intense noise event can injure cochlear structures and cause immediate tinnitus with measurable hearing change.
Head or temporal-bone trauma
Direct impact may damage the middle or inner ear, auditory nerve or central auditory pathways.
Whiplash with ear symptoms
Tinnitus can be reported after acceleration-deceleration, but the file still needs an ear or hearing diagnosis and causal analysis rather than assuming the neck injury explains it.
The injuries that may actually occur
- acoustic trauma with sensorineural hearing loss
- temporal-bone or ossicular injury
- cochlear or auditory nerve injury
- tinnitus associated with traumatic brain or vestibular injury
Symptoms and functional effects to document
- ringing, buzzing, humming or hissing
- sleep interruption and difficulty in quiet environments
- reduced concentration or listening fatigue
- sound sensitivity or hearing difficulty
- fluctuating distress that should be distinguished from loudness and permanence
Urgent health warning
Pulsatile tinnitus, sudden hearing loss, severe vertigo, facial weakness or neurological signs require prompt medical assessment.
Medical evidence
What tests and findings matter?
There is no blood test or scan that measures the perceived sound. The evidence therefore focuses on the accident chronology, ENT assessment, reliable audiology, permanence, severity and whether accident-caused hearing loss is present.
| Test or record | What it can establish | What it cannot establish alone |
|---|---|---|
| Calibrated audiogram | Establishes whether permanent accident-caused hearing loss accompanies the tinnitus. | Tinnitus with a normal or unrelated hearing result does not satisfy clause 6.180. |
| ENT assessment | Examines the ear, excludes treatable causes and considers the relationship to head or acoustic trauma. | A tinnitus label alone does not supply the required hearing-loss calculation. |
| Contemporaneous records | Show whether tinnitus began immediately or soon after the crash and remained consistent. | A late first report needs causal explanation and is not automatically rejected or accepted. |
| Treatment and functional history | Documents sleep treatment, sound therapy, hearing aids and communication effects. | Distress alone does not create a separate pain or psychiatric WPI rating. |
A separate legal classification
Threshold injury is not the same as WPI
Tinnitus may accompany a structural ear, hearing or neurological injury, but the threshold classification depends on the diagnosed physical injury. A symptom of ringing without a supported non-soft-tissue injury does not itself settle the threshold question.
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?
Clause 6.180 is the controlling CTP modification. If tinnitus is permanent and severe, and both tinnitus and hearing loss were caused by the crash, up to 5% may be added to the binaural hearing impairment before that hearing result is converted to WPI. The tinnitus addition is not a separate WPI percentage.
| Assessment issue | CTP method | Important limit |
|---|---|---|
| Is there accident-caused hearing loss? | Apply clauses 6.181-6.186 and the prescribed NAL binaural hearing method. | Without accident-caused hearing loss, tinnitus is not assessable under clause 6.180. |
| Is the tinnitus permanent and severe? | Review consistent clinical history, treatment and functional effect after reasonable time and care. | The maximum addition is not automatic merely because tinnitus is described as constant. |
| Where is the addition made? | Add the supported tinnitus amount to percentage binaural hearing impairment, then convert the total to WPI with AMA4 Table 3. | Do not combine a tinnitus WPI with a hearing WPI; that reverses the required order. |
Verified Guidelines example or rule
The verified rule is clause 6.180: up to 5% may be added, not combined, to percentage binaural hearing impairment before conversion to WPI, but only if permanent severe tinnitus and hearing loss are both caused by the motor accident.
What may result in 0% or no assessable WPI?
- tinnitus without accident-caused hearing loss
- temporary ringing that resolves
- mild tinnitus that does not meet the permanent severe criterion
- tinnitus better explained by a verified unrelated condition
What may support a higher assessment if verified?
- reliable permanent binaural hearing loss from the accident
- contemporaneous onset after acoustic or head trauma
- persistent severe tinnitus supported by treatment and functional records
- a separate objectively established vestibular or neurological impairment assessed by its own method
Combination and overlap rules
- The tinnitus amount is added to binaural hearing impairment before WPI conversion, not combined afterward.
- A psychiatric diagnosis arising from tinnitus is assessed separately under PIRS and cannot be combined with physical WPI to pass the greater-than-10% test.
- There is no separate AMA4 Pain chapter allowance for tinnitus-related distress.
What does not establish impairment by itself?
- ringing described without an audiogram
- a tinnitus severity questionnaire by itself
- the maximum 5% addition assumed automatically
- hearing loss that is not caused by the accident
Crash-specific examples
Immediate ringing after airbag deployment
The timing supports causation, but the clause still requires permanent accident-caused hearing loss and evidence that the tinnitus is permanent and severe.
Pre-existing tinnitus that worsens after the crash
Earlier records and audiograms are needed to identify the baseline and any accident-related change. The assessor cannot simply rate the entire current complaint as new.
Claim file preparation
Evidence checklist
Assessment source
Tinnitus assessment under the NSW CTP Guidelines
Assessment source: Motor Accident Guidelines Part 6, clause 6.180 and clauses 6.181-6.186; AMA4 Chapter 9, Table 3 (page 228).
Threshold injury: Classification follows the diagnosed accident-caused injury; tinnitus as a symptom does not by itself decide threshold status.
What the assessor checks
- accident-caused hearing loss must be present
- tinnitus must be permanent and severe
- the supported addition is made before WPI conversion
- binaural hearing uses the current CTP method
What does not establish the result by itself
- tinnitus alone
- a maximum addition assumed without reasons
- hearing loss from another cause
- sleep difficulty without the required hearing evidence
Official sources
Related NSW CTP guides
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Frequently asked questions
- Can tinnitus receive WPI if my hearing is normal?
- Not under clause 6.180. Tinnitus is only assessable in the presence of accident-caused hearing loss.
- Is the 5% tinnitus amount automatically WPI?
- No. Up to 5% is added to binaural hearing impairment before conversion to WPI, and only where the permanent severe criteria are supported.
- Does constant tinnitus always qualify as severe?
- No. Permanence, severity, treatment history and real functional effect require medical assessment.
- Can tinnitus and vestibular impairment both be assessed?
- Potentially, if both are objectively supported and accident-caused. They use different methods and overlap must be addressed.
- What if tinnitus existed before the accident?
- The assessment needs reliable baseline evidence and a reasoned account of any accident-caused worsening.