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Last checked: 9 October 2019
COMPENSATION FOR OCCUPATIONAL INJURIES AND DISEASES ACT
Act 130 of 1993.
CIRCULAR INSTRUCTION NO. 171
THE DETERMINATION OF
PERMANENT DISABLEMENT RESULTING FROM HEARING LOSS CAUSED BY EXPOSURE TO
EXCESSIVE NOISE AND TRAUMA
[Updated to 16 May 2001]
GoN 422, G. 22296 (c.i.o 16 May 2001).
I, Emmanuel Ramadzuli Ramashia, Director General of the Department
of Labour, hereby give notice that, after consultation with the
Compensation
Board and acting under the powers vested in me by section 49 of the Compensation
for Occupational Injuries and Diseases
Act, 1993, (Act 130 of 1993) I hereby
issue Circular Instruction No. 171 dealing with the determination of permanent
disablement
resulting from exposure to excessive noise and trauma in
industry.
This circular instruction comes into effect on 16 May 2001 and
supersedes all previous instructions regarding loss of
hearing.
(Signed)
DIRECTOR GENERAL: LABOUR
A6/3/1
A10/4/3/4
Circular Instruction No. 171
TABLE OF CONTENTS
- Binaural hearing impairment
- Monaural hearing impairment
- Documentation to accompany a claim for compensation
- Calculation of permanent disablement
Annexure A: Determination of percentage
loss of hearing
The
following instructions are issued to clarify the position in regard to claims
for impairment of hearing—
1.1 An occupational disease due to excessive noise in industry; and
1.2 An occupational injury due to factors other than excessive industrial noise [head trauma (resulting from e.g. blows to the head), or acoustic trauma causing the immediate loss of hearing produced by one or more exposures to sudden intense forms of acoustic energy such as explosions, gunfire or blasts].
Such “accidents” may cause binaural (both ears) or monaural (one ear) impairment of hearing.
1.3 In loss of hearing “by accident” in either one or in both ears the impairment may be caused by either conductive loss when the middle ear is injured or by perceptive loss when the inner ear is injured or by a combination of both conductive and perceptive loss when both the middle and the inner ear are injured - the so-called “mixed deafness”.
1.4 Impairment of hearing claimed to result from exposure to excessive noise in industry (occupational noise of an excessive nature) usually manifests itself over a number of years and results in binaural impairment of hearing.
1.5 The provisions of section 65(4) of the Act referring to prescription shall be strictly applied with due regard to the provisions of section 38 of the Act.
1.6 The date of the commencement of the disease shall be the date of the first audiogram showing an increase from the baseline in the percentage loss of hearing (PLH) by 10% or more. The PLH values are calculated using the results of the baseline audiogram and the diagnostic audiogram using the attached tables. Annexure A
1.7 Persons to be submitted for compensation consideration would be—
- Employees whose PLH has deteriorated by more than 10% PLH from the baseline audiogram; or
- Employees who have more than 10% PLH and for whom no baseline is available (see section 5).
1.8 A medical opinion must be provided by either—
1.8.1. An ENT-specialist if the case is complicated or the degree of disablement is expected to exceed 15% (PLH > 30% from baseline); or
1.8.2 An Occupational Medical Practitioner if the case is uncomplicated and
the degree of disablement is expected to be 15% or less
(PLH 30% from
baseline).
- BINAURAL HEARING IMPAIRMENT
2.1 In cases where binaural hearing impairment is claimed as a result of
mechanical or acoustic trauma, the principles as laid down
under paragraph 1.4,
1.5 and 1.6 for occupational hearing loss due to excessive noise in industry
apply, with the exception that
the ENT-Surgeon / Occupational Medical
practitioner should certify that the impairment found on examination is
compatible with the
nature of the injury sustained or is due to acoustic trauma
of the nature and intensity experienced by the employee and that no other
cause(s) for the impairment of hearing were found on examination.
- MONAURAL HEARING IMPAIRMENT
3.1 Noise-induced hearing loss affects both ears to more or less an equal
degree and the impairment is due to a perceptive loss.
If, therefore, the loss
of hearing is monaural, it must be assessed whether the loss is commensurate
with noise exposure to one ear
more than the other such as gun shots in security
workers. The assessment of permanent disablement for the loss of hearing in one
or both ears as detailed takes cognisance of such additional factors as
tinnitus, unhealed perforations of the tympanic membranes
with possible
recrudescence of infections following thereon and / or mastoidectomies. In the
event of recurring infections in the
two latter instances, medical treatment
should be provided and the employee should receive periodical payments.
- DOCUMENTATION TO ACCOMPANY A CLAIM FOR COMPENSATION
Claims will be submitted either to the Compensation Commissioner or to the
Mutual Association as applicable. Over and above the standard
documentation
required i.e. Employer’s Report of an Occupational Disease Injury (W
C1.1/2) and Notice of an Occupational Disease
/ Injury and Claim for
Compensation (WC1.14/3), the following documents are required—
4.1 Claimant’s service record - this should confirm in writing
exposure to excessive occupational noise. The intensity and duration of exposure
should be commensurate
with the hearing impairment.
4.2 It should be proved that the noise was of such a nature and intensity
and exposure to it of such duration, as to be likely to
have caused permanent
noise-induced hearing impairment. The compensability of a claim can only be
considered where noise level readings
exceed the maximum laid down by the South
African Bureau of Standards (S.A.B.S. 083-1983) and which is known as the N85
Noise Rating
Curve Level.
4.3 Medical opinion - this should state that the hearing loss is
compatible with noise induced hearing impairment. In atypical cases an
appropriate explanation
should be provided.
4.4 Audiograms - two audiograms conducted by the diagnostic
audiologist should be submitted. The audiograms should be performed after at
least 24
hours have elapsed from the last exposure to excessive noise. The
audiograms may be done on the same day but at different sittings.
The audiograms
must not differ by more than 10 dB at any frequency. The better diagnostic
audiogram will be used to calculate PLH
for compensation purposes.
If required, a third audiogram shall be performed. If this is still not
within the 10 dB limit then the assessment shall be delayed
for a period of six
months. If audiograms of the required quality are still not obtained after six
months then referral to an ENT-specialist
will be made in order to determine
hearing loss.
4.5 A copy of the baseline audiogram (and calculated PLH) - This is
important as the baseline PLH will be subtracted from the better diagnostic
audiogram PLH to determine
the hearing loss for which the Commissioner, Mutual
Association or Employer Individually Liable, is responsible.
4.6 Proof of employee’s identity - the audiologist performing
the audiogram should attest in writing to the employee’s identity.
- CALCULATION OF PERMANENT DISABLEMENT
5.1 The better of the two diagnostic audiograms will be used: Ensure that all documentation (4) is present and correct.
5.2 Calculate (from PLH tables - Annexure A) a PLH for each of the following frequencies: 500, 1000, 2000, 3000 and 4000 Hz (Air conduction results to be taken except if specified otherwise by the medical officer).
5.3 Sum the values for each frequency to obtain the PLH.
5.4 If a baseline PLH is available this value is subtracted from the PLH obtained from 5.3.
5.5 If a baseline PLH is unavailable the PLH in 5.3 is taken as the value from which permanent disability will be calculated.
5.6 Permanent Disablement is calculated by halving the value of the PLH
obtained in either: 5.4 (if a baseline PLH is available) or
5.5 (if a baseline
PLH is unavailable).
Annexure A
Determination of percentage loss
of hearing
Using the hearing threshold levels (HTL) determined by baseline, periodic
screening, exit or diagnostic audiometry (as applicable),
determine the
contribution to percentage loss of hearing (PLH) from hearing losses at the
frequencies of 0,5; 1; 2; 3 and 4kHz, using
Tables A1-1 to A1-5, respectively.
Then sum the contributions from the stated frequencies to determine PLH.
Table A1-1
Contribution to PLH by hearing losses at
0,5 kHz
Table A1-2
Contribution to PLH by hearing losses at
1 kHz
Table A1-3
Contribution to PLH by hearing losses at
2 kHz
Table A1-4
Contribution to PLH by hearing losses at
3 kHz
Table A1-5
Contribution to PLH by hearing losses at
4 kHz
(Please note that a copy of any / all of the above Tables
will be provided upon request. Kindly refer to our website for our contact
details.)