Decision #58/00 - Type: Workers Compensation
Preamble
A Non-oral File Review was held on May 26, 2000, at the request of the employer.
Issue
Whether or not responsibility should be accepted for digital hearing aids.
Decision
That responsibility should be accepted for digital hearing aids.
Background
On June 4, 1999, the claimant submitted an application for compensation benefits in relation to noise induced hearing loss. Following investigations into the case, the claim was accepted by the Workers Compensation Board (WCB) and responsibility was accepted for the cost of digital hearing aids.
On January 11, 2000, the employer disagreed with the WCB's decision to pay for the costs associated with the digital hearing aids. The employer contended that the claimant misrepresented his work duties to the audiologist to convince her that digital aids were required. The employer indicated that while there was a trend toward the use of digital hearing aids, employers should not be subjected to the higher costs of these aids when it was proven that individuals would be certain to benefit from the conventional hearing aids which was the case here.
In a February 18, 2000, decision, Review Office confirmed that responsibility was correctly accepted for digital hearing aids. Review Office indicated the following when rendering its decision:
- the practice of the WCB's Occupational Disease Unit was that digital hearing aids would be provided where the WCB's Ear, Nose and Throat Consultant determined that they are advisable rather than conventional hearing aids;
- the attending audiologist had indicated that the claimant's hearing impairment was such that it was very difficult to fit with standard hearing aids. She believed that digital aids were warranted as did the WCB consultant;
- the exact hearing requirement of the worker's job was not the critical issue in the decision to provide digital hearing aids to the worker.
On March 16, 2000, the employer appealed Review Office's decision and a non-oral file review was arranged. On April 26, 2000, the employer provided the Appeal Panel with a submission for consideration.
Reasons
The issue in this appeal is whether or not responsibility should be accepted for digital hearing aids. The relevant subsection of The Workers Compensation Act (the Act) is subsection 27(1) which provides for medical aid.
The subsection states:
Provision of medical aid
27(1) The board may provide a worker with such medical aid as the board considers necessary to cure and provide relief from an injury resulting from an accident.
Relevant WCB Policy is Section 44.20.50.20.01, Hearing Loss. The policy states in part:
A. Policy
5. Where a claim for hearing loss is accepted and a specialist recommends the use of a hearing aid(s), a worker shall be entitled to suitable hearing aid(s) of a reasonable cost as approved by the Workers Compensation Board.
In this appeal we reviewed all the evidence on file and find that the evidence supports a finding, on a balance of probabilities, that responsibility should be accepted for the costs of digital hearing aids.
The employer has argued that they should not have to bear the costs of digital hearing aids for this claim as in their view conventional aids were initially recommended by the practitioners and that it was only after the claimant requested digital aids that the audiologist was prepared to recommend them on the basis of what the claimant had said about his job duties.
With respect, we cannot accept this argument. In this regard we note that in a letter dated June 15, 1999 the attending audiologist indicated that the claimant’s hearing loss was significant enough to warrant amplification. In this report the audiologist states: “Amplification was discussed and I have left it up to Mr. [the claimant] to pursue this option.”
In a further report dated August 13, 1999 the attending audiologist provides further clarification. We note she states:
“ A standard hearing aid, which is covered by WCB, will not assist Mr. [the claimant] to overcome the wide variety of situations that Mr. [the claimant] encounters. His hearing impairment is very steeply sloping which is very difficult to fit with standard hearing aids. Given his degree of hearing impairment and the type of listening environment he is required to work in, the digital hearing aid recommended will provide the most flexibility.” (emphasis added)
The audiologist further points out that should there be any changes in the claimant’s level of loss that digital aids could be programmed to reflect the change. A WCB Ear, Nose and Throat (ENT) consultant reviewed the file and concurred with the findings and recommendation of the audiologist.
We find that in their initial reports the practitioners involved did not specify the type of appliance suitable for the claimant and only considered this following the claimant’s enquiry. Nevertheless, we find it to be entirely reasonable for the claimant to have investigated digital hearing aids as an option to reduce his level of impairment and then to discuss this with his audiologist and seek her recommendation.
Irrespective as to whether or not the claimant is required to interact extensively with the public, speak on the telephone or attend numerous meetings, it remains the opinion of the audiologist that due to the nature of the claimant’s hearing loss that standard hearing aids would be difficult to fit and therefore, in our view, are not suitable for the claimant. Also with respect to the above we are of the view that, in any event, the claimant would be unable to completely avoid some of the activities that have been outlined above. Therefore the employer’s appeal on this issue is denied.
Panel Members
D.A. Vivian, Presiding Officer
A. Finkel, Commissioner
R. Frisken, Commissioner
Recording Secretary, B. Miller
D.A. Vivian - Presiding Officer
(on behalf of the panel)
Signed at Winnipeg this 8th day of June, 2000