- Meniere's disease
- Hearing loss (sensorineural)
The issue under appeal was the worker's initial entitlement for occupational noise induced hearing loss. The worker had a 28-year career as a Sheet Metal Worker, and reported a noise induced hearing loss related to occupational noise exposure over his 28-year career. The worker also had a clinical diagnosis of right Meniere's Disease, which is characterized by fluctuating right unilateral sensorineural hearing loss.
The Vice-Chair allowed the appeal.OPM Document No. 16-01-04 allows entitlement for NIHL where a worker has work-related hearing loss of 22.5 dB in each ear when the hearing loss in the four speech frequencies is averaged. The policy states that the following two elements are persuasive evidence that a worker's sensorineural hearing loss is work-related: (i) the worker meets certain thresholds of noise exposure, and (ii) the worker's pattern of hearing loss is consistent with noise-induced hearing loss. The worker had adequate noise exposure to meet the first of the factors. The worker was continuously exposed to loud noise including air hammers, impact guns, hand-held grinders, cold cut saws, chop saws, hammers, and chisels as a Sheet Metal Worker for over 28 years. The Vice-Chair considered whether the pattern of the worker's bilaterial hearing loss was consistent with an occupational noise induced hearing loss. The Medical Discussion Paper notes that audiograms showing NIHL show a "dip" or "notch" at 4000 Hz. However, it does not provide information on what an audiogram would look like where a worker had hearing loss attributed to both NIHL and Meniere's Disease. This was also confirmed by the worker's Otolaryngologist, Dr. Kandasamy, in his report dated July 1, 2021, that there is no typical audiogram for an individual suffering from Meniere's disease and NIHL. The Vice-Chair concluded that the worker's occupational noise exposure significantly contributed to his hearing loss, although later audiograms may not show the classic pattern of NIHL, due to the overlay of Meniere's Disease. In addition, the worker's specialist clearly opined that the workplace exposure significantly contributed to the worker's NIHL. The Vice-Chair found Dr. Kandasamy's opinion as a specialist with his history of treating the worker to be persuasive in this regard. The worker's occupational exposure to noise over 28 years as a Sheet Metal Worker and the worker's pattern of hearing loss showed sufficient consistency with the pattern of NIHL to support a finding that the occupational noise made a significant contribution to the worker's ongoing hearing loss.