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Operational policy manual

Hearing Devices

Health Care
Application Date
This policy applies to all requests for the provision, replacement, or repair of hearing aids and related accessories, and hearing assistive technologies that are received by the WSIB for approval on or after January 9, 2017, for all injuries/diseases.
Published
03-Jan-2017
Subject
Prosthetic and Assistive Devices
Title
Hearing Devices
Document No.
17-07-04

Policy

The WSIB may authorize the provision, replacement, or repair of hearing devices, which includes, hearing aids and related accessories, and hearing assistive technologies, where entitlement has been established for any work-related hearing loss.

Purpose

This policy outlines the criteria for allowance and payment for the provision, replacement, or repair of hearing devices in cases where work-related hearing loss entitlement has been established.

Guidelines

Definitions

Audiologist: regulated health professional qualified to measure hearing, and prescribe, supply, and fit hearing aids and assistive technologies according to individual needs.

Hearing aid: a small battery-powered electronic apparatus which typically fits in or behind the worker’s ear, and is designed to amplify and modulate sound to compensate for impaired hearing.

Hearing aid related accessories: items required for ease of use, and for the proper care and maintenance of hearing aids (e.g., cleaning kit, sanitizer, wipes, brush, carrying case, battery tester, telephone pads, dri-aid kit, wax guard/basket, ear mold blower).

Hearing assistive technologies (HATs): items that can present auditory, visual, or tactile information to workers with impaired hearing (e.g., alerting systems, telephone amplifiers, television specific devices, FM systems).

Hearing aids

Entitlement criteria

Workers should request approval from the WSIB before purchasing a hearing aid to avoid having to pay for the device if it is not ultimately approved by the WSIB.

The WSIB may authorize the purchase of a hearing aid when

  • the worker has an allowed claim for work-related hearing loss, and
  • it is prescribed by an audiologist or physician, and
  • a hearing evaluation (i.e., audiogram) has been conducted which meets practice standards, and contains findings that support the use of a hearing aid.

The worker is entitled to a trial period of at least 30 days from the date the hearing aid was dispensed. This trial period helps ensure the worker has been fitted with the proper hearing aid.

Models

When the worker has entitlement to a hearing aid, the WSIB considers hearing aid models available from two categories.

The primary category includes a range of hearing aid models that consist of various integrated components and types of fit that meet the needs of most hearing aid users.

For those workers with specific clinical requirements that cannot be met by a hearing aid model from the primary category, the WSIB may consider offering a suitable hearing aid model from the alternate category. When reviewing these exceptional cases, the WSIB considers the supporting clinical evidence provided through the hearing evaluation report and documented clinical rationale. The WSIB considers whether the integrated components and features requested for the aid are clinically required for the worker to be able to function fully and safely at home, work, and/or in the community.

To view the hearing aid models available in each category, see Hearing Devices which is accessible through the WSIB website.

Hearing aid repairs

After the warranty period for a hearing aid previously authorized by the WSIB expires, the WSIB may pay reasonable costs to repair the hearing aid unless there is evidence that the hearing aid was deliberately damaged, misused, or the operating instructions were not properly followed. The WSIB also covers the cost for the loan of a hearing aid while repairs are being made.

Hearing aid replacements

Generally the WSIB does not replace a hearing aid before 5 years. When determining the necessity for replacement before 5 years, the WSIB considers the condition of the hearing aid and/or changes in the worker's clinical requirements.

All hearing aid replacement requests before 5 years must be accompanied by documentation which substantiates the worker's need for a new hearing aid. The documentation must include a detailed explanation as well as any recent evaluation (i.e., audiogram) and/or other supporting information.

Condition of the hearing aid

The WSIB recognizes that the longevity of a hearing aid can be dependent on the extent of usage which may warrant a replacement aid before 5 years.

The WSIB may authorize a replacement before 5 years when a hearing aid is beyond repair unless there is evidence that the hearing aid was deliberately damaged, misused, or the operating instructions were not properly followed. A hearing aid may be considered beyond repair when high repair costs make replacement a more appropriate alternative, or the nature/extent of the damage prevents repairs.

Change to the worker's clinical condition

The WSIB will consider authorizing a replacement before 5 years when there is a permanent change in the worker's work-related or non-work-related clinical condition that impacts the ongoing use of the current hearing aid and this is substantiated by the clinical documentation.

Lost or stolen hearing aid

If the worker's hearing aid is lost or stolen, the WSIB may authorize a replacement aid once before 5 years. For each replacement aid requested due to loss or theft, the worker must provide the WSIB with a signed written declaration confirming the same.

In the event the WSIB has authorized a replacement and the hearing aid is lost or stolen again before 5 years, the purchase of a new device is generally the worker’s responsibility.

Hearing aid accessories

The WSIB may authorize payment for hearing aid accessories that are required for ease of use and for the proper care and maintenance of hearing aids.

Hearing aid batteries

The WSIB may authorize reasonable requests for the replacement of hearing aid batteries.

Hearing assistive technologies (HATs)

Workers should request pre-approval from the WSIB for the initial purchase and for the subsequent repair/replacement of a HAT.

The WSIB may authorize the provision of HATs. When determining entitlement, the WSIB considers whether evidence supports that the requested HAT will assist the worker’s return to work, facilitate improved communication at home or in the community, or increase the worker’s personal safety.

After the warranty period for a HAT previously authorized by the WSIB expires, the WSIB may pay reasonable costs to repair the HAT unless there is evidence that the HAT was deliberately damaged, misused, or the operating instructions were not properly followed.

The WSIB may replace a previously authorized HAT if necessary. When determining the necessity of replacement, the WSIB considers factors such as the condition of the HAT, and permanent changes in the worker’s clinical requirements that impact the ongoing use of the HAT as supported by clinical documentation.

Application date

This policy applies to all requests for the provision, replacement, or repair of hearing aids and related accessories, and hearing assistive technologies that are received by the WSIB for approval on or after January 9, 2017, for all injuries/diseases.

Document history

This document replaces document 17-07-04 dated February 1, 2011.

This document was previously published as:
17-07-04 dated November 23, 2009.
17-07-04 dated October 12, 2004.
06-04-03 dated February 23, 1994.

References

Legislative authority

Workplace Safety and Insurance Act, 1997, as amended
Sections 32, 33, 119(1)

Workers’ Compensation Act, R.S.O. 1990, as amended
Sections 50, 51, 52, 73

Minute

Administrative
#1, December 14, 2016, Page 537

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