Worker wins disability payout over hearing aid problem
A self-employed carpet layer who said he could not work because sweat interfered with his hearing aids has won an income protection claim dispute.
The claimant began wearing aids in August 2023 to help with his “severe” hearing loss, but after a few weeks he found he was unable to use them at work because of the sweat issue.
He said he did not feel safe working without them because he could not hear other people or safety alarms. He tried to manage the problem but could not find a solution.
The man’s claim for a disability benefit was rejected by TAL Life, which said the sweating issue was manageable and the claimant had not shown it was unsafe to work without the aids.
The claimant’s GP said he was “unable to perform his usual work”, noting he could not hear lower tones, safety alarms or clapping, and found male voices hard to hear.
But his ear specialist said the hearing loss was “amendable” and he did not believe he “would be medically unfit for work in consideration of his usual work tasks as a carpet layer and the physical and mental demands of his work”.
The specialist suggested he work with his audiologist to find aids that don’t lead to as much sweat, or use antiperspirants in or around his ears.
The man’s audiologist agreed he was “having chronic reliability issues with the hearing aids due to excessive sweating”. But they said an occupational health and safety expert was best suited to evaluating whether he was fit to work.
Neither the claimant nor the insurer provided findings from an OHS expert in their case before the Australian Financial Complaints Authority.
AFCA says that of the people involved in the case, the complainant is best placed to give an opinion on whether he is fit to work.
The authority says an OHS expert opinion would be useful but it is unreasonable to expect the insured to find one to have his claim accepted.
It says the insurer could have engaged an expert but chose not to.
AFCA accepts the complainant “cannot work safely without hearing aids” and is “unable to use the hearing aids because of his sweating”.
“Although the [ear] specialist suggested some strategies that might be used to avoid these problems, he deferred to the audiologist on that question, and the audiologist does not suggest that the problem of sweating can be overcome,” the authority’s ombudsman said. “I also accept that the complainant has made reasonable efforts to overcome this problem but has been unable to.”
AFCA rejects TAL’s assessment that the man did not meet disability criteria because his issue was not “solely due to sickness or injury”.
“The complainant needs hearing aids because of his hearing loss. He cannot work because he cannot use his hearing aids at work. That is enough for his disability to be caused ‘solely due to sickness or injury’,” the ombudsman said.
TAL must pay the claim, plus $3500 compensation for unnecessary delays caused by the claim denial.
Click here for the ruling.