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You are here: BAILII >> Databases >> UK Social Security and Child Support Commissioners' Decisions >> [2008] UKSSCSC CAF_2792_2006 (12 February 2008) URL: http://www.bailii.org/uk/cases/UKSSCSC/2008/CAF_2792_2006.html Cite as: [2008] UKSSCSC CAF_2792_2006 |
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[2008] UKSSCSC CAF_2792_2006 (12 February 2008)
CAF/2792/2006
DECISION OF THE PENSIONS APPEAL COMMISSIONER
REASONS
"The condition relates to a road traffic accident in 1951 near Northampton. The contemporary medical records say that he was unconscious for about ½ minute and do not record any complaint of hearing loss. Later records from Headley Court treatment similarly relate no hearing problem. These findings are inconsistent with any significant degree of acquired hearing loss attributable to a head injury in the road traffic accident of 1951. Audiometric evidence of 1987, 1999 and 2002 shows a pattern of hearing loss typical of noise induced hearing loss. It does not demonstrate a severe hearing loss through all frequencies, such as would support a conclusion that in 1951 he hit his head in such a manner as to produce post-traumatic sensorineural hearing loss, not consistent with hearing loss due to a head injury in 1951. Perusal of the evidence leads us to conclude that it is most improbable that the Appellant acquired any significant degree of hearing loss in the road traffic accident of 1951. The evidence shows that the brain injury sustained in that accident was probably relatively minor in nature. We do not, given the above conclusions, agree with or accept the Consultant's opinion of 4.10.2002. We accept the conclusion of Dr Finucane in her Opinion in the papers."
"1. That of a bilateral sensorineural loss which is more marked on the left than on the right due to his severe head injury.
2. This loss is compounded by a noise induced hearing loss factor associated with exposure to aircraft engines.
These hearing levels will, at this stage, have an age related factor present."
The asymmetry of the hearing loss was a major factor in Mr Houlihan's thinking. He said –
"I understand that the injury was to the left side of the skull and the above findings are in keeping with the greater sensorineural loss being on the left side with a less of an effect on the right side. These findings are well documented and acceptable with the inner ear hearing loss associated with head injury."
"The left ear shows a sensory neural loss of about 50% in the higher frequencies. I am unable to explain why this should be so."
Mr Houlihan reiterated his view that –
"the original injury seems to have caused a hearing loss, which was more marked on the left than the right. The loss at the time was static and not progressive but obviously other factors such as exposure to loud noise and of course age related deafness will be contributory factors. I think this is borne out clearly by the series of audiograms that have been taken over number of years."
"The patient says that in 1951 he suffered a severe cranial trauma with loss of consciousness and coma, and was hospitalised for a period of one year in England.
He currently presents with perception hypoacusis with predominance on the acute frequencies, more pronounced on the left than the right.
His clinical examination is absolutely normal.
The appearance of the curve suggests to me presbyacusis aggravating an earlier perceptional deafness, which may well square with the cranial trauma that [the claimant] suffered in 1951.
Therefore at present he is affected b y deafness that is clearly more pronounced than the presbyacusis that is normal for his age, because of his trauma case history."
"2. … given the high frequency hearing loss and [the claimant's service noise exposure, an element of the sensorineural hearing loss is due to service noise exposure. …
4. The consultant ENT Surgeon's letter dated 9.1.87 shows that whilst noise induced exposure was deemed to be a cause of the hearing loss the Consultant felt unable to explain the asymmetry, there being a greater loss in the left than in the right ear. However, such asymmetry is not uncommon in those who have fired guns, the ear that is more affected being that opposite the shoulder from which the gun is fired."
She also said –
"In none of the service evidence is there any reference to any damage to, or symptoms or signs in respect of, the ears and hearing. Nor does that evidence in our opinion support a notion that the in-service head injury was severe or that it resulted in more than a brief loss of consciousness at the time. … The service medical records also show that at the Release Medical examination no disablement relating to the ears or hearing was claimed by [the claimant] or noted by the examining Medical Officer."
"On pages 62 to 63 Hans Heinz Naumann refers to sensorineural hearing loss associated with head injury and gives a series of audiograms found in such cases. It is only in the very extreme cases that a flat audiogram is to be found. In the milder head injuries it is a high frequency hearing loss that is seen on the side of impact with a lesser degree of a high frequency hearing loss on the contra-lateral side."
I take that to be an expression of disagreement with the tribunal's view that post-traumatic sensorineural hearing loss is necessarily through all frequencies.
Bundles of documents
(signed on the original) MARK ROWLAND
Commissioner
` 12 February 2008