What are hearing services and devices?
The WorkSafe Agent (the Agent) can pay the reasonable costs of approved hearing services and hearing devices provided by WorkSafe approved hearing service providers to assist workers in the rehabilitation of work-related injuries or illness under Victorian workers compensation legislation.
Prior approval from the Agent is required before a hearing device can be provided to a worker with an accepted hearing loss claim.
In this policy:
- Hearing services include:
- Hearing needs assessments
- Submission of a Hearing Assessment and Device Request Form, or a Hearing Assessment and Device Exception Request Form
- provision and review of hearing devices from the List, and
- fitting, repair, adjustment or replacement of hearing devices and supply of hearing device batteries.
- WorkSafe Approved Hearing Device List (List) is the list of each WorkSafe approved hearing device by manufacturer, including the model name, number and the price Agents can pay as the reasonable costs for that device.
- Hearing devices include hearing aids, assistive listening devices or accessories as outlined in the List.
- Assistive Listening Device (ALD) is any device which assists a person to overcome their hearing loss. The term ALD is applied to personal devices that transmit, process or amplify sound, but does not refer to hearing aids.
- Replacement hearing device replaces the initial device if it is no longer fit for its purpose because the worker's needs have changed or the device has been lost or damaged.
What the Agent can pay for in relation to hearing services and devices
The Agent can pay the reasonable costs of an hearing services and devices:
- required as a result of a work-related injury or illness and where the claim has been accepted by the Agent in accordance with WorkSafe's guidelines
- that are reasonable, necessary or appropriate in the circumstances
- that are clinically justified, safe and effective in the context of a worker's physical, psychological, vocational and functional status
- that have been assessed as necessary and appropriate by an approved provider for the communication, functional and clinical needs of the worker
- that are on the current List or approved by WorkSafe in exceptional circumstances
- approved by WorkSafe under Victorian workers compensation legislation.
The Agent can pay for the following hearing services:
Hearing needs assessment
A hearing needs assessment determines the worker's level of independence and hearing needs resulting from their work-related injury or illness. This includes:
- undertaking a range of diagnostic testing
- setting agreed rehabilitative goals with the worker
- recommendation of options for achieving the goals at a reasonable cost
- the provision of clinical justification for the proposed options
- completion of the Hearing Assessment and Device Request Form or the Hearing Assessment and Device Exception Request Form.
The Agent can only pay the reasonable costs of a Hearing Needs Assessment once every five years for the same worker.
Hearing device fitting package
The Hearing Device Fitting Package covers:
- the provision and fitting of the hearing device(s)
- a six month supply of batteries provided at the time of device fitting; and
- all subsequent follow up consultations required to facilitate the worker's understanding of, recovery from, or adjustment to their work related hearing loss during the period of 12 months from the date the device was fitted.
The Agent can pay the reasonable costs of a Hearing Device Fitting Package once every five years for the same worker. The Agent may consider approval of an additional Hearing Device Fitting Package within five years if a worker was initially supplied with a monaural hearing device and there is significant clinical evidence that the worker now requires a binaural hearing device. In these circumstances the fitting of the binaural device can only be paid after written Agent approval has been obtained.
Hearing review and/or hearing device
Hearing rehabilitation and adjustment of the hearing device is covered by the Hearing Device Fitting Package for a period of 12 months from the date the device was fitted. After this period the Agent can pay for hearing device maintenance, adjustment and aural rehabilitation if it is necessary to ensure that the device is functioning to specification or to facilitate the worker's understanding of, recovery from, or adjustment to, their work-related hearing loss.
The Agent can pay the reasonable costs of Hearing Review and/or Hearing Device Maintenance in accordance with the WorkSafe Hearing Services Fee Schedules:
- after 12 months following the fitting of a hearing device
- for a maximum of up to 7 hours of service within five years of the provision of a hearing device.
Management fees take account of the handling costs involved in the provision of a hearing device. The Agent can pay the following management fees:
- Hearing aid(s) only – one hearing aid management fee.
- Hearing aid(s) plus an ALD within 12 months of provision of the hearing aid(s) – one hearing aid management fee.
- Hearing aid(s) plus an ALD 12 months or more after provision of the hearing aid(s) – one hearing aid management fee paid when the hearing aid(s) was provided and one ALD management fee paid when the ALD is provided.
- ALD only – one ALD management fee.
WorkSafe Approved Hearing Device List
The List contains a range of hearing devices with features identified by WorkSafe that will meet the majority of workers' needs.
The List is provided to all Agents and hearing service providers and is reviewed annually. Hearing service providers must refer to the current List to ensure that a particular device is currently approved.
WorkSafe will consider approving a hearing device not on the List in exceptional circumstances where it can be substantiated that a non-listed device is essential.
WorkSafe will consider:
- information provided on the Hearing Assessment and Device Exception Request Form
- supporting clinical justification for the additional features in the context of the worker's communication and/or functional needs
- medical or clinical requirements that indicate or contraindicate the use of particular features of the proposed hearing device; and
- information received from the WorkSafe Clinical Panel.
Please refer to the information sheet - More Information About Hearing Devices Exceptions Process.
Assistive Listening Device
An ALD is any device which assists a person to overcome their hearing loss. The term ALD is applied to personal devices that transmit, process or amplify sound, but does not refer to hearing aids. ALDs can be used with or without a hearing aid.
If an ALD is approved within five years of an initial Hearing Needs Assessment:
- an ALD Management fee may apply in accordance with the Management Fee policy – see above.
- a Hearing Device Fitting Package fee will not apply - see above.
Hearing device battery supply
A six month supply of batteries is included in the Hearing Device Fitting Package which should be provided to the worker at the time the device is fitted. The Agent can pay the reasonable costs of batteries at the Worker's request after this period in accordance with the List.
Hearing device repairs
The Agent can pay the reasonable costs of maintenance repairs to hearing devices caused by normal wear and tear. As all hearing devices on the List are covered by a minimum 12 month warranty, the Agent will not pay for the repair and maintenance of hearing devices where it is covered by the manufacturer or supplier warranty.
All approvals for the reasonable costs of hearing device repairs are at the discretion of the Agent and will only be considered on receipt of a copy of the manufacturer's invoice for the repairs.
Prior written approval is required for the supply of a replacement hearing device. The Agent will only pay for a replacement device(s) five years after the initial fitting if replacement is reasonable and or necessary.
A request for a replacement hearing device should follow a Hearing Needs Assessment undertaken by the Worker's audiologist or audiometrist at which the adequacy of his or her existing hearing device(s) is assessed. In addition to diagnostic testing, the audiologist or audiometrist should obtain sufficient information about the worker's current communication, functional and clinical status and whether this has changed since the provision of the current hearing device(s).
A provider must supply the Agent with the following before a decision can be made on a replacement hearing device(s):
- the date the worker contacted the provider and the reasons given by him/her for requesting a replacement hearing device
- confirmation that the worker has attended a Hearing Needs Assessment with the provider and the date of the assessment
- details of the worker's current communication, functional and clinical status and whether this has changed since the provision of the current hearing device(s); and
- a Hearing Assessment and Device Request Form or the Hearing Assessment and Device Exception Request Form signed by the worker at the Hearing Needs Assessment.
The Agent will consider the following when deciding whether to pay for a replacement hearing device:
- whether the current hearing device continues to meet the worker's needs
- evidence of the worker's use of the existing hearing device over the previous five years
- the current nature and circumstances of the worker's hearing loss and its relationship to work
- the hearing service provider's assessment of the worker's current communication, functional and clinical needs
- the worker's reasons for requesting a new hearing device
- the clinical justification for the make, model and features of the requested replacement hearing device
- any changes to the worker's hearing since the last hearing device was supplied; and
- whether the proposed device is on the approved list or whether separate approval is required in exceptional circumstances.
Early replacement of devices
The Agent may approve the replacement of a hearing device within five years if:
- the worker's hearing has changed significantly, and
- the existing hearing device is no longer suitable and cannot be adjusted to meet the worker's current hearing needs.
- When considering a request for early replacement, the Agent will consider:
- the clinical justification for the requested hearing device, and
- whether it will meet the worker's needs for the next five years.
- a Hearing Device Fitting Package fee and management fee may apply where early replacement is approved.
Lost or damaged devices
WorkSafe will not replace a device which has:
- not been used, maintained and stored in accordance with the manufacturer's instructions
- been wilfully damaged or destroyed
- been used by persons other than the worker.
The Agent may replace a lost or damaged hearing device in exceptional circumstances and only once within five years of supply of an original or replacement device. The loss or damage must:
- be explained in a statutory declaration; and
- not be covered by the manufacturer or supplier warranty or the worker's insurance.
If the Agent accepts liability for a lost or damaged hearing device, it will:
- pay for a replacement hearing device that is identical to the lost [or damaged] hearing device where that device is available on the current List
- consider a different hearing device if:
- an identical hearing device is not available on the current List; or
- the lost or damaged device was provided more than 12 months previously and the hearing service provider submits a Hearing Assessment and Device Request Form or the Hearing Assessment and Device Exception Request Form to provide information about the worker's hearing status and the clinical justification for a different hearing device.
The Agent will not pay a Hearing Device Fitting Package fee or Management Fee for replacement hearing devices that are identical to the lost or damaged device The Agent will only consider paying the reasonable costs of the applicable excess where a lost hearing device is covered by a manufacturer's loss and damage warranty.
Who can provide hearing services and devices
Hearing services and devices can only be provided by audiologists or audiometrists approved by WorkSafe. Approval can be obtained by completing the WorkSafe Application for Registration to Provide Services to Workers.
Hearing Service providers can be contracted or noncontracted. Contracted hearing service providers are approved hearing service providers who have a contract with WorkSafe to provide hearing services and hearing devices in accordance with the WorkSafe Hearing Services Fee Schedule For Contracted Providers. Contracted providers are located in Melbourne.
Non-contracted hearing service providers are approved hearing service providers that do not have a contract with WorkSafe – please refer to the information sheet Hearing services and devices, Information for workers.
What information the Agent requires to consider paying for hearing services and devices
To consider paying for Hearing Services and Devices, the Agent requires:
- a valid Worker's Injury Claim Form, and
- an Employer Injury Claim Report Form.
The hearing service provider should complete the WorkSafe Hearing Assessment and Device Request Form or the Hearing Assessment and Device Exception Request Form and send it to the Agent for prior approval.
If additional information is required the Agent may request one or all of the following:
- Worker Questionnaire - Hearing Services
- Employer Questionnaire - Hearing Services
- GP Questionnaire - Hearing Services.
When the Agent will respond to a request
Within 10 working days of receiving the WorkSafe Hearing Assessment and Device Request Form (or the Hearing Assessment and Device Exception Request Form), the Agent will advise whether:
- the request has been approved
- the request has been denied, or
- further information is required to make a decision which may include referral to the WorkSafe Clinical Panel for review.
The Agent will advise whether the request has been approved or denied within 10 working days of receiving the requested additional information or the Clinical Panel's advice.
WorkSafe's invoicing requirements
Refer to the How to Invoice WorkSafe guidelines.
What fees are payable for hearing services and devices
Refer to the fee schedules at the bottom of the page.
In relation to hearing services and devices, what the Agent won't pay for
The Agent will not pay for:
- treatment or services for a person other than the worker
- treatment or services that are not reasonable, necessary or appropriate in the circumstances
- devices that are not approved by WorkSafe under the legislation or services not in the Hearing Services Fee Schedules
- services or devices provided by an audiologist or audiometrist not approved by WorkSafe under the legislation
- services provided more than once on the same day to the same worker
- fees associated with cancellation or non-attendance
- treatment or services provided outside the Commonwealth of Australia without prior written approval from the Agent
- treatment or services provided by telephone or other non face to face mediums
- telephone calls and telephone consultations between providers and clients/workers, and between other providers, including hospitals.
Suspended from providing services to WorkSafe clients
If WorkSafe gives notice to a provider advising them that they are suspended from providing services to WorkSafe clients, WorkSafe will notify their professional body of the suspension and the grounds on which the suspension has been issued.