The Workplace Safety and Insurance Board (WSIB) may consider requests for an exception-level hearing aid as a clinical exception for people that have entitlement to hearing-related impairment and have clinical requirements not met by the entry/mid-level devices. This can include the hearing aid integrated components and features that are clinically required for the person to be able to function fully and safely at home, work and /or in the community.
People with work-related injuries seeking a clinical exception model are required to receive pre-approval from the WSIB before purchasing the hearing aid.
Note: If someone requires a replacement of a hearing aid(s) before the five-year renewal date, regardless of the age of the hearing aid(s), submit a request for consideration under the Replacement of hearing aid(s) guidelines.
Process
The hearing health professional must complete the clinical exceptions section on the Hearing aid replacement form and submit it with the prescription and the hearing assessment form. The hearing health professional must provide, in writing, the following information:
- the rationale for the selection of the replacement hearing aid from the exceptions category or from a non-preferred manufacturer
- All authorized (entry and/or mid-level) hearing device(s) that may have already been trialed, including manufacturer invoices.
- the difficulty or dissatisfaction of the experience with authorized (entry and/or mid-level) hearing device(s);
- the proposed exception level hearing aid; and
- relevant clinical/medical reports or other supporting documentation
Features that support clinical exceptions
1. Hearing loss and medical considerations
- People with severe to profound hearing loss of 70 dB or poorer or a severe to profound single-sided deafness where audibility of sound, localization of sound, summation of sound, and understanding of speech in quiet and background noise cannot be met by the authorized models in the entry and mid-level range.
- Higher gain/output that is clinically required with additional flexible frequency responses, including frequency lowering to meet the person’s hearing loss. A hearing assessment form should be completed with speech in noise information.
- The person is a bimodal user with a cochlear implant on one side and hearing aid on the other side that has specific needs for a bimodal solution for compatibility and streaming.
- The person is a bimodal user of a bone conduction system and hearing aid on the other side that have specific needs for a bimodal solution for compatibility and streaming.
- The person has significant hearing and vision loss that requires hearing aids that directly stream from reading devices not available from the authorized models.
2. Physical fit
- Style not available from the preferred suppliers in the entry and mid-level that is necessary, sufficient and appropriate for the hearing loss.
- Materials needed for allergic reactions not provided by preferred suppliers in the entry and mid-level categories.
- Models needed that have robust moisture protection as per IP 68 standard not available from the preferred suppliers in the entry and mid-level categories.
3. Work duties and environment
- The person continues and/or returns to work and requires exception-level hearing aid(s) related to a change in their work duties.
Note: supporting documentation should include a description of the work duties, job environment and hearing protection devices used.