Introduction
From November 10, 2025, to January 30, 2026, the Workplace Safety and Insurance Board (WSIB) is conducting a public consultation related to occupational noise-induced hearing loss (NIHL). The WSIB invites feedback from businesses, people who are ill or injured, trade and labour organizations, health professionals, and other interested members of the public.
This consultation note provides background on Operational Policy Manual (OPM) document #16-01-04, Noise-Induced Hearing Loss (NIHL Policy) and summarizes key proposed updates.
It is important to note that the Consultation Draft of the NIHL Policy does not reflect the WSIB’s final conclusions or positions. All feedback received during this consultation will be carefully reviewed and considered and will help inform revisions to the NIHL Policy before it is finalized.
Through this consultation, the WSIB aims to ensure that the revised NIHL policy strengthens consistency, timeliness, and quality in entitlement decisions for NIHL claims and seeks to enhance transparency about decision-making for occupational NIHL for workers, employers, and the broader stakeholder community.
Once the review is complete, the final approved version of the updated NIHL Policy will be posted along with a consultation summary report. In addition, all submissions received during the consultation process will be made publicly available on the WSIB website.
Background
Occupational NIHL is recognized as an occupational disease under the Workplace Safety and Insurance Act, 1997 (WSIA).
Occupational NIHL is a permanent but preventable condition. Though occupational noise exposure is regulated, hazardous noise exposure, and occupational NIHL, remain highly prevalent in Canada. Many Ontario workers who file NIHL claims do not have their hearing assessed until well after they have retired.
At the WSIB, the total number of NIHL claims has generally increased year over year since 2009, with the most significant growth occurring from 2020 onwards. Similar upward trends have also been relayed by other Canadian workers’ compensation boards.
The entitlement guidelines for NIHL claims are set out in the NIHL Policy. This longstanding policy, which has guided entitlement decisions since 1992, has not been updated in over three decades.
In early 2024, the Operational Policy Branch (OPB) conducted a comprehensive review of the NIHL Policy to assess whether its guidelines continue to reflect current scientific evidence on the relationship between occupational noise exposure and hearing loss. As part of this process, OPB engaged with the Scientific Advisory Table on Occupational Disease (SATOD) to review the latest scientific evidence, particularly regarding the interaction between occupational NIHL and age-related hearing loss (i.e., presbycusis). Both the scientific evidence and SATOD’s insights informed the development of the Consultation Draft of the NIHL Policy.
The OPB’s review also provided the opportunity to re-examine policy criteria, include new guidance, and provide clarity to existing guidance for the adjudication of NIHL claims.
Overview
OPB has undertaken several activities to assess policy issues related to the adjudication of NIHL claims and support policy development. These activities have included:
- engaging with SATOD to review the latest scientific evidence,
- collaborating with internal partners to understand operational and adjudicative challenges,
- reviewing the scopes of practice of relevant regulated health professionals (i.e., physicians, and audiologists) and hearing instrument practitioners,
- conducting a detailed jurisdictional scan of Canadian workers’ compensation board policies and practices, and
- reviewing relevant alignment with other OPM policies.
OPB’s analysis has identified areas where the NIHL Policy could be clarified or strengthened to better support consistent, timely, and evidence-informed decision-making. Key findings included:
- the opportunity to streamline decision-making processes to address increasing claim volumes and to connect workers with benefits in a timely manner,
- the need for greater clarity around audiogram requirements and the quality of medical documentation submitted,
- recognition of differences in administrative practices across Canadian jurisdictions,
- opportunities to align more closely with recently published scientific evidence, and
- the need for clearer entitlement criteria and additional guidance on issues; some which are not addressed in the current NIHL Policy.
High-level summary of proposed policy changes
The Consultation Draft of the NIHL Policy includes the following notable updates:
- Moving to 26.25 dB loss as the minimum threshold for initial entitlement to align with permanent impairment requirements.
- Removing the presbycusis (aging) deduction factor.
- Clarifying that the noise exposure threshold (NET) in the NIHL Policy is 90 dBA exposure for 5 years, or the equivalent, to streamline decision-making.
Policy guidance has been incorporated or clarified in several areas, such as:
- hearing assessment requirements
- asymmetrical hearing loss
- use of hearing protective devices
- non-economic loss (NEL) benefits for NIHL
- tinnitus
Notable policy changes:
Aligning the hearing loss and permanent impairment requirements
The Consultation Draft of the NIHL Policy sets a minimum average hearing threshold of 26.25 dB for initial entitlement, replacing the previous threshold of 22.5 dB. This change aligns with the minimum level of hearing loss required for a ratable permanent impairment under the American Medical Association Guides to the Evaluation of Permanent Impairment (3rd edition) (AMA Guides), which is the prescribed rating schedule under Ontario Regulation 175/98 of the WSIA.
According to the AMA Guides, a threshold of 26.25 dB or greater in each ear represents the minimum level at which hearing loss is recognized as a permanent impairment.
This change will harmonize the compensation thresholds for health care and permanent impairment benefits into a single, evidence-informed threshold. It will also align Ontario’s approach to that of most other Canadian workers’ compensation boards.
Removing the presbycusis factor
The Consultation Draft of the NIHL Policy removes the presbycusis factor. Under the current NIHL Policy, this factor requires a deduction of 0.5 dB for every year the worker is over the age of 60 at the date of audiogram. This “age correction” approach was historically applied by many workers’ compensation boards to separate age-related hearing loss from occupational NIHL.
Advances in scientific understanding now show that hearing loss observed with age is complex, reflecting the cumulative and synergistic effects of both extrinsic and intrinsic risk factors for hearing impairment, including occupational exposure to noise. 1 2 Applying a fixed correction factor risks overstating the role of age and understating the potential contribution of occupational noise exposure. For this reason, most compensation boards have moved away from automatic age deductions.
Under the revised approach, age-related loss can still be considered, but it is evaluated in the context of an individual claim, where a decision-maker may assess whether age-related hearing changes are more likely than not to have overwhelmed the effects of occupational exposure, taking into account the audiogram pattern, the level and duration of occupational noise exposure, and overall severity of the hearing loss.
Clarifying the NET to streamline decision-making
The Consultation Draft of the NIHL Policy maintains the existing NET of 90 dBA, measured over an 8-hour workday, for a cumulative duration of at least 5 years, or an equivalent combination of occupational noise level and duration of exposure.
The NET is designed to streamline initial entitlement decisions: when the NET is met and NIHL confirmed, the worker’s occupational exposure to noise will generally be accepted as sufficient to have caused or significantly contributed to the development of the NIHL, without the need for a more in-depth exposure review.
The Consultation Draft of the NIHL Policy also makes it clear that not all claims just below the NET are denied, and not all claims just over the NET are allowed. In these cases, initial entitlement determinations must still be considered. However, such claims may require a more detailed review, with the decision-maker assessing the totality of the evidence to determine whether the worker’s occupational exposure to hazardous noise, either on its own or in combination with other factors, was sufficient to have significantly contributed to the NIHL.
Select highlights of other updates:
Hearing assessment requirements
The Consultation Draft of the NIHL Policy sets out that decision-makers will assess every hearing assessment and audiogram submitted to determine whether the quality of the information is sufficient to be used for NIHL determinations.
Furthermore, the Consultation Draft of the NIHL Policy requires that all hearing assessments (including audiograms) conducted after the policy’s implementation must include both air and bone conduction testing and need to meet the practice standards of the applicable regulatory college or professional association.
The WSIB has developed a comprehensive hearing assessment and standardized audiogram template in collaboration with the College of Audiologists and Speech-Language Pathologists (CASLPO) and Association of Hearing Instrument Practitioners (AHIP). The Consultation Draft of the NIHL Policy expresses a preference for hearing assessments to be completed using the WSIB’s form. That said, other compliant report formats will also be acceptable if they provide the same required information.
Asymmetrical hearing loss
Occupational NIHL is bilateral hearing loss. Hearing loss that is greater in one ear than the other is referred to as asymmetrical hearing loss. The Consultation Draft of the NIHL Policy clarifies that asymmetry is consistent with NIHL when the difference in average hearing loss is 15 dB or less between ears. Asymmetry that exceeds 15 dB may be considered as occupational only if there is relevant evidence that the worker was exposed to occupational noise exposure that was asymmetrical to account for the difference.
Consideration of hearing protective device (HPD) use
Workers may wear HPDs, such as ear plugs or earmuffs, to help protect against hazardous noise. The Consultation Draft of the NIHL Policy clarifies that wearing HPDs, on its own, is not sufficient to outweigh evidence that a worker was exposed to hazardous noise in the workplace when they have met the NET or an equivalent and developed NIHL. That said, the policy clarifies that HPD use may strengthen a conclusion that the employment was not a significant contributor to the hearing loss when considered alongside other evidence suggesting the worker’s hearing loss is not work-related (e.g., workplace noise exposure was limited (less than the NET), or there is significant non-occupational exposure to hazardous noise that could explain the loss).
Non-economic loss (NEL) benefits for NIHL
As previously outlined, the Consultation Draft of the NIHL Policy provides that workers with entitlement to NIHL (hearing loss of at least 26.25 dB in both ears) are considered to have a ratable permanent impairment and are eligible for a NEL benefit. In the updated policy this determination will be based on hearing loss levels that will not be adjusted by a presbycusis factor.
The Consultation Draft of the NIHL Policy explains that the degree of work-related permanent impairment resulting from occupational exposure to noise encompasses both the exposure period(s) that is attributable to the employer who significantly contributed to the development of NIHL for initial entitlement to NIHL, and any other prior noise exposure periods where the worker had coverage under the WSIA. Further, the updated policy clarifies that all non-covered exposure is removed from the permanent impairment determination and describes how that is calculated.
Importantly, the updated policy also makes clear that a worker who already has entitlement for NIHL and a NEL benefit and experiences a worsening of their hearing impairment is only eligible for consideration of additional NEL entitlement if they have remained in or returned to occupational noise exposure. There is limited scientific evidence that hearing loss progresses after the cessation of excessive noise exposure at work.3
Tinnitus
The Consultation Draft of the NIHL Policy also includes a section outlining the criteria for entitlement to NIHL-related tinnitus and how the degree of permanent impairment is determined for this condition. This guidance is intended to replace OPM document #16-01-08 Tinnitus, Post-January 2, 1990, as it applies to new NIHL-related tinnitus entitlement decisions post-implementation.
1 Leroux, T. and A. Pinsonnault-Skvarenina (2018). Review of the Literature on the Links between Occupational Hearing Loss and Presbycusis, Institut de recherche Robert-Sauve en sante et en securite du travail.
2 Themann, C. L. and E. A. Masterson (2019). "Occupational noise exposure: A review of its effects, epidemiology, and impact with recommendations for reducing its burden." J Acoust Soc Am 146(5): 3879.
3 Leroux, T. and A. Pinsonnault-Skvarenina (2018). Review of the Literature on the Links between Occupational Hearing Loss and Presbycusis, Institut de recherche Robert-Sauve en sante et en securite du travail.
Feedback
We are inviting feedback on the draft NIHL policy from businesses, people who are ill or injured, trade and labour organizations, health professionals, and other interested members of the public. We value all stakeholder feedback and will carefully consider it.
By submitting feedback and comments to a public and transparent consultation process, respondents agree to the WSIB making public the content that they submit, and to the WSIB’s Terms of Use. We will post all stakeholder submissions on this webpage. Please don’t send personal information in emails or written submissions. We will not publish any information that includes personal details.
Please email your feedback to [email protected] by January 30, 2026. We look forward to hearing from you.