We may consider a replacement request before the five-year renewal date in certain conditions regardless of the age of the aid. This can include cases where there is a change in the person’s medical condition or unresolved fitting issues, among other reasons.
For hearing aid replacements, a rationale and/or supporting medical documentation, where applicable, must be submitted with the Hearing aid replacement/clinical exceptions request form. Any new prescriptions by the audiologist must be submitted with the request form. When submitting a request, information on the steps taken to resolve any issues and/or clinical solutions must be provided.
Note: If someone requires an exception-level hearing aid(s), please refer to the Clinical exceptions guidelines. If a replacement also includes a request for an exception-level hearing aid, complete both Section A: Hearing aid(s) replacement and Section C: Clinical exceptions on the request form.
The WSIB may authorize new aid(s) if they are due to the following:
1. Change in hearing
- A significant change defined as a minimum of 20 dB change in three or more of the following frequencies, in 500 Hz, 1000 Hz, 2000 Hz and 3000 Hz in the ear that the aid was originally authorized. A description of the type of loss, conductive or sensorineural and if the loss is temporary or permanent is required.
Note: A prescription and a completed Hearing assessment form must accompany the replacement request. Please continue to submit audiograms until the new Hearing assessment form is available. Audiogram reports must be submitted within six months of the hearing test. If available, please also include any relevant medical reports from the person’s physician.
Where appropriate, the WSIB may request additional information from the physician or audiologist regarding the change in condition and/or the temporary or permanent nature of the change. In exceptional cases, the WSIB may request an assessment report from an ear, nose and throat (ENT) specialist to assist in decision-making.
2. Change in the ability to operate hearing aids
- A significant change in the person’s medical condition throughout their claim, resulting in their inability to operate their hearing aid (e.g., dexterity, cognitive, mobility and/or vision issues). The clinician must provide details about impacts on the person’s daily living activities, including family and support availability.
Physician to submit a consultation report.
3. Fitting issues
- Hearing aid(s) no longer physically fit in the ear and remakes to the shell are no longer viable. Change in style not suitable due to changes in:
- the person’s ear canal size
- surgery to the external or middle ear
- any growth/atrophy of the person’s ears
Change in style due to occlusion after physical and electronic modifications were attempted. Change needed for non-allergic materials that are not provided by the current manufacturer.
A physician, or if applicable, an audiologist report that explains the fitting issues and need for a replacement should be submitted. If available, manufacturer remake estimates or confirmation must also be submitted.
4. Change in work duties and environment
- The person with a claim continues and/or returns to work and requires a change in hearing aid(s) related to a change in their work duties.
Supporting documentation should include a description of the work duties, job environment and hearing protection aids used.
5. Bimodal use of hearing aid and other medical causes
- Person with a claim 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.
- Person with a claim is a bimodal user of a bone conduction system and hearing aid on the other side that has specific needs for a bimodal solution for compatibility and streaming.
- Person with a claim has developed a significant hearing and vision loss that requires hearing aids that directly stream from reading aids.
Supporting ENT specialist medical report must be submitted.
- All repairs are to continue within the renewal period, and are covered during the warranty period. A replacement may be considered if the number of manufacturer’s accumulated repairs make the hearing aid(s) no longer viable.
- Out-of-office (manufacturer’s) repairs may include circuit or shell changes, hearing aid(s) that are no longer functioning, internal feedback is present, noisy/hissing, or the hearing aid device does not meet the manufacturer’s electro-acoustic specifications.
Provider will be required to submit supporting documentation that includes the history of all manufacturer repair or remake invoices to date.