The Personal Capacity Assessment and Hearing.

The full title for this activity is "hearing with a hearing aid or other aid if normally worn".

This activity has six descriptors. The figures in brackets represent the points awarded if that descriptor is met.

• Cannot hear sounds at all; (15)
• Cannot hear well enough to follow a television programme with the volume turned up; (15)
• Cannot hear well enough to understand someone talking in a loud voice in a quiet room; (15)
• Cannot hear well enough to understand someone talking in a normal voice in a quiet room; (10)
• Cannot hear well enough to understand someone talking in a normal voice on a busy street; (8)
• No problem with hearing.(0)

The second descriptor refers to not being able to follow a television programme with the volume turned up to maximum. The handbook says that this would imply a very severe degree of hearing loss that will only apply in "exceptional" cases- those with a binaural hearing threshold of above 90db.

The term "busy street" does not mean one "rendered intolerably noisy by exceptional machinery" but to one with busy traffice passing by.

Doctors are advised to consider hearing with the claimant wearing and using their normal hearing aid. The handbook goes on to say that, in the case of those claimants who have been inconvenienced a hearing aid and have abandoned it then the hearing should be assessed without aids.

With regard to the relevant activities of daily living the handbook says that significant deafness is such a disadvantage that the claimant is likely to report problems with-

• social isolation;
• domestic difficulties;
• communication in shops;
• family occasions;
• inability to continue with certian hobbies, eg going to the cinema or theatre, playing bingo or bridge.

With regard to Tinnitus, the handbook says tha this condition can be very disabling. Doctors are advised that the following are indicators that disabling tinnitus is present-

• Referral to a specialist unit;
• The prescription of maskers/hearing aids;
• The need for night sedation;
• The prescription of anti-depressant medication.

Doctors are advised to consider using the mental health tests in cases of tinnitus where there is cognitive impairment or disablements such as anxiety.

With regard to Meniere's disease, the handbook acknowledges that this can lead to progressivve hearing loss. Doctors are advised to note the frequency and duration of the attacks as well as the therapeutic measures been taken to cope with the condition and the effect of those measures.

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