Five Months After Abbott: Some Reflections on Military Hearing Loss

It is now almost five months since the High Court handed down judgment in Abbott v Ministry of Defence. Since then, I have been contacted by dozens of serving personnel and veterans about military hearing loss.

Some I represent, some I served alongside, and many have spent considerably longer in noisy military environments than I ever did.

One aspect of the judgment has remained particularly interesting to me: the Court’s findings concerning latency and the possible acceleration of age-related hearing loss following military noise exposure.

Latency and Acceleration

One of the generic issues in Abbott was whether hearing damage caused by military noise could manifest itself after exposure had ceased — the so-called “latency issue” — and the extent to which natural or age-related hearing loss might subsequently be accelerated by previous military noise induced exposure. Those questions were expressly identified for determination in the litigation. 

The claimants did not succeed on that part of the case.

In practical terms, the evidence did not establish that hearing loss caused by military noise continues to progress after the damaging exposure has ceased, or that the earlier acoustic injury accelerates subsequent age-related deterioration.

It is that conclusion which particularly interests me.

Because in a number of the cases I am now dealing with, the starting point is not a veteran who left service with entirely normal hearing and first developed noise induced hearing loss 20 years later.

There is contemporaneous evidence that hearing damage had already occurred during military service. What has happened subsequently is that the hearing has deteriorated very substantially. Some of these veterans, 15 or 20 years after leaving service, now require hearing aids.

That raises what seems to me to be a straightforward question of causation:

On the balance of probabilities, would that veteran’s hearing today have been materially better but for the damage sustained during military service?

The Evidence before the Court

Abbott involved thousands of military hearing loss claims. Inevitably, the generic issues could not be determined by hearing evidence from every individual claimant. They were therefore tried through a small number of selected lead cases.

The Court determined the latency and acceleration issues on the factual and expert evidence arising from those cases. As with any litigation, the findings necessarily reflected the evidence before the Court. 

That is important when considering the wider significance of the judgment.

I act for a number of former servicemen who spent many years in artillery units, including my Regiment, 29 Commando Regiment Royal Artillery, with repeated exposure to very substantial levels of noise.

Their service histories and, in some cases, their longitudinal audiometry present a markedly different factual picture from the lead cases considered in Abbott. 

Some left service with measurable hearing damage but which was relatively modest at the time. Years later, their hearing is markedly worse.

That is not quite the same question as hearing loss appearing for the first time decades after noise exposure has ceased. It raises a separate and, to my mind, important question: can an ear which has already been permanently damaged by military service subsequently deteriorate differently from an ear which has not sustained that damage?

Had a long-serving artillery case presenting that evidential picture been selected as a lead case, the Court would necessarily have had different evidence before it when considering the long-term consequences of military noise exposure.

That question has remained in my mind during the months since the judgment.

What I have seen since Abbott

A few days after the judgment was handed down, I attended a reunion involving veterans of the Falklands conflict in 1982 and others who joined the Regiment shortly afterwards.

There were around 100 former servicemen in the room. Everyone was over 50, many were in their 60s and some in their 70s.

What struck me immediately was their hearing.

More than half appeared either to be wearing hearing aids or, from ordinary conversation, struggling sufficiently with their hearing that they probably ought to have been.

These were men who had spent years exposed to tremendous levels of military noise — artillery, small arms, explosives, helicopters and vehicles — during operational deployments and peacetime training. Many had been outside the Army for more than 20 years in peacetime environments. 

That experience has been reinforced repeatedly in my work since. Again and again, I encounter veterans in their 50s, 60s and early 70s who now rely upon hearing aids or struggle considerably with their hearing.

Of course, these are my observations. This is not epidemiological or scientific evidence.

But I am perfectly entitled to make those observations. I served alongside some of these men. I know the environments in which they worked and the extraordinary levels of noise to which they were repeatedly exposed. I now see many of them, decades later, wearing hearing aids or plainly struggling with their hearing.

I cannot help asking the obvious question. Had those same men spent their formative working lives — from their late teens into their 30s and 40s — as office workers rather than around artillery, small arms, explosives and military aircraft and vehicles, would anything like the same proportion now require hearing aids?

I find the pattern increasingly difficult to ignore. 

A Clinical Perspective

My observations prompted me to discuss the issue with a senior consultant ENT surgeon who regularly prepares independent expert evidence for the courts in military hearing loss claims.

His response was striking.

He told me that my observations had not escaped him or other medical colleagues. In his clinical experience, he has seen many former servicemen whose military audiometry was near normal on leaving service but who, 20 years later, demonstrate what he regards as a classical noise-induced pattern of hearing loss.

He also raised an important question about the weight now being placed upon historic military audiometry. His experience, including discussions with former service personnel, is that military hearing surveillance was not always conducted in circumstances comparable with modern diagnostic audiometry. Servicemen wanted to pass the test and remain medically fit for their role; testing could be undertaken quickly; and background noise and other conditions could affect the result. He also points to the inherent margin of variability in pure-tone audiometry itself. 

There is a further issue which particularly interests me. Pure-tone thresholds do not necessarily capture the whole functional effect of hearing damage. The consultant drew attention to discriminatory hearing loss: an individual may have relatively normal measured thresholds yet experience considerable difficulty understanding speech, particularly against background noise — precisely the difficulty so many veterans describe to me.

He also offered a simple medical analogy.

A sportsman may retire apparently fit but develop musculoskeletal degeneration earlier than somebody who did not subject his joints to the same stresses when younger. He questions whether the same principle may apply to the ear: if the inner-ear hair cells have already sustained acoustic damage when somebody is young, might that damage make subsequent deterioration manifest earlier than it otherwise would? 

The analogy is readily understood in other areas of personal injury litigation. A knee damaged in a young man may function reasonably well for years, yet subsequently become arthritic considerably earlier than an undamaged knee. The fact that the claimant has been removed from the activity which originally damaged the joint does not, of itself, answer the question whether that earlier injury materially contributed to its later deterioration.

The medical question which interests me is whether the same principle can apply to an ear already damaged beyond repair. 

That is a medical question requiring medical and scientific evidence. But it is particularly interesting because it arises not merely from my own observations. It has been raised independently by a senior clinician who has examined military hearing loss cases and recognises the same pattern that I have been observing amongst veterans.

It reinforces my view that the medical and scientific debate about the long-term consequences of military service on hearing is not over.

Where does this leave us?

For the moment, Abbott is the judgment we have, and those of us advising veterans must apply it.

The claimants did not establish in Abbott that previous military noise exposure can cause hearing deterioration to manifest after exposure has ceased or accelerate subsequent age-related hearing loss.

But there is a factual situation which particularly interests me.

There will be cases in which contemporaneous evidence demonstrates that a serviceman did sustain noise induced hearing damage during military service, but where that hearing has deteriorated very substantially during the following 15 or 20 years.

In such a case, the important question may not simply be whether hearing loss can first appear decades after noise exposure has ceased.

It is as I state earlier:

On the balance of probabilities, would that veteran’s hearing today have been materially better but for the damage sustained during military service?

That seems to me to be an important medico-legal question.

From what I have observed amongst veterans with long histories of military noise exposure, and from the clinical concerns now being expressed to me, I find it increasingly difficult to accept that the scientific or legal debate is over.

That question deserves to be tested on the right evidence and in the right case.

I suspect that Abbott will not be the last time the High Court is asked to consider it.

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23.09.2026

G Evatt - Founder of Alma Law