Audiovestibular specialist medico-legal reports
Independent expert reports on hearing loss, tinnitus, dizziness, vertigo and balance disorders, prepared for civil proceedings in England and Wales and written in accordance with CPR Part 35.
Audiovestibular consultants assess hearing and balance disorders, including hearing loss, tinnitus, dizziness and vertigo. Their medico-legal reports provide an independent expert opinion to help courts and legal teams understand the medical evidence, its significance and its limitations.
The expert considers the clinical findings, relevant test results, possible causes, prognosis and the effect on daily life or work. We match each instruction to the appropriate discipline, and reports for civil proceedings in England and Wales are prepared in accordance with CPR Part 35 and Practice Direction 35.
For what a report contains and how to instruct one, see our guide to medico-legal reports.
What is a vestibular assessment report?
A vestibular assessment report is an independent medical report on the balance system, prepared for a legal claim rather than for treatment. It sets out the diagnosis, what caused it and the likely prognosis, under CPR Part 35.
Conditions and symptoms assessed
The scope can include hearing loss, tinnitus, hyperacusis, dizziness, vertigo and imbalance, and conditions such as BPPV, vestibular migraine, labyrinthine concussion, Ménière's disease and persistent postural-perceptual dizziness.
Tests selected for the case
There is no standard test battery for every claimant. The expert may consider audiometry, positional testing, VNG, vHIT, VEMP or caloric testing where clinically indicated, and explains the significance and limits of each result.
Diagnosis, causation and prognosis
The report separates diagnosis, medical causation and prognosis. It considers the incident, symptom chronology, records, test findings, alternative explanations and pre-existing conditions before setting out a reasoned conclusion.
Impact on daily life and work
The expert can consider the effects on communication, concentration, sleep, travel, mobility and employment. The report separates the person's own account of those effects from the ones that are supported by the clinical evidence.
How to instruct the expert
Provide the medical questions, incident and symptom chronology, relevant records and test results, with the deadline and any appointment requirements. We confirm the proposed discipline and scope before the instruction proceeds.
What the report can address
The report explains the evidence relied upon, the expert's reasoning and any material limitations. It gives the court a clear opinion on the hearing or balance issues within the expert's discipline.
- Hearing loss, tinnitus and sound sensitivity
- Dizziness, vertigo, imbalance and falls risk
- BPPV, vestibular migraine and labyrinthine concussion
- Persistent postural-perceptual dizziness (PPPD)
- Review of medical records, audiograms and imaging
- Proportionate hearing and vestibular testing where indicated
- Opinion on causation, prognosis, treatment and functional impact
- CPR Part 35 reports and responses to written questions
Audiovestibular medico-legal reports: FAQs
What is an audiovestibular examination and how is it used in a medico-legal report?
An audiovestibular examination is a specialist assessment of the hearing and balance systems. The consultant reviews the history and medical records, performs a clinical examination and considers any appropriate hearing or vestibular test results. The medico-legal report then explains the diagnosis, relevant findings, causation, prognosis and any limitations in the evidence.
Which symptoms and conditions can an audiovestibular expert assess?
An audiovestibular expert may assess hearing loss, tinnitus, hyperacusis, dizziness, vertigo and imbalance. Depending on the instruction and clinical evidence, the opinion may also consider conditions such as benign paroxysmal positional vertigo (BPPV), vestibular migraine, labyrinthine concussion, Ménière's disease and persistent postural-perceptual dizziness (PPPD).
Which hearing and balance tests may be needed?
Testing is selected according to the medical questions and the claimant's presentation; there is no single standard battery for every case. It may include pure-tone audiometry, positional testing, videonystagmography (VNG), video head impulse testing (vHIT), vestibular evoked myogenic potentials (VEMP) or caloric testing where clinically indicated.
Can the report address causation and prognosis?
Yes. Within the expert's discipline, the report can consider whether the hearing or balance symptoms are consistent with the incident alleged, while taking account of their timing, test findings, alternative explanations and any pre-existing condition. It can also give an evidence-based prognosis and address treatment or further investigation where appropriate.
What should solicitors provide when instructing an audiovestibular expert?
The letter of instruction should set out the issues to be addressed, the incident and symptom chronology, the relevant deadline and any appointment requirements. Relevant GP and hospital records, audiograms, imaging, previous expert reports and other hearing or vestibular test results should be supplied where available. We can help confirm the appropriate discipline and scope before the instruction proceeds.
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