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Two colleagues talking at a standing desk in a glass-walled office

Sudden Hearing Loss: The First Weeks and Returning to Work

/ Hearing loss, Professionals / By

If anyone reading this has lost hearing suddenly, in one ear or both, stop reading and get urgent medical help now. The NHS advises asking for an urgent GP appointment or getting help from NHS 111 for sudden hearing loss in one or both ears. Do not wait to see whether it settles. Everything else in this article can wait until that has happened.

For employers, occupational health teams and case managers, the harder question comes a little later. A colleague is off sick, or back at their desk, and nobody knows yet what their hearing will do. It may recover, partly recover or not recover, and the answer may take weeks. Managers are left deciding how to stay in touch, how to talk to someone who cannot follow a phone call, and when to start talking about a return, all without a diagnosis or a prognosis to lean on. This article covers that uncertain stretch from the workplace side only. It does not give medical, treatment or prognosis advice, and it is not a substitute for the clinicians involved.

Two colleagues talking at a standing desk in a glass-walled office

What sudden hearing loss is, and why it is urgent

Sudden sensorineural hearing loss is a rapid drop in hearing, often in one ear, that is not explained by something like earwax or a middle ear problem. The NHS hearing loss page lists sudden hearing loss in one or both ears as a reason to ask for an urgent GP appointment or call NHS 111, and adds that it might not be anything serious but may need to be treated quickly. RNID describes sudden hearing loss as something that can be a medical emergency, with a short window of time for treatment to work, and says to contact NHS 111 or your GP, or go to accident and emergency if you cannot reach either.

The timings in clinical guidance are tighter than many people expect. NICE guideline NG98 (updated October 2023) says adults whose hearing loss developed over three days or less within the past 30 days should be referred immediately, to be seen within 24 hours, to an ear, nose and throat service or an emergency department. One NHS trust patient page describes it as a medical emergency and advises a GP appointment within 24 hours. Wording differs slightly between sources, but the message is the same: act on the day, not next week.

No incidence figure is quoted here. Published estimates vary by country and method, and a reliable UK figure could not be verified for this article.

How the first weeks can affect work

Sudden loss is different from gradual loss in one important way. The person has had no time to adapt, and neither has anyone around them. Phone calls that were routine may become impossible. Meetings with several voices, open-plan noise and video calls without captions may become exhausting overnight. Many people also experience tinnitus or balance symptoms alongside the hearing change, as RNID notes, which can affect concentration, travel and confidence.

There is an emotional side too, and managers should expect it. Someone facing sudden change, medical appointments and an uncertain outcome may be anxious about their health, their role and how colleagues will react. That is an understandable response, not a performance issue. The Acas guidance on mental health at work advises managers to arrange a conversation promptly, meet in private, stay calm and reassuring, listen with open questions, and keep what is shared confidential unless there is a good reason to share it.

The uncertainty itself is the practical problem. Hearing may fluctuate, change after treatment or settle at a new level, and nobody can plan around a fixed picture. The sensible approach is to plan around what the person can and cannot do this week, and review it.

The first days and weeks: what managers can do

In the first days, the job is simple. Keep contact respectful and agreed. The fit note guidance for employers from the Department for Work and Pensions says the employer and employee should agree how they will stay in touch during sickness absence and how much contact is reasonable, and Acas says much the same. Ask which channel works now. Email, text or a message in writing will usually be easier than a phone call, and the person should decide how often they hear from you. Avoid chasing, and equally avoid silence, which people often read as being forgotten.

Keep the first conversation about wellbeing and practicalities, not return dates. Make sure payroll, sick pay and fit note questions are handled without the employee having to chase them. Employees can self-certify for the first seven calendar days, after which a fit note is needed. GOV.UK guidance notes that a fit note can be issued for a maximum of three months at a time in the first six months of a condition, with a review date if needed.

When a return is being considered, the fit note itself is a useful prompt. The employer guidance explains that where the healthcare professional says someone may be fit for work, they can tick options such as a phased return, altered hours, amended duties or workplace adaptations, and add comments on the functional effects. These discussions are meant to be interactive, because the employee is best placed to say how their symptoms affect particular tasks. Anything a fit note says about fitness for work is a clinical judgement for the healthcare professional. It is not for HR or a line manager to second-guess, and it is certainly not for an article like this to predict.

An occupational health referral is often sensible at this stage, particularly where the picture is complicated. The same DWP guidance says referral can be useful in complex cases and that a risk assessment may be needed to accommodate fit note advice.

Interim communication adjustments while hearing is uncertain

Where hearing is uncertain or fluctuating, adjustments should be light, quick to put in place and easy to change. The aim is to keep the person connected to work without locking in arrangements that may not suit them in a month. Most of them cost little.

No-cost and low-cost workplace adjustments

Area Suggested adjustment Why it helps
Keeping in touch Agree the channel and frequency in writing, favouring email or text over calls Removes the strain of phone calls and gives the person control over contact
Meetings Send agendas and notes in advance, use one speaker at a time, and sit the person facing the speaker with good lighting Reduces the effort of following speech and supports lip reading and context
Video calls Turn on live captions where the system has them, keep cameras on and ask people to speak one at a time Gives a written and visual back-up when audio alone is hard
Noise Offer a quieter desk, a side room for key conversations, or home working where practical Background noise can make speech very hard to follow
Instructions Confirm verbal instructions and decisions in writing Prevents missed detail and misunderstanding
Phased return Start with reduced hours or fewer meetings and review at agreed points Lets workload build as the person finds out what works
Alerts and safety Check that alarms, fire evacuation and building announcements can be perceived, for example through visual alerts and a buddy Supports safe working without singling anyone out
Review Put a review date in the diary for every interim arrangement Hearing may change, so arrangements should change with it

What this means for occupational health, HR and case managers

For referrers, the gap is usually not in goodwill but in sequence. A person is signed off while the medical picture is unclear, then returns to a workplace nobody has looked at in terms of communication. The most useful thing you can do is separate the clinical questions, which belong to the treating team and occupational health, from the functional ones: how does this person communicate at work right now, and what would help this week?

A return to work assessment is the natural point to ask the functional question before or soon after the person comes back. Done well, it looks at the actual tasks, meetings, phone use and environment, and gives the employer practical, proportionate recommendations that can be reviewed as hearing changes. A hearing loss workplace assessment does the same job where hearing loss is established, or where the person is back at work and the arrangements are not working. At Visualise Training and Consultancy Ltd, our assessments are specialist and practical rather than clinical, and they sit alongside occupational health, audiology and rehabilitation input, never in place of it.

For insurers and case managers, it helps to ask early whether communication support has been considered, since a workable return plan can be the difference between a staged return and an extended absence. Build review points into the plan rather than treating the first set of recommendations as final.

Hints and tips for the individual

  • Say how you prefer to be contacted while off, and ask for written follow-up of anything agreed.

  • Tell your manager what is hardest right now, such as phone calls or group meetings, rather than trying to explain the whole condition.

  • Ask for a phased return and a review date if you are unsure how you will manage.

  • Keep a note of what helps and what does not, as it will make any later assessment faster.

  • Look at Access to Work early, as it can take time to arrange.

  • If anxiety about work is building, talk to your GP or occupational health, and ask your manager what employee support exists.

Building awareness and communication

Colleagues do not need medical detail, and the person decides what is shared. RNID’s advice for employees is to agree with the manager or HR what information will be passed on. A short, agreed message to the team is usually enough: what has changed in how to communicate, and what to do differently. Face the person when speaking, do not talk while turning away, write things down, and check understanding rather than assume it.

Keep the tone matter-of-fact. Awareness that treats the person as fragile, or that implies hearing loss makes them unsafe or less capable, does more harm than the loss itself. Training for teams on practical deaf awareness, delivered before the person returns where possible, makes the first week far easier for everyone.

Legal rights and support

Under the Equality Act 2010, a person is disabled where they have an impairment with a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. Schedule 1 treats an effect as long-term if it has lasted or is likely to last at least 12 months, and treats an effect that is likely to recur as continuing. It also says that where measures such as medical treatment or aids are being used to treat or correct an impairment, the effect is considered as it would be without them. Because sudden hearing loss may recover, partly recover or persist, it is often unclear early on whether the definition will be met, and employers are generally wise to act supportively in the meantime. Where the definition is met, the employer must make reasonable adjustments. Whether it is met for a particular person depends on their circumstances, and this article is general information rather than legal advice.

Access to Work can help with practical support, including specialist equipment, support workers and communication support, as well as mental health support. According to GOV.UK, you must be in paid work, or about to start or return to paid work within 12 weeks, and live and work in England, Scotland or Wales, as there is a different system in Northern Ireland. Access to Work does not pay for reasonable adjustments an employer must legally make, though it will advise the employer if changes should be made as such. Mental health support through Access to Work can only be claimed once.

Summary

Sudden hearing loss needs urgent medical help first. After that, the workplace job is to keep contact agreed and respectful, use the fit note and occupational health to plan a return, and put light interim communication adjustments in place with review dates attached. Do not wait for certainty before acting. Hearing may change, so the plan should be built to change with it, and the person should be listened to throughout.

Watch the short film

This short film follows an employee who has kept their hearing loss to themselves, nodding in meetings and writing numbers down on the phone. When a colleague asks if they are alright, they say it aloud, and their manager arranges a workplace assessment covering calls, meeting rooms, noise and equipment. It is a reminder of how much easier work becomes once the conversation starts. The film lasts just over a minute.

Frequently Asked Questions

Get urgent medical help straight away. The NHS advises asking for an urgent GP appointment or getting help from NHS 111, and RNID says to go to accident and emergency if you cannot reach either. Do not wait to see whether it improves.

Agree the method and frequency with them, in writing where possible. Email or text is often easier than calls. Keep contact supportive rather than focused on return dates.

That is a decision for the individual and their healthcare professionals, shown on any fit note. Where they are cleared to return, a phased return, altered hours or amended duties, with interim communication adjustments and a review date, is a common approach.

It helps when the person is returning, or has returned, and the practical question is how they will manage meetings, calls and the working environment. It gives the employer proportionate recommendations that can be reviewed as hearing changes.

If you or someone in your team is deaf or has hearing loss and would like expert, tailored support to stay productive and comfortable at work, you can arrange a hearing loss workplace assessment with us.

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