‘The Opinion further notes that the worker “did not report any symptoms until around one week after the
training course began,” offering this as additional support for ruling out acoustic shock. This reasoning again
tests only the mechanism the worker did not claim. Acoustic shock and acoustic trauma are single-event
mechanisms in which onset is, by definition, immediate. Tensor tympani and TM]J-mediated tension responses
to sustained exposure are cumulative strain mechanisms — delayed onset following several days of continuous
exposure is the anticipated clinical picture for this pathway, not evidence against it. Notably, the worker's own
January 22, 2026 report — filed within the first two weeks of exposure-and before the Pain escalated — already
documents the exposure as a live concern, consistent with a cumulative process building toward the acute
presentation nine days later, rather than a sudden, undocumented event.

6. Ignored Audiological Asymmetry and Confirmed Hyperacusis

The Opinion states that a comparison of pre- and post-incident industrial audiograms shows the worker's
hearing thresholds “have remained stable,” characterizing differences of 0-10 dB as “test-retest variability” and
concluding there is “no evidence of any significant changes in hearing thresholds.” The worker does not contest
this finding as far as it goes — he has never claimed conventional hearing loss, But it answers a question that
was never in dispute, and both submissions treat it-as though it resolves the claim.

Independent testing conducted by the Waveffont Centre for Communication Accessibility — 5 days after the
Clinical Opinion — produced findings materially relevant to the claim actually made:

* Asymmetric threshold shift: a 20-30 dB asymmetry between the ears at 10,000~12,500 Hz, with the tight
car demonstrating worse thresholds — an extended high-frequency range the standard industrial
audiogram comparison in the Opinion does not test.

e Confirmed hyperacusis: reduced loudness tolerance at 4~10 kHz and to running speech, specifically in the
left ear.

e Severity, objectively scored: the Khalfa Hyperacusis Questionnaire returned a score of 32 out of 40, in the
range of “severe fevel.of loudness intolerance.”

An asymmetric high-frequency threshold shift and an objectively scored, severe hyperacusis finding are
audiological findings squarely within Ms. Pang's own area of expertise. Their absence from.an Opinion that
otherwise relies heavily on audiogram comparison is a material gap, not a difference of clinical interpretation
~ and hyperacusis, specifically, is direct audiological evidence of the sensory-processing sensitivity discussed
in Section 8, below.

Source: Wavefront Centre for Communication Accessibility, audiological assessment report; Khalfa Hyperacusis
Questionnaire results,

7. Selective Use of the January 30, 2026 Emergency Room Record

The Opinion's own account of the evidence includes the following entry from the Royal Columbian Hospital
emergency record of January 30, 2026, describing a discussion between the attending physician and Dr. Zahabi,
ENT:

“The ENT specialist suspect{ed] that the noisy environment might have triggered his migraine headache

leading to the patient's symptoms.” -— Royal Columbian Hospital Emergency Record, January 30, 2026
(Meditech Report ID 3001-00357, pA)

Ms. Pang's own Opinion acknowledges this entry in near-identical terms:

“Dr: Zahabi suspected that the work environment might have triggered the worker's migraine headaches."
Clinical Opinion, F. Pang, March 20, 2026

Having recorded that the treating ENT specialist identified the work environment as the trigger for the acute
escalation, the Opinion does not apply that.finding. Instead, it pivots to the audiological measurement that the
average noise level (57.6 dBA) was “not considered hazardous to hearing,” and concludes on that basis that the
worker's “pre-existing and non-occupational conditions,” rather than the incident, are the main driving factor.

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