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Hearing Loss and Tinnitus
It is the experience of VAWatchdog that your claim for tinnitus and hearing loss will be denied.
We receive many emails from frustrated veterans on this topic.
Vets who have Purple Hearts or CIB's are often denied a hearing loss or tinnitus claim because they have no record of combat. We often read that the VA audiologist who conducted the exam reports that the veteran was not cooperative.
VAWatchdog recommends that you plan to appeal as it is more likely than not going to be required. The majority of appeals are handily won at the DRO Process appeal.
VAWatchdog also recommends that you seek a reputable civilian audiologist to perform an examination. You will probably have to pay for the exam out of pocket. This is an investment that is well worth the fee.
Hearing aids are expensive. If your hearing was damaged because of your service to our country, don't accept a denial or a low rating.
Hearing Impairment
Hearing
loss affects more veterans than most can imagine. From the first day of
basic training we were subjected to noises that most civilians will
never hear.
The Veterans Administration has strict regulations governing hearing loss and disability compensation. The veteran who wants to see a benefits award must be prepared to fight and appeal.
§ 4.85 Evaluation of hearing impairment. (h) Numeric tables VI, VIA*, and VII.
The VA uses a strictly defined criteria to determine the degree of hearing loss. An examination for hearing loss must be conducted by a licensed audiologist and include controlled speech discrimination test (Maryland CNC) and a puretone audiometry test.
The results of the tests are then calculated according to a system of tables to arrive at a percentage of the disability attributed to hearing loss.
The veteran who is applying for a hearing loss benefit should consider the degree of tinnitus that he or she may have that often accompanies acoustic trauma and hearing loss. (Tinnitus is the correct term for a ringing or buzzing sound in your ears.)
Also to be considered are any psychological or mental health and safety considerations that sometimes result from hearing loss. If the veteran believes that hearing loss and tinnitus have caused or aggravated anxiety, anger, depression, PTSD or otherwise contributed to a loss in the quality of the veteran's activities of daily living, those facts should be recorded for consideration.
Does your hearing loss make you eligible to claim a secondary disability for mental health conditions? Yes!
Service connection may be established on a secondary basis for a disability that is proximately due to, the result of, or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires (1) competent evidence (a medical diagnosis) of current chronic disability; (2) evidence of a service-connected disability; and (3) competent evidence that the current disability was either (a) caused by or (b) aggravated by a service-connected disability. 38 C.F.R. § 3.310(a); see also Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303(a).
Link between Hearing Loss and Depression Highlighted
The Board of Veterans Appeals has awarded numerous claims of depression secondary to hearing loss.
Board of Veterans Appeals: Citation Nr: 1139373
Service connection for depression secondary to service-connected hearing loss and tinnitus, is granted, on the basis of aggravation.
Board of Veterans Appeals: Citation Nr: 1116719
Service connection for adjustment disorder with depressed mood, as secondary to the service-connected hearing loss, is granted.
Board of Veterans Appeals: Citation Nr: 1101172
Service connection for reactive depression is granted.
Board of Veterans Appeals: Citation Nr: 1003291
Service connection for an acquired psychiatric disorder, as secondary to service-connected bilateral hearing loss, is granted.
Hearing Loss in Older Adults — Its Effect on Mental Health
How To File A Claim For A Secondary Condition
More suffer from hearing loss than expected, study shows
What's this constant ringing in my ears?
Tinnitus
Advice from
Ed Ball
Veterans Service Office
133 S. Ohio Ave.
Sidney, Ohio 45365
(937) 498-7283
A few web sites that will definitely help the veterans in providing the VA Regional Offices the actual exposure levels they may have been exposed to:
A good civilian web site and file would be found at:
http://www.e-a-r.com/hearingconservation/faq_main.cfm
Then under Noise Hazard they would want to download the Excel Database that list over 1700 Noise sources.
http://www.e-a-r.com/pdf/hearingcons/NoiseNav.xls
The individual Service Departments have web sites or instructions on Hearing Conservation programs as well:
U.S. Army (one of the best)
http://chppm-www.apgea.army.mil/hcp/NoiseLevels.aspx
U.S. Navy (click on the modules - great reference material)
http://www-nehc.med.navy.mil/occmed/HCToolbox.htm
USMC
http://hqinet001.hqmc.usmc.mil/sd/occhealth.htm
U.S. Air Force (restricted by username and password - probably active duty only)
Then I remind the RVSRs at the VA Regional Office of OSHA's permissible noise exposure in Table G-16:
http://www.osha.gov/pls/oshaweb/owadisp.show_document? p_table=STANDARDS&p_id=9735
A traumatic acoustic event in conjunction with noise induced hearing loss greatly weighs in on the "benefit of the doubt" in favor of the veteran. For good measure, aircraft carrier flight decks during flight ops is normally 146db and pain in the ear happens around 130db.
Noise Induced Hearing Loss;
http://www.nidcd.nih.gov/health/hearing/noise.asp
Given the medical evidence supports the claim based on the 1000 to 4000 hz frequency range along with indicators for speech discrimination for disability purposes, recommend folks talk up their exposure to noise in the military when visiting their doctors for hearing exams and make sure it's noted in the exam.
(i.e., (+) Severe noise exposure in military) or if the veteran has copies of his/her medical service records, and can show audiograms periodically since released from active duty, they may be able to get a medical opinion to support their claim.
Veterans must be able to show two key factors:
1. Traumatic Acoustic Event
2. Disability incurred in Service
As the VA has a "Duty to Assist" will their raters look up the impulse noise levels? I don't believe so, that's why I provide all the information up front.
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Personal Health: Lifelines for People With Hearing Loss
We so often forget that many of the worst wounds aren't visible.
Jim's Mailbag
Jim;
I was reading the VA Watchdog site, as I always do, and I could not help but reflect on the life long effects of my own war caused disabilities. As a combined 280% disabled Vietnam vet with A/A there is so much in the world that I miss out on. Besides the emotional trauma of PTSD and physical wounds there are two disabilities that rank among the highest disabilities. Those are blindness and deafness.
I have all my extremities. What I don't have is peace of spirit due to PTSD and, most of all, good hearing. I have not heard the sweet song of a bird in four decades. I cannot go into public places or even family functions without feeling left out due to my inability to hear what is being said. All I hear is noise. I cannot distinguish the noise with words. It all adds to more loneliness on my part and I feel left out in every aspect of life. I wish I could trade my poor hearing for a lost extremity. I would love to sit in a wheelchair in a park and hear the sounds of nature instead of sitting there and hearing nothing.
I'm not trying to belittle those wonderful wounded vets who have lost body parts in defense of our great nation but I am asking every vet to understand too that those of us who lost our sight or hearing are every bit as much disabled as those who have lost a limb.
God bless you all. One day we will all go a place where no one has defects or suffering.
Reply;
Your email really touched me. My dad was a combat veteran. He was 18 years old when he went with the first wave of marines to land on Iwo Jima. By then, his ears were bleeding. He had been aboard one of the Navy ships that bombarded Iwo Jima for days in advance.
He was an engineer with the 4th Marines. He told me of nights when he'd fall asleep, or simply pass out from fatigue, next to some artillery.
He was a machine gunner, an ordinance disposal professional, a rifleman and above all else, he was a proud marine. He retired at age 36 as a Master Gunnery Sargent E-9.
His hearing was shot all to hell. By his late 40s he was more or less deaf. He applied for some help from VA and was denied. The VA informed him that there was no record of his participating in any combat. They ignored his Iwo Jima service, his Korean War service and his 3 Purple Hearts. For the next 25 years, he bought his own hearing aids. He spent an average of about $4000.00 each year until I learned about it. I refiled for him and he received a 30% rating for loss of hearing. His tinnitus was denied. It wasn't long after that he passed away, cursing the VA the whole time.
His hearing loss was profound. He gave up any social activities because he felt foolish trying to communicate with people. He couldn't go to a movie, shop at a mall or do any small task that required him to meet strangers. He denied depression but his depression was apparent to me.
Most people don't think about hearing loss as anything other than a slight annoyance. They don't recognize that it's more than a loss of hearing, it's a set of symptoms that can reduce a conversation into unintelligible noise. There may be roaring sounds like a train on a track. Any normal sounds, such as the background noise in a restaurant, can become such a cacophony of jumbled sounds that it becomes frightening. Hearing aids provide little help to many sufferers. They may amplify sounds but not filter them correctly.
Many veterans become withdrawn and seem antisocial. It's embarrassing to have strangers speak to you and you can't figure out what they said.
Thanks for your message. I'm going to publish this as a reminder to everyone of just how serious a disability this can be.
Comment 01/27/2012 1:05 PM Eastern
Jim,
It is not usual that reading your site brings me close to tears (cussing, often - tears, seldom) but today's VAWatchdog.org mailbag from the 280% VN vet lamenting about his hearing loss and your personal reply regarding your father's hearing loss really touched me. I, too, had a WWII veteran father with SC hearing loss. He was lucky. His was covered under VA and he got excellent care, hearing aids, and batteries and was able to continue conversing with people and being active until the CHF got the better of him in his mid 80s. The vet's letter and your reply made me realize that we took Dad's ability to hear with his hearing aids for granted. When he was in cardiac ICU we could always tell when he was on the mend because he would ask for his teeth, his hearing aids, and a paper.
You have mentioned that many VA employees read your site. It would be my prayer that today's mailbag and reply would be required reading by everyone in the entire claims processing chain of command, especially the raters, to give them a true disability picture beyond what the tests may measure and the rating schedule may dictate. This column so clearly shows the quality of life issues that can be affected by hearing loss and tinnitus.
Thank you, Jim, for all you do for veterans and their families.
Please let your VN vet know that today, as I go about my day, chatting with others I encounter, I will see the birds and revel in their color and hear their song with joy in my heart on behalf of the veteran who wrote, your father, my father, and all the other veterans in a similar situation. I humbly thank you both for reminding me of the things I have that I take for granted.
Sincerely,
TSS
