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VA Benefits for Sleep Apnea
as a service
connection to PTSD
Brett Valette, Ph.D.
Licensed Clinical Psychologist
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Tinnitus is a frequent companion to hearing loss.
Acoustic trauma can cause many types of damage to your inner ear. Tinnitus is a
separate condition from hearing loss.
This is a good page that describes what tinnitus is.
Click the link below;
Tinnitus; from the Latin word tinnītus meaning "ringing" is the perception
Hearing loss, tinnitus, and other auditory complaints among military veterans are
common and costly, with more than 75,000 cases of auditory impairment among
new recipients of VA compensation in 2003, and estimated payments at an annual
rate of $850 million at the end of 2004 to veterans with
hearing loss and tinnitus as their major disability.
The Institute of Medicine carried out a study mandated by Congress and
sponsored by the Department of Veterans Affairs to provide an assessment of
several issues related to noise-induced hearing loss and tinnitus associated
with service in the Armed Forces since World War II. The resulting report,
titled Noise and Military Service: Implications for Hearing Loss and Tinnitus,
provides findings regarding the presence of hazardous noise in military settings,
levels of noise exposure necessary to cause hearing loss or tinnitus, risk factors
and timing of the effects of noise exposure, and the adequacy of military hearing
conservation programs and audiometric testing. The report recommends steps to
improve prevention of and surveillance for hearing loss and tinnitus, and stresses
the importance of conducting hearing tests (audiograms) at the beginning and end of
military service for all military personnel. The report also outlines areas where
additional research is needed, including topics specifically related to military service.
The Board of Veterans Appeals has awarded numerous claims of depression secondary to hearing loss.
Board of Veterans Appeals: Citation Nr: 1139373
Board of Veterans Appeals: Citation Nr: 1116719
Board of Veterans Appeals: Citation Nr: 1101172
Board of Veterans Appeals: Citation Nr: 1003291
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
§ 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.
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?
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).
It is our experience 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.
We recommend 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.
We also recommend 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.
Speak With A
Veterans Law Attorney
An Expert Physician
Case Evaluations Are
Service Connection for Tinnitus
It’s very common for veterans to suffer from tinnitus without accompanying hearing loss.
Unfortunately, when a veteran submits a claim for service connection for tinnitus
without hearing loss, VA examiners will often render a
negative nexus opinion that goes something like this:
“Although the veteran served in a high hazardous noise MOS, the veteran has
bilaterally normal hearing indicating intact cochlear function. Therefore, the veteran’s
reported tinnitus is less likely than not caused by military noise exposure.”
In other words, the examiner denies service connection because the veteran has normal
hearing and the examiner believes tinnitus must be accompanied by hearing loss. As an
initial matter, this belief is wrong. The American Tinnitus Association writes that while
it is common for hearing loss to accompany tinnitus, “there are many who have no
measurable hearing loss but have tinnitus.” So, because it’s possible to suffer from
tinnitus without hearing loss, the veteran can still win service connection in this situation.
First, it’s possible a Decision Review Officer or the Board of Veterans’ Appeals will grant
service connection based solely on the veteran’s lay statements, even with the negative
nexus opinion. This is because the presence of tinnitus is capable of lay observation, and
the VA must take into account and consider the veteran’s lay observations. If the veteran
hasn’t already, he or she should submit a sworn statement of support detailing the onset
of their tinnitus, their symptoms shortly after discharge, and their current symptoms.
If the positive and negative evidence of record is in approximate balance (i.e.
veteran’s positive lay statements versus VA’s negative opinion) and there’s no
reason to doubt the credibility of the veteran, then the VA should grant
service connection under the benefit-of-the-doubt doctrine.
Second, the veteran can strengthen their case even more by obtaining a private
nexus opinion addressing the absence of accompanying hearing loss.
A positive nexus opinion would read something like this:
“Although the veteran’s tinnitus is not associated with measurable hearing loss, it is still at
least as likely as not related to his noise exposure during military service. As is well known,
the ‘cochlear reserve’ in younger people often masks the cochlear damage –
and noise-induced hearing loss from his past exposure may present in future decades.”
Even though VA often denies claims for tinnitus without hearing loss, service connection
is still obtainable. If you’ve been denied service connection for tinnitus because
you don’t have measurable hearing loss, contact us today.
Gregory M. Rada - After Service Advocates