VA Disability Benefits for Bilateral Hearing Loss

Hearing loss is one of the most common conditions that veterans experience as a result of their military service.  Specifically, hearing loss is the second most common service-connected condition among all VA disability compensation recipients, surpassed only by tinnitus.  In 2020, VA reported that roughly 1.3 million veterans were service connected for hearing loss.  If you are a veteran affected by hearing loss linked to your time in service, continue reading to find out more about the benefits that may be available to you.

What is “Bilateral Hearing Loss?”

Although hearing loss can occur naturally as we age, there are certain causes which can damage a person’s hearing, such as:

• Damage to the inner ear: Exposure to loud noise over time may cause wear and tear on the nerve cells in the ear that send sound signals to the brain.  When these nerve cells are damaged, hearing loss occurs.
• Gradual buildup of earwax: Earwax can block the ear canal and prevent conduction of sound waves.  This cause tends to produce a more temporary problem as earwax removal can help restore hearing.
• Ear infection and abnormal bone growths/tumors: Infections or abnormal growths in the outer or middle ear.
• Ruptured eardrum (i.e., tympanic membrane perforation): Loud blasts of noise, sudden changes in pressure, and poking the eardrum with an object can all cause an eardrum to rupture and subsequently affect hearing.

These causes, among others, can lead to bilateral hearing loss, or hearing loss that affects both ears.

Symptoms of Bilateral Hearing Loss

• Muffling of speech and other sounds
• Difficulty understanding words, especially against background noise or in a crowd
• Trouble hearing consonants
• Frequently asking others to speak more slowly, clearly, and loudly
• Needing to turn up the volume of the television or radio
• Withdrawal from conversations
• Avoidance of some social settings

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How To Establish Service Connection for Bilateral Hearing Loss

It is necessary to establish service connection in order for veterans to receive any form of VA disability benefits.  To do this, veterans need to submit:

(1) A current diagnosis of hearing loss;

(2) An in-service event that may have caused or contributed to their hearing loss; AND

(3) A medical opinion definitively linking the in-service event to their hearing loss

Current Diagnosis

A current diagnosis of hearing loss, in both ears, needs to be submitted in order for benefits for bilateral hearing loss to be considered.  VA can be very strict about the type of diagnosis it accepts for hearing loss, so it is important to ensure that the veteran’s diagnosis meets the requirements.

Specifically, for VA purposes, veterans must undergo a hearing exam performed by a licensed audiologist.  The audiologist needs to administer two separate audio tests for VA to accept the diagnosis.

• Maryland CNC Test—Measures hearing loss in veterans through a 50-word test that scores how well you recognize speech.  VA uses the results of this test to determine if your hearing loss qualifies for disability benefits and, if so, to rate the severity of your condition.
• Puretone Audiometric Test—Determines your level of general hearing loss by measuring the faintest tones you can pick up on. In other words, you typically wear a set of headphones and raise your hand when you hear a beep.

While a veteran may have a diagnosis of bilateral hearing loss from a primary care physician, VA will not count this as evidence toward your claim.

In-Service Event or Stressor

An in-service event or stressor is the cause or aggravating factor of the veteran’s hearing loss.  There are many possible causes of hearing loss related to military service, such as combat service, exposure to artillery fire and small arms fire, and certain military occupational specialties (MOS) that involve mechanical work such as on vehicles or aircrafts.  Veterans will need to submit evidence to indicate how the in-service event or stressor caused or aggravated their hearing loss.

Medical Nexus Opinion

Obtaining a medical nexus opinion that links the in-service event and the current, diagnosed hearing loss is crucial in establishing direct service connection.  Usually, a positive medical nexus opinion will state that your hearing loss is “at least as likely as not” due to your time in service.

VA Disability Ratings for Bilateral Hearing Loss

VA uses a grid chart to determine a Roman numeral designation for hearing impairment based on a combination of the percent of speech discrimination and the Puretone threshold average.

Veterans should first find the Roman numeral going down the left side for the ear that has greater auditory function

Next, they should locate the Roman numeral of the ear with less auditory functioning, which can be found across the top of the table.

Finally, veterans should look at where the two Roman numerals intersect to find their rating.

Disability ratings for hearing loss are assigned based on severity from 0 to 100 percent.  Most often, veterans receive a 10 percent rating for hearing loss.  Importantly, VA rates both ears together, meaning veterans will receive only one rating for hearing loss.

Below is the chart VA uses to rate hearing loss:

What Veterans Should Know About Bilateral Hearing Loss Claims

Since ratings are based on specific hearing tests that invoke a very literal application of the rating schedule, it is very difficult for veterans to receive a disability rating for hearing loss higher than the one assigned based on their test results alone.

However, veterans can submit additional evidence supporting the fact that their hearing loss warrants a higher disability rating.

Special Monthly Compensation and Bilateral Hearing Loss

If a veteran has total hearing loss in both ears, they may also be entitled to compensation through SMC (Special Monthly Compensation) beyond standard VA disability benefits.

Namely, 38 CFR § 3.350 instructs VA to assign SMC(k) at a minimum based on loss of use of the sense of hearing, which is paid in addition to your regular VA disability compensation based on rating.

TDIU and Bilateral Hearing Loss

Veterans who receive a rating for bilateral hearing loss may be eligible for TDIU.  TDIU, or total disability based on individual unemployability, is a monthly benefit offered by VA which compensates veterans at the 100 percent rating level, even if their overall rating percentage is less than that.

There are generally two ways a veteran can be eligible for TDIU:

• 38 CFR § 4.16a (“Schedular”) – For this form of TDIU, the veteran must have:
  • One condition rated at minimum 60 percent OR
  • Two conditions that can be combined to reach 70 percent, where one condition is at minimum 40 percent

• 38 CFR § 4.16b (“Extraschedular”) – This form of TDIU is for veterans who may not be able to achieve the ratings necessary for schedular TDIU but are still unable to obtain substantially gainful employment on account of their conditions.

A rating given for bilateral hearing loss can contribute to a veteran’s eligibility for TDIU.  For example, if a veteran has a rating of 60 percent for bilateral hearing loss, they could be eligible for TDIU.  If a veteran has a rating of 40 percent for bilateral hearing loss and another rating that it can be combined with to reach 70 percent, the veteran may also be eligible for TDIU.

Need Help with Your Bilateral Hearing Loss Appeal?

Appeals for bilateral hearing loss benefits can be challenging due to VA’s strict rating criteria.  If you need an accredited representative to assist with your appeal, the talented veterans’ advocates at Chisholm Chisholm & Kilpatrick may be able to help.  Call our office today for a free case evaluation.