VA Disability Rating for Hearing Loss and Tinnitus

According to the Department of Veterans Affairs (VA), more than 3.6 million veterans currently receive disability benefits for hearing loss or tinnitus.  In addition, the Centers for Disease Control and Prevention (CDC) found that veterans are 30 percent more likely than non-veterans to have severe hearing impairment.  Specifically, those who served after 9/11 are four times more likely to have hearing loss compared to their civilian counterparts.

If you are suffering from hearing loss and/or tinnitus due to your military service, you may qualify for service-connected disability benefits from VA.  Read on to learn how VA rates hearing loss and tinnitus and how to establish service connection for these conditions.

Hearing Loss Explained

Hearing loss can affect a person in varying degrees of severity.  It can be partial or total, gradual or sudden, and temporary or permanent.  Additionally, hearing loss can also affect one ear (i.e., unilateral) or both ears (i.e., bilateral).

Hearing loss is categorized into three main types:

• Conductive – involves outer or middle ear.
• Sensorineural – involves inner ear.
• Mixed – a combination of the two.

In general, hearing loss may cause a variety of symptoms, such as:

• 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

Hearing loss can significantly impact a person’s quality of life and daily functioning.  It is important for those with hearing loss to receive a diagnosis and seek treatment from a health professional.

Causes of Hearing Loss

Hearing loss can have many causes.  In some cases, the specific cause may determine the severity of the condition.  Some common causes include:

• 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.

Certain conditions – such as diabetes, hypertension, or Meniere’s disease – can also contribute to gradual hearing loss.

Tinnitus Explained

Tinnitus generally refers to the perception of noise or ringing in the ears.  Most often, tinnitus is a symptom of an underlying condition, such as hearing loss, an ear injury, or a circulatory system disorder.

Common symptoms include phantom noises in the ears such as ringing, buzzing, roaring, clicking, hissing, and humming.  Such phantom noise may vary in pitch from low to high and can occur in one or both ears.  In some cases, the noise can be so loud that it interferes with an individual’s ability to concentrate or hear external sounds.  Furthermore, tinnitus may be consistent, or it may come and go.

There are two main types of tinnitus, one of which is significantly more common than the other:

• Subjective tinnitus – Tinnitus only you can hear, and the most common type of tinnitus.  It can be caused by (1) problems in the outer, middle, or inner ear; (2) problems with the auditory nerves; or (3) problems with the part of the brain that interprets nerve signals as sound (i.e., auditory pathways).
• Objective tinnitus – Tinnitus the doctor can hear when they perform an examination.  This type is extremely rare.  It can be caused by (1) a blood vessel problem; (2) a middle ear bone condition; or (3) muscle contractions.

Causes of Tinnitus

There are several health conditions that can cause or aggravate tinnitus, but an exact cause may not always be established.  However, in many people, tinnitus is caused by one of the following:

• Age-related hearing loss – Hearing loss often occurs around age 60 and progresses over time. Such hearing loss may cause tinnitus.
• Exposure to loud noise – Loud noises (e.g., heavy equipment, firearms, etc.) can contribute to tinnitus and hearing loss. Both short-term and long-term exposure to loud sound can cause permanent damage.
• Earwax blockage – Earwax protects the ear canal by trapping dirt and slowing the growth of bacteria. However, when too much earwax accumulates, it becomes too hard to wash away naturally, causing hearing loss or irritation of the eardrum, which can then lead to tinnitus.
• Ear bone changes – Stiffening of the bones in the middle ear (i.e., otosclerosis) may affect hearing and cause tinnitus.
• Meniere’s disease – Tinnitus can be an early indicator of Meniere’s disease (i.e., an inner ear disorder that may be caused by abnormal inner ear fluid pressure).
• Traumatic brain injury (TBI) – TBI can lead to tinnitus by causing auditory nerve damage.

Connection Between Hearing Loss and Tinnitus

Many individuals who have tinnitus also experience some form of hearing loss.  This is especially true if a person’s hearing loss was caused by a traumatic experience or exposure to loud noise.  Additionally, sensorineural hearing loss is often accompanied by tinnitus.

Some researchers also believe that subjective tinnitus cannot exist without some form of hearing loss or damage to the auditory system.  However, the exact connection between hearing loss and tinnitus is still being investigated by experts.

Veterans may develop both tinnitus and some level of hearing loss due to an in-service event or a service-connected condition.  If this is the case, they can file a claim for VA disability compensation.

How to Establish Service Connection for Hearing Loss and Tinnitus

The Department of Veterans Affairs offers disability benefits to veterans for both hearing loss and tinnitus.  To qualify, veterans must first establish the three elements of service connection:

• An in-service event, injury, or illness that led to the hearing loss and/or tinnitus;
• A current diagnosis of hearing loss and/or tinnitus by a medical professional; and
• A nexus, or link, between the in-service event and current disability.

Diagnosing Hearing Loss

To diagnose hearing loss, veterans must undergo a hearing exam by a licensed audiologist.  The audiologist must administer two separate tests in order for VA to accept your current diagnosis of hearing loss:

• Maryland CNC Test: This test uses 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 and, if so, to rate the severity of your condition.
• Puretone Audiometric Test: This 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.

Again, VA requires these specific tests to establish a diagnosis of hearing loss for compensation purposes.  A diagnosis of hearing loss from a primary care doctor will not count towards a VA claim.  Importantly, veterans should remove hearing aids before both tests to ensure the results to show their ability without assistive devices.

Types of Evidence

In addition to the two separate hearing tests required by VA, veterans can use other evidence to strengthen their claim for hearing loss and/or tinnitus.

• Service records – for example, to show regular or prolonged noise exposure during training exercises or in combat.
• Medical records – to establish that you did not have hearing-related issues prior to your military service.
• Lay evidenceor buddy statements
• Statements from doctors – can establish when you began complaining of the ringing in your ears or hearing loss, and treatments to mitigate the symptoms.
• A medical nexus opinion from an expert – can opine as to the cause of tinnitus or hearing loss.

Secondary Service Connection for Hearing Loss and Tinnitus

If a veteran developed tinnitus secondary to service-connected hearing loss, they may qualify for secondary service connection.  In addition, if a veteran develops hearing loss secondary to another service-connected condition, such as type 2 diabetes or hypertension, they may also be eligible for secondary service-connected compensation for hearing loss.

To establish secondary service connection, veterans must show evidence of the following:

• A current diagnosis of hearing loss and/or tinnitus by a medical professional; and
• A nexus linking the secondary condition to the primary service-connected condition.

VA Disability Ratings for Hearing Loss and Tinnitus

Hearing Loss VA Ratings

Once service connection is established, VA will assign a disability rating based on the severity of the hearing loss.  Specifically, VA takes the results of veterans’ pure tone threshold test and averages it for each ear.

To do so, VA uses a grid chart with different frequencies and lines up the thresholds, using the “Numeric Designation of Hearing Impairment Based on Puretone Threshold Average and Speech Discrimination,” to determine a Roman numeral designation (I through XI) for hearing impairment based on a combination of the percent of speech discrimination (i.e., horizontal rows) and the puretone threshold average (i.e., vertical columns).  The Roman numeral is located at the point where the percentage of speech discrimination and puretone threshold average intersect.

Veterans can find the above-mentioned intersection using the table below.  To do so, veterans should first find the Roman numeral going down the left side for the ear that has greater auditory function.  Next, veterans 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 locate the rating where the two Roman numerals intersect.  Please note that VA rates both ears together, resulting in only one rating for hearing loss.

Hearing Loss Rating Table

Therefore, veterans can receive up to a 100 percent disability rating for hearing loss; however, this is rather uncommon.  Most often, veterans receive a 10 percent rating for hearing loss.  Again, disability ratings are based on specific hearing tests, thereby invoking a very literal application of the rating schedule.  That is, 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.

Tinnitus VA Rating

VA rates tinnitus under 38 CFR § 4.87, Schedule of Ratings – Ear, Diagnostic Code 6260.  The condition of tinnitus is typically assigned 10 percent disability rating.  Importantly, this singular 10 percent disability rating takes both ears into account.

Tinnitus is the most claimed disability for VA compensation.  The current consensus is that a lot can be done to relieve tinnitus in terms of the symptoms, despite the damage that may have been done.  Therefore, veterans rarely receive a rating higher than 10 percent for tinnitus.

Was Your Tinnitus or Hearing Loss VA Claim Denied?

If VA denied your claim for tinnitus or hearing loss, Chisholm Chisholm & Kilpatrick LTD may be able to help.  The accredited attorneys and claims agents at CCK have decades of collective experience assisting veterans in securing disability benefits.  Call CCK today at 800-544-9144 for a free consultation regarding your case.