What is the Maximum VA Rating for Hearing Loss?
Hearing Loss Explained
Hearing loss is a very common problem among older adults in the United States (U.S.). Specifically, approximately one-third of adults in the U.S. between the ages of 65 and 75 have some degree of hearing loss. The percentage increases to 50 in adults over the age of 75.
Hearing loss is categorized into three main types: (1) conductive (i.e., involves outer or middle ear); (2) sensorineural (i.e., involves inner ear); and (3) mixed (i.e., a combination of the two). Regardless of the type of hearing loss, the symptoms remain fairly consistent and include the following:
- 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 have many causes, and in some cases, the specific cause may determine the level of severity. 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.
Hearing Loss and Veterans
According to VA, more than 2.7 million veterans currently receive disability benefits for hearing loss or tinnitus (i.e., ringing in the ears); however, the actual number may be even higher. That is, there may be additional veterans with hearing loss who are not receiving VA disability compensation.
The Centers for Disease Control and Prevention 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 as compared to their civilian counterparts. Hearing loss can significantly impact veterans’ quality of life and daily functioning. It is important for veterans with hearing loss to receive a diagnosis and seek treatment from a health professional.
How to Receive VA Disability Benefits for Hearing Loss
In order to receive VA disability benefits for hearing loss, veterans must prove to VA that their hearing loss is the result of their time in service. For direct service connection, they must establish the following three elements: (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.
As mentioned above, the first step to getting VA disability benefits for hearing loss is demonstrating that you are currently diagnosed with a qualifying condition. VA is extremely strict about the type of diagnosis it accepts when it comes to hearing loss.
Generally speaking, you are usually diagnosed with hearing loss when there are certain decibel levels that are lost at different frequencies of hearing, which can be determined in a regular doctor’s office. However, for VA purposes, 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 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 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. You may have a diagnosis of hearing loss from your primary care doctor, but this will not count as evidence towards your claim.
The second part of establishing direct service connection involves submitting evidence of an in-service event that may have caused or contributed to your hearing loss. Common in-service events that lead to hearing loss include 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.
Medical Nexus Opinion
Obtaining a medical nexus opinion that links your in-service event and your 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.
How Does VA Rate Hearing Loss?
Once service connection is established, VA will assign a disability rating based on severity. 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.
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 off of 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.
Nonetheless, veterans can submit additional evidence supporting the fact that their hearing loss warrants a higher disability rating. For example, veterans can submit lay testimony from family members describing the need to speak loudly, constantly repeat things, or any other hearing-related issues that they have witnessed the veteran experience since service.
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