VietNow National Magazine

Hearing Loss Claims and the VA
You might be surprised to find that getting any type of compesable evaluation for hearing loss is a hard thing to do.

By Raymond F. Gustavson, Jr.

During World War II, the Armed Services and the Department of Veterans Affairs (VA) used a simple test to measure hearing loss. The examiner stood behind the subject and spoke, whispered, or clicked a coin. The test was repeated at varying distances. Recorded readings of 15/15 or 20/20 represented normal hearing for VA purposes. Alternately, a tuning fork was used for the same test.

Several years later, the VA adopted revised audiometric testing procedures consisting of pure tone audiometry, and controlled speech recognition scores. Using earphones, the veteran listened to a variety of tones. Pure tone audiometry checked how clearly the veteran heard sounds traveling through the ear canal (air conduction) or the bones (bone conduction). Additionally, the test checked how well he understood speech.

If you want to make a claim for hearing loss, write a letter to the VA and tell them you are claiming service connection for hearing loss. With your claim, you should submit current medical evidence showing you have such a loss.

If you do not have current medical evidence, the VA will send you a release form (VA Form 21-4142) for you to list your doctor’s name, address, and date(s) of treatment. Return the form to the VA, and they will obtain the necessary medical report(s). Failure to do this relieves the VA of any obligation to secure your private medical records.

If you were treated at a VA medical center or other U.S. government facility, the VA must obtain these records.

After the VA has received all medical evidence, the Rating Specialist will schedule you for a VA examination to determine the severity of your hearing loss. To ensure consistent results, the VA requires that a state-licensed audiologist conduct these tests.

At the VA examination the examiner will review your claims file and give you a hearing test. When he finishes, he will submit a summary of his findings. The examiner must state that it is as likely as not that your hearing loss was due to acoustic trauma experienced during military service. This statement is what is called a nexus and, without it, your claim will be denied.

The Rating Specialist in the VA Regional Office uses the tables found in 38 CFR 4.85 to determine the severity of your hearing loss. Table VI assigns a numeric designation of hearing impairment based on threshold average and speech discrimination. This table is used for most evaluations. Table VIA (Puretone Threshold Average) is used when the veteran has language difficulties or inconsistent speech discrimination scores, etc., and is not able to answer the examiner’s questions. An example would be a veteran with facial paralysis.

The table at the bottom of this page shows my Puretone and decibel losses.
To compute the average Puretone loss in my right ear, I added 5, 5, 20, and 15 for a total of 45. Then I divided 45 by 4 for an average of 11.25 or 11.

Next, I used Table VI and found my right ear Speech Recognition score of 96% in the left-hand row (92-100) and ran my finger across this row until I found my Puretone Threshold Average of 11. This equated to Roman numeral I. However, under the provisions of § 3.385 none of my Puretone readings was 40 decibels or greater; the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz were not 26 decibels or greater; and my speech recognition score was not less than 94%. Thus, service connection for my right ear was denied.

To compute the average Puretone loss in my left ear, I added 5, 25, 30, 40 for a total of 100. Then I divided 100 by 4 for an average of 25.

Next, I used Table VI, found my left ear Speech Recognition score of 92% in the left-hand column (92-100), and ran my finger across this row until I found my Puretone Threshold Average of 25. This equated to Roman numeral I. Since I had one reading of 40 decibels (at 4000 HZ), service connection was granted for the left ear.

Finally, I used Table VII to determine the percentage disability in my left ear. I ran my finger across the “I” row until it intersected with the “I” column. That left me with a 0% evaluation. I did not qualify under Table VIA because I had no difficulty understanding the examiner’s instructions. I did not qualify under § 4.86(a), Exceptional Patterns of Hearing Impairment, because none of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) in my left ear was 55 decibels or more.

And I did not qualify under § 4.86(b), Exceptional Patterns of Hearing Impairment, because my left ear did not have a Puretone threshold of 30 decibels or less at 1000 Hertz, or 70 decibels or more at 2000 Hertz.

As a result, the VA granted me 0% service connection for my left ear. They denied service connection in the right ear. I received a letter informing me of the effective date of the grant, along with a copy of my appeal rights.

Of note, it is very hard to get any type of compensable evaluation for hearing loss. By this, I mean 10%, 20%, etc., which translates to a dollar amount.

Also of note, when processing the claim, the Rating Specialist must consider 38 CFR 3.350 to see if the veteran qualifies for special monthly compensation due either to deafness, or deafness in combination with other disabilities.

What if your claim is denied?
If your claim for tinnitus is denied, read the VA letter in its entirety. Look specifically at the reasons why the claim was denied. If you think the denial was unfair, send a one-sentence letter to the VA stating that you disagree with the deci­sion. This protects your appeal rights; however, the VA must receive your letter within one year of the denial. In your letter, you may submit any additional evidence you feel is relevant to your claim, or any information the VA requested but you failed to send.

Since the VA appeals process is a precise yet often confusing process to understand, I would strongly advise contacting a local service organization or a local County Service Officer. One of their representatives will explain exactly why your claim was denied and help you process your appeal. Sometimes, it’s as simple as not sending in that one piece of information you thought was a waste
of time. Don’t lose hope.

Raymond Gustavson served with the U.S. Army in Vietnam, and is a retired VA Rating Specialist. He is currently working on a novel about the Civil War, and also is writing a self-help book for veterans who want to better understand the complexities of the VA claims process.

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