NGArtilleryMedic

Thank you all for the advice. I still haven't received my denial letter yet, however I have received back pay and my first monthly payment on the musculoskeletal injury rated at 30%. The only way I know its SC and rated at 30% is because I looked on ebenefits. The information from one of my earlier posts comes directly from the blue button for health records. Ebenefits also shows that hearing loss and tinnitus were both denied. I have requested my file as you have suggested on April 14th and am waiting to receive it. I looked at the fast letter as Ms Berta suggested and unfortunately the 68W MOS is categorized as low. I assume that is because its called a "healthcare specialist" and many of the 68w's spend time in a medical BN, BDE or BAS. I was not one of those. Even though we did have sick call hours, most of the time I was on the line with 155mm Paladins or at the ranges for annual qualification, familiarization, shoot houses, etc. Anytime my BN was in the field for live fire exercizes I was with, anytime my BN had anything more than a moderate risk level I had to accompany them. I've even flown in helicopters, both Blackhawks and Lakotas. I am so perplexed with the fact that even though I told the audiologist that I have constant ringing it was denied. Is there a way to speed up the process of getting the letter from them so I can see why I was denied? Also should I find an audiologist now and have an IMO/IME so that when the letter arrives I can follow a NOD immediately? I know I only have a year to appeal it and time waits for no man.... Again thank you all for the advice. I appreciate the help, I just want to get help with my hearing. It truly causes alot of frustration for me and my family. I can be staring at my wife and not understand what shes saying and have to ask her to repeat it.

I've copied the results of my audiology exam and am wondering if I should proceed with a NOD for tinnitus. I have no history of hearing loss or tinnitus prior to military service. From what I read below the audiology exam shows hearing loss, just not significant enough to be compensable. Having said that the audiologist checked the box for ipsilateral and contralateral loss in the left ear, along with Sensorineural loss in the left ear. I've also stated that I hear a constant ringing. I'm not sure why I didn't receive a rating for the tinnitus alone. Whats my best course of action ? gned: 03/03/2017 08:13 Date/Time: 01 Mar 2017 @ 0800 Note Title: C&P AUDIO Location: FAYETTEVILLE AR VAMC Signed By: SHELDON,MISTY D Co-signed By: SHELDON,MISTY D Date/Time Signed: 17 Mar 2017 @ 1515 Note LOCAL TITLE: C&P AUDIO STANDARD TITLE: AUDIOLOGY C & P EXAMINATION CONSULT DATE OF NOTE: MAR 01, 2017@08:00 ENTRY DATE: MAR 17, 2017@15:15:21 AUTHOR: SHELDON,MISTY D EXP COSIGNER: URGENCY: STATUS: COMPLETED Hearing Loss and Tinnitus CONFIDENTIAL Page 26 of 54 Disability Benefits Questionnaire Name of patient/Veteran: Is this DBQ being completed in conjunction with a VA 21-2507, C&P Examination Request? [X] Yes [ ] No ACE and Evidence Review ----------------------- Indicate method used to obtain medical information to complete this document: [X] In-person examination Evidence Review --------------- Evidence reviewed (check all that apply): [X] VA e-folder (VBMS or Virtual VA) [X] CPRS Evidence Comments: RESTATEMENT OF OPINION REQUEST: DBQ AUDIO Hearing Loss and Tinnitus ___________________________________________________________________________ _ The following contentions need to be examined: hearing loss left foot sprain Active duty service dates: Branch: Army EOD: 04/06/2011 RAD: 07/08/2011 DBQ AUDIO Hearing Loss and Tinnitus: Please review the Veteran's electronic folder in VBMS and state that it was reviewed in your report. The Veteran is claiming that his or her hearing loss is related to audio threshold shift. Please fill out the Direct medical opinion template in the CONFIDENTIAL Page 27 of 54 DBQ. Additional remarks for the examiner: Tab A Pg 19-21, 23-25 of 138 in STR's received on 1/17/2017 ________________________________________________________________________ CFILE/SERVICE RECORDS: AD 4/6/11 to 7/8/11; Reserves 1/6/10-7/5/16; Hearing tests found for 2012, 2013, 2014, 2015, and 2016 - 2012 showed hearing loss in high frequencies for left ear. There are no earlier hearing tests to determine if shift from 2010 basic training and 2011 active duty period. MILITARY, OCCUPATIONAL, AND RECREATIONAL NOISE EXPOSURE: Veteran reported military noise exposure from initial entry training - for ANG he has served as medic for artillery battalion and has been exposed to live fire exercises as well as small arms. He reported occupational noise exposure from 2002 to present with fire dept (wears headset). He denied recreational noise exposure. MEDICAL HISTORY: Medical history positive chicken pox, blood pressure, dizziness/vertigo (says lasts a min or so, feels off balance). He denied any known familial hearing loss, known ototoxic medications and head or ear injury/trauma. TEST RESULTS: Hearing sensitivity was within-normal-limits (WNL) from 250-8000 Hz for right ear and WNL from 250-3000 Hz sloping to a moderate sensorineural hearing loss at 4000 hz rising to WNL at 8000 Hz for left ear. Negative pure tone stenger. Tympanometry was Type A, indicative of normal middle ear function. This exam is for: Hearing loss and/or tinnitus (audiologist, performing current exam) SECTION 1: HEARING LOSS (HL) ----------------------------- 1. Objective Findings --------------------- a. Puretone thresholds in decibels (air conduction): RIGHT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| LOYER, LANCE MICHAEL CONFIDENTIAL Page 28 of 54 |========+========+========+========+========+========+========+========| | 5 | 10 | 15 | 15 | 10 | 25 | 20 | 13 | +=======================================================================+ LEFT EAR +==============================================================+ | A | B | C | D | E | F | G | |========+========+========+========+========+========+========+========+ | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | 8000 | Avg Hz | | Hz* | Hz | Hz | Hz | Hz | Hz | Hz | (B-E)**| |========+========+========+========+========+========+========+========| | 10 | 10 | 15 | 15 | 50 | 40 | 25 | 23 | +=======================================================================+ * The puretone threshold at 500 Hz is not used in determining the evaluation but is used in determining whether or not a ratable hearing loss exists. ** The average of B, C, D, and E. *** CNT - Could Not Test b. Were there one or more frequency(ies) that could not be tested: No c. Validity of puretone test results: Test results are valid for rating purposes. d. Speech Discrimination Score (Maryland CNC word list): +=======================+ | RIGHT EAR | 94% | |=============+=========| | LEFT EAR | 94% | +=======================+ e. Appropriateness of Use of Word Recognition Score (Maryland CNC word list): Right Ear: Is Word Discrimination Score available? Yes Word Discrimination Score appropriateness: Use of word recognition score is appropriate for this Veteran. Left Ear: Is Word Discrimination Score available? Yes Word Discrimination Score appropriateness: Use of word recognition score is appropriate for this Veteran. f. Audiologic Findings Summary of Immittance (Tympanometry) Findings: +=============================================================================+ | | RIGHT EAR | LEFT EAR | |=====================+===========================+===========================| CONFIDENTIAL Page 29 of 54 | Acoustic immittance | [X] Normal [ ] Abnormal | [X] Normal [ ] Abnormal | |=====================+===========================+===========================| | Ipsilateral | | | | Acoustic Reflexes | [ ] Normal [X] Abnormal | [ ] Normal [X] Abnormal | |=====================+===========================+===========================| | Contralateral | | | | Acoustic Reflexes | [ ] Normal [X] Abnormal | [ ] Normal [X] Abnormal | |=====================+===========================+===========================| | Unable to interpret | | | | reflexes due to | [ ] | [ ] | | artifact | | | |=====================+===========================+===========================| | Unable to obtain/ | | | | maintain seal | [ ] | [ ] | +=============================================================================+ 2. Diagnosis ------------ RIGHT EAR --------- [X] Normal hearing [ ] Conductive hearing loss ICD code: [ ] Mixed hearing loss ICD code: [ ] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* ICD code: [ ] Sensorineural hearing loss (in the frequency range of 6000 Hz or higher frequencies)** ICD code: [ ] Significant changes in hearing thresholds in service*** LEFT EAR -------- [ ] Normal hearing LOYER, LANCE MICHAEL CONFIDENTIAL Page 30 of 54 [ ] Conductive hearing loss ICD code: [ ] Mixed hearing loss ICD code: [X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* ICD code: H90.42 [X] Sensorineural hearing loss (in the frequency range of 6000 Hz or higher frequencies)** ICD code: H90.42 [ ] Significant changes in hearing thresholds in service*** NOTES: * The Veteran may have hearing loss at a level that is not considered to be a disability for VA purposes. This can occur when the auditory thresholds are greater than 25 dB at one or more frequencies in the 500-4000 Hz range. ** The Veteran may have impaired hearing, but it does not meet the criteria to be considered a disability for VA purposes. For VA purposes, the diagnosis of hearing impairment is based upon testing at frequency ranges of 500, 1000, 2000, 3000, and 4000 Hz. If there is no HL in the 500-4000 Hz range, but there is HL above 4000 Hz, check this box. *** The Veteran may have a significant change in hearing threshold in service, but it does not meet the criteria to be considered a disability for VA purposes. (A significant change in hearing threshold may indicate noise exposure or acoustic trauma.) 3. Etiology ----------- Right Ear Was there a permanent positive threshold shift (worse than reference threshold) greater than normal measurement variability at any frequency between 500 and 6000 Hz for the right ear? No Opinion provided for the right ear: Yes If present, is the Veteran's right ear hearing loss at least as likely as not (50% probability or greater) caused by or a result of an event in military service? Cannot determine a medical opinion regarding the etiology of the Veteran's right ear hearing loss without resorting to speculation: Rationale (Provide rationale for either a yes, no answer or speculation reason): AD 4/6/11 to 7/8/11; Reserves 1/6/10-7/5/16; Hearing tests found for 2012, 2013, 2014, 2015, and 2016 - 2012 showed hearing loss in high frequencies for left ear. There are no earlier hearing tests to determine if shift from 2010 basic training and 2011 active duty LOYER, LANCE MICHAEL CONFIDENTIAL Page 31 of 54 period. Left Ear Was there a permanent positive threshold shift (worse than reference threshold) greater than normal measurement variability at any frequency between 500 and 6000 Hz for the left ear? No Opinion provided for the left ear: Yes If present, is the Veteran's left ear hearing loss at least as likely as not (50% probability or greater) caused by or a result of an event in military service? Cannot determine a medical opinion regarding the etiology of the Veteran's left ear hearing loss without resorting to speculation: Rationale (Provide rationale for either a yes, no answer or speculation reason): AD 4/6/11 to 7/8/11; Reserves 1/6/10-7/5/16; Hearing tests found for 2012, 2013, 2014, 2015, and 2016 - 2012 showed hearing loss in high frequencies for left ear. There are no earlier hearing tests to determine if shift from 2010 basic training and 2011 active duty period. 4. Functional impact of hearing loss ------------------------------------ Does the Veteran's hearing loss impact ordinary conditions of daily life, including ability to work: Yes If yes, describe impact in the Veteran's own words: "I often have to ask people to repeat what they have said." 5. Remarks, if any, pertaining to hearing loss: ----------------------------------------------- No response provided SECTION 2: TINNITUS -------------------- 1. Medical history ------------------ Does the Veteran report recurrent tinnitus: Yes Date and circumstances of onset of tinnitus: Veteran reported "I constantly have ringing in my ears. There is not a day that goes by where I do not." He says he first noticed the noise prob 2011/2012ish. 2. Etiology of tinnitus ----------------------- Cannot provide a medical opinion regarding the etiology of the Veteran's tinnitus without resorting to speculation. Reason speculation required: AD 4/6/11 to 7/8/11; Reserves 1/6/10-7/5/16; Hearing tests found for 2012, 2013, 2014, 2015, and 2016 - 2012 showed CONFIDENTIAL Page 32 of 54 hearing loss in high frequencies for left ear. There are no earlier hearing tests to determine if shift from 2010 basic training and 2011 active duty period. The first documentation of complaint of tinnitus is 2016 with ANG. 3. Functional impact of tinnitus -------------------------------- Does the Veteran's tinnitus impact ordinary conditions of daily life, including ability to work: Yes If yes, describe impact in the Veteran's own words: "I have a constant ringing in my ears, sometimes it is so bad that is is louder than anything else. I often can not understand what people have said and have to ask them to repeat it. This causes much frustration with my family and often leaves my wife and children and I aggravated because I can't hear. These feelings of aggravation and frustration leave me feeling upset and depressed. I often will have problems finishing thoughts and recalling words/speech to go along with those thoughts. I can be in the middle of conversation and completely lose the conversation because of it." 4. Remarks, if any, pertaining to tinnitus:: -------------------------------------------- No response provided NOTE: VA may request additional medical information, including additional examinations if necessary to complete VA's review of the Veteran's application. /es/ MISTY D SHELDON, AuD STAFF AUDIOLOGIST-FAYETTEVILLE Signed: 03/17/2017 15:15

63Charlie I havent recieved my letter yet from the VARO. As a matter of fact the only reason I know I have a service connection is because I had a letter/application packet for service connected disability insurance show up at the house. I logged into EBenefits and thats where I saw that I had been denied for hearing and approved for musculoskeletal. Broncovet I looked at the records that I was able to get from the VA records website and youre exactly correct. they averaged my hearing loss so that even though I have 40 or 50 mhz loss in certain frequencies the overall percentage is 23 in right ear and around 38 in left, with a 94% Maryland speech recognition rating. And yes I was in a unit that fielded 155mm howitzers... Paladins

I had my C&P exams done and was awarded 30% for a foot/ankle injury sustained while at drill. I ended up in the ER because of it and to be honest with what I had read previously expected to be service connected, I just didn't know to what extent. However I also had an audiology exam and was denied service connection because even though there is hearing loss apparently it isn't enough in each of the categories. I've had multiple PHA exams done that show "asymmetrical hearing loss" and now had an audiology exam at the VA and it even shows hearing loss in almost every frequency range with a 94% speech recognition pattern. I guess my question is this, can I appeal it and is it likely to be successful? I've got ringing in my ears constantly and its not getting any better. I constantly have to ask people to repeat themselves. I'm at a loss as to what to do. I'm thankful that I established a service connection for the musculoskeletal exam, but am frustrated with the audiology part. Thank you