Hearing Loss and Tinnitus

[dagoatmarine]

Hello, to my fellow service men and women.  I just had a C&P for Hearing Loss and Tinnitus.  I wanted to get the experts thoughts on this.  It looks like I don't have a good chance for the hearing loss, but I might for the Tinnitus.  What do you think? and at what percentage?....thanks everyone.

 LOCAL TITLE: C&P AUDIO                                          
STANDARD TITLE: C & P EXAMINATION NOTE                          
DATE OF NOTE: DEC 23, 2015@08:30     ENTRY DATE: DEC 23, 2015@10:07:40      
      AUTHOR: TAYLOR,CHRISTOPHER   EXP COSIGNER:                           
     URGENCY:                            STATUS: COMPLETED                     

                            Hearing Loss and Tinnitus
                        Disability Benefits Questionnaire

    Name of patient/Veteran:  TAYLOR,DAVID G
    
    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)

    Evidence Comments:
      C-file reviewed in VBMS.  Audiological evaluations dated 
8/4/94(enlistment)
      and 6/10/99(separation) revealed hearing within normal limits, 
bilaterally.
      No STS noted between enlistment and separation evaluations.

    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)**|
    |========+========+========+========+========+========+========+========|
    |     0  |     0  |     5  |    10  |    10  |     5  |     5  |     6  |
    +=======================================================================+

                                    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)**|
    |========+========+========+========+========+========+========+========|
    |     0  |     5  |     0  |     5  |     5  |    15  |     0  |     4  |
    +=======================================================================+

      * 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  |   100%  |
       |=============+=========|
       |  LEFT EAR   |   100%  |
       +=======================+

    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          
|
    
|=====================+===========================+===========================|
    | Acoustic immittance | [ ] Normal  [ ] Abnormal  | [ ] Normal  [ ] Abnormal  
|
    
|=====================+===========================+===========================|
    | Ipsilateral         |                           |                           
|
    |   Acoustic Reflexes | [ ] Normal  [ ] Abnormal  | [ ] Normal  [ ] Abnormal  
|
    
|=====================+===========================+===========================|
    | Contralateral       |                           |                           
|
    |   Acoustic Reflexes | [ ] Normal  [ ] Abnormal  | [ ] Normal  [ ] Abnormal  
|
    
|=====================+===========================+===========================|
    | Unable to interpret |                           |                           
|
    |   reflexes due to   |            [ ]            |            [ ]            
|
    |   artifact          |                           |                           
|
    
|=====================+===========================+===========================|
    | Unable to obtain/   |                           |                           
|
    |   maintain seal     |            [X]            |            [X]            
|
    
+=============================================================================+

    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
    --------
       [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***
       
    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? No
         Rationale (Provide rationale for either a yes, no answer or speculation
         reason): Given there was no significant shift in hearing sensitivity
         between Enlistment and Separation audiological evaluations, and current
         hearing levels do not meet the criteria for disability under VA
         regulations, it is not necessary to discuss etiology of hearing loss.

    Did hearing loss exist prior to service? No

    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? No
         Rationale (Provide rationale for either a yes, no answer or speculation
         reason): Given there was no significant shift in hearing sensitivity
         between Enlistment and Separation audiological evaluations, and current
         hearing levels do not meet the criteria for disability under VA
         regulations, it is not necessary to discuss etiology of hearing loss.

    Did hearing loss exist prior to service? No

    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: Veteran reports having
      difficulty understanding speech, especially when in environments with
      background noise present.
      
    5. Remarks, if any, pertaining to hearing loss:
    -----------------------------------------------
       Veteran reports history of noise exposure to gunfire and explosions while
       serving in the military.  Veteran denies history of post service
       occupational noise exposure working IT in quiet environments.
       

 

 

                              SECTION 2:  TINNITUS
                              --------------------
    1. Medical history
    ------------------
    Does the Veteran report recurrent tinnitus: Yes
       Date and circumstances of onset of tinnitus: Veteran reports subjective,
       mild, intermittent (occurring only when in quiet environments) tinnitus
       bilaterally that started while serving in the military.
       
    2. Etiology of tinnitus
    -----------------------
    At least as likely as not (50% probability or greater) caused by or a result
    of military noise exposure.
      Rationale: Based on the veteran's reported history, it is at least as
      likely as not that the tinnitus is a result of military noise exposure.
      
    3. Functional impact of tinnitus
    --------------------------------
    Does the Veteran's tinnitus impact ordinary conditions of daily life,
    including ability to work: No
    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.

[Buck52]

If the examiner based this from a VA Hearing test&Dr  and your denied?

NOD   go to a private Audoligist Specialist and get another hearing test, Even if  you had good hearing after you got out of military  you could have Noise Induced Hearing loss caused form your military service  and Noise Induced hearing loss only gets worse over the years.   MOS will be helpful if you were around loud noise  in the military

Besides the VA Hearing Equip is worn out  & no telling how many times its all be ''re-calibrated.

consider an inadequate VA Hearing test & go get a Private IMO/IME with a specialist.

http://kidgalore.com/2014/07/16/tinnitus/

 

jmo

 

....................Buck

Edited December 31, 2015 by Buck52

[boomer2]

Damn, Your hearing is good. Wish mine were that good. You'll get the tinnitus for 10%. Your hearing will get worse as you get older. You should keep up with your hearing, have it tested every couple of years. What was your MOS in the military. You can't fail a hearing test, it only gives you a DB level of what you can't hear and yours are within the normal range. If your medical records show a higher DB level then I would file a NOD and request a new test.

[Gastone]

Tinnitus, 1 or both ears SC = straight 10%SC, no Bilateral Factor applicable.

Your Boned on the Hearing Loss, 100% Word Recognition, even considering "Guesses" sinks your boat for a Hearing Loss SC. You actually have to have a Hearing Loss DX, doesn't appear that you do. The fact that all Hearing testing is from recordings and Computer generated tones, takes the guess work out, human error is virtually eliminated.

Unless you were DX'd with a Hearing Trauma while on active duty, that resolved itself prior to your discharge Hearing tests, looks like you came out as you went in: normal hearing. It appears that even your post service noise exposure hasn't affected your Hearing and word recognition. My Lay research indicates that Hearing Loss due to noise exposure is generally cumulative and worsens with exposure and time. Can't say I ever read anything regarding a DX'd long standing Hearing Loss improving by itself, not to mention back to a normal range.

What was your MOS, I didn't see where the Examiner opined as to your MOS or receipt of a CAR award.

Semper Fi

[MarkInTexas]

Buck's right.  Got to a private audiologist for an IME/IMO.  You can get one pretty cheap if you shop around.  I found one for $40 here in East Texas, and she helped me get the 10% Tinnitus and 0% Hearing Loss, Left Ear.

Also, like Buck said, your MOS is a key, and depending on what it is, may help greatly in getting a rating.

Mark

 

[dagoatmarine]

I was rated for 10% Tinnitus

[PCW]

Looks like 10% for Tinnitus as the others have said. According to my entrance and exit hearing exams my hearing improved during my 8 years - 9 months - and 23 days (but who was counting) of service, most of which was on a flight line without ear protection. Thus no SC on my claim. I paid for an outside hearing exam that includes a "more likely than" statement, so we'll see what happens on a re-file. It will be tough to overcome that improved hearing exit exam however. It would be nice to get SC - even at 0%.