Tinnitus & Hearing Loss C&P Exam

[63Charlie]

Yesterday I reported to the Orlando VA Medical Center for the above-styled exam

As he escorted me into the exam room, he asked me a question in a low voice.

I couldn't understand what he said.

I replied, "What did you say?"

Then he spoke clearly and loud enough for me to understand him.

So I replied to his question.

The initial part of the exam involved inserting some kind of medical device in each ear canal, one side at a time, and I felt pressure and it made beeping noises.

Then came the tone response test where you tell them when you can hear the tone.

Finally, sentences were said where you have to identify a particular word and repeat that word.

After it was over, the examiner led me out of the exam room and walked about ten steps ahead of me.

I have spine problems and use a cane so I'm slow anyway.

I see the examiner standing in the corridor and he asked me another question in a low voice that I could not understand.

I asked him to repeat what he said, and he asked me in a louder voice, so I could understand him, "Do you have any more exams today?"

Which I replied, "No."

While in the exam room he asked me how the tinnitus affects me.

I told him that the constant ringing in my ears annoys the crap out of me.

I told him that I turn on a fan next to my bed each night when I go to bed, to help drown out the noise from the ringing in my ears.

He asked," Have I had my hearing checked lately?"

I told him , no.

He said, "What makes you think that you have hearing loss?"

I said, "My wife gets aggravated because I have to turn up the volume of the TV to be able to hear it."

I said, "I've had to stop watching TV in the room with her because it always starts an argument."

He also asked what my civilian job occupation is/was.

I told him I've been a HVAC technician since the early nineties.

He said so you were exposed to noise made by air conditioning compressors.

He asked me what my military occupation was and I told him I worked as a diesel repair mechanic as my MOS.

I told him I was also exposed during training to noise from firing .50 caliber machine guns, .30 caliber machine guns,M16 Rifles, live grenades, and artillery simulators.

He asked if I used hearing protection, and I told him not when repairing the diesel engines, and I don't remember if we did when firing our weapons during training.

I had nothing to hide but honestly this guy left me with a bad vibe and an unpleasant experience.

The last thing I noticed was, Holy mackerel did this guy have some large feet! 

His shoes might have been a size 18.

 

Edited April 24, 2016 by 63Charlie

[Grunt]

16 hours ago, Buck52 said:

Ifrom 1000   up to 5000  your hearing loss looks pretty bad to me. When the decibels are 55 or more &  When speech recognition is 92% or less, a performance intensity function must be obtained.

yours is 46 % left ear 48% right ear

§4.86   Exceptional patterns of hearing impairment.

(a) When the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa, whichever results in the higher numeral. Each ear will be evaluated separately.

(b) When the puretone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa, whichever results in the higher numeral. That numeral will then be elevated to the next higher Roman numeral. Each ear will be evaluated separately.

(Authority: 38 U.S.C. 1155)

[64 FR 25209, May 11, 1999]

 it looks like to me you could get a high rating loss of better than 50%   ...50% hearing loss is consider major hearing loss and  close to being completely deaf ,  also with tinnitus  and a Profound severe hearing loss  you could possibly be rated 90% and inferred to TDIU P&T if this keeps you from working . or what you were trained to do.

the test looks like you have profound hearing loss.

but that's just my opinion  what matters is the opinion of the raters and how they see this test.

if you get a 60% or 70% 80% 90%  ask for IU.... IF THEY DON'T GIVE IT TO YOU.

Thank you Buck 52. I appreciate your information. Sometimes, I am glad I don't hear well :) I will keep you posted on the results. It is a combined claim for the hearing and diabetes type 2 which has related issues like the pain and numbness in my feet. I had my feet digitized for some type of inserts for my shoes to help. Not sure how that is going to work as they have not come back to the VA yet. I was 100% when I was diagnosed with both Hodgkin's & Non-Hodgkin's lymphoma but due to the remission, that has been taken away. 

Happy Holidays to you and yours. 

Wally

[Grunt]

On 12/13/2016 at 0:32 PM, Grunt said:

Thank you Buck 52. I appreciate your information. Sometimes, I am glad I don't hear well :) I will keep you posted on the results. It is a combined claim for the hearing and diabetes type 2 which has related issues like the pain and numbness in my feet. I had my feet digitized for some type of inserts for my shoes to help. Not sure how that is going to work as they have not come back to the VA yet. I was 100% when I was diagnosed with both Hodgkin's & Non-Hodgkin's lymphoma but due to the remission, that has been taken away. 

Happy Holidays to you and yours. 

Wally

Hello Buck,

I received my determination letter from the VA regarding my hearing loss and Ischemic Heart Disease (Agent Orange Presumptive) today. My hearing loss was increased from 50% to 60% and I was granted 60% for the Ischemic Heart issue. My benefit payment will continue unchanged (100%) but I am not classified as TDIU or P&T from what I am reading. I receive 10% for tinnitus, 10% peripheral neuropathy for each foot total of 20%, 20% for Type II Diabetes, 50% PTSD, 60% for the hearing loss and 60% for the Ischemic Issue. Total of the disabilities = 220%  although the VA math I know does not sum it up that way. My thoughts are to just leave my situation as is. I am told that TDIU does not increase the disability and I don't know if there are any other benefits to gain from that classification. Any thoughts you may have would be appreciated. 

Hope you are well and I appreciate your help.

Wally

[Buck52]

I think I would agree with the decision  but also ask for the P&T.  The benefits are super great with P&T.

Having this many S.C. Conditions   they should have gave you the scheduler 100% P&T Rating.

If any of these S.C. Conditions keeps you from working  they should have inferred the TDIU P&T with possibly SMC-S

THE 10% Increase with your hearing Now S.C. at 60% could boost you up to the extra scheduler b for the bump up to the TDIU if it keeps you from find marginal gainful employment or make less that 13.000 a year because of this S.C. hearing impairment, and with the other separate S.C. Conditions as high % as they are  you could also meet the criteria for SMC-S 1 H.B.

But if your happy with what they gave you  then thats ok too  its just that you can or should have recieved so much more.

jmo

[CostieBM1]

Hey Guys! First time posting long time follower. I have finally got my ratings from the VA and got 40% first go around, but was rated at 0% on my hearing even though my C&P stated: 

SECTION1: HEARINGLOSS(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|AvgHz|

 

 

| Hz*| Hz| Hz| Hz| Hz| Hz| Hz|(B-E)**|
| ========+========+========+========+========+========+========+========| | 10| 5| 10| 15| 25| 35| 45| 14| +=======================================================================+

LEFT EAR +==============================================================+ |A|B|C|D|E|F|G|
| ========+========+========+========+========+========+========+========+ | 500| 1000| 2000| 3000| 4000| 6000| 8000|AvgHz|
| Hz*| Hz| Hz| Hz| Hz| Hz| Hz|(B-E)**|
| ========+========+========+========+========+========+========+========| | 15| 10| 10| 20| 40| 50| 65| 20| +=======================================================================+

* 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 CNCword list): +=======================+
| RIGHTEAR| 94%|
| =============+=========|

|LEFTEAR| 94%| +=======================+

e. Appropriateness of Use of Word Recognition Score (Maryland CNCword l i st ) :

Right Ear:
I s W o r d D i s c r i m i n a t i o n Sc o r e a v a i l a b l e ? Y e s

Word Discrimination Score appropriateness:
Use of word recognition score is appropriate for this Veteran.

Left Ear:
I s W o r d D i s c r i m i n a t i o n Sc o r e a v a i l a b l e ? Y e s

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 | [X] Normal [ ] Abnormal | [X] Normal [ ] Abnormal

  |

• |  =====================+===========================+===========================| | Ipsilateral | |

  |

| Acoustic Reflexes | [X] Normal [ ] Abnormal | [X] Normal [ ] Abnormal

|

| =====================+===========================+===========================| | Contralateral | |

|
| Acoustic Reflexes | [X] Normal [ ] Abnormal | [X] Normal [ ] Abnormal

|
| =====================+===========================+===========================|

| | |

[] | |

[]

| Unabletointerpret| | reflexesdueto |
| artifact |

|

| =====================+===========================+===========================| | Unabletoobtain/ | |

|
| +=============================================================================+

| maintainseal | [] |

[]

2. Diagnosis ------------

RIGHT EAR ---------

[ ] Normal hearing
[ ] Conductivehearingloss [ ] Mixed hearing loss

ICDcode: ICD code:

[X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* ICD code: H90.3

[X] Sensorineural hearing loss (in the frequency range of 6000 Hz or higher frequencies)** ICDcode: H90.3

[ ] Si g n i f i c a n t c h a n g e s i n h e a r i n g t h r e s h o l d s i n s e r v i c e * * *

LEFT EAR --------

[ ] Normal hearing

 

[ ] Conductivehearingloss ICDcode:
[ ] Mixed hearing loss ICD code:
[X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)*

ICD code: H90.3
[X] Sensorineural hearing loss (in the frequency range of 6000 Hz or

higher frequencies)** ICDcode: H90.3
[ ] Si g n i f i c a n t c h a n g e s i n h e a r i n g t h r e s h o l d s i n s e r v i c e * * *

NOTES:
* The Veteran may have hearing loss at a level that is not considered to

be
adisabilityforVApurposes. Thiscanoccurwhentheauditory thresholdsare greater than 25 dBat one or more frequenciesin the 500-4000 Hz range.

** TheVeteranmayhaveimpairedhearing,but it doesnot meet thecriteria tobeconsideredadisabilityforVApurposes. ForVApurposes,the diagnosis of hearing impairment is based upon testing at frequency

ranges
of500,1000,2000,3000,and4000Hz. IfthereisnoHLinthe

500-4000
Hzrange,but thereisHLabove4000Hz,checkthisbox.

* * * The Veteran may have a significant change in hearing threshold in service, but it does not meet the criteria to be considered a disability forVApurposes. (Asignificantchangeinhearingthresholdmay

indicat e
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? Yes

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? Yes
Rationale (Provide rationale for either a yes, no answer or speculation reason): The veteran's enlistment physical exam dated 6/ 20/ 2000 indicated normal hearing in the right ear. His separation physical exam dated10/29/2015indicatedhearingloss.Therefore,it isasleast as likely as not that the veteran's present right ear hearing loss is
related to military noise exposure.

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? Yes

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? Yes

Rationale (Provide rationale for either a yes, no answer or speculation reason): The veteran's enlistment physical exam dated 6/ 20/ 2000 indicated a mild high frequency hearing loss in the left ear. His separation physical exam dated 10/29/2015 indicated significantly worse hearing in the left ear. Therefore, it is as least as likely as not

t hat
the veteran's present left ear hearing loss is related to military

noise exposure.

Did hearing loss exist prior to service? Yes
If yes, was the pre-existing hearing loss aggravated beyond normal progression in military services? Yes

Provide rationale for both yes or no: See above comments.

4. Functional impact of hearing loss
------------------------------------
Does the Veteran's hearing loss impact ordinary conditions of daily

life,
including ability to work: No

5. Remarks, if any, pertaining to hearing loss: -----------------------------------------------

The veteran served in the Coast Guard from 2000 to 2015. His MOSwas boatswains mate. He reports noise exposure from diesle boat engines and small arms qualification. He states that he wore hearing protection some of thetime.Hedeniesahistoryof civilianoccupational/recreational

noise exposure. His otologic history is unremarkable.

SECTION2: TINNITUS

-------------------- 1. Medical history

------------------
Does the Veteran report recurrent tinnitus: Yes

Date and circumstances of onset of tinnitus: The veteran states that his tinnitus began while he was in the military. It is in both ears and is const ant .

2. Etiology of tinnitus
-----------------------
At least as likely as not (50%probability or greater) caused by or a result

of military noise exposure. Rationale: The relationship between noise exposure, nose-induced hearing loss and tinnitus is well documented   Should I have been entitled to a zero rating, and if in YHO should I appeal it?  I want to say thank you, as all of the advice on this site was a great resource and made this battle a little easier.

[jbasser]

Dont forget about the recurrent tinnitus . That is a 10 percent rating and is a cue if not rates or rated zero percent.

[CostieBM1]

I got 10% on the tinnitus, thought a 0% on hearing was warranted based on all of my reading and post on this great site.