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    When a Veteran starts considering whether or not to file a VA Disability Claim, there are a lot of questions that he or she tends to ask. Over the last 10 years, the following are the 14 most common basic questions I am asked about ...
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  • Can a 100 percent Disabled Veteran Work and Earn an Income?

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    You’ve just been rated 100% disabled by the Veterans Affairs. After the excitement of finally having the rating you deserve wears off, you start asking questions. One of the first questions that you might ask is this: It’s a legitimate question – rare is the Veteran that finds themselves sitting on the couch eating bon-bons … Continue reading

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NGArtilleryMedic

Tinnitus Denied/Foot Injury Approved

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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

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What are the specific reasons the VARO gave you for the denial of each disability you claimed?

Need more info.

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VA can "service connect" hearing loss, sometimes at 0% rating.  Or, if you dont meet the minimum criteria which defines "hearing loss" then you wont have a current diagnosis, and you will be denied.  It sounds like your hearing has worsened, OR the tinnitus is masking your hearing so you just hear ringing.  

If you are an "artillary medic" then your MOS "should" explain your in service hearing loss (from noise exposure).  However, welcome to the world of VA where they fight you for compensation every nickel.  

YOu should appeal the hearing loss, even if it only results in a zero percent rating, in part, because you can get an increase if your hearing loss continues to worsen.  (Likely).  Hearing loss is progressive, and HOH individuals often lose up to about an additional 5 percent per year.  The tinnitus maxes out at 10percent, and its regurarly awarded when the Veteran self reports tinnitus along with a hearing loss diagnosis.  

Do you know your average Maryland CNC hearing loss score?  You may be able to find that number in your records.  

The way VA takes an average hearing loss is a shaft to Vets.  Let me explain. Lets say you lose 50 percent of your right hand to an explosion...you lose your thumb, index fingers and more.  Your hand is rendered useless.  By figuring it, however, the same way hearing loss is figured, you "average" your bad hand with your two feet, good hand, your eyes and ears, and kidneys, which did not get blown off.  When you "average" this:

right hand   5 (for 50 percent)

left hand    10

left foot      10

eyes           10  each

ears           10 each

kidneys      10 each.

Total         85.    So, 5/85  = 5%.

So, this means your hand would "round down" to zero percent.  This is the way they calculate hearing loss..they

average the frequency you lost hearing in with frequencies you did not lose anything, so it will result in lower compensation.   

Its worse with hearing loss.  By using an "average"...dividing it into the frequencies where you do not have a loss, it often means your rating comes out at zero percent.  

Some genius at VA concocted this way to shaft Veterans after insurace company crooks figured it out first.  (Its called the "whole man" theory.)

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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

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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

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NGArtilleryMedic

If and when your denied for this?

 A Private IMO/IME Recommended. 

If I was you I'd go get a new hearing test with a private ENT that has state certified Audiologist And have the ENT Specialist Examine you & read your VA Audiology Records & Military records describes your MOS. (he just needs to read about the MOS part so have that hi-lighted.) AS to how you were around sudden LOUD NOISE while in the Military.

Usually a Private Dr that has tested Veterans for compensation purposes would be great,  if not then just be honest with the Dr and let him know what you need.

Take  your medical audiology records /and report of the VA Audiology test  to compare after  this new testing is completed & have the Dr and Audiologist to go by the VA guidelines and use the Maryland CNC Word Test....>you can check with the VA Audiology Dept and ask for a CD of he Maryland CNC Word Test   they may charge you a couple bucks, if they say no then go up to the place that has your medical records on file on CD like Mri's &older X-Ray's ect,,ect,,, you can request the Maryland CNC Word test there. (they should have one in stock)

if anyone says  they never heard of it then check with the hospital director...if they use the CD Maryland CNC Word test at your VA Audiology Dept  then they should have the C.D. Or Ask your private ENT Specialist to call the VA AND Request this Maryland CNC Word test CD.

Just be honest with your VA Audiology Dept and let therm know your seeing an outside ENT for private hearing testing  and he needs this CD.

The VA is suppose to send it to the private Dr when Requested.

The Test has to be done using the VA'' Strong Guidelines''

The Private Dr can give his opine after reading your Service Records that pertain to this issue and has examine you tested you and read your military medical records as to his pro opinion  and state it is ''likely as not that this veteran hearing loss is related to his military service and has a noise induced Bilateral Hearing loss'' and how it occurs over time.  the Dr needs to give his Credentials and also the Audiologist that performs the test.

ALso what would help is to get about 7 Notarized statements from family and friends  to give their lay statements about your hearing impairment, how it effects your life ect,,ect,,,

You have a year to do all of this but the sooner the better, you can get this private Dr Medical report & copy of the Hearing test and send it in as your evidence with your NOD Form.

Be honest in your NOD let them know you was not hard of hearing after you got out  or maybe you was but never notice it (if this is the case with you?) state that your hearing loss seem to get worse as the years go by....b/c that's the way Noise Indused Hearing loss does  it gradually fades away as you become older...you may ask the private Dr to state that in his report...we have to spoon feed these raters when it comes to service connecting hearing loss  so any favorably thing the private Dr can report will obviously help your claim.

a good lay statement from you in detail about how your loss of hearing effects your life and the people around you and its very upsetting/frustrating for you...try not use the word depression when trying to explain about your hearing loss.

About tinnitus there is no test for that  you need to mention it to the Audiologist after the test and let him/her know you have a ''ringing in your ears and it is of constant sounds & about drives you batty  especially at night. 

Remember to put your claim # on ever page of evidence you send the VA.

There maybe more that you can do ...but this should get you on the right track with those raters....

Ms berta and broncovet are very intelligent as for as submitting claims especially complicated claims such as hearing loss and CUE claims...its just my opinion here but Hearing loss claim are very hard to win  you need to be damn near deaf to get a rating.

Edited by Buck52

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