Hearing loss c&p - Hobbies mistake

[Usaf9498]

I got my Hearing Loss C&P Tuesday Morning.

This morning it was available on myhealthevet. When she asked about my hobbies, she specifically asked me if I rode motorcycles. I told her no. Never have. Sure enough under hobbies ( SEE below) It lists my hobbies as motorcycles and hunting. 

Good news is it looks like it will be easy to service connect my hearing loss, however, it is not enough for a rating. 

Tinnitus should be rated and looks to be service connected from what I can see. 

Other good news is she stated that there was not a hearing test done in STRs so hearing loss during service is not ruled out. Sounds to me like this should be fairly easy but I know not to count my chickens before they hatch.  

 

 

Date/Time: 10 Sep 2019 @ 0803 

Note Title: KC-AUDIOLOGY 

Location: VA Heartland-West VISN 15 Signed By: BREAUX,KATHERINE A Co-signed By: BREAUX,KATHERINE A Date/Time Signed: 10 Sep 2019 @ 0805 

Note LOCAL TITLE: KC-AUDIOLOGY STANDARD TITLE: AUDIOLOGY NOTE DATE OF NOTE: SEP 10, 2019@08:03 ENTRY DATE: SEP 10, 2019@08:03:23 

AUTHOR: BREAUX,KATHERINE A EXP COSIGNER: URGENCY: STATUS: COMPLETED 

S: The veteran has requested an Audiology Compensation/Pension examination. The 

case history information is included in the CAPRI report. 

O: The following procedures were performed: Work Related or Medical Disability Examination 99456, SP206, RVU=90 

A: The disability assessment included a review of medical and service records, 

 

review of past, social, family, occupational, and military history. A comprehensive audiometry examination, formulation of a diagnosis, assessment of capabilities, and completion of necessary documentation was administered. The audiological findings were discussed with the veteran and will be forwarded to the compensation pension department. 

P: The patient was informed to return for further treatment when necessary pending their eligibility status. 

Time: 90 mins 

/es/ Katherine A Breaux Clinical Audiologist Au.D., CCC-A Signed: 09/10/2019 08:05 

Date/Time: 10 Sep 2019 @ 0730 

Note Title: C&P AUDIO 

Location: VA Heartland-West VISN 15 Signed By: BREAUX,KATHERINE A Co-signed By: BREAUX,KATHERINE A Date/Time Signed: 10 Sep 2019 @ 1330 

Note LOCAL TITLE: C&P AUDIO STANDARD TITLE: C & P EXAMINATION NOTE DATE OF NOTE: SEP 10, 2019@07:30 ENTRY DATE: SEP 10, 2019@13:30:56 

AUTHOR: BREAUX,KATHERINE A EXP COSIGNER: URGENCY: STATUS: COMPLETED 

Hearing Loss and Tinnitus Disability Benefits Questionnaire 

 

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 [X] Other (please identify other evidence reviewed): 

Case History: 

Post: Union Iron Worker, tile setter helper, insurance sales, retial. Hobbies: Motorcycle, hunting 

Right: 10@ 500, 0 @1000, 10 @ 2000, 10 @ 3000, 10 @ 4000 Left: 0 @ 500, 0 @ 1000, 20 @ 2000, 0 @ 3000, 5 @ 4000 

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)**| |========+========+========+========+========+========+========+========| | 15 | 15 | 25 | 30 | 60 | 50 | 40 | 33 | +=======================================================================+ 

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)**| |========+========+========+========+========+========+========+========| | 15 | 15 | 30 | 20 | 25 | 20 | 15 | 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 | 88% | |=============+=========| | LEFT EAR | 96% | +=======================+ 

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 | [X] Normal [ ] Abnormal | [X] Normal [ ] Abnormal | |=====================+===========================+===========================| 

| Ipsilateral | | | 

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

| Contralateral | | | 

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

 

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

| Unable to interpret | | | 

| reflexes due to | [ ] | [ ] | 

| artifact | | | |=====================+===========================+===========================| 

| Unable to obtain/ | | | 

| maintain seal | [ ] | [ ] | +=============================================================================+ 

2. Diagnosis ------------ 

RIGHT EAR --------- 

[ ] Normal hearing 

[ ] Conductive hearing loss ICD code: 

[ ] Mixed hearing loss ICD code: 

[X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* 

ICD code: H90.3 [ ] 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 

[ ] Conductive hearing loss ICD code: 

[ ] Mixed hearing loss ICD code: 

[X] Sensorineural hearing loss (in the frequency range of 500-4000 Hz)* 

ICD code: H90.3 [ ] 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? Yes 

Rationale (Provide rationale for either a yes, no answer or speculation reason): The C-file was reviewed. The compensation and pension exam request indicated a chief complaint of hearing loss and tinnitus. The service medical record was reviewed by the examiner. The veteran served honorably in the Air Force from 1994-1998. The veteran's MOS was Aircrew 

Egress Systems which is rated by the DOD as having a high probability of 

hazardous noise exposure. The veteran reported being exposed to flight line noise exposure, generators, and tools. Military records indicated an enlistment physical dated 3-11-1994 which showed normal hearing by calibrated audiometry. There were no other hearing exams within the STRs, therefore, hearing loss at military separation was not ruled out. Since hearing loss at military separation was not ruled out, it is at least as likely as not that hearing loss was caused by acoustic trauma during military service. 

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): The C-file was reviewed. The compensation and pension exam request indicated a chief complaint of hearing loss and tinnitus. The service medical record was reviewed by the examiner. The veteran served honorably in the Air Force from 1994-1998. The veteran's MOS was Aircrew 

Egress Systems which is rated by the DOD as having a high probability of 

hazardous noise exposure. The veteran reported being exposed to flight line noise exposure, generators, and tools. Military records indicated an enlistment physical dated 3-11-1994 which showed normal hearing by calibrated audiometry. There were no other hearing exams within the STRs, therefore, hearing loss at military separation was not ruled out. The veteran currently does not have hearing loss in the left ear that meets VA criteria as disabling 21 years after his exit from the service. 

As stated in the Handbook of Standard Procedures and Best Practices for Audiology: Compensation and Pension Examinations, impaired hearing is considered to be a disability when the auditory thresholds in any of the 

frequencies 500, 1000, 2000, 3000, and 4000 Hertz is 40 dB HL or greater; or when the auditory thresholds for at least three of these frequencies are 26 dB HL or greater. The examiner is not denying exposure to noise, rather stating that the exposure did not result in hearing loss that meets criteria for service connection. Therefore, it is less likely as not that hearing loss was caused by acoustic trauma during military service. 

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: No 

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: The veteran reports constant bilateral tinnitus that started while was in the military during the bombing of "Khobar towers" in Saudi Arabia in 1996. 

2. Etiology of tinnitus ----------------------- The Veteran has a diagnosis of clinical hearing loss, and his or her tinnitus 

is at least as likely as not (50% probability or greater) a symptom associated with the hearing loss, as tinnitus is known to be a symptom associated with hearing loss. 

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. 

/es/ Katherine A Breaux Clinical Audiologist Au.D., CCC-A Signed: 09/10/2019 13:30 

[GBArmy]

I've never had to do this but I have seen where they can correct a "mistake" if you get it done within a few days, maybe a week. Otherwise, if is is changed, the original posting remains. You know what happens; the rater sees the negative comment and proceeds from there. I would call again and ask to speak to the head honcho there and just keep ongoing up the ladder until you get someone that will fix the problem. It has to be in scheduling I  should think, but don't let it slide; it is going to cost you on a hearing disability. "System is down" is VA-speak for delay and deny.

[Usaf9498]

56 minutes ago, GBArmy said:

I've never had to do this but I have seen where they can correct a "mistake" if you get it done within a few days, maybe a week. Otherwise, if is is changed, the original posting remains. You know what happens; the rater sees the negative comment and proceeds from there. I would call again and ask to speak to the head honcho there and just keep ongoing up the ladder until you get someone that will fix the problem. It has to be in scheduling I  should think, but don't let it slide; it is going to cost you on a hearing disability. "System is down" is VA-speak for delay and deny.

I called the regional office back and spoke with someone else. She said the system was partially still down but that she could add a note to my file, I assume my C-File, stating that I called in to the regional office and that there was a mistake on my hobbies. She also suggested I go into ebenefits and upload a statement saying I was challenging the mistake. I explained that I think there is a way to correct that, not challenge it, if done quickly enough. She advised that I call back this afternoon and see if the system is back up. I asked if there was someone above her that I could talk to. She said at the time that I call back, and the system is back up, there is. She said there is no point in going above her now with the system down.

She advised that if I can see the C&P on myhealthevet, that I should send my PCP a message there. I told her the PCP had nothing to do with the C&P. 

I am getting first names and writing it all down along with phones numbers called, times and dates. Nobody seems to want to give me last names.

I called back to my VAMC and spoke with c&P again. Got a different guy. He took down my info, verified spelling and asked who did the C&P. He said that he would notify her of my situation and if she has any questions, she would contact me. 

Edited September 16, 2019 by Usaf9498

[GBArmy]

USAF9498,  you are on the right tract. Now, if I were you (and I don't want to be because I am better looking), I would write up, with names and times if possible, in a little more detail, what you did. Upload it into ebenies in support of your (name,claim #, C&P Exam, dated--,etc.) so it is in your record. Later, confirm it is in there. You will have taken affirmative steps to show that the examiner made a mistake and it should be corrected, not challenged. But you see what I said; no one at the VA wanted to correct it, Delay, deny, see the veteran die!