TINNITUS C and P

[Duster4-60]

Just finished my C and P for Tinnitus and Hearing loss. And why I most likely will be denied.

My appointment was made through LHI. This was June 24, 2021 and the appointment was for September 10, 2021. I called LHI and asked why it would take 11 weeks for an appointment, no answer.

My appointment was for 1PM. I arrived at 12:45 to find the location at a small store front in an older strip mall, my first thought was, Dingy and Dirty.  No one was at the reception desk so I called out to someone in the back. Turns out it was the Doctor who answered she was with a patient and came to the front and informed me they were out to lunch and to sit down until the receptionist returns. Needless to say she seem a bit miffed that I bothered her.

The receptionist arrived and took my info and asked that I take a seat until the Doctor finished with the other patient. I waited until 1:15 when the doctor called me in. Her 1^st question was “how are you doing” and my reply was “I’ve been better” she seemed to want to push the issue and I pushed back saying I didn’t know want she wanted me to say. At this point I started to feel this was not going to go well for me.

She began interviewing me first about my hearing. It was pretty basic like, are both ears affected, is one side better that the other. When did I notice my hearing lost and what may have caused it. I told her about being in the Artillery in Viet-Nam for a years. I was honest to tell her that age may also be a factor. Then she started asking about my Tinnitus, normal questions like, when did it start, what it sound like to me. I explained besides being in the Artillery there was one incident of a large road land mine that blew up right in front me. I was driving a deuce and half with some replacements from Pleiku to Kon Tum. The deuce and half in front of me hit the mine and it blew off the double dual tires of the deuce and half as well bending the bed as if it was a toy. It was the loudest thing I ever heard. She took notes about it but seemed to want to know about my life after Viet-Nam.

At this point she seemed confrontational about my answers. I told her I worked in the accounting department of a large trucking company for about 15 years and then computer work. Nothing in noisy areas or running heavy machinery. She didn’t seem to want to listen how Tinnitus impacted my life. She just seemed to want to find some other reason why I might have Tinnitus. She keep asking about if I go hunting or to a shooting range. Then if I own a motorcycle or loud lawn equipment. I told I didn’t but she asked a second and third time about the same thing at which point I felt she was badgering me.

We started the hearing test and to my surprise my hearing was better than I expected. I don’t know if she played with the equipment but it sure didn’t feel right, but the results are the results. So I doubt I would get any rating for hearing loss. As for the Tinnitus I assume it is what opinion she puts in her report but I have little hope it will be in my favor.

Overall I didn’t find her to be a very professional and wish that they had choose another doctor to do the testing. Just wondering if anyone has any comment about LHI as a contractor?

[GBArmy]

Duster4-60 Welcome to Hadit.

From what you have described, it sounds like a typical hearing/tinnitus C&P exam. The doctor doesn't sound like she has much experience related to military noise exposure but the questions are usual. She wants to dig to see if you had outside exposure to noise, such as lawn mowers, etc. You can do a couple things: First, you can complain to the VA about her demenier and interactions right away, and request a re-do. Although she wasn't the best communicator, it doesn't sound like there is anything terrible you can point too. (forget how you feel; you can't express it forcefully enough to get the VA to do another C&P IMHO. You need something more serious) Second, you wait for your decision letter; if you get approved for tinnitus, great. If not, appeal  either HLR or BVA or get another private audiologist to exam and submit a supplemental claim. Be sure to describe in your own statementment in support of a claim (Buddy Letter) your exposure experiences if you go supplemental or BVA. The VA examiners may not understand the noise you were exposed to without hearing protection. For your hearing, claim, I would definitely get a private hearing exam to see if you got low-balled. You may have been awarded a 0% rating for hearing. The VA scale for compensation for hearing loss is a high standard, meaning 0% or 10% is usually the award. If you go outside for evidence,be sure the exam is done using the criteria the VA uses. see https://www.law.cornell.edu/cfr/text/38/4.85

You may be better than you think. I'd just wait myself. If denied, get your own evidence and re-submit is your best bet. A 0% rating  hearing is better than none as you you can appeal if it gets worse for you. And Tinnitus is 10% or nothing; no higher rating is given out.

[brokensoldier244th]

Even a 0 is a win for HL. It means you qualify for hearing aids if you need then, So there is 5000 you don't need you spend on your own, and many of them have tinnitus masking programs built into then.

[broncovet]

I agree with GB Army.  "Its better than you think".  Is your Army MOS consistent with what you were doing?  That is, was your Army MOS Artillary/related?  If what you did is inconsistent with your MOS that is when its a problem.  People dont always do what the army trained them to do.  

 

While you did "not" post hearing loss numbers, based strictly on your post, my opinion is the most likely result is 10 percent tinnitus, and 0 for hearing loss.  

 

If you had operated loud machinery post service, you may have a problem with SC.  

Its also likely you are NOT diagnosed with hearing loss if your "numbers" are too low.  

Are you wearing hearing aids?

Can you watch TV without Close captions (I can not).  

Do you have other listening devices?  Example:  Close caption phone, doorbell that lights up, etc.  

I started at 0 percent hearing loss and 10 percent tinnitus.  Interestingly, the VARO increased me to 20 percent for hearing loss, yet my hearing did not actully worsen significantly, according to the numbers only.  However, when I plugged my hearing loss numbers into the chart, even when it was zero percent, I get a 50 percent rating.  Now, I could appeal but there is nothing in it for me.   Reason:   (no additional compensation) if my hearing loss were increased to 50 %, as I am already 100 percent p and t plus smc S). 

The only real way for me to get above SMC S, is if I need A and A, or, if I have loss of use which is service connected.  

Edited September 11, 2021 by broncovet

[brokensoldier244th]

See M21-1 III.iv.4. Sec B, starting on P11,  and the chart below. The bar for Audio Aggravation based on MOS induced hearing loss is a low bar to clear. 

Duty-MOS-Hearing-Loss-Probability-Chart-VA-Fast-Letter-10-35.pdf

[john999]

When the C&P doctor for hearing asks you how are you doing say "  what was that you say?"  "Can you speak up?"  "What was that I can't hear you when you whisper".  I went for a hearing exam at the VA and doc said I had hearing loss.  Like others I am not filing a claim since it would get me no more compensation.  When I was in Vietnam we fired weapons all the time and we had no hearing protection.

[brokensoldier244th]

If you aren't that hard of hearing don't do that. The exam will show it not to be the case, and the examiner DOES sometimes put notes in there for speech discrimination that make note of wide discrepancies between the audiological test and the interview portion with you. The hearing test is computer driven anyway- they aren't pushing buttons for each tone, and they aren't adjusting it as you go along to make it sound different. They load up your current hearing profile based on your hearing aids (if you have one), they push a button and the test starts. 

I just had one of these (not C&P, just a regular exam) for new hearing aids and my doctor was a younger guy that also wore hearing aids (in his 30s), but also does C&Ps. I asked him quite a lot about how the new hearing tests work since we got a new building/clinic with mostly all updated stuff that was built about 8 months ago. Once he found out I work on the other side he asked me some questions about what it looks like on the benefits side of things, and how we decide who to send for hearing exams, and whatnot. He's the full time audiologist at my CBOC and not a contractor so I indulged him.

It was a pretty good 20 minute conversation. He also asked me about Basic Training, and A school, and what kinds of things could cause noise exposure that AREN'T specifically in the MOS list of Noise exposure limits. He was genuinely interested in things that we could be exposed to that wouldn't be obvious as noise exposure based on MOS, cause we all know that just because our 'job' may have been "the IT guy" or "the quartermaster", or "the machinist/engine repair, vehicle driver...." , we didn't all just spend our time around the noises limited to just our MOS/Job Rate. He acknowledged that and said that he doesn't just go by the MOS 'noise exposure rating' because he knows it is really limiting, but he's also not a veteran so he was asking questions. That was cool.