HEARING LOSS CLAIMS AND THE VA

You might be surprised to find that getting any type of compensable evaluation
for hearing loss is a hard thing to do.
By Raymond F. Gustavson, Jr.

With your VA claim, you should submit current medical evidence showing you have such a loss.

During World War II, the Armed Services and the Department of Veterans Affairs (VA) used a simple test
to measure hearing loss. The examiner stood behind the subject and spoke, whispered, or clicked a coin.
The test was repeated at varying distances. Recorded readings of 15/15 or 20/20 represented normal
hearing for VA purposes. Alternately, a tuning fork was used for the same test.
Several years later, the VA adopted revised audiometric testing procedures consisting of pure tone
audiometry, and controlled speech recognition scores. Using earphones, the veteran listened to a variety
of tones. Pure tone audiometry checked how clearly the veteran heard sounds traveling through the ear
canal (air conduction) or the bones (bone conduction). Additionally, the test checked how well he
understood speech.
If you want to make a claim for hearing loss, write a letter to the VA and tell them you are claiming service
connection for hearing loss. With your claim, you should submit current medical evidence showing you
have such a loss.
If you do not have current medical evidence, the VA will send you a release form (VA Form 21-4142) for
you to list your doctors name, address, and date(s) of treatment. Return the form to the VA, and they will
obtain the necessary medical report(s). Failure to do this relieves the VA of any obligation to secure your
private medical records.

After the VA has received all medical evidence, the Rating Specialist will schedule you for a VA
examination to determine the severity of your hearing loss.
If you were treated at a VA medical center or other U.S. government facility, the VA must obtain these
records.

After the VA has received all medical evidence, the Rating Specialist will schedule you for a VA
examination to determine the severity of your hearing loss. To ensure consistent results, the VA requires
that a state-licensed audiologist conduct these tests.
At the VA examination the examiner will review your claims file and give you a hearing test. When he
finishes, he will submit a summary of his findings. The examiner must state that it is as likely as not that
your hearing loss was due to acoustic trauma experienced during military service. This statement is what
is called a nexus and, without it, your claim will be denied.
The Rating Specialist in the VA Regional Office uses the tables found in 38 CFR 4.85 to determine the
severity of your hearing loss. Table VI assigns a numeric designation of hearing impairment based on
threshold average and speech discrimination. This table is used for most evaluations. Table VIA
(Puretone Threshold Average) is used when the veteran has language difficulties or inconsistent speech
discrimination scores, etc., and is not able to answer the examiners questions. An example would be a
veteran with facial paralysis.
The table at the bottom of this page shows my Puretone and decibel losses. To compute the average
Puretone loss in my right ear, I added 5, 5, 20, and 15 for a total of 45. Then I divided 45 by 4 for an
average of 11.25 or 11.
Next, I used Table VI and found my right ear Speech Recognition score of 96 percent in the left-hand row
(92-100) and ran my finger across this row until I found my Puretone Threshold Average of 11. This
equated to Roman numeral I. However, under the provisions of 3.385 none of my Puretone readings
was 40 decibels or greater; the auditory thresholds for at least three of the frequencies 500, 1000, 2000,
3000, or 4000 Hertz were not 26 decibels or greater; and my speech recognition score was not less than
94 percent. Thus, service connection for my right ear was denied.
To compute the average Puretone loss in my left ear, I added 5, 25, 30, 40 for a total of 100. Then I
divided 100 by 4 for an average of 25.
Next, I used Table VI, found my left ear Speech Recognition score of 92 percentin the left-hand column
(92-100), and ran my finger across this row until I found my Puretone Threshold Average of 25. This
equated to Roman numeral I. Since I had one reading of 40 decibels (at 4000 HZ), service connection
was granted for the left ear.
Finally, I used Table VII to determine the percentage disability in my left ear. I ran my finger across the I
row until it intersected with the I column. That left me with a 0 percent evaluation. I did not qualify under
Table VIA because I had no difficulty understanding the examiners instructions. I did not qualify under
4.86(a), Exceptional Patterns of Hearing Impairment, because none of the four specified frequencies
(1000, 2000, 3000, and 4000 Hertz) in my left ear was 55 decibels or more.

It is very hard to get any type of compensable evaluation for hearing loss. By this, I mean 10 percent, 20
percent, etc., which translates to a dollar amount.
And I did not qualify under 4.86(b), Exceptional Patterns of Hearing Impairment, because my left ear did
not have a Puretone threshold of 30 decibels or less at 1000 Hertz, or 70 decibels or more at 2000 Hertz.
As a result, the VA granted me 0 percent service connection for my left ear. They denied service
connection in the right ear. I received a letter informing me of the effective date of the grant, along with a
copy of my appeal rights.
Of note, it is very hard to get any type of compensable evaluation for hearing loss. By this, I mean 10
percent, 20 percent, etc., which translates to a dollar amount.
Also of note, when processing the claim, the Rating Specialist must consider 38 CFR 3.350 to see if the
veteran qualifies for special monthly compensation due either to deafness, or deafness in combination
with other disabilities.
What if your claim is denied?
If your claim for tinnitus is denied, read the VA letter in its entirety. Look specifically at the reasons why
the claim was denied. If you think the denial was unfair, send a one-sentence letter to the VA stating that
you disagree with the decision. This protects your appeal rights; however, the VA must receive your letter
within one year of the denial. In your letter, you may submit any additional evidence you feel is relevant to
your claim, or any information the VA requested but you failed to send.
Dont lose hope
Since the VA appeals process is a precise yet often confusing process to understand, I would strongly
advise contacting a local service organization or a local County Service Officer. One of their
representatives will explain exactly why your claim was denied and help you process your appeal.
Sometimes, its as simple as not sending in that one piece of information you thought was a waste of time.
Dont lose hope.

Retired VA Rating Specialist Raymond F. Gustavson, Jr. served with the U.S. Army in
Vietnam, and is writing a self-help book to help veterans understand the complexities of the VA claims
process. His first novel, A Thirst for War, was a semi-finalist in the 2009 William Faulkner Competition.
The sequel, In the Hands of the Wolf, was a semi-finalist in the 2011 William Faulkner Competition, and
won Third Prize at the 2012 Florida Writers Association convention.
http://www.vietnow.com/va-claims-hearing-loss/