One of the most common problems shared by millions of veterans is damage to hearing caused while in-service. Military training, and much of military life, not to mention the unique rigors of combat and hazardous duty, include being exposed to significant noise. It is a very real problem for veterans, especially as they grow older. And unlike most medical conditions, hearing problems from in-service noise exposure can become symptomatic years after the veteran has left military service.
Generally, noise trauma can be thought of in two ways. The first is actual acoustic trauma. That is the veteran is exposed to damaging sound volumes whether over extended periods of time, or short bursts of enormous volumes. The second is the compressive or concussive impact of changes in the atmospheric pressure which cause extremes pressures pushing inwards into the ear as well as internal pressures pushing outwards from the ear. This is normally experienced in large explosions or the firing of large guns.
As the long-term problems have become known, the military has encouraged, and in some instances required, service-members to wear protective ear-wear, while being exposed to loud volumes of sound. However, this was not always the case. In fact, for decades the exposure to enormous volumes of sound caused by cannons and other weapon fire was considered part of the job. To even think about wearing, much less actually wearing protective ear-wear was considered a sign of weakness. Today the military takes precautions against this hearing damage.
The concussive blast caused by exposure to high impact explosions, or the firing of large guns can do significant damage to the inner ear. The rapid pressure change between the external and internal ear can cause permanent hearing loss of significant proportions.
Unlike many medical conditions hearing is normally tested routinely while in-service, and especially upon discharge from active military duty. Effectively, despite all reasons given by the military to the contrary, this discharge-from-active-duty hearing examination is a precaution used to limit future disability claims. However, recent court decisions have gutted the effectiveness of this approach. The courts have recognized, and have imposed on the VA, the practical reality hearing disabilities become evident over time. Simply because a person at discharge shows to have normal hearing, does not preclude a veteran showing in-service acoustic or concussive trauma is the cause or aggravation of a presently existing hearing loss. Even many years after departure from active military duty.
Hearing loss, unlike some other medical conditions, is tested by objective means. That is, the hearing examiner does not rely solely on the subjective complaints of the veteran. In fact, the veteran's statements of his symptoms are seldom of probative force absent a hearing test's results showing an actual hearing loss.
Hearing like any other disability is subject to a finding of "service connection" as well as an actual disability rating. The disability rating is computed based upon specific regulations which specifically define formulas for the computation of the amount of disability, which in turn determines the amount of the monthly benefit to be received. The disability rating is based upon specific formulas which combine the hearing loss of both ears. The testing includes speech recognition, as well as auditory testing of the veteran's abilities to hear specific frequencies.
Tinnitus is a condition which is closely associated with, but yet different and apart from a hearing loss. It is in essence a continued ringing or other audible noise which the veteran believes originates in his ears. Like any other sound the veteran hears it in his mind, and, like hearing, the veteran believes it originates in his ears.
Unlike a hearing loss as described above, it instead is based primarily on a veteran's subjective complaints and description of the symptoms he or she suffers from. There is no accepted objective medical testing for the condition, but for the fact it often accompanies a hearing loss which is objectively testable.
Unlike hearing, the disability award for tinnitus is not bilateral. That is a veteran can only recover for it once and not for both ears as in a hearing loss. The benefit is also capped at 10%.
The determination of "service connection" for the disability is quite similar to the decision-making process in a hearing loss claim. Normally proof is presented showing the veteran suffered an in-service exposure to acoustic trauma, and his medical examination shows the veteran suffers from the recognized symptoms normally present in a veteran suffering from the medical condition.