Military Hearing Loss

Military hearing loss and tinnitus — a ringing, buzzing or whistling in the ears — are the top two reasons for VA disability compensation claims. Most cases of military hearing loss are caused by exposure to loud noises that damage delicate hairs in the inner ear.

3M Dual-Ended Combat Arms Earplugs

In 2016, more than a million veterans received disability compensation for hearing loss, and about 1.6 million received compensation for tinnitus, according to The American Academy of Audiology.

Surgery, medication and hearing aids may help veterans live with hearing loss, and earplugs may lower the risk of hearing damage.

Healthy hearing is an asset for service member survival on the battlefield, as it affects the ability to communicate information necessary to plan and complete a mission.

Hearing Loss and Tank Gunner Performance
Combat Event Good Hearing Poor Hearing
Time to identify target 40 seconds 90 seconds
Incorrect command heard 1 percent 37 percent
Tank crew killed by enemy 7 percent 28 percent
Correct target identification 98 percent 68 percent

Hearing also affects service members’ ability to interact with friends and loved ones back home and be a part of their community. Unfortunately, veterans are 30 percent more likely than nonveterans to suffer severe hearing impairment, according to the Centers for Disease Control and Prevention.

“Given the links between warrior health, safety, quality of life, economic impact and mission accomplishment — or defending our nation and its freedoms — hearing is a crucial sense that must be protected,” according to the Department of Defense Hearing Center of Excellence.

Types and Symptoms of Hearing Problems

According to the VA, there are two broad categories of hearing loss: conductive hearing loss and sensorineural hearing loss. Some people have a combination of both types.

Damage to the eardrum and middle ear causes conductive hearing loss. This damage is often reversible with medication or surgery.

Sensorineural hearing loss is permanent damage to the inner ear and auditory nerve, but hearing aids can help. This type of hearing loss is the most common.

Diagram that shows the internal organs of the ear
Damaged hairs inside the cochlea cause tinnitus.

Veterans may also suffer from tinnitus, a buzzing or ringing in the ears that happens when no external noise is present. Though about 80 percent of tinnitus sufferers can function normally, others suffer lost sleep and difficulty concentrating, according to the VA.

In addition to the traditional types of hearing loss, veterans also suffer from auditory processing disorder, a condition associated with blast exposure. This disorder makes it difficult for some veterans to understand speech even if they score normally on hearing tests.

Ten signs of hearing loss:
  1. Buzzing, whistling or ringing in the ears (tinnitus symptoms)
  2. Difficulty understanding conversations when you are in a noisy place, such as in a restaurant
  3. Difficulty understanding speech over the phone
  4. Having to ask others to speak more slowly and clearly
  5. Having to ask someone to speak more loudly or repeat what they said
  6. Hypersensitivity to or pain from certain sounds
  7. Muffled speech and other sounds
  8. Problems hearing high-pitched sounds such as bird chirps, alarm clocks or doorbells
  9. Trouble distinguishing between the sounds of s and f, between p and t or between sh and th in speech
  10. Turning up the volume of the television or radio
Hearing loss and tinnitus are the most disabilities among veterans
Hearing loss and tinnitus are the most common disabilities among veterans.

What Causes Military Hearing Problems?

Military service members have a greater risk for hearing loss than civilians. Hearing damage can occur over time or as a result of a one-time exposure to high-intensity noise, such as small-arms fire, improvised explosive devices (IEDs) or artillery fire.

Exposure to sounds that are too loud, too close or that last too long can damage delicate hairs and cells in the inner ear that are housed inside a shell-like organ called the cochlea. The microscopic hair cells, or cilia, cannot repair themselves.

Decibels (dB) measure the noise level of a sound based on how much pressure it puts on the eardrum. Hearing damage occurs at noise levels at or above 85 dB.

Noise levels in the military:
  • Ambulance – 85 dB
  • Anti-tank gun – 182 dB
  • Anti-tank missile – 166 dB
  • Armored personnel carrier (APC) – 120 dB
  • Cargo transport – 88 dB
  • Explosions/IEDs – 180+ dB
  • Grenade (at 15 m ft.) – 164 dB
  • Heavy artillery – 185 dB
  • Helicopter – 105 dB
  • Jet engine (at 100 m) – 140 dB
  • M-16 – 130-150 dB
  • Machine gun – 155 dB
  • Pistol fire – 157 dB
  • Recoilless rifle – 190 dB
  • Rifle fire – 157 dB
  • Tank – 115 dB

Traumatic Brain Injury

Traumatic brain injury (TBI) is a blow or jolt to the head that disrupts normal brain function, and VA studies show that veterans with TBI also suffer hearing loss or tinnitus.

Veterans who served in Iraq and Afghanistan suffered TBI from blasts associated with improvised explosive devices (IEDs), land mines, mortars, bombs or grenades. But soldiers may also suffer TBI without blast damage.

A 2012 VA study reviewed medical charts of 250 veterans with mild TBI. Eighty-seven percent of these veterans reported experiencing some type of hearing problem.

Jet Fuel and Noise-Induced Hearing Loss

Researchers have also found a connection between jet propulsion fuel-8 — commonly known as JP-8 — and hearing loss.

A study cited by the VA and published in the Journal of Toxicology and Environmental Health found JP-8 interacted with noise to cause auditory processing dysfunction in the brain.

People with auditory processing dysfunction may hear sounds, but their brains have a hard time deciphering the message.

3M Dual-Ended Combat Arms Earplugs
Defective 3M Combat Arms Earplugs may have caused hearing loss and tinnitus in thousands of soldiers.

Defective 3M Combat Arms Earplugs

Because hearing loss and tinnitus are such prevalent problems for service members, the military provides standard-issue hearing protection, and earplugs are standard-issue across the services.

3M provided its dual-ended Combat Arms Earplugs to several branches of the United States military from 2003 to 2015.

But in 2018, a whistleblower complaint accused 3M of selling defective earplugs to the military and exposing unsuspecting soldiers to hearing damage. According to the complaint, millions of soldiers used the defective earplugs and thousands may have suffered hearing loss and tinnitus as a result.

3M paid $9.1 million to the United States Department of Justice to resolve allegations, though they admitted no wrongdoing. Since then, hundreds of veterans have filed lawsuits against 3M.

Fact
Veterans who receive VA hearing loss or tinnitus disability compensation can file a lawsuit against 3M without losing their benefits.

Hearing Tests

The military uses two basic tests to check for hearing loss and disability ratings: pure-tone audiometry and speech audiometry, also called speech discrimination.

Pure-tone audiometry is the most common type of hearing test. It tests the faintest tones a person can hear at different frequencies, or pitches. An audiologist uses the test to determine the degree of hearing loss.

Audiologists determine the level of hearing loss by measuring the difference between a person’s hearing threshold and the normal average. A score of zero means normal hearing. The higher the score, the louder it has to be for a person to hear the tone.

Pure-tone hearing loss scores:
  • Mild hearing loss: 20 to 40 dB higher than normal
  • Moderate hearing loss: 40 to 55 dB higher than normal
  • Moderate-to-severe hearing loss: 55 to 70 dB higher than normal
  • Severe hearing loss: 70 to 90 dB higher than normal
  • Profound hearing loss: 90 dB or more

It’s important to keep in mind that pure-tone tests measure the sounds a person can hear but not how well they can understand speech.

Two different speech audiometry tests (also called Maryland CNC tests) can be used to measure a person’s ability to understand human speech. One test measures the softest level at which a person recognizes speech, and a second test assesses their ability to understand speech.

Disability Ratings and VA Benefits

The VA provides disability compensation for hearing loss and tinnitus.

The first thing a veteran needs to do is to establish that their hearing loss or tinnitus is connected to their service. Visit the VA’s eligibility for benefits webpage to read more about how to start a claim.

For hearing loss and tinnitus, a veteran will need to know the basics of their condition:
  1. Current diagnosis
  2. Evidence of the service-related event that caused the condition
  3. Medical opinion linking the event and hearing problems

The VA requires both a pure-tone and a Maryland CNC test for hearing loss. Depending on the results, the VA will assign a disability rating from 0 to 10 percent. You can read more about disability ratings from the VA’s ratings guide.

For tinnitus, the disability rating is 10 percent. Veterans with hearing loss and tinnitus can get separate ratings for each disability.

Is There a Cure?

Health providers treat reversible hearing loss with medications or surgery. For example, fluid buildup from an infection may clear up with antibiotics, and corticosteroids treat conditions caused by autoimmune issues.

Some hearing loss caused by damage to the middle ear from head trauma can be reversed with surgery.

But noise-induced hearing loss is permanent. Treatments for this condition usually focus on preventing the hearing loss from worsening, improving hearing or learning other ways to communicate.

Hearing Aids and Listening Devices

Hearing aids pick up and amplify sound. They have microphones, computer chips and receivers to direct the sound into the ear.

Health providers will look at several factors to decide which type of hearing aid might be best for a particular patient. Factors considered include the shape of the ear, the type and severity of hearing loss and features needed to improve an individual’s hearing.

VA benefits cover hearing aids.

Cochlear Implants

Cochlear implants are for people with severe to profound hearing loss. These people receive little to no benefit from a hearing aid.

The electronic devices are surgically implanted in the ear, and an external device controls them. A microphone processes speech and sound and transmits the coded signal as FM radio signals to an implant under the skin. The signal then travels to the nerve in the inner ear, bypassing damaged hair cells in the cochlea.

Woman with cochlear implant in ear
Cochlear implants are for people who get little or no benefit from hearing aids.

Bone-conduction Devices

Bone-conduction devices work by stimulating the inner ear through the skull. These devices have a battery, a digital processor and a microphone.

The patient can wear the device behind the ear, on their tooth like a retainer or surgically embedded in the temporal bone. Some models have a magnet that anchors the device to the skull.

The patient removes the small receiver before showering or sleeping.

Tinnitus Management

Tinnitus is difficult to treat because there are no standard tests for it, and the cause of the ringing often can’t be identified. There is no cure for tinnitus, but VA centers have programs that can help manage it.

Sound therapy, hearing aids and cognitive behavioral therapy may help. The majority of people find that hearing aids relieve tinnitus symptoms, according to the Hearing Center of Excellence.

Locate a hearing loss or tinnitus health provider on the Hearing Center of Excellence webpage.

How to Protect Your Hearing

While hearing loss and tinnitus are common among veterans, proper hearing protection can help reduce the risk for this population. Getting regular hearing screenings and wearing hearing protection devices while in active duty are the best ways to maintain hearing health.

Hearing protection devices:
  • Foam earplugs
  • Noise muffs
  • Tactical Communication and Protective System, or TCAPS
  • Tactical earplugs
  • Triple- and quad-flange earplugs

Veterans with hearing loss and tinnitus can take measures to ensure their condition doesn’t worsen. Regular hearing tests are recommended.

Wear hearing protection when exposed to loud noises such as rock concerts, gunfire at the shooting range, jet skiing or auto racing. Even lawn mower noise can exceed healthy sound levels.

Overall, try to give ears some quiet time by avoiding noisy environments.

Please seek the advice of a medical professional before making health care decisions.

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Michelle Llamas, Senior Content Writer
Written By Michelle Llamas Senior Writer

Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for seven years. She specializes in fluoroquinolone antibiotics and products that affect women’s health such as Essure birth control, transvaginal mesh and talcum powder. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include:

  • American Medical Writers Association (AMWA) Engage Committee and Membership Committee member
  • Centers for Disease Control and Prevention (CDC) Health Literacy certificates
  • Original works published or cited in The Lancet, British Journal of Clinical Pharmacology and the Journal for Palliative Medicine

26 Cited Research Articles

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  2. Centers for Disease Control and Prevention. (2011). Severe hearing impairment among military veterans — United States, 2010. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21775950
  3. Centers for Disease Control and Prevention. (n.d.). How Do I Know if I Have Hearing Loss Caused by Loud Noise? Retrieved from https://www.cdc.gov/nceh/hearing_loss/how_do_i_know_if_i_have_hearing_loss.html
  4. Hearing Center of Excellence. (n.d.). Treatment Overview. Retrieved from https://hearing.health.mil/Resources/Education/Treatment-Overview
  5. Hearing Center of Excellence. (n.d.). Causes of Injury. Retrieved from https://hearing.health.mil/Prevention/Causes-of-Injury
  6. Hearing Center of Excellence. (n.d.). Hearing Tests and Evaluations. Retrieved from https://hearing.health.mil/Resources/Education/Hearing-Tests-and-Evaluations
  7. Hearing Center of Excellence. (n.d.). Importance of Hearing. Retrieved from https://hearing.health.mil/Prevention/Importance-of-Hearing
  8. Hearing Center of Excellence. (n.d.). Proper Use of Hearing Protection Devices. Retrieved form https://hearing.health.mil/Resources/Training/Proper-Use-of-Hearing-Protection-Devices
  9. Hearing Center of Excellence. (n.d.). Bone-Conduction Devices. Retrieved from https://hearing.health.mil/Resources/Education/Treatment-Overview/Bone-Conduction-Devices
  10. Hearing Center of Excellence. (n.d.). Cochlear Implants. Retrieved from https://hearing.health.mil/Resources/Education/Treatment-Overview/Cochlear-Implants
  11. Hearing Center of Excellence. (n.d.). Dangers of Loud Noise. Retrieved from https://hearing.health.mil/Prevention/Dangers-of-Loud-Noise
  12. Hearing Center of Excellence. (n.d.). Find a Provider. Retrieved from https://hearing.health.mil/Resources/Help-and-Support/Find-a-Provider
  13. Hearing Loss Association of America. (n.d.). Hearing Loss Facts and Statistics. Retrieved from https://www.hearingloss.org/wp-content/uploads/HLAA_HearingLoss_Facts_Statistics.pdf?pdf=FactStats
  14. Military Disability Made Easy. (n.d.). The Ears. Retrieved from http://www.militarydisabilitymadeeasy.com/theears.html
  15. Oleksiak, M. et al. (2012). Audiological issues and hearing loss among Veterans with mild traumatic brain injury. Retrieved from https://www.rehab.research.va.gov/jour/2012/497/pdf/page995.pdf
  16. The American Academy of Audiology. (2017, November 9). Hearing Loss is a Significant Factor for Many Veterans. Retrieved from https://audiology.org/sites/default/files/news/20171109_VeteransandHearingLoss.pdf
  17. The National Hearing Test. (2014, June 3). How to Read an Audiogram and Determine Degrees of Hearing Loss. Retrieved from https://www.nationalhearingtest.org/wordpress/?p=786
  18. U.S. Department of Veterans Affairs. (2014, March 20). Exposure to jet fuel, not just noise, contributes to hearing problems. Retrieved from https://www.research.va.gov/currents/spring2014/spring2014-11.cfm
  19. U.S. Department of Veterans Affairs. (n.d.). Hearing Loss. Retrieved from https://www.research.va.gov/topics/hearing.cfm
  20. U.S. Department of Veterans Affairs. (2019, September 3). 38 CFR Book C, Schedule for Rating Disabilities. Retrieved from https://www.benefits.va.gov/warms/bookc.asp
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  22. U.S. Department of Veterans Affairs. (2019, September 27). Eligibility for VA disability benefits. Retrieved from https://www.va.gov/disability/eligibility/
  23. United States Marine Corps Safety Division. (n.d.). Hearing Conservation Stand-Down. Retrieved from https://www.safety.marines.mil/LinkClick.aspx?fileticket=6dz_2oMMFdA%3D&tabid=5191&portalid=92&mid=14056
  24. United States of America ex rel. Moldex-Metric, Inc. v. 3M Company. (2016, May 12). In the United States District Court for the District of South Carolina Columbia Division. Complaint, Jury Trial Demanded. Case No. 3:16-1533-MBS. Retrieved from https://www.docketbird.com/court-documents/United-States-of-America-et-al-v-3m-Company/COMPLAINT-against-3M-Company-Filing-fee-400-receipt-number-0420-6549289-filed-by-Moldex-Metric-Inc/scd-3:2016-cv-01533-00001
  25. Wadsworth, M. (n.d.). Getting Veterans Disability Compensation for Vision or Hearing Loss. Retrieved from https://www.nolo.com/legal-encyclopedia/getting-veterans-disability-compensation-vision-hearing-loss.html
  26. Yong, J.S. & Wang, D.-Y. (2015, February 25). Impact of noise on hearing in the military. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455974/
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