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.
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.
|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.
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.
- Buzzing, whistling or ringing in the ears (tinnitus symptoms)
- Difficulty understanding conversations when you are in a noisy place, such as in a restaurant
- Difficulty understanding speech over the phone
- Having to ask others to speak more slowly and clearly
- Having to ask someone to speak more loudly or repeat what they said
- Hypersensitivity to or pain from certain sounds
- Muffled speech and other sounds
- Problems hearing high-pitched sounds such as bird chirps, alarm clocks or doorbells
- Trouble distinguishing between the sounds of s and f, between p and t or between sh and th in speech
- Turning up the volume of the television or radio
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.
- 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.
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.
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.
- 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.
- Current diagnosis
- Evidence of the service-related event that caused the condition
- 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 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.
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 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.
- 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.
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