Hearing loss va disability number,tinnitus heart medication verapamil,noise free ear plugs celular,plugged ears and tinnitus 2014 - Good Point

Author: admin, 26.07.2014
Disability payments to veterans for hearing loss show a continuing upward trend, as demonstrated in the graph below. Given the enormity of the increase in spending by the VA on hearing loss disability payments to former Navy personnel, it is important to find the sources of hearing loss in the Navy and then investigate ways to reverse this trend. This section of the Acquisition Safety website concentrates on the occupational safety and health challenges encountered while working in high noise level environments onboard Naval surface warships.
Noise exposure can be described by the intensity of the noise, its frequency, and its duration. The decibel scale uses powers of ten; an increase of ten decibels represents a ten fold increase in sound power. The Navy considers any sound above 84dB as noise hazardous, or having the potential to cause hearing loss. Environmental noise is a concern with regard to environmental compliance and encroachment of military operations on adjacent civilian activities. A total systems engineering approach should be conducted in order to have effective acoustic solutions. By teaming decades of Navy quiet ship design experience with ship builders' construction experience, a more effective noise proof ship design can be executed.
All sources of shipboard noise will potentially contribute to the overall shipboard noise level. Even though quieter equipment generally can be more expensive to purchase, the equipment is usually better built and has high efficiency. The US Navy's DDX destroyers are being designed and built to be powered by an electric drive featuring integrated power system (IPS) architecture. That’s where you say one thing, and the VA understands it to mean something completely different.
This recently happened to a Veteran in his claim for an extra-schedular rating – he thought that his VA disability hearing loss payments were not enough. 1) First, compare the level of severity of the Veteran’s actual symptoms and limitations with the established criteria in the VA Impairment Ratings Table. 1) If your disability has symptoms and limitations that are not discussed in the VA Impairment Ratings Table, or the rating does not adequately compensate you due to a unique disability picture, be sure to tell the VA you want them to consider a claim for an extra-schedular rating under 38 CFR 3.321(b).
2) If the VA does not analyze your claim exactly as laid out above – or if they do not refer your case to the proper person for decision (see Thun Step #3) above, then make sure that you file a timely Notice of Disagreement to the Ratings Decision. 3) If the BVA still denies, consider reaching out to an attorney to appeal to the Veterans Court to raise a Thun violation before the Court. The Court is increasingly frustrated with the VA and BVA’s  improper analyses of these types of claims.
But now I was just going to agree with them and say, but now my condition is worse and warrants the higher rating. Key words: compensation, hearing disorders, loudness matching, loudness perception, malingering, pitch matching, pitch perception, rehabilitation, reliability of results, tinnitus, tinnitus diagnosis. Abbreviations: ANOVA = analysis of variance, HL = hearing level, LM = loudness match, PM = pitch match, PVAMC = Portland VA Medical Center, SD = standard deviation, SL = sensation level, SPL = sound pressure level, TES = Tinnitus Evaluation System, VA = Department of Veterans Affairs, VHA = Veterans Health Administration.
Chronic tinnitus is the persistent sensation of hearing a sound that exists only inside the head. Special audiological tests are effective in detecting deliberate exaggeration of hearing loss [10-11], but no documented test exists that is capable of detecting the presence or absence of tinnitus.
Any type of audiometric test for tinnitus diagnosis may rely at least partly upon the demonstration of response reliability. We completed a pilot study to investigate the potential for LM functions to detect differences between 12 subjects with tinnitus versus 12 subjects without tinnitus [16].
Study inclusion criteria were intended to identify two groups of individuals: those who experienced chronic tinnitus (tinnitus subjects) and those who did not experience tinnitus (nontinnitus subjects).
Candidates who passed telephone screening were invited to make an appointment to determine whether they met the audiometric criteria for study entry. After signing informed consent, subjects had their hearing evaluated manually by an audiologist (conventional hearing threshold evaluation that obtained results in decibel hearing level [HL]). Following the conventional hearing threshold evalua-tion, subjects completed a baseline questionnaire that asked their age, sex, veteran status, and tinnitus status.
To ensure that the tinnitus and nontinnitus groups exhibited approximately the same degree of hearing loss, we matched subjects by hearing loss with respect to both their low (0.5, 1, 2 kHz) and high (3, 4, 6 kHz) frequency average hearing thresholds (in decibel HL). Audiometric testing was conducted in a double-walled sound-attenuated suite (Acoustic Systems Model RE-245S, ETS Lindgren; Cedar Park, Texas). The TES Module also serves as a control device (user interface), enabling patients to easily control stimulus parameters and respond to tests. All-new programming was required to support the new platform and to create new testing capabilities.
All testing data are stored via connectivity to a Microsoft Access database (Microsoft Corp; Redmond, Washington).
The management interface is used to manage patient information, create and configure test session templates (preconfigured test scenarios), launch test sessions, and report on test results.
As a single integrated device with earphones (ER-4B, Etymotic Research, Inc; Elk Grove Village, Illinois) permanently attached, the TES Module is calibrated independently in the laboratory and then sent out to a testing site. Prior to conducting the tinnitus matching tests, we carefully instructed the nontinnitus subjects to ensure that they responded to all testing as if they were attempting to prove that they did in fact experience chronic tinnitus. Tinnitus matching requires patients to make a clear distinction between the tinnitus perception and the matching tones. For the nontinnitus subjects, if one ear had better hearing sensitivity, then that ear was selected as the stimulus ear. Following the general instructions, we provided specific instructions for obtaining hearing thresholds (in decibel sound pressure level [SPL]) with the TES.
After a threshold was obtained at 1 kHz, we then obtained an LM (in decibel SPL) at the same frequency. This sequence of testing (average hearing threshold followed by average LM) was then repeated at the next higher test frequency (1,260 Hz) followed by the remainder of the test frequencies in ascending order. When hearing thresholds and tinnitus LMs had been obtained at all 13 test frequencies, on-screen instructions were shown to explain the PM task.
The previously described testing was conducted during two sessions that were at least 3 days apart. Within- and between-session correlations were computed for the dB SPL LMs and compared between the tinnitus and nontinnitus subjects. Within-subject PM variability (five observations for each of the two tests within the two test sessions) was pooled within and across subjects and compared between the tinnitus and nontinnitus subjects on the premise that subjects with tinnitus would exhibit less variability in pitch matching. Demographic and audiometric characteristics of tinnitus subjects (n = 36) and nontinnitus subjects (n = 36). Tables 2 and 3 show the LM means (and standard errors) in decibel SPL and decibel SL, respectively, for the sessions and runs in the tinnitus and nontinnitus subjects for 1 to 16 kHz.
Across-subject mean loudness matches (dB sound pressure level) for tinnitus subjects (n = 36) and nontinnitus subjects (n = 36). Across-subject mean loudness matches (decibel sensation level) for tinnitus subjects (n = 36) and nontinnitus subjects (n = 36). Table 4 shows the within-session LM correlations (between two test runs on the same day) for the tinnitus and nontinnitus subjects for 1,000 to 12,700 Hz. Within-session loudness-match correlations (decibel sound pressure level) for tinnitus subjects (n = 36) and nontinnitus subjects (n = 36).
You need the four frequency average in order to compare to the hearing charts (dB at 1000, 2000, 3000 and 4000 Hz). One has to have more than a "moderate" or even a "moderately-severe" hearing loss for compensation purposes. Have you obtained hearing aid (s)?  They will provide them free and they will help considerably. As Rusty mentioned, you need the 4 decibel losses at 1000-4000 hz to determine your percentage loss, and since you are already service connected you can file for an increase. The economic consequences to the Navy of hearing impairment include lost time and decreased productivity, loss of qualified workers through medical disqualification, military disability settlements, retraining, and expenses related to medical treatment, such as for hearing aids.
In 2004, the Veterans Administration (VA) spent $108 million dollars in disability payments to 15,800 former Navy personnel for hearing loss - an increase of $65 million in VA spending on Navy hearing disability payments since 1999. Specifications and guidelines for permissible noise levels and noise control measures can be found in the Resources Section.


Intensity of noise reflects the loudness of the sound while the frequency of the noise is reflected in how high or low pitched the noise is.
Measurements obtained using the A-weighting scale provides a better estimation of the threat to human hearing than do other weighting scales.
The faintest sound humans with normal hearing can detect has a value between 0 and 10 decibels, and the loudest sound the human ear can tolerate without pain is about 120 decibels.
Prolonged noise at levels greater than 84dB over an eight-hour period may result in temporary, and gradually permanent, hearing loss. Hearing loss may result in diminished quality of life because of loss of ability to communicate and social isolation, as well as impaired and misinterpreted communication with family members, the public, and coworkers. Total ship systems engineering evaluates what is appropriate to integrate, as a function of location, into the acoustic design of a ship. This approach entails developing effective design guidance to evaluate and recommend the appropriate amount of acoustic treatment for specific areas of the ship. Therefore, the entire ship should be measured and mapped for noise levels and their sources. Many such methods can be leveraged from existing surface ship and submarine acoustic programs. The most effective and efficient noise control method is the prevention or reduction of noise generation at the source. Noise emission values obtained from various suppliers can be compared with each other, and can be used for prediction of the noise levels in the area where equipment is to be placed. The IPS helps to reduce noise and vibration aboard ship due to the elimination of the drive shaft and reduction gears found in traditional Navy ships. One of the distributive system airborne noise sources which runs through a significant area of aircraft carriers is the Jet Blast Deflector (JBD) hydraulic system on the gallery deck. This seemingly small change reduces the noise level from the JBD hydraulic system by 30dB (see Figure 7) and costs less than $500.00 per unit. Even though his hearing loss had a profound impact on his ability to function in the world, the VA assigned him a 0% rating. Ascertaining the presence of tinnitus in individuals who claim tinnitus for compensation purposes is very difficult and increasingly becoming a problem. That is, the validity of any response depends upon its reproducibility; thus, response reliabili-ty is expected to be an important component of any test developed to assess the presence of tinnitus for claims purposes. Testing was done using a computer-automated program that had recently been modified to allow more patient control of test stimuli (through the use of a handheld control pad device). Essentially the same protocol was used, except this study used a computer-automated testing system that was completely redesigned for improved functionality. Subjects were recruited by a local newspaper advertisement, by flyers posted around the Portland Department of Veterans Affairs (VA) Medical Center (PVAMC), and from other auditory investigations that were being conducted at the National Center for Rehabilitative Auditory Research. As part of the informed consent process at the start of the appointment, all candidates were told that the study was being conducted to determine the effectiveness of a new technique for measuring various aspects of tinnitus.
Subjects with tinnitus completed a written tinnitus questionnaire in which they reported the length of time they had had tinnitus, whether their tinnitus was tonal or nontonal, and whether their tinnitus was binaural or unilateral. Collection of data from human subjects was approved by the PVAMC institutional review board committee. We used the latest version of our computer-automated testing system that has undergone several revisions over a period of 10 years [16-19]. This was accomplished by constructing the TES Module enclosure to also serve as a handheld control pad for patients to control the auditory stimuli. They were instructed to "Imagine a sound in your head or ears and try to match that sound consistently to the sounds that you will hear through earphones. This is done most easily if the stimulus in one ear is compared to the tinnitus in the contralateral ear [21-22]. Before testing began, the program presented a series of screens describing the general testing procedures, followed by specific instructions for hearing threshold testing.
Each test frequency was presented at the output level previously selected as a tinnitus LM during the threshold and LM testing.
Two test runs (thresholds, loudness matching, and pitch matching) were conducted within each session.
A repeated measures analysis of variance (ANOVA) was used to assess the difference in LMs (dB SPL and dB SL) between the tinnitus and nontinnitus subjects across the four tests. This analysis was motivated by the expectation that the correlations between the two tests within a session and the correlations between sessions would be greater for the tinnitus subjects than for the nontinnitus subjects and would represent more consistent responses for the tinnitus subjects.
With one exception (10,080 Hz), mean SPL LMs were consistently greater for nontinnitus than for tinnitus subjects.
Now, I have to turn up the TV so loud the kids and ole lady began nagging me to have my ears check, so I got'er done.I am hoping someone can relate my info to those charts the VA uses to rate hearing disability. Now, I have to turn up the TV so loud the kids and ole lady began nagging me to have my ears check, so I got'er done.I passed that but the audiologist recommended hearing aids. In addition to flight operation noise, there are numerous noise sources on deck and throughout Navy ships that exceed safe limits for all but the shortest exposures. The duration or length of time an individual is exposed to noise may have a significant detrimental impact on that person's hearing. The louder the sound and more prolonged the exposure, the shorter amount of time it takes to cause permanent hearing loss. On-the-job hearing loss can result in diminished ability to respond to warning signals in the work environment, which could lead to increased injuries resulting from impaired communication. The ideal way to develop this design guidance is to perform shipboard testing of various acoustic solutions. Before any course of action is adopted to maximize noise reduction, the vessel must be analyzed completely and a Computer Aided Design-based model should be constructed to depict structure, vibrational, and acoustical pathways.
A total ship engineering approach will include evaluation of the appropriate noise technologies and their integration into the ship design. This preventive approach avoids the need to redesign at a later stage and is more cost effective. These features help to reduce the operating and maintenance costs of the equipment, reducing its total life cycle cost.
This relatively inexpensive fix reduces the amount of noise energy from the JBD hydraulics that enters the environment of the gallery deck and the ship's structure. Lay evidence is going to be a HUGE factor – so make sure you have plenty to show all the symptoms and limitations outside the rating schedule. This study examined the potential to observe differences in loudness and pitch matches between individuals who experience tinnitus versus those who do not. Epidemiology studies reveal that between 10 and 15 percent of all adults experience chronic tinnitus [2-7]. Because so many parameters of tinnitus are capable of being measured, any of those parameters could potentially be used for repeated testing to evaluate a tinnitus claim. Candidates with tinnitus were told that they had been invited to participate in the study because they had tinnitus that was constant and therefore could be measured.
The system enabled direct patient control of certain stimulus parameters during testing to make testing more efficient. For most of the tests, the computer presents a starting sound and the patient turns a dial on a peripheral hardware device (TES Module) to control output level, frequency, or bandwidth of the sound. The peripheral hardware device (TES Module) was developed to enable specialized auditory tests. The TES control pad includes a continuous rotating encoder dial that provides a single-point adjustment of a parameter of interest (programmable and determined according to the particular test or test phase).
Information about test parameters is stored in an Access database, which also determines which tests to run for each session and provides parameters to control the hardware behavior. The TES uses decibel SPL because normative hearing threshold levels have not been established for frequencies above 8 kHz and because the earphones used with the TES have not been documented for conventional audiometric testing of hearing sensitivity.) Testing started when a hearing threshold was obtained at 1 kHz.
It is critical for them to clearly understand the difference between these two psychological attributes of sound for us to obtain well-informed, and therefore accurate, matching measurements [21,23].
These differences were significant at frequencies of 2 kHz and below and diminished in the higher frequencies.
The nontinnitus group had a similar distribution of correlations, except that half the frequencies had correlations that were below 0.90. Exposure to loud noise levels for short periods of time may cause temporary hearing loss (hearing is usually restored within 24 hours).


Temporary (short-term) hearing loss is often considered an indicator of the risk of permanent hearing loss with continued exposure.
Noisy work environments can also result in missed commands with dire consequences to personnel and equipment, such as running aground or firing a missile at the wrong time. Below the flight deck is the gallery deck in which approximately 1400 sailors live and work. Shipboard testing will evaluate the effectiveness of the various acoustic treatment options and will assist in determining which areas require treatment. An additional benefit of reducing noise at its source is usually a commensurate increase in energy efficiency and machinery longevity. This study follows a previous pilot study we completed that included 12 subjects with and 12 subjects without tinnitus. The basis for awarding a tinnitus disability is that the tinnitus is (1) at least recurrent (intermittent) and (2) related to military service [8-9].
Jacobson et al., however, reported results from an experiment that showed test-retest reliability of LMs to be similar between individuals with and those without tinnitus [13]. The key is to determine which test, or combination of tests, will be most effective in accomplishing this purpose.
No other screening criteria were applied because the intent was to simulate real-life individuals who might be attempting to claim the presence of tinnitus. Candidates who did not have tinnitus were told that they could represent individuals who might want to claim tinnitus when they do not actually experience it.
The present fifth-generation system is referred to as the Tinnitus Evaluation System (TES).
The TES Module brings various capabilities together in one small device that connects to a personal computer. In addition, four push buttons are included on the TES control pad to facilitate patient responses. Patient responses made with the TES Module encoder dial and response buttons are recorded to the same database from which the test session parameters are read. The management interface presents configuration options through the test session configuration dialogs, in which tests and their parameters can be preset into session templates to allow an operator to easily run many patients through the same battery of tests. A testing interface program checks the device's calibration time stamp and compares it with the one already stored in the database.
Subjects determined on their own how they would respond in a consistent manner in spite of their nonexistent tinnitus. They were queried to ensure that they understood that they would be matching tones in one ear to an imagined tinnitus in the contralateral ear. To ensure that the subjects understood pitch and loudness, we included a series of instruction screens that explained the concepts prior to performing tinnitus loudness matching.
Tinnitus and nontinnitus subjects were similar in age, sex, veteran status, and mean hearing thresholds (Table 1).
SL LMs were essentially equal between the tinnitus and nontinnitus subjects across the frequencies. Shipboard noise control is critical to the preservation of crew health, mission success, and personnel retention. This temporary threshold shift is often captured on periodic audiograms (hearing tests) and used to provide workers and medical staff with an early warning of potential permanent hearing loss. Army studies show that noise-impaired communications affect combat performance (the likelihood of hitting the target and returning safely from a combat mission). Because of space constraints, air ducts used aboard ships are often very small and have sharp curves and bends.
The data generated by this effort will help control the business risk that shipbuilders will assume to meet the new design criteria. The number of tinnitus disability claims has increased dramatically during this decade (Figure 1). The only difference was that individuals without tinnitus generally provided LMs at higher levels.
Tinnitus loudness matching has been shown to be very reliable with tinnitus patients, but the Jacobson et al. Reliability of the LMs was at least as good for the nontinnitus group as for the tinnitus group, both within and across sessions. Any screening criteria other than the presence or absence of tinnitus might have introduced bias to the samples.
These capabilities include signal genera-tion (pure tones and noise bands) and signal processing (mixing, switching, muting, attenuation, and headphone buffering).
Testing sessions can then be launched by selecting a patient record and preconfigured template. If newer calibration data are available, they are downloaded from the TES Module, saved in the database, and used in testing to provide calibrated stimulus levels.
If the tinnitus was perceived to be symmetrical, then the stimulus ear was determined randomly. Subjects rotated the encoder dial to find the point of minimum audibility for the tone and then selected the threshold level by pressing the response button. In session 2, the tinnitus subjects showed significantly greater correlations in 4 of the 12 frequencies. The economic effects of hearing loss to the Navy include lost time and decreased productivity, loss of qualified workers through medical disqualification, civilian workers' compensation costs, and military disability settlements, retraining, and expenses related to medical intervention such as hearing aids and audiometric testing. Gallery deck noise levels, often in excess of 100dBA, can have the effect of reducing cognitive skill levels and cause miscommunication problems, both causes of fatal accidents.
This results in air moving through the ducts at very high velocities, causing noise and vibration in the ventilation system. Results of this study revealed no significant differences between groups with regard to decibel sensation level (SL) loudness matches and within-session loudness-match reliability.
As of October 2008, 558,232 veterans had been awarded tinnitus service-connection disability.* Among veterans returning from the Iraq and Afghanistan wars, tinnitus is the most common service-connected disability (67,689 veterans in 2008). In addition, pitch matches (PMs) were obtained from each subject, which involved subject selection of the frequency that most closely matched the pitch of the tinnitus from the different test frequencies. The pure tone quality, output linearity, frequency accuracy, pulse characteristics, and signal cross talk of the TES Module conform to the American National Standards Institute specification for audiometers across the standard frequency range from 125 to 8,000 Hz [20].
The operator can override the template tests' default values of some parameters on a per-session basis. Following the instructions, we presented the tone at a randomized output level above the level of the hearing threshold that had just been established. Between-group differences revealed that the tinnitus subjects had (1) greater decibel sound pressure level loudness matches, (2) better between-session loudness-match reliability, (3) better pitch-match reliability, and (4) higher frequency pitch matches.
These concerns have prompted our overall effort to develop tests that can help ensure that a tinnitus disability is accurately rated and that allow for reexamination whenever a need exists to verify the continued existence of tinnitus. These PMs were performed multiple times after loudness matching and the multiple PMs were averaged. A special test template was devised to enable the device to be calibration-checked on-site at regular intervals.
Finally, noise may be generated at the air duct outlets that distribute air in the work environment if proper design parameters are not followed. These findings support the data from our pilot study with the exception that decibel SL loudness matches were greater for the tinnitus subjects in the pilot study. The result of pitch matching was that the mean PMs for the tinnitus group were significantly higher in frequency than for the nontinnitus group. The reporting module of the management interface uses preformatted reports for presenting test results from the response database.
However, under conditions of hazardous noise levels in both occupational and recreational activities, there is limited or no audiological recovery time. Tinnitus loudness and pitch matching may have some value in an overall battery of tests for evaluating tinnitus claims.
All calibration procedures are conducted in a double-walled sound-attenuated suite (Acoustic Systems Model RE-245S).



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