Table of Contents
- Blast Injuries
- Treatment for Blast Injuries
- Age-Related Hearing Loss
- Medicines That Cause Hearing Loss
- Service-Connected Disability Compensation for Veterans with Ear Problems
- Disability Ratings for Hearing Problems
- Hearing Aids
- Preventing Hearing Loss in the Military
Hearing problems are two of the biggest health issues the Department of Veterans Affairs (VA) helps veterans with.
According to the VA, hearing loss affects more than 28 million Americans, including more than half of people over the age of 75.
Hearing problems, including tinnitus, which is a ringing or noise that originates in the head are the most prevalent service-connected disability among veterans, reports the VA.
The following are some of the other general things to know about veterans and hearing loss, based on information from the VA.
- Almost all people with hearing loss could be helped by hearing aids, but only around one in five people who would benefit actually use them.
- At the end of fiscal year 2014, more than 933,000 veterans were receiving disability compensation for hearing loss.
- By 2017, there were almost 1.8 million disability compensation recipients for tinnitus and 1.16 million recipients of disability compensation for hearing loss
- At the end of that same fiscal year, almost 1.3 veterans received compensation for tinnitus.
- Many veterans score normally when they take hearing tests, but still have difficulty understanding speech, which is called auditory processing disorder.
- Loud noises veterans are exposed to include blasts as well as aircraft and gunfire.
- When a veteran sustains a traumatic brain injury, it may be challenging for them to process speech when there is background noise.
Many veterans of more recent wars in Iraq and Afghanistan are exposed to what are called blasts, during their time in service. VA researchers are currently working on research to learn more about the effects of these blasts on the brain.
Hearing loss can occur in veterans, even if there isn’t a visible or apparent injury.
Blasts not only can cause damage to the actual ear, but they can create problems in the connection between the ear and the brain.
A blast injury leads to trauma that damages the hair cells in the inner ear. When someone experiences sound-based trauma, they may feel a sense of increased pressure in their ear. Then, blast waves enter the ear, and it can cause injury and hearing loss.
There are three types of blast injury that can affect hearing and may impact veterans:
- A primary blast injury means a loud explosion or sound led to the transmission of waves that damage an organ or tissue. The pressure caused by the sound is the only cause of the injury in this situation.
- A secondary blast injury occurs when flying debris from an explosion causes an injury. The trauma comes from something actually hitting the person’s ear in this scenario.
- Tertiary blast injuries occur when the sound caused by a blast causes your body to be thrown, and then you are injured as a result of that.
To diagnose blast injuries, a doctor will need to perform a hearing test.
Treatment for Blast Injuries
There are different ways to treat a blast injury. Initially, there is something called hemorheological infusion therapy, followed by the administration of cortisone. If these treatments don’t work, hyperbaric oxygen therapy may be a treatment option or surgery can be done to repair the inner ear windows.
Even when a blast injury is treated, someone may experience ongoing hearing damage in the upper-frequency range.
This means you would have trouble hearing in louder surroundings, and in this case, you might use a hearing aid.
Tinnitus is described as the number one disability for veterans, according to Military.com.
Veterans have higher rates of tinnitus than the general public because of all the loud noises they encounter when they’re on active duty.
Tinnitus is when you perceive sounds such as ringing or hissing in your head or ears when there’s no external sound. Tinnitus can range from mildly annoying to something that severely impacts your quality of life.
There are two categories of tinnitus, which are subjective and objective. Subjective tinnitus occurs when only the person who suffers from the condition can hear the sounds produced within their own head. Objective tinnitus means people around you can hear clicks or crackling in the middle ear.
Unfortunately, tinnitus can be linked to other conditions. A study in 2015 found more than 70% of veterans with tinnitus were also diagnosed with anxiety, and 60% with depression. Fifty-eight percent had both conditions.
There isn’t any particular cure for tinnitus, but there are some things that a health care professional may recommend to help a veteran deal with the symptoms.
These can include:
- Relaxation exercises that help someone struggling with tinnitus learn how to control muscle groups and their circulation, which may reduce the intensity at which they experience the condition.
- White noise can make tinnitus less noticeable.
- Hearing aids may help eliminate noise in the head, but for people with tinnitus, hearing aid should be set at a moderate level in most cases because levels that are too loud can worsen the condition.
Age-Related Hearing Loss
Veterans may struggle with hearing loss not related to their service, but their age. Some veterans may have service-related hearing loss that’s worsened by aging as well.
Nearly one in two adults over the age of 65 experience some degree of hearing loss.
Some of the causes of age-related hearing loss can include:
- Changes in the inner ear structure
- Changes in how blood flows to the ear
- Nerve impairment
- Alterations in the brain’s processing of speech and sound
- Damage to the hairs in the ear that transmit sound to the brain
Certain health conditions can cause age-related hearing loss including diabetes and poor circulation. The use of some medicines, a family history of hearing loss and smoking can also be contributors.
Symptoms of age-related hearing loss may include:
- Hearing some sounds too loudly
- Problems hearing in loud places
- Difficulty distinguishing between S and Th sounds
- Ringing in the ears
- Having to turn up the volume on the TV or radio louder than normal
- Needing to have people repeat themselves
- Struggling to understand conversations on the phone
Age-related hearing loss can’t be cured, but it can be treated so that you can hear more, and your quality of life can be improved.
Hearing aids are one way age-related hearing loss is treated, as are assistive devices. For someone with severe age-related hearing loss, lip-reading classes may be useful.
Cochlear implants are also an option. These devices are implanted into your ear via surgery and they make sounds louder, although they don’t restore your hearing to a normal level. Cochlear implants are only used for people who struggle with severe hearing loss.
Medicines That Cause Hearing Loss
Certain medications are linked to hearing loss, and these are medicines that veterans may frequently use.
If the medicine is known to cause ear damage and hearing loss, it’s called an ototoxic medicine. With medication-related hearing loss, it often occurs because the medicine damages the cochlea located in the inner ear.
With medication-related hearing loss, the first symptoms are usually tinnitus and vertigo. Some people find that their hearing returns to normal if they stop using the medicine, but sometimes the damage is permanent.
- Aspirin (usually only when large doses are taken daily)
- NSAIDs like naproxen and ibuprofen
- Some antibiotics such as neomycin
- Loop diuretics used to treat heart failure and high blood pressure
- Medicines used to treat cancer including cisplatin and bleomycin
Service-Connected Disability Compensation for Veterans with Ear Problems
If you’re a veteran and you’re dealing with a hearing-related issue, help is available, including through the Department of Veterans Affairs.
You may be able to qualify for disability benefits if you have a hearing problem caused by your service, however, as with other service-connected disabilities you’ll have to prove the connection with your military duty.
To prove your hearing disability is service-related, you’ll need to have a current diagnosis of a hearing condition, evidence of an event during your service that caused it, and a medical opinion connecting the hearing condition to the event during your service.
Disability Ratings for Hearing Problems
There is something called the VA Schedule of Ratings Disabilities, and hearing problems are included.
The most common issues included in the VA Schedule are hearing loss and tinnitus but also included is cancer. If you have hearing loss following cancer treatment, you’re entitled to a 100% rating for six months after your treatment ends.
Peripheral vestibular disorders, which are problems with the inner ear that lead to dizziness, are rated anywhere from 10 to 20%. The loss of one or both ears is also a disability included on the VA’s list.
For tinnitus, the only rate available is 10%.
Hearing Loss Requirements
If you want to prove a link between your hearing loss and loud noises you were exposed to while on active duty, you would need a test from a licensed audiologist.
The VA requires that two specific tests be done.
The first is called a Maryland CNC test which measures your ability to recognize speech and the other is a pure-tone audiometric test to evaluate your level of hearing loss.
If you are older, you may still be able to establish your hearing loss is related to noise exposure during your service.
If you would like to receive hearing aids you may be able to do so through the VA. You would have to either go to a VA Medical Center or clinic or fill out the Form 10-10EZ online. You can also fill out a hard copy 10-10EZ and mail it to your nearest medical center.
- Once you’re registered, you can schedule an appointment at the Audiology and Speech Pathology Clinic to have your hearing evaluated.
If the VA audiologist recommends hearing aids, then the cost of the fit, the aids themselves, repairs, and future batteries are provided at no charge as long as you remain eligible for VA care.
Other services you may be eligible for through the VA’s audiologists include:
- Disability audiology exams
- Assessment, management, and treatment of tinnitus and balance disorders
- Assistive listening devices like phone and TV amplifiers
- Noise-induced hearing loss prevention services
- Aural rehab services to make the most of the hearing you have left
The VA contracts with different hearing aid manufacturers, and if they were purchased privately, they would cost upwards of $4,000.
When you get hearing aids through the VA, they have a six-month trial period.
If you have tinnitus or mental health conditions linked to your hearing loss, you can also go through the VA for counseling and cognitive behavioral therapy.
You don’t need a referral from a primary care doctor to see an audiologist at the VA.
Through the Veterans Choice Program, if you live more than 40 miles from a VA clinic or you can’t get an appointment within 30 days, you may also be able to see a private audiologist.
Preventing Hearing Loss in the Military
For people currently in the military, it’s extremely important to take the necessary precautions to protect hearing.
Hearing protective devices that work well for people in the military without compromising safety include:
- Level-dependent earplugs that allow soft noises to be heard but eliminate high-frequency noises
- Earmuffs create an air-tight barrier around the entire ear
- Noise-attenuating helmets
- Suppressors on service weapons
As we get older, it’s important to pay particular attention to our hearing health, and this is especially true for veterans.
As a veteran, you should get your hearing tested at least every few years because it can help diagnose underlying medical conditions that you might not otherwise be aware of.
By knowing more about your hearing health, it can also help prevent future damage. If your hearing loss goes undiagnosed and untreated, not only will the loss itself get worse but you may be more likely to suffer from anxiety and depression, as well as social isolation.
In older people hearing loss is linked to an increased risk of being involved in accidents as well.
If you suspect you could have even a mild hearing problem, proactively seek help. You aren’t alone, and hearing issues are something veterans frequently deal with, but it doesn’t have to diminish your quality of life.