Veterans Day may be behind us, but hundreds of thousands of veterans are still living with service-related hearing disorders. While post-traumatic stress disorder (PTSD) and traumatic brain injuries (TBI) are serious and newsworthy wounds, hearing damage, whether in the form of hearing loss or tinnitus, is the most common injury reported by veterans. More than 750,000 veterans of Iraq and Afghanistan have suffered some level of hearing loss, and even more have developed tinnitus, better known as ringing in the ears.
Prolonged exposure to noise above a level of 85 decibels–roughly anything above the level of noise made by a heavy truck–has the potential to cause hearing damage. With minimal decibel increases, the duration of exposure required to cause hearing damage decreases significantly. According to a Government Accountability Office (GAO) report, the Department of Defense (DOD) permits exposure to 85 decibels over a prolonged period of time, a requirement in accordance with recommendations made by the National Institute for Occupational Safety and Health (NIOSH). NIOSH suggests that exposure be cut in half with each 3 decibel increase. At 140 decibels, damage is immediate–and 140+ decibels happens to be the sound level caused by the detonation of improvised explosive devices (IEDs), the roadside bombs that are so frequently featured on the nightly news. Other battlefield noises and common military operations involve sounds at even higher levels, making it no wonder that hearing damage is commonplace. In 2009, the Veterans Administration paid $1.1 billion dollars in disability benefits for tinnitus alone. Although certain measures can be taken to minimize the impact of, or even prevent, hearing damage, military personnel are often concerned that by covering their ears, they will be unable to communicate, and more vulnerable, during battle.
Veterans and others suffering from hearing injuries who do not seek treatment run the risk of social isolation and depression resulting from difficulty communicating with others on a social or professional basis. Some forms of hearing loss can be corrected or minimized through the use of hearing aids, or in more severe cases, through cochlear implants. However, little can be done to treat tinnitus, a side effect of other maladies, including ear injury cause by loud noises. Typically, tinnitus involves auditory noises usually described as ringing, but sometimes described as whooshing, ticking, or other sounds. Tinnitus is rated on a scale ranging from “slight” to “catastrophic,” depending on the level at which it interferes with daily activities like sleeping or talking. Sufferers typically need to learn to block the sounds out, sometimes using white noise machines at night to avoid insomnia.
The Department of Veterans Affairs currently pays disability compensation to veterans according to the degree of disability. Disabilities range from 0% to 100% and are assigned in increments of 10. Thus, a veteran with a service-related injury will not receive any compensation if his or her disability is rated at 0%, unless it is combined with a separate 0% disability and the two, when combined, interfere with employment. According to one VA-accredited insurance claims adjuster, tinnitus is automatically rated at 10%, regardless of the severity. At the end of fiscal year 2011, more than 700,000 veterans were compensated for hearing loss, but many more likely suffer from hearing loss that is rated at 0%. The VA will provide hearing aids to veterans with service-related disability ratings of at least 10% and in other limited circumstances. Some private programs, such as that offered by hi HealthInnovations, offer deep hearing aid discounts to veterans. Without discounts, hearing aid prices can range from $1,000 to $6,000 per ear, although retailers like Costco offer discounted options.
Congress has acknowledged the extensive nature of these service-related hearing afflictions. As part of the National Defense Authorization Act for Fiscal Year 2009 (P.L. 110-417, Title VII, Subtitle C, Section 721), it directed the Secretary of Defense to establish the Hearing Center of Excellence (HCE). The Center of Excellence was to work in conjunction with the Veterans Health Administration to develop and maintain a registry that tracked the diagnoses, treatments, and follow-up care of veterans with active duty-related hearing loss or injury. In addition, the center was to research methods of preventing or mitigating hearing damage. In a March 16, 2011 Congressional hearing, however, the National President of the Blinded Veterans Association (BVA) noted that the HCE was staffed by two Air Force officers and no full-time Veterans Affairs (VA) staffers. More than one year later, on November 13, 2012, the National President of The Retired Enlisted Association (TREA) decried the fact that the HCE was staffed by . . . two Air Force officers and no VA staffer. The president of the BVA noted that the government devoted an amount equivalent to less than 1 percent of hearing damage compensation payments to research to prevent hearing trauma. He urged Congress to increase funding to the Hearing Center of Excellence and to encourage preventative research. Whether Congress will remain committed to the HCE, and how expeditiously the HCE will act, remains to be seen.