Auditory/Hearing

Hearing Loss C&P Exam Guide

Associated DBQ Form: DBQ Hearing Loss and Tinnitus

What to Expect During Your Exam

The hearing loss C&P exam includes an audiological evaluation lasting about 30-45 minutes. You'll be tested in a soundproof booth.

The exam includes:
1. Pure tone audiometry (testing hearing at different frequencies)
2. Speech recognition testing (Maryland CNC word list)
3. Review of your noise exposure history
4. Comparison with in-service hearing tests
5. Physical examination of your ears

Questions the Examiner May Ask

  • 1 What noise exposure did you have during military service?
  • 2 Did you use hearing protection?
  • 3 When did you first notice hearing difficulties?
  • 4 Do you have trouble understanding conversations?
  • 5 Do you need to turn up the TV or radio volume?
  • 6 Do you have difficulty hearing in noisy environments?
  • 7 Have you had any ear injuries or infections?
  • 8 Do you have any recreational noise exposure (hunting, concerts)?

Documentation to Bring

  • In-service audiograms (entrance and exit physicals)
  • Documentation of military noise exposure (MOS, combat, equipment)
  • Post-service audiograms
  • Buddy statements about shared noise exposure
  • Personal statement about noise exposure and hearing difficulties

How to Prepare

Before your exam:

1. **Gather service records** - Especially entrance and exit audiograms showing threshold shifts

2. **Document noise exposure** - List specific sources: weapons, vehicles, aircraft, explosions

3. **Don't wear hearing aids** - If you have them, the examiner will test without them

4. **Rest your ears** - Avoid loud noise for 24 hours before the exam

5. **Be honest during testing** - Only respond when you actually hear the tone

Helpful Tips

- VA uses specific criteria - puretone thresholds and speech recognition scores
- An audiogram must meet certain thresholds to qualify as a disability
- Be honest during the hearing test - respond only when you actually hear the tone
- Don't guess or anticipate sounds
- Mention all noise exposure sources during service
- If your hearing has worsened since service, document the progression
- Comparing entrance and exit audiograms is key evidence

Common Mistakes to Avoid

- Inconsistent responses during the hearing test
- Entrance audiogram showing pre-existing hearing loss
- Significant recreational noise exposure not disclosed
- Responses that don't match the pattern expected for your claimed condition

How VA Rates This Condition

Hearing loss is rated under 38 CFR § 4.85-4.86 using Tables VI, VIA, and VII:

Ratings are based on:
1. **Puretone threshold average** (average of 1000, 2000, 3000, 4000 Hz)
2. **Speech recognition score** (Maryland CNC test)

These two numbers create a Roman numeral for each ear (I through XI), which are then cross-referenced in Table VII for the rating percentage.

**Rating range:** 0% to 100%

**Note:** Hearing must meet specific thresholds to qualify. Mild hearing loss may not qualify for a compensable rating.