C & P Hearing Loss and Tinnitus Exam


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Those Vets have driven us bonkers…

My DH had his first C & P Exam last week in a VA-contracted independent audiologist.  The exam was cursory at best.  We’ll be writing for our one free copy of the exam since the VA has a duty to assist him.  I’m sure this was an “insufficient exam.”  For example, the examiner didn’t ask any questions about the functional effects of his hearing loss and tinnitus.  In fact, she didn’t ask about tinnitus at all. 

However, the evening before the exam, I did a little poking around in Google and found some slides by VA employee, Kyle C. Denis, Ph.d. to review.  Whoa!  I told my DH that he needed to proactively report to the examiner that he had tinnitus because if he didn’t speak up, the VA instructs examiners to say the veteran denied tinnitus!

The VA’s tinnitus instructions of “don’t ask, don’t tell” is far from what one would expect from an institution that deals with veterans’ health.  

Reporting Tinnitus

  •  VBA worksheet was changed because almost all people have a history of  tinnitus. The pertinent question is whether or not there is current complaint of tinnitus. 
  •  The appropriate way to inquire about tinnitus is to ask about the current complaints without asking specifically about tinnitus or ringing in the ears.
  •  Audiologists should not use history forms or questionnaires that prompt for a history of tinnitus, ringing in the ears, or head noises.
  •  VBA feels that if a Veteran has tinnitus that is disabling they will report it when asked about his/her current complaints. However, if tinnitus is a claimed condition or VBA specifically asks for information regarding tinnitus, then you MUST respond to the issues. Otherwise, the exam may be returned as incomplete or inadequate.

And, “If the Veteran does not report tinnitus as a current complaint during the history, then indicate that the veteran denied tinnitus as a current complaint in the medical history.”  Shady, shady, shady…

The slides were presented to other Joint Defense and VA (JDVA) audiologists at lovely   vacation spots.   They offer useful summaries about topics like “conceding noise exposures,”  Fast Letters, case studies, speculation, medical opinion templates and much much more!  There’s something for everyone so save to your Google Drive, dropbox or other cloud storage while their available online. (For Nod, the 2013 slides contain summaries about a few relevant BVA docket numbers, legal cases which are important for audiologists to know about:  Ledford v Derwinski, Dalton v. Nicholson Hensley v. Brown, and Martinak v. Nicholson.)

2010 C & P Conference Slides (long link required):

http://myavaa.org/documents/conferences/AVAA-March-2010-Conference/PDF-Presentations/Dennis%20C&P%20Wed%201000%20JDVAC%202010.pdf

2011 C & P Conference Slides:

http://www.myavaa.org/documents/JDVAC-2011-Presentations/Dennis_JDVAC2011.pdf

2012 Slides “Navigating the DBQ Audiology Questionnaire”: http://www.myavaa.org/documents/conferences/JDVAC-2012/JDVAC2012-April2012/Dennis%20AVAA%20DBQ.pdf

C & P Updates for 2013 Conference: 

http://www.myavaa.org/documents/JDVAC_2013/Dennis%20JDVAC%202013%20DBQ.pdf

Don’t worry–they’re not stressing themselves with depressing veteran hearing problems at these educational events. What the heck are our military audiologists were up to at a recent conference?  Recognize your VA audiologist in these photos?  If so, I’m not sure if you should rely on him/her for medical opinions. 

Photo

We met our 2011 quota denying service-connected hearing disabilities.
Yay!

We’re on vacation! Yay!

We just like to have fun….

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4 Responses to C & P Hearing Loss and Tinnitus Exam

  1. Bruce says:

    Well this is not surprising. I had my audio C & P back in 2011, the examiner stated that he could not diagnose hearing loss/tinnitus with out resorting to mere speculation. Yes of course I was denied and I filed 2 NOD’s one in 06/11 and 08/11, the 06/11 was granted in my favor, however the 08/11 NOD is outstanding and it contains my hearing /tinnitus contention. I completed a new round of C & P exams for the 2nd NOD in 02/13. The RO never scheduled another hearing C & P. Got the feeling this is another denial. I was a 13B by the way

    • Kiedove says:

      Stinkers! 13B–is that your MOS? We’re written a letter asking for a copy of my DH’s C & P exam and his past two VA hearing exams and notes which I believe we are entitled to in order to develop this portion of the claim. (“duty to assist”)
      Tinnitus is a symptom of hearing loss.

      • Bruce says:

        13B was my MOS….I know that MOS’s arent used to determine hearing loss but in conjuction with my statement in support of claim….maybe they would give the benefit of doubt…….yea I know…….wishful thinking

        • Kiedove says:

          2013 Slide 34 & 35
          (The link to the listing doesn’t work and I can’t find the info. online. Does someone else have a good link?)
          Fast Letter 10-35
          * Duty Military Occupational Specialty (MOS) Noise Exposure Listing
          * DoD-verified lists of occupational specialties and the corresponding probability of
          hazardous noise exposure.
          * If there is no documented evidence of an in-service illness, injury, or event with
          which the claimed conditions could be associated, the Duty MOS Noise Exposure
          Listing will be considered.
          *If the duty position has a “Highly Probable” or “Moderate” probability of noise
          exposure, exposure to such noise will be conceded for purposes of establishing
          the in-service event.
          * If there is a current disability and exposure to hazardous noise is conceded based
          on the Duty MOS Noise Exposure Listing, VSC must request a VA examination and
          opinion to determine if there is a medical nexus.

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