Employees with Hearing Loss 

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

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Preface 

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Authored by Tracie DeFreitas Saab, M.S. Updated 03/22/10.
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JAN’S ACCOMMODATION AND COMPLIANCE SERIES

Introduction 

JAN’s Accommodation and Compliance Series is designed to help employers determine 

effective accommodations and comply with Title I of the Americans with Disabilities Act 

(ADA). Each publication in the series addresses a specific medical condition and 

provides information about the condition, ADA information, accommodation ideas, and 

resources for additional information. 

The Accommodation and Compliance Series is a starting point in the accommodation 

process and may not address every situation. Accommodations should be made on a 

case by case basis, considering each employee’s individual limitations and 

accommodation needs. Employers are encouraged to contact JAN to discuss specific 

situations in more detail. 

For information on assistive technology and other accommodation ideas, visit JAN's 

Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar. 

Information about Hearing Loss

How prevalent is hearing loss?

According to the National Institute on Deafness and Other Communication Disorders, 

approximately 15 percent (32.5 million) of American adults report some degree of 

hearing loss (NIDCD, 2008). 

What is hearing loss?

Hearing loss is a decrease in ability to hear and can occur at birth, suddenly, or 

gradually over time. Depending on the cause, hearing loss can range from mild to 

severe and can be reversible, temporary, or permanent (WebMD, 2008). There are 

three types of hearing loss; conductive, sensorineural, and mixed. 

Conductive hearing loss is associated with the bones of the ear, the eardrum, or the 

membranes that relay sound to the inner ear. Essentially, sound is not conducted 

through the ear and usually involves a reduction in sound level, or the ability to hear 

faint sounds. Conductive hearing loss may be caused by fluid build-up from a cold, 

allergies, ear infections, and benign tumors (ASHA, 2008). 

Sensorineural loss is associated with the nerves that transmit messages from the inner 

ear to the brain. Sensorineural hearing loss involves a reduction in sound level, ability to 

hear faint sounds, and also affects ability to clearly hear and understand speech. 

Sensorineural hearing loss can be caused by noise exposure, head trauma, viruses, 

tumors, birth injury, drugs that are toxic to the auditory system, and genetic syndromes 

(ASHA, 2008). 
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Mixed hearing loss is characterized by a combination of both conductive and 

sensorineural hearing loss, where there is damage in the outer or middle ear as well as 

in the inner ear or auditory nerve (ASHA, 2008). 

Can hearing loss be treated or corrected?

Conductive hearing loss can often be medically or surgically corrected. However, 

sensorineural hearing loss is a permanent loss that cannot be corrected. Some 

individuals can benefit from hearing aids and assistive devices that improve hearing and 

listening abilities. However, in some cases, a hearing aid may not enable an individual 

to discriminate environmental sounds or clearly understand speech. 

A cochlear implant is an assistive device that may be beneficial for some people with 

hearing loss. A cochlear implant is a device that is surgically implanted into the cochlea 

and aids the individual in hearing sounds through a magnet attached to a small bodyworn computer. 

What does it mean to have a mild, moderate, severe, or profound hearing loss?

Degree of hearing loss refers to the severity of the loss. The degree of hearing loss is 

determined by measuring hearing threshold. Hearing threshold refers to the levels in 

decibels (dB) at which a signal is just barely heard. A mild hearing loss is characterized 

as loss at 26-40 dB. Mild hearing loss may result in difficulty hearing soft voices, 

speakers at a distance, or understanding conversation in noisy environments. A 

moderate hearing loss is characterized as loss at 41-55 dB and moderate to severe at 

56-70 dB. In this range, conversation even in quiet environments can be difficult and 

speech may need to be loud. A severe hearing loss is characterized as loss at 71-90 

dB. At this level, hearing is difficult in all situations. An individual with profound hearing 

loss, loss at 91+ dB, may not hear even loud speech or sounds. In this instance, hearing 

would not be used as a primary method for processing information and communicating 

(House Ear Institute, 2008). 
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Hearing Loss and the Americans with Disabilities Act (ADA)

Is hearing loss a disability under the ADA? 

The ADA does not contain a list of medical conditions that constitute disabilities. 

Instead, the ADA has a general definition of disability that each person must meet 

(EEOC, 1992). Therefore, some people with hearing loss will have a disability under the 

ADA and some will not. 

A person has a disability if he/she has a physical or mental impairment that substantially 

limits one or more major life activities, a record of such an impairment, or is regarded as 

having such an impairment (EEOC, 1992). For more information about how to 

determine whether a person has a disability under the ADA, visit 

http://askjan.org/corner/vol02iss04.htm. 

Is it a reasonable accommodation for an employer to make sure that an employee 

wears a hearing aid or uses another mitigating measure? 

No. The ADA does not require employers to monitor an employee to ensure that he 

uses an assistive hearing device. Nor may an employer deny an individual with a 

hearing disability a reasonable accommodation because the employer believes that the 

individual has failed to take some measure that would improve his hearing (EEOC, 

2006). 

Must an employer provide a sign language interpreter as a job accommodation?

An employer may be required to provide a qualified interpreter as an accommodation, 

absent undue hardship. An interpreter may be requested and required during any stage 

of the employment process (e.g., interview, training, on-the-job) (EEOC, 1992). 

Must an employer provide reasonable accommodation, such as a sign language 

interpreter or realtime CART captioning service, so an employee may attend 

training programs? 

According to the Equal Employment Opportunity Commission (EEOC), an employer 

must provide sign language interpreters, CART services, and other reasonable 

accommodations, that will provide employees with disabilities with an equal opportunity 

to participate in employer-sponsored training, absent undue hardship. This obligation 

extends to in-house training, as well as to training provided by an outside entity. 

Similarly, the employer has an obligation to provide reasonable accommodation 

whether the training occurs on the employer's premises or elsewhere (EEOC, 2002). 
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Is an employer required to purchase a prescribed hearing device (e.g., hearing aid 

or cochlear implant) as a reasonable accommodation? 

An employer is not required to provide an accommodation that is primarily for personal 

use. Reasonable accommodation applies to modifications that specifically assist an 

individual in performing the duties of a particular job. Equipment or devices that assist a 

person in daily activities on and off the job are considered personal items that an 

employer is not required to provide. However, in some cases, equipment that otherwise 

would be considered "personal" may be required as an accommodation if it is 

specifically designed or required to meet job-related rather than personal needs (EEOC, 

2002). 

When an employee does not own or benefit from a hearing aid, an employer may be 

required to provide a reasonable accommodation(s) that will enable effective 

communication, barring undue hardship. 

Is more information available regarding hearing loss and the ADA?

Yes. The EEOC enforces the employment provisions of the ADA and offers a fact sheet 

regarding hearing loss and the ADA. For more information, visit Questions and 

Answers about Deafness and Hearing Impairments in the Workplace and the Americans 

with Disabilities Act at http://www.eeoc.gov/facts/deafness.html. 
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Accommodating Employees with Hearing Loss

How people "label" themselves in terms of their hearing loss is personal and may reflect 

identification with the deaf community or merely how their hearing loss affects their 

ability to communicate. Generally, the term "deaf" refers to those who are unable to 

hear well enough to rely on their hearing and use it as a means of processing 

information. The term "hard of hearing" refers to those who have some hearing and are 

able to use it for communication purposes (NAD, 2008). 

People who are deaf or hard of hearing may develop some of the limitations discussed 

below, but seldom develop all of them. Also, the degree of limitation will vary among 

individuals. Be aware that not all people with hearing loss will need accommodations to 

perform their jobs and many others may only need a few accommodations. The 

following is only a sample of the possibilities available. Numerous other accommodation 

solutions may exist. 

Questions to Consider: 

1. What limitations is the employee with hearing loss experiencing? 

2. How do these limitations affect the employee and the employee’s job performance? 

3. What specific job tasks are problematic as a result of these limitations? 

4. What accommodations are available to reduce or eliminate these problems? Are all 

possible resources being used to determine possible accommodations? 

5. Has the employee with hearing loss been consulted regarding possible 

accommodations? 

6. Once accommodations are in place, would it be useful to meet with the employee 

with hearing loss to evaluate the effectiveness of the accommodations and to determine 

whether additional accommodations are needed? 

7. Do supervisory personnel and employees need training regarding hearing loss? 
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Accommodation Ideas: 

*Denotes see Appendix A at the end of the document 

Difficulty Communicating Face-to-Face 

• Write notes with pen and paper, tablet PC, dry erase or chalk board, etc. 

o Note: Some individuals who are deaf may not be able to read or write 

English. A language barrier can exist when American Sign Language 

(ASL), or some other form of manual or visual communication, is the 

primary or only language the individual uses. If the individual does not 

read or write English, written communication will not be an effective form 

of communication. When written communication is not effective consider 

providing a qualified sign language interpreter on an as-needed basis. 

• Use a computer and keyboard to type messages back and forth 

• Use a computer and speech-recognition software to communicate one-on-one 

• Send e-mail or text messages as an alternative to face-to-face communication 

• Hire a qualified sign language or oral *interpreter, or *video remote interpreter 

(VRI) on an as-needed basis (e.g., during a job interview, orientation, benefits 

seminar, training, or disciplinary meeting) 

o Note: The Registry of Interpreters for the Deaf (RID) offers an 

interpreter/agency referral service. Visit www.rid.org to locate an 

interpreter/agency by state or zip code. 

• Use a personal *assistive listening device (ALD) or portable assistive listening 

system (ALS) if the individual can benefit from amplification 

• Use portable *communication access technology designed for individuals who 

are deaf or hard of hearing 

• Use an *augmentative and alternative communication device (AAC), with or 

without speech 

• Encourage employees to learn and use basic sign language 

• Install mirrors to communicate the presence of other workers or customers (e.g., 

in areas where an employee’s back may be turned) and ask the employee how 

he or she prefers to be approached so that he or she is not startled 

• Position a small sign at the employee’s workstation (e.g., check-lane register, 

help desk) that indicates the person has a hearing loss and that communication 

should be direct, in writing 
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o Note: The employee with hearing loss may volunteer to have such a sign 

at his or her workstation; the employer should not require such a sign. 

• Provide disability awareness training when integrating employees who are deaf 

into the work environment 

Difficulty Communicating in Groups, Meetings, or Training 

• Meet in a small group and sit at a round table to facilitate lip-reading 

 

• Meet in a quiet room to avoid distractions and exposure to extraneous noise 

(e.g., office equipment, hallway chatter, machinery, etc.) and if necessary install 

noise abatement panels to reduce noise 

• Adjust lighting and seating to create an optimal listening experience 

• Educate staff regarding meeting etiquette (e.g., one person talk at a time, do not 

cover mouth with hands or papers, maintain eye contact) 

• Provide written materials in advance, such as the meeting agenda, training 

outline, or course materials, or offer minutes afterwards 

• Allow extra time for training 

• Use an FM, infrared, or induction loop *assistive listening system (ALS) 

• Hire a qualified sign language or oral *interpreter, or *video remote interpreter 

(VRI) on an as-needed basis (e.g., during a job interview, orientation, benefits 

seminar, training, or disciplinary meeting) 

o Note: The Registry of Interpreters for the Deaf (RID) offers an 

interpreter/agency referral service. Visit www.rid.org to locate an 

interpreter/agency by state or zip code. 

• Contract for on-site or remote real-time captioning services, known as 

communication access real-time translation or *(CART) 

• Provide computer-assisted note taking where a skilled note taker/typist uses a 

laptop to compose notes during the meeting 

• Record and transcribe meetings 

• Caption training DVDs/videos and web-based training modules that include 

sound 

• Use *relay conference captioning (RCC) during group conference calls 
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• Use high quality conferencing equipment during group conference calls 

• Use a conferencing phone with a headset for more direct sound 

• Provide disability awareness training when integrating employees who are deaf 

into the meeting or training environment 

Difficulty Communicating by Telephone 

• Use telephone *amplification/clarity technology 

• Use a hearing aid compatible headset or amplified noise canceling headset. 

Hearing aid compatible headsets are designed for use with t-coil equipped 

hearing aids. 

• Use a *cochlear implant patch cord 

• Use a *captioned telephone 

• Use a *TTY 

• Use a *voice carry over phone (VCO) 

• Use *video relay service (VRS) 

• Use a voicemail transcription service to send an e-mail or a text message of 

voicemail messages. For employees who are deaf who receive direct calls, 

voicemail messages could be left so the employee could call the caller back 

using the relay system. 

• Include the *Telecommunications Relay Service (TRS) number (711) with the 

employee’s business number on his or her business card, as well as a note 

about using the relay service 

• For employees who are severe to profoundly deaf, and who do not use speech, 

methods for receiving and handling incoming telephone calls include: 

o Use the relay service with a TTY (analog line required) or VCO phone, 

o Use the relay service with PC as a TTY (software), 

o Use the relay service with videophone equipment (video relay (VRS) 

calls), or 

o Use an interpreter to interpret calls 

• Use e-mail or instant messaging (IM) instead of voice phone 

• Use mobile two-way text messaging instead of voice phone 
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• Use *Bluetooth technology and mobile phone amplification and clarity devices 

with cell phone 

• Use *relay conference captioning (RCC) during group conference calls 

• Use high quality conferencing equipment during group conference calls 

• Use a conferencing phone with a headset for more direct sound 

Difficulty Communicating in the Field 

• Use a high-end professional two-radio system with noise-canceling technology 

• Use a two-way radio with text-messaging capability 

• Use a cellular phone with text messaging, a two-way mobile device, or a cellular 

phone that has both text messaging and two-way radio capability 

• If "in the field" communication takes place within sight, workers may be able to 

use hand signals and signs to communicate instead of two-way radios 

• Use a portable TTY and relay service 

Safely Operating or Working Around Vehicles 

• Establish set paths of travel for industrial vehicles and pedestrians using 

industrial tape, paint, or ropes 

• Establish and enforce rules requiring all moving equipment, forklifts, and vehicles 

to stop and flash lights/beep horn at intersections 

• Install flashing strobe lights on moving vehicles 

• Install a *directional worker alert system that provides a visual warning of 

oncoming vehicles 

• Install industrial mirrors in strategic locations (e.g., blind corners) at the work 

environment 

• The individual who is deaf or hard of hearing may be willing to wear a hat or vest 

of a unique color to serve as a warning to others to be cautious 

o Note: An employer should not require such a vest or hat if other 

employees do not wear such vests or hats. 
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• Use a *vibrating personal pager to alert the person who is deaf. Pagers can be 

useful when it is possible to have another employee send a warning signal to the 

person who is deaf. 

• Install a *vehicle rear vision system in the forklift or other vehicle, to improve the 

operator's ability to visually assess the environment 

Difficulty Responding to Sounds in the Environment 

• Use a visual or vibrating *alerting device 

o Note: Alerting devices are used to alert people to a broad range of 

sounds, including (but not limited to) abnormal machine sounds, timers, a 

telephone ringing, doorbell, baby crying, and emergency signals. 

• Modify equipment by adding a light to the sound source 

o Note: Speak with the manufacturer of the equipment for suggestions 

before making modifications and consult with an electrician, or appropriate 

professional. 

• Install lighted fire strobes and other visual or vibrating alerting devices to 

supplement audible alarms 

• Provide a vibrating text pager that may be triggered by the emergency alerting 

system or establish a web-based text alert system 

• Allow the employee to bring his or her *hearing dog into the workplace 

Difficulty Wearing Hearing Protection 

• Turn-off hearing aids and use ear muffs 

• Turn-off hearing aids and use *active hearing protection, ear muffs that block 

sound but use electronic circuitry to transmit low-level sounds through the 

earmuffs 

• Remove hearing aids and use ear plugs or muffs 

• Turn-off/remove hearing aids and use communication headset that provides 

noise attenuation and radio communication 

• Use hearing aid turned-off, with no protector, only if the ear piece of the hearing 

aid is not vented and fits snugly in the ear 

• Use custom-made hi-fidelity ear plugs; see an audiologist 
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Situations and Solutions: 

A nurse with a hearing impairment worked the night shift and had to talk to doctors who 

called for information. She was having difficulty hearing over the telephone. The 

employee asked to be moved to a dayshift where there would be other nurses who 

could talk to the doctors but there were not any openings on the dayshift. The employer 

purchased a telephone amplifier, which enabled the nurse to hear effectively over the 

telephone. According to the employer, the accommodation helped the employee serve 

patients better. Cost $50. 

An electric serviceman with progressive hearing loss sometimes worked in a bucket 

truck and needed to communicate to coworkers. The usual method of communication 

was via a radio. The employer switched to cell phones and the employee was able to 

use text messaging to communicate. The employer reported the accommodation 

improved communication and kept a valuable employee. Cost $500. 

A government employee who was deaf was not communicating effectively with 

coworkers. The employer provided video relay interpreting equipment and service 

access. According to the employer, the accommodation improved communication. 

Cost $200. 

A professional employee with a hearing loss had difficulty responding when "on call." 

The employee stated she could not be "on call" because at night she takes her hearing 

aids out and cannot hear the phone ring. The employer contacted JAN looking for 

accommodation ideas that would satisfy both the individual and the employer's needs. 

JAN suggested the use of a vibrating pager or personal alerting device, and to clarify 

with the employee what the essential functions of the position are. The employer 

purchased a vibrating bed shaker, telephone receiver, and transmitter to send the signal 

to the bed shaker. The employee could then be alerted to the telephone ringing at night. 

Cost $125. 

An employee working in an office environment had hearing loss due to tinnitus and 

hyperacusis. She could not be around noise in the office environment for long periods of 

time. The individual's employer provided her with a private room to work in alone. This 

was reported to be very effective. Cost $0. 

An employer was considering hiring an employee with a severe hearing impairment to 

be a material handler. The employer had some safety concerns and called JAN seeking 

accommodation ideas for working around forklift traffic and running machinery. JAN 

suggested the employer set paths of travel for forklifts and pedestrians, provide mirrors, 

require that all vehicles to stop at each intersection, install strobe lights on the 

equipment, ask the individual if he would feel comfortable wearing a bright colored vest 

or hard hat, and provide a personal vibrating pager to be activated by a coworker in 

dangerous situations. Cost not reported. 
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A state employer had several employees who were deaf or hard of hearing. These 

employees needed to respond to emergency signals and communicate in emergency. 

Each employee was provided with a vibrating pager that was connected to the alarm 

system. When the alarm sounded they were paged. Laminated note cards with 

communication options and flashlights to assist with signs or lip reading were also 

provided. Cost not reported. 

A medical technician who was deaf could not hear the buzz of a timer, which was 

necessary for specific laboratory tests. An indicator light was attached to the equipment. 

Cost $27. 

A field geologist who was deaf and worked alone in remote areas was unable to use 

two-way radio communication to report his findings. Text telephone technology was 

used to allow the geologist to communicate using a cellular telephone. Cost $400 plus 

monthly service fee for the phone. 

Interested in hiring a candidate who was deaf, a bank manager called JAN for 

assistance. The position required conversations with hearing customers. JAN 

suggested communication access technology that enables two people to type to each 

other while facing each other. Using the equipment, the teller and customer would be 

able to type their conversation, both viewing the text on a personal screen. This 

technology would also enable bank customers who are deaf or hard of hearing to 

access banking services. Cost $1,995. 

A physical therapist who attended weekly staff meetings and occasional training was 

having difficulty participating in groups due to hearing loss. She wore hearing aids and 

could benefit from amplification, but sometimes found it difficult to follow-along during 

long meetings or training seminars. For short staff meetings, JAN suggested a round 

meeting table to make it easier to read lips and follow sounds and an assistive listening 

system with a table microphone. CART captioning service was suggested for longer 

meetings and training seminars. Remote CART, where the CART writer listens-in from 

another location and creates captions over the Internet, could be used for the longer 

meetings. It was also suggested that the employee obtain written materials (e.g. 

agenda, text books, outlines, etc.) prior to the meeting/training and minutes afterwards. 

Cost not reported. 
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Products: 

There are numerous products that can be used to accommodate people with limitations. 

JAN's Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar is 

designed to let users explore various accommodation options. Many product vendor 

lists are accessible through this system; however, upon request JAN provides these 

lists and many more that are not available on the Web site. Contact JAN directly if you 

have specific accommodation situations, are looking for products, need vendor 

information, or are seeking a referral. 
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Appendix A 

Active Hearing Protection 

Active hearing protectors use electronics to amplify signals, voices, and warning signals 

while suppressing harmful noise levels. Hearing protection products have a Noise 

Reduction Rating (NRR), which is the measure, in decibels, of how well a hearing 

protector reduces noise; the higher the number, the greater the noise reduction. For 

example, a rating of NRR 31 provides greater noise reduction than NRR 24. 

Alerting Device 

An alerting device can be used to notify a person with hearing loss about sounds in the 

environment. An individual can be alerted to sounds like a telephone ringing, a doorbell 

or an emergency alarm, through vibration or a light signal. A transmitter detects certain 

sounds and then sends a signal to a receiver that vibrates or blinks a light. 

Amplification/Clarity Technology 

Amplification makes it possible for people with hearing loss to benefit from increased 

volume when using landline and cellular telephones. Amplification can be achieved by 

using an in-line amplifier that is connected between the handset and the base unit of the 

phone; by using a portable amplifier that can be placed over the handset; by using an 

assistive listening device, neck loop, or hearing aid compatible headset; or by adjusting 

the sound level buttons on a telephone unit. The level of amplification required depends 

on the individual’s specific needs, but the amplification available from most telephone 

technology can range from about a 23 decibel (dB) gain to up to a 50 dB gain above 

normal conversation level. dB is a measurement of sound intensity. For example, 

normal conversation occurs at about 60 dB and the sound of a car horn falls at about 

the 110 dB range. 

Clarity technology enables individuals with sensory neural hearing loss, or high 

frequency loss, to receive enhanced sound clarity. This technology digitally alters tones, 

shapes sound, removes distortions, and amplifies desired sounds to make speech 

clearer and easier to understand. For example, clarity technology makes it possible to 

hear the difference between high frequency sounds like "ch" and "st."

Assistive Listening Device or System (ALD/S) 

An ALD is a type of assistive technology that enables an individual who benefits from 

amplification to focus directly on the sound source, reducing distractions from 

background noises that can make it difficult to concentrate during a conversation. ALD 

types include personal assistive listening devices, small and large area FM systems, 

infrared, and induction loop technologies. The speaker talks into a microphone or 

transmitter and the listener either uses the T-switch on his/her hearing aid or wears a 

receiver designed to work with the specific assistive listening device. 
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Augmentative and Alternative Communication Device (AAC) 

AAC devices enable individuals with speech and language limitations to communicate. 

Dynamic display speech-output solutions allow users to select the words or phrases 

they want to say from a series of customized pages on a touch screen. Type and talk 

devices allow users with some literacy skills and motor function to generate electronic 

speech by typing words on a keyboard. Handheld speech-output devices give users a 

portable communication option. 

Bluetooth 

Bluetooth technology provides wireless communication between hearing aid wearers 

and Bluetooth enabled phones or other devices and allows the hearing aid and wireless 

device to connect digitally, thus avoiding interference common with other types of 

wireless transmission. 

Captioned Telephone 

A captioned phone works like any other telephone but it displays live captions of the 

conversation. The phone automatically connects to a captioning service where a trained 

operator transcribes what is being said using voice recognition technology. This same 

service is also available over the Internet. The person makes or receives phone calls 

using any phone, while viewing captions of the call in the Internet browser window on 

his or her computer. 

Cochlear Implant Patch Cord 

For people with cochlear implants, there are cochlear patch cords that can be used with 

telephones. A cochlear implant patch cord is a short wire that enables a connection 

between a cochlear implant (CI) speech processor and the jack of the equipment the CI 

user is listening to. 

Communication Access Technology 

Communication access technology is assistive technology that is uniquely designed to 

be used by and with individuals who are deaf or hard of hearing. This type of 

equipment offers such features as speech to text, speech to video sign language, 

speech to computer-generated voice, text to computer-generated voice or video sign 

language, and face-to-face text communication solutions. 

Directional Worker Alert System 

A directional worker alert system alerts pedestrians and other drivers that a forklift is 

coming. This wall mounted device employs a photo-sensor that sends out a red light 

beam to detect a reflective strip mounted on the forklift. The warning is activated when a 

forklift or other vehicle passes the alert system. 

Hearing Dog (or Hearing-Ear Dog) 

A hearing dog is trained to alert the person with hearing loss to sounds such as a 

fire/smoke alarm, telephone ringing, door knock, doorbell, ringing timer or alarm clock, 

and a name call. 
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Relay Conference Captioning (RCC) 

Relay Conference Captioning (RCC) is a service that provides functional equivalency to 

deaf and hard-of-hearing participants in conference calls and/or multi-party calls. The 

service uses captioners that deliver realtime text streamed to an Internet-connected 

computer. During captioned conference calls, participants can follow along with the 

dialogue by reading realtime captions. 

Sign Language Interpreter (Interpreter) 

Sign Language/spoken English interpreters are highly skilled professionals that facilitate 

communication between hearing individuals and individuals who are deaf or hard-ofhearing (RID, 2008). 

Telecommunications Relay Service (TRS) 

Telecommunications Relay Service (TRS) is a telephone service that allows persons 

with hearing or speech disabilities to place and receive telephone calls. TRS is available 

in all 50 states, the District of Columbia, Puerto Rico, and the U.S. territories for local 

and/or long distance calls. Dial 711 to connect to certain forms of TRS anywhere in the 

United States. 

TRS uses operators, called communications assistants (CAs), to facilitate telephone 

calls between people with hearing and speech disabilities and other individuals. A TRS 

call may be initiated by either a person with a hearing or speech disability, or a person 

without such disability. When a person with a hearing or speech disability initiates a 

TRS call, the person uses a TTY or other text input device to call the TRS relay center, 

and gives a CA the number of the party that he or she wants to call. The CA in turn 

places an outbound traditional voice call to that person. The CA then serves as a link for 

the call, relaying the text of the calling party in voice to the called party, and converting 

to text what the called party voices back to the calling party. For further information, 

visit the Federal Communications Commission Consumer Fact Sheet found at 

http://www.fcc.gov/cgb/consumerfacts/trs.html. 

TTY 

A TTY is a text telephone device that enables individuals who are deaf, hard of hearing, 

or who have a speech impairment, to make and receive telephone calls through 

interactive text based transmission of coded signals across a telephone network. TTY 

calls can be made using internet-based relay services. Using a PC or wireless device, a 

text call can be made over the Internet using the relay service without a TTY. 
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Vehicle Rear Vision System 

A video-camera system that provides rear, side, and forward views on a monitor located 

inside a moving vehicle.

Vibrating Personal Pager 

A wireless alerting system used to summon help or get a person’s attention by simply 

pushing the button on the pager transmitter. The portable pager receiver chimes or 

vibrates in response to receiving a signal from the transmitter. 

Video Relay Service (VRS) 

VRS is a form of Telecommunications Relay Service (TRS) that enables persons with 

hearing disabilities who use American Sign Language (ASL) to communicate with voice 

telephone users through video equipment, rather than through typed text. Video relay 

calls are made using a high-speed or broadband Internet connection (i.e., DSL, cable, 

or T1 line) and a videophone connected to a TV, or through a personal computer 

equipped with a Web camera and video relay software. The person who is deaf signs to 

a video interpreter who then communicates with a hearing person via a standard phone 

line by relaying the conversation between the two parties. For information, visit Video 

Relay Services FCC Consumer Facts found at 

http://www.fcc.gov/cgb/consumerfacts/videorelay.html.

Video Remote Interpreter/Interpreting Services (VRI) 

Video interpreting is a service that uses web-based technology for on-demand access 

to remote sign language interpreting services. Using video interpreting, an individual 

who signs can access interpreting services using a computer, webcam, and a highspeed broadband connection. 

Voice Carry Over (VCO) 

VCO is a telephone option for a person who uses his or her own voice, but cannot hear. 

The phone receives TTY messages, but the caller with hearing loss responds to the 

message using voice. Using VCO, the person who is deaf places a call to the 

Telecommunications Relay Service. The relay operator types messages to the VCO 

user, and the VCO user responds to the voice caller with his or her own voice instead of 

using a TTY.
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Resources 

Job Accommodation Network 

West Virginia University 

PO Box 6080 

Morgantown, WV 26506-6080 

Toll Free: (800)526-7234 

TTY: (877)781-9403 

Fax: (304)293-5407 

jan@askjan.org 

http://askjan.org 

The Job Accommodation Network (JAN) is a free consulting service that provides 

information about job accommodations, the Americans with Disabilities Act (ADA), and 

the employability of people with disabilities. 

Office of Disability Employment Policy 

200 Constitution Avenue, NW, Room S-1303 

Washington, DC 20210 

Toll Free: (866)633-7635 

TTY: (877)889-5627 

Fax: (202)693-7888 

http://www.dol.gov/odep/ 

The Office of Disability Employment Policy (ODEP) is an agency within the U.S. 

Department of Labor. ODEP provides national leadership to increase employment 

opportunities for adults and youth with disabilities while striving to eliminate barriers to 

employment. 

Alexander Graham Bell Association for the Deaf and Hard of Hearing 

3417 Volta Place NW 

Washington, DC 20007-2778 

Toll Free: (866)337-5220 

Direct: (202)337-5220 

TTY: (202)337-5221 

Fax: (202)337-8314 

info@agbell.org 

http://www.agbell.org 

Emphasizes the use of technology, speech, speech reading, residual hearing, and 

written and spoken language. Focuses specifically on children with hearing loss, 

providing ongoing support and advocacy for parents, professionals, and other interested 

parties. 
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21 

American Academy of Audiology 

11730 Plaza American Dr. 

Suite 300 

Reston, VA 20190 

Toll Free: (800)222-2336 

TTY: (703)790-8466 

Fax: (703)790-8631 

Phone: (703)790-8466 

info@audiology.org 

http://www.audiology.org 

The American Academy of Audiology promotes quality hearing and balance care by 

advancing the profession of audiology through leadership, advocacy, education, public 

awareness, and support of research. 

American Speech-Language-Hearing Association 

2200 Research Blvd 

Rockville, MD 20850 

Toll Free: (800)638-8255 

TTY: (800)498-2071 

actioncenter@asha.org 

http://www.asha.org 

Promotes the interests of, and provide the highest quality services for, professions in 

audiology, speech-language pathology, and speech and hearing science; and an 

advocate for people with communication disabilities. 

American Tinnitus Association 

65 SW Yamhill St. 

Suite 200 

Portland, OR 97204 

Toll Free: (800)634-8978 

Fax: (503)248-0024 

Phone: (503)248-9985 

tinnitus@ata.org 

http://www.ata.org 

Strives to silence tinnitus through education, advocacy, research, and support. This 

nonprofit organization provides the latest information and resources to tinnitus patients, 

promotes tinnitus awareness to the general public and the medical community, and 

funds the nation's brightest tinnitus researchers. 
Practical Solutions • Workplace Success 

22 

Better Hearing Institute 

1444 I Street, NW 

Suite 700 

Washington, DC 20005 

Toll Free: (800)EAR-WELL 

Fax: (202)449-1100 

Phone: (202)449-1100 

mail@betterhearing.org 

http://www.betterhearing.org 

A nonprofit, educational organization that implements national public information 

programs on hearing loss and available medical, surgical, hearing aid, and rehabilitation 

assistance for millions with uncorrected hearing problems. BHI maintains a toll-free 

Hearing HelpLine telephone service that provides information on hearing loss and 

hearing help. 

HEAR NOW 

Starkey Hearing Foundation 

6700 Washington Avenue South 

Eden Prairie, MN 55344 

Toll Free: (800)648-4327 

joanita@sotheworldmayhear.org 

http://www.sotheworldmayhear.org/forms/hearnow.php 

This national program provides assistance to individuals and families with limited 

financial resources. HEAR NOW maintains the National Hearing Aid Bank, which 

provides new and reconditioned hearing aids to deaf and hard of hearing people who 

cannot afford them. These hearing aids are distributed through hearing health care 

providers in communities nationwide. HEAR NOW also has a Cochlear Implant Program 

that raises funds to provide cochlear implants and related services to both adults and 

children. In addition, HEAR NOW has developed the National Hearing Assistance 

Directory (NHAD), which provides state-by-state listings of financial and social 

resources offered through government agencies and private organizations. 
Practical Solutions • Workplace Success 

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Hearing Loss Association of America 

7910 Woodmont Ave. 

Suite 1200 

Bethesda, MD 20814 

Direct: (301)657-2248 

TTY: (301)657-2248 

Fax: (301)913-9413 

http://www.hearingloss.org/index.asp 

The Mission of HLAA is to open the world of communication to people with hearing loss 

by providing information, education, support and advocacy. Its primary purpose is to 

educate families, coworkers, teachers, hearing health care providers, industry, 

government, and others about hearing loss. 

National Association of the Deaf 

8630 Fenton Street, Suite 820 

Silver Spring, MD 20910-3819 

Direct: (301)587-1788 

TTY: (301)587-1789 

Fax: (301)587-1791 

http://www.nad.org 

Consumer organization safeguarding the accessibility and civil rights of deaf and hard of 

hearing Americans in education, employment, health care, and telecommunications. 

Focuses on grassroots advocacy and empowerment, captioned media, deafnessrelated information and publications, legal assistance, policy development, and 

research, public awareness, certification of interpreters, and youth leadership 

development. 

National Institute on Deafness and Other Communication Disorders Information 

Clearinghouse 

National Institutes of Health 

31 Center Drive, MSC 2320 

Bethesda, MD 20892-2320 

Toll Free: (800)241-1044 

TTY: (800)241-1055 

Fax: (301)402-0018 

nidcdinfo@nidcd.nih.gov 

http://www.nidcd.nih.gov/ 

National Resource center for health information about hearing, balance, smell, taste, 

voice, speech, and language for health professionals, patients, industry, and the public. 

 
Practical Solutions • Workplace Success 

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References 

American Speech-Language Hearing Association (ASHA), (2008). Type, Degree, and 

Configuration of Hearing Loss. Retrieved June 13, 2008, from 

http://www.asha.org/public/hearing/disorders/types.htm 

Equal Employment Opportunity Commission (EEOC), (1992). A technical assistance 

manual on the employment provisions (title I) of the Americans with Disabilities 

Act. Retrieved July 1, 2005, from http://askjan.org/links/ADAtam1.html 

Equal Employment Opportunity Commission (EEOC), (2006). Questions and answers 

about deafness and hearing impairments in the workplace and the Americans 

with Disabilities Act. Retrieved June 19, 2008, from 

http://www.eeoc.gov/facts/deafness.html 

House Ear Institute, (2008). Hearing Disorders – Hearing Loss. Retrieved June 13, 

2008, from http://www.houseearclinic.com/hearingloss.htm 

National Association of the Deaf (NAD), (2008). What Is the Difference Between a Deaf 

and a Hard of Hearing Person? Retrieved June 20, 2008, from 

http://www.nad.org/site/pp.asp?c=foINKQMBF&b=180410 

National Institute on Deafness and Other Communication Disorders (NIDCD), (2008). 

Quick Statistics. Retrieved June 12, 2008, from 

http://www.nidcd.nih.gov/health/statistics/quick.htm 

Registry of Interpreters for the Deaf (RID), (2008). Practice of Interpreting. Retrieved 

August 12, 2008, from http://www.rid.org/interpreting/practice/index.cfm 

WebMD, (2008). Hearing Loss Overview. Retrieved June 12, 2008, from 

http://www.webmd.com/a-to-z-guides/hearing-loss-overview 
Practical Solutions • Workplace Success 

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This document was developed by the Job Accommodation Network, funded by a 

contract agreement from the U.S. Department of Labor, Office of Disability Employment 

Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the 

position or policy of the U.S. Department of Labor. Nor does mention of trade names, 

commercial products, or organizations imply endorsement by the U.S. Department of 

Labor.