Document ID: chunk:federal_register_of_legislation:F2023C00151:reg:70:p24
Version: federal_register_of_legislation:F2023C00151
Segment Type: reg
Provision Reference: reg 70 (pt 24/25)
Character Range: 266765–269559

reliable and suitable for hearing loss calculations.

The audiogram

Assessment of hearing impairment requires a pure tone audiogram. For the purposes of assessment of impairment, hearing loss is to be measured without the benefit of any hearing aid. Measurements of the hearing threshold level (HTL) should be taken at each of the following frequencies:

         500 Hz,  1000 Hz,  1500 Hz,  2000 Hz,  3000 Hz, and 4000 Hz

Ideally, the audiogram should include both air conduction HTLs and masked bone conduction HTLs at each of these frequencies.

The four criteria for a reliable audiogram

1. The date of the audiogram must be appropriate to the period of assessment.

The audiogram should not be more than six months older than the relevant time in the assessment period to which the information is to be applied. If there is a specific assertion that the veteran's hearing has deteriorated within the last six months, then the audiogram should not be more than six weeks old at the time of assessment.

2. The frequencies tested should be appropriate.

Measurements of HTL should be available for each of the frequencies mentioned above (that is, 500 Hz, 1000 Hz, 1500 Hz, 2000 Hz, 3000 Hz, and 4000 Hz).

If HTL measurements are missing at one or two frequencies, the missing values can be estimated (interpolation) by inspection of the audiogram, by applying knowledge of the type of hearing loss, and by examination of other audiograms. If the nature and extent of missing information in an audiogram are considered to be such that interpolation would not be sufficiently accurate, the audiogram should be repeated. If the deficient audiogram is recent, the new audiogram is to be used in its place. The new audiogram may also be used to assist in interpolation of an older, deficient audiogram.

3. Bone conduction HTLs should be available when necessary.

An audiogram showing both bone conduction and air conduction HTLs should be used for the assessment of all types of accepted hearing loss unless the total accepted hearing loss is equivalent to:
    Bilateral mixed deafness;
    Right mixed deafness;
    Left mixed deafness;
    Bilateral conductive deafness with right sensorineural deafness; or
    Bilateral conductive deafness with left sensorineural deafness,
for each of which only air conduction HTLs are required; or unless it is not practicable or appropriate to obtain bone conduction HTL values.

Reasons why it may not be practicable or appropriate to obtain bone conduction HTL values include the following:
    the veteran cannot reasonably attend a clinic where bone conduction HTL values can be measured;
    the veteran's other conditions are of such a degree that it will make no appreciable difference to the final assessment; or
    an