Document ID: chunk:federal_register_of_legislation:F2016L01332:reg:3d:p2
Version: federal_register_of_legislation:F2016L01332
Segment Type: reg
Provision Reference: reg 3D (pt 2/13)
Character Range: 226148–229099

an integral feature of an accepted condition.

     Chapter 7
     Ear, Nose, and Throat
     Impairment

    This chapter contains two parts:

    Part 7.1- Hearing Loss and Tinnitus
    Part 7.2- Ear, Nose, and Throat

    PART 7.1: HEARING LOSS AND TINNITUS

    Because it causes a single loss of function, accepted hearing loss is to be assessed as if it were a single condition even if the loss is described under several diagnostic terms. For example, a veteran who has accepted conditions of both "right conductive deafness" and "left conductive deafness" will have them rated as if the conditions had been described as "bilateral conductive deafness".

cochlear nerve

pinna external ear canal
    timpanic membrane

malleus cochlea

incus

Only a single impairment rating may be made from Part 7.1 for accepted hearing loss irrespective of how many diagnostic terms have been used in describing the hearing loss.

    However, a second impairment rating may be made from Part 7.1 (Table 7.1.11) for tinnitus if appropriate.

Definitions

     For the purposes of this chapter:

     "Air Conduction"

     "APHL" or "Accepted Percentage Hearing Loss"

     "Bone conduction"

     "HTL" or "Hearing
     Threshold Level"

"Presbyacusis"

     "TBHL" or "Total
     Bilateral Hearing Loss"

is the manner in which sound transmitted through the air reaches the inner ear in the normal way.

is the percentage of total hearing that the veteran has lost due to accepted deafness. It is found by summing the losses at each of 6 important frequencies.

is the manner in which sound is heard when the source of sound  is placed directly over any bony part of the hearer's cranium. In such a case the sound is conducted to the inner ear through the bones of the skull.

is, for any given frequency, the volume (loudness) of the faintest sound that the veteran can hear. For each frequency, there will be a hearing threshold level for the right ear and a hearing threshold level for the left ear. Hearing threshold levels can be determined using either bone or air conduction information.

is the normal loss of hearing which accompanies ageing.

is the percentage of total hearing which the veteran  has lost from all conditions whether accepted or not.
    Calculation of the impairment rating for accepted hearing loss

    Follow the steps below to calculate the accepted hearing loss. (Each of these steps is elaborated in the following pages.)

    STEP Apply Table 7.1.1 to determine the type of accepted Page
     1 hearing loss. 130

    STEP Determine whether the audiogram is reliable and Page
     2 suitable for hearing loss calculations. 131

    STEP Calculate the APHL. Page
3 132

    STEP Determine what age adjustment (if any) must be sub- Page
     4 tracted from the APHL. Subtract it.  145

    STEP Determine the functional impairment rating by Page
5