Hearing Loss

A. Definition
The definitions of deafness and hard of hearing (HoH) are not the same but they are often used interchangeably. You are HoH if you don’t hear well. You are deaf if your inability to hear makes it impossible for you to rely on the spoken language as your primary mode of communication without supplementary support, i.e., sign language, cued speech, or hearing aids. The extent of hearing loss is commonly divided into four categories:

Mild hearing loss refers to an average air conduction hearing threshold of between 25 and 40 decibels in your better ear. If you have mild hearing loss, you may have some difficulties keeping up with conversations, especially in noisy surroundings.

Moderate hearing loss refers to an average air conduction hearing threshold of between 40 and 70 decibels in your better ear. If you have moderate hearing loss, then you likely have difficulty keeping up with conversations when not using a hearing aid.

Severe hearing loss refers to an average air conduction hearing threshold of between 70 and 95 decibels in your better ear. If you suffer from severe hearing loss, then you will benefit from powerful hearing aids, but often rely on lip-reading even when using hearing aids. You may use sign language.

Profound hearing loss refers to an average air conduction hearing threshold of 95 decibels or greater in your better ear. If you suffer from profound hearing loss, then you probably rely on lip-reading and/or sign language.

B. General information
It is estimated that 28 million people in the United States have some degree of hearing loss. The largest part of that group (perhaps 25 million or more) can hear well enough that with proper hearing aids or assistive listening devices, they can continue with their spoken language as their primary communication mode.

Hearing loss can occur in a variety ways. Aging and prolonged exposure to loud noise may cause wear and tear on your hairs or nerve cells in your cochlea, which sends sound signals to your brain. When these hairs or nerve cells are damaged or missing, electrical signals aren’t transmitted as efficiently, and hearing loss occurs. Higher pitched tones may become muffled to you. It may become difficult to pick out words against background noise. Heredity can make you more prone to these changes. This type of hearing loss is known as sensorineural hearing loss, which is permanent.

Infections, abnormal bone growths or tumors can cause hearing loss. A ruptured eardrum (tympanic membrane perforation) is another way hearing can be compromised. Loud blasts of noise, sudden changes in pressure, or poking your eardrum with an object can cause your eardrum to rupture and affect your hearing.

Lastly, a small number of the population may fall victim to sudden sensorineural hearing loss (SSHL). This is defined by a hearing reduction of 30 decibels or more over at least three contiguous frequencies, occurring 72 hours or less. The cause of SSHL is usually inexplicable.

Until recently, there was little help for people suffering from hearing loss, but there have been medical advances made in recent years. However, the Social Security Administration (SSA) recognizes that profound hearing loss may impact your ability to engage in substantial gainful activity for a year or more.

C. SSA Medical Listings 2.10 – Hearing Loss Not Treated with Cochlear Implantation

Your hearing loss will be considered disabling if your average air conduction hearing threshold is 90 decibels or greater in the better ear with an average bone conduction hearing threshold of 60 decibels or greater in the better ear. To determine whether your hearing loss meets the air and bone conduction criteria in 2.10A, the SSA will average your air and bone conduction hearing thresholds at 500, 1000, and 2000 Hertz (Hz). If you do not have a response at a particular frequency, a threshold of 5 decibels (dB) over the limit of the audiometer will be used.

Word recognition testing using the Hearing in Noise Test (HINT) performed under medically accepted practices is another method of evaluation of disability due to hearing loss. Your word recognition score must be 40 percent or less to be considered disabling.

SSA Medical Listings 2.11 – Hearing Loss Treated with Cochlear Implantation

If you have a cochlear implant, you will be considered disabled until one year after initial implantation. After that period, word recognition testing must be performed with any version of the Hearing in Noise Test (HINT) to determine whether your impairment is still disabling. Your word recognition score must be 60 percent or less determined by using the HINT with your implant functioning properly and adjusted to your normal settings.

Your representative can help you determine whether your hearing loss, with or without cochlear implantation, is severe enough to meet the criteria for you to receive Social Security Administration disability benefits.