At least some of the hearing loss must be caused by your job(s) to become an L&I claim. Over a lifetime noise related hearing loss comes from multiple sources and at various times. For legal purposes the answer to the following question decides if your hearing loss is job related:
“Doctor, on a more probable than not basis, is some or all of the hearing loss, the result of occupational exposure (did it happen on the job)?”
The doctor’s answer to this question decides if your hearing loss is job related.
Conductive hearing loss is usually the result of a single event, such as a sudden explosion or head trauma. Because it is a one time event, conductive hearing loss is an injury, not an occupational disease. This means you must file an L&I claim within one year of the injury, or you lose your claim.
Sensorineural hearing loss usually results from long-term exposure to noise and is considered an occupational disease, if job related. It is permanent, and not treatable by medicine or surgery. This type of hearing loss is usually helped by a hearing aid. Most occupational disease claims, including sensorineural hearing loss can be filed anytime. All such accepted claims are eligible for treatment (usually hearing aids). However to also be eligible for a Permanent Partial Disability (PPD) settlement, the occupational disease hearing loss claim must be filed within two years of the date of manifestation.
The date of manifestation is important because it, together with the claim filing date, determines weather an L&I occupation hearing loss claim is eligible for medical benefits only, or for both medical and a permanent partial disability (PPD) settlement.
The date of manifestation for hearing loss claims is the:
Medical treatment is the date the worker consulted with a doctor or received a hearing aid from a licensed provider, which ever occurred first. An audiogram is not considered medical treatment.
Audiograms are hearing tests. Audiograms chart the intensity of a sequence of tones that have been used to measure hearing thresholds. A hearing threshold is a measure of the softest sounds that a particular human can hear at various pitches.
A valid audiogram is needed to determine what type of hearing loss is present and if it is due to excessive noise exposure. In routine testing, a sound is produced and gradually reduced in intensity until the patient hears it approximately 50 percent of the time – the threshold of hearing.
To be considered valid, an audiogram just be:
If a worker is still being exposed to injurious occupational noise at the employer of record, the most recent valid audiogram is used to determine permanent impairment.
If a worker is not currently being exposed to injurious occupational noise, or has changed employers since filing the claim, the first valid audiogram performed closest to the date of last injurious exposure is used. However, if a subsequent valid audiogram shows a lower percentage of hearing loss, that audiogram is used.
In order to calculate the amount of permanent impairment, the claims manager takes the readings from the appropriate audiogram. The audiogram is read at the 500 Hz, 1000 Hz, 2000 Hz and 3000 Hz levels for each ear. The readings are then applied to a formula as recommended by the American Medical Association’s Guide to the Evaluation of Permanent Impairment.
When both ears have hearing loss, the loss in each ear is calculated separately and the total loss in each ear is then combined to calculate the binaural hearing loss.
When only one ear shows having loss, then the calculation is done only for that ear.
Conductive Hearing Loss – Usually caused by a one time event, such as a very loud explosion or head trauma. L&I classifies it as an injury.
Sensorineural Hearing Loss – Usually the result of long term exposure to noise. L&I classifies if as an occupational disease.
Presbycusis – The gradual reduction of hearing caused by aging.
Tinnitus – The perception of sound when there is nothing external to cause sound. Tinnitus is eligible for PPD settlement money for occupational hearing loss only if there is an otherwise compensable hearing loss. However if tinnitus results from an industrial injury, the L&I will accept a tinnitus rating with or without an otherwise compensable hearing loss.
Date of Manifestation
PPD-Permanent Partial Disability – A money settlement at L&I claim closure for significant loss of hearing, For a sensorineural hearing loss claim PPD is only paid if the claim is filed within two years of the date of manifestation
Medical Opinion – What the doctor(s) have to say about your hearing loss. A Medical opinion is required to file a claim, get hearing aids, or get a PPD settlement.
Audiogram – A hearing test looking for a worker’s ability to hear pure tones in each ear. Audiograms are valid or invalid. Simple tests, such as the ones done at work, are usually invalid. A valid audiogram is necessary to accurately diagnose most hearing problems and determine the amount of impairment.
Binaural Hearing – Having to do with the perception of sound in both ears
This webpage borrowed from the hard work and genius of trial lawyers who came before me and the L&I self insurance claims manual.