I am trying to get together a Hearing Loss claim for my husband. He is a Navy Veteran and I’ve run in to a problem concerning his audiological exams from 1968 and 1973. I belong to another group and posted my problems there and one of the members was kind enough to send me to your group. But first, I would like to thank everyone in advance for your kind help. Ok, so here is the issue: I am posting pics of the Navy Audiograms of my hubby from his entrance in 1968 to his separation in 1973- the Rudmose Audiogram. I just need someone to explain to me the procedure the Navy used to read these. From where- within each frequency range- (highest peak? lowest peak? junction of vertical & horizontal axis??? ) are they taking the reading because when I try to compare the audiograms to the chart results, some of the information just doesn’t match at all–but then again, I’m only guessing because here I am asking for help. From several appeals, the judges have mentioned that the " Rudmose audiometric findings are somewhat inconsistent with the audiometric results reported" and this is just what I believe concerning my husband’s case. So, if anybody has any knowledge of these diagrams, or you’re an audiologist, or know of one, I would appreciate any help anyone can give me. I’ve Googled with no definite results on procedure, and exhausted the colleges and universities locally here.
That looks like my audiogram when I got out of the Navy in 1977, I was told it was due to jet engines. I was at Naval Air Station Kingsville, Texas. Also, I did a lot of traveling around the world on jet cargo planes.
Thank you for your service, sir. I can imagine what your audiograms must have looked like! My husband was in the Navy and an Engineman so I know hearing loss can be devastating.
It looks to me like it’s a frequency sweep, where the point at the right of each section would be at the frequency in the bottom box. So the first line starts at some unknown hz, maybe 250 hz, and then ends at 500 hz, and so on. That’s my read as an enginerd . But I am just making a guess.
What exactly is the issue that you’re experiencing? Plenty of vets on the forum that may know more (and to be clear, I am not one, but my wife and I are both career Navy civilians).
Thank you for responding. Yes, it is a constant sweep recording and the frequencies range from 500 to 6K. And the Db range from 0 to 80. The issue: the horizontal lines form a frame for the Db’s: 10 Db, 20 Db, etc. and the vertical lines form a frame for each frequency 500, 1K, 2K etc. And within each frame of frequency there are (for want of a descriptive word) peaks and valleys both above and below each decibel. So, for instance, on the 1968 audiogram, LEFT ear,4K frequency, the range I from apx 15 down to apx 45 and they transcribed that into the chart as 35 So my big dilemma is at which particular peak or valley within that range did they choose to record? On both audiograms, none of the recording see to match up with the transcribed numbers on each chart. I really need someone to look at the audiograms( I have larger 100% original size audiograms) and tell me how they got those numbers or if the Navy did not transcribe the correct readings. Ugh, this is so confusing to me! Thanks for your help!
Disclaimer: I have zero formal training in audiology, know nothing about military disability processing. I have never met a Rudmose audiogram-- But I do know the name, from sound reinforcement studies. (Wayne worked a wide field.)
Rudmose made many audiometers, but this looks like one of his recording audiometers, 1950s-1960s.
A beep is presented to S (subject). If S hits the button, level is reduced; if S does not press, level is raised and beep repeated. After a few trials the levels tend to be “around” S’s true threshold. After 10-12 tests at one frequency, it moves to the next frequency; after one ear, the other ear. All levels are plotted on a card.
So the “true” HL is the average of the later (more right, more-even) jags.
“Normal” is to 15HL, “Mild” to 25HL. These definitions are arbitrary and have changed with circumstance. I doubt the Navy would be concerned about 25HL.
The 1968 gram shows an almost-moderate 35HL at 4000Hz left. This is not atypical in men, even young (I was losing some by age 15).
Your interest is how much was lost from 1968 to 1973. I fiddled with the graphics to get the two on the same pane.
Yes, it says 10dB more HL at 500Hz. However 20HL is such a low level, and 500Hz a low frequency, that this may be contaminated by background rumble (nobody could hear under 20HL in that test room). Left shows a 10dB change at 6000Hz except it is inconsistent from the first few tones to the last half of this sequence. Right ear shows IMprovement at 4000Hz; or a thumb twitching from 9 minutes of stupid ear-tones; or tinnitus in this area.
What you expect to see after 5 years of big noise is maybe like this:
But that is not what you have.
In my NON-Expert opinion: the audiograms show little or no hearing loss '68-'73.
I believe that in recent years more experts understand that hearing loss is not right away. That short term damage “that gets better” actually sets the stage for earlier onset of hearing loss in later life. Of course this is impossible to prove in humans, and is not popular with benefits policy-makers.
The methodology @PRR followed is the same that I would suggest.
First, let me thank you for taking the time to respond. When I started reading all that you left for me, I felt like it was Christmas and I was opening one wonderful gift after another! You will never know how much I appreciate this information. You were the answer to my prayers. I just knew that there had to be somebody somewhere that knew the answers and could help me. I will go through all the info more thoroughly tomorrow, but I just couldn’t sign off tonight without letting you know how much you are appreciated. Thankyou again,
P.S. Spring Forward tomorrow-Time to set our clocks up one hour!
At 15, there was no response, so level was dropped. 20, 30, past 40 before S heard a tone. Now tone goes softer, no response at 30. It wanders between 32 and 42. Calling it “35”, the nearest 5dB mark, seems quite valid. (We would want many repetitions with breaks and headset re-sets before calling it “37”.)
Thank you for your help. This group is wonderful and so willing to help. I appreciate you all. Thanks again!
Office of Naval Research, Department of the Navy, 1961, page 723 et seq
You can download as a PDF file. 26 MB. 800+ pages of which only 17 pages are about “hearing”. 1961 is just before the period you are interested in. No longer whisper/coin/watch hearing-test, they developed a “sailor proof” tape player. And defined 15dB<2kc 30dB>2kc as “normal”. The zig-zag in your 1968 test suggests they had got as far as stable controllable oscillators.
Note a MAJOR interest in speed and economy.
Here is what that test-card “should” look like. Before multiple microfilm and fax transfers.
It was on an IBM/Hollerith punch-card. Tone level is varied from “heard” to “not-heard”, and the “true HL” is about the center of the zig-zags. When there is a large change from one frequency to the next, there is an initial “slide” until “heard” is found again. There is a glitch when tone switches from left to right, where Subject says “Whaaa?” This subject stayed sharp all the way to the end (6+ minutes of beep-beep).
The paper I got this from has a description of the process: (You get invited to join the site, but it isn’t necessary.)
"…Rudmose. Their machine has a program sequence in which the tone at each of six frequencies is maintained for approximately 30 seconds, the two ears being tested separately in the usual way.
"With this type of audiometer the subject has to press a control button as soon as he or she hears a tone and to release it when it is no longer audible. Each frequency is started at -10 dB and the amplitude steadily increased at the rate of about 2 dB per second. As soon as the tone is heard and the button pressed the mechanism is reversed so that the amplitude decreases at the same rate.
"This decrease will continue as long as the button is being pressed which will be until the subject can no longer hear the pure tone. As soon as the button is released the sound level will increase. Normally the resulting trace is recorded on a card about six to eight times for each frequency before the machine automatically tums to the next frequency.
“For each frequency a line can be drawn indicating the average of the maximum and minimum values of the trace. Half way through the program, the presented tones are switched to the other earphone. Most types of automatic recording audiometers use pulsed tones in order to help the subject to distinguish from background sounds such as tinnitus; in others the tone is continuous.”
First of all you do not need the results from when he went into service and when he got out. Just go to your local doctors office and have him draft a letter stating that you husbands hearing was more than likely caused by loud noise when he was in the service. Then go to a VA facility that tests for hearing and get tested. Get the results. Once you get the results file a claim. It will more than likely be denied since they deny all claims the first time. Then go to a veterans organization such as Vietnam veterans of America. Have them file an appeal. Wait about 2 years and usually the appeal comes back granted and you get what is due to you. I had 3 va audiologists state it was military related and my claim was denied. I went to Vietnam veterans of America and they sent in an appeal stating how can you deny the claim when 3 of your doctors are stating it is military related. It came back 2 years later stating it was irronously denied and I was granted service connected disability. The key here is not to give up. keep appealing
Or do your research as you are doing, which is the correct way and have a better chance of getting the claim approved on the first pass. The VA most definitely compares current hearing results to the last audiogram before leaving active duty. Glad you took my advice and found this forum. Good luck
DBLDPR, The more involved the govt. is with health care, the better the health care is.
MY discharge audiogram was a doctor asking if I can hear him. I said yes and he said next. Never was put into a booth upon discharge. Did have one upon entry. Was good enough to get into sonar school if I wanted it. Better than normal hearing.
Without getting into audiograms and other technical details involving hearing tests
If you have access to his entry/exit physical exams, you should find a PULHES (military physical profile) PULHES stands for Physical capacity/stamina, Upper extremities, Lower extremities, Hearing/ear, Eyes, Psychiatric (military physical profile) which looks something like this:
You will be interested in the H rating of 1 to 4 with 1 being the best (acceptable) and a 2, 3 or 4 would be unacceptable. Compare that with the Exit physical PULHES which should show something other that 1 for H (hearing) like this:
Anything other than a 111111 on an exit physical is usually a slam dunk for establishing service connection for VA benefits. The details of his hearing when he entered service are superfluous (presumed acceptable unless a waiver was noted at time of entry). Once service connection is established, the only important hearing test is what his hearing is at the present time.
I’d agree with that. There doesn’t appear to be further degradation during the period of service.
There does appear to be some pre-existing noise damage though.
Thank you for your kind help. The first claim was filed in 2005. SC for Left ear and bilateral tinnitus. The claim was reopened in Sept 2019 for SC for Rt ear and Va is asking for more information so trying to get our ducks in a row before we send in other files. Have already had a private Audiology Test and one from VA( which, of course, we cannot get the results at this point). Trying to get it as right as we can. Thanks again!
VA testing is released within 30 days of testing by running a Blue Button report on VA.gov provided it was done by the VA and not a private contractor.