AudiologyOnline Phone: 800-753-2160


MED-EL - Bonebridge - August 2023

Percentage of Hearing Loss

Robert Dobie, MD

July 6, 2001

Share:

Question

What are the most popular methods used to calculate ''percentage of hearing loss?'' Please give examples

Answer

Usually, what is estimated in hearing loss compensation cases is called
''hearing handicap'' (HH) or ''binaural hearing impairment'' (BHI or BI) with
the basic concept being interference with activities of daily living, especially speech communication. Since the 1950's, most states and federal
agencies that award compensation calculate HH from the pure-tone audiogram. At first, this was considered a temporary or stopgap measure, assuming that speech tests, using words or sentences, would soon be developed to the point that they would predict self-reported HH better than pure-tone tests could. Fifty years later, we are still using the audiogram for this purpose, because speech testing has proved disappointing.

The 1959 AMA method used the pure-tone average of thresholds at 0.5, 1, and 2 kHz. If that average was less than 15 dB HL in both ears(25 dB after conversion to ISO/ANSI calibration), HH was zero. For every dB above 15 (now 25), HH increased by 1.5%, reaching a maximum at 82 (now 92)dB. If the two ears had unequal pure-tone averages, HH was calculated by a weighted average giving the better ear 5 times the weight of the worse ear. The AMA modified their method in 1979 to add 3 kHz. Most states use or permit the 1979 AMA method, a few use the 1959 method, and some have their own idiosyncratic formulas.

Here is an example of HH calculated by the 1979 AMA method:



Right (better ear) impairment = 1.5(30-25) = 7.5%
Left (worse ear) impairment = 1.5(40-25) = 22.5%

HH (or BI) =
5/6(7.5%) + 1/6(22.5%) = 10%

A more complete discussion of the history, validity, and use of these and
other methods can be found in Chapter 5 (Impairment and Handicap) of Medical Legal Evaluation of Hearing Loss, 2nd edition, 2001, Singular Thomson Learning.

BIO:
Robert A. Dobie, M.D., is Director, Division of Extramural research,
National Institute on Deafness and Other Communication Disorders, in
Bethesda Maryland. He completed medical school and residency in otolaryngology at Stanford University, as well as fellowships in neuro-otology (University of Zurich) and auditory neurophysiology (LSU Medical School). A former president of the Association for Research in Otolaryngology, he has published over 100 papers; the second edition of his book, Medical-Legal Evaluation of Hearing Loss, has recently (March 2001)been published by Singular/Delmar Thomson Learning.


robert dobie

Robert Dobie, MD

clinical professor of otolaryngology at both the University of Texas (San Antonio) and the University of California (Davis)

Robert Dobie is clinical professor of otolaryngology at both the University of Texas (San Antonio) and the University of California (Davis). His research interests in recent years have included noise-induced and age-related hearing loss, as well as tinnitus. He is the author of Medical-Legal Evaluation of Hearing Loss (Singular – Thomson Learning, second edition, 2001) as well as over 150 other publications.


Related Courses

Empowerment and Behavioral Insights in Client Decision Making, presented in partnership with NAL
Presented by Simon Alperstein, MSc BE, Paola Incerti, MAudiology, AAudA
Recorded Webinar
AudiologyOnline

Presenters

Simon Alperstein, MSc BEPaola Incerti, MAudiology, AAudA
Course: #37124Level: Intermediate1 Hour
  'The information was relevant, and I was able to relate to example given and found the suggestions to address these could be implemented in clinic'   Read Reviews
Behavioral Insights can be used to understand and support hearing health decision-making, particularly in the appointment setting. An overview of empowering the individual's first awareness of hearing loss to hearing aid fitting and then to becoming an active hearing aid user will be covered.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Cognition and Audition: Supporting Evidence, Screening Options, and Clinical Research
Presented by Regina Presley, AuD, FAAA, CCC-A
Recorded Webinar
Cognivue

Presenter

Regina Presley, AuD, FAAA, CCC-A
Course: #37381Level: Introductory1 Hour
  'Well presented and very informative, particularly given that we are in the early stages of implementing Cognivue into our practice'   Read Reviews
The evidence supporting the connection between cognitive health and hearing performance continues to expand, further supporting the need for a cognitive screening tool as part of an audiology clinical practice. This course will provide guidance on cognitive screening options, the benefits and challenges of each, evidence to support the use of each tool, and current clinical research that is underway exploring new technologies, implementation, and clinical outcomes.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Innovative Audiologic Care Delivery
Presented by Rachel Magann Faivre, AuD, Lori Zitelli, AuD, Heather Malyuk, AuD, Ben Thompson, AuD
Recorded Webinar
AudiologyOnline

Presenters

Rachel Magann Faivre, AuDLori Zitelli, AuDHeather Malyuk, AuDBen Thompson, AuD
Course: #38661Level: Intermediate4 Hours
  'Clear information, a bit lengthy'   Read Reviews
This four-course series highlights the next generation of audiology innovators and their pioneering approaches to meeting unmet audiologic needs in their communities and beyond. This peer-to-peer educational series highlights researchers, clinicians, and business owners and their pioneering ideas, care delivery models, and technologies which provide desperately needed niche services and audiologic care.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

AURICAL HIT Applications Part 1 - Applications for Hearing Instrument Fittings and Beyond
Presented by Wendy Switalski, AuD, Jack Scott, PhD
Recorded Webinar
Natus

Presenters

Wendy Switalski, AuDJack Scott, PhD
Course: #28678Level: Intermediate1 Hour
  'Very clear presentation and instruction to those who have been reluctant to use the HIT Box'   Read Reviews
Hearing instrument test boxes can provide clinicians with invaluable information about hearing instrument function, from evaluating technical status using electroacoustic analysis to assessing gain and output and advanced feature performance. This course will highlight the process for each of these using the Otometrics Aurical HIT. Additionally, clinical applications for these techniques will be overviewed.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Rethinking Your Diagnostic Audiology Battery: Using Value Added Tests
Presented by James W. Hall III, PhD
Recorded Webinar
AudiologyOnline

Presenter

James W. Hall III, PhD
Course: #29447Level: Introductory1 Hour
  'Concisely delivered and very relevant'   Read Reviews
This practical session offers guidance for creating an individualized diagnostic test battery for each patient to enhance efficient and accurate assessment of auditory function. The presentation stresses the importance of selecting test procedures that add value to the diagnosis and management of hearing loss and related disorders.

Please note: You may earn ABA Tier 1 credits for this course if you complete it as part of the course 29608, "Audiological Test Battery Series." Course 29608 contains recordings of all three events from our 2017 series on Audiological Test Batteries. ABA Tier 1 CEUs can be earned only when all modules are completed as part of course 29608.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.