Approximately 46 million Americans experience some form of communication disorder. Communication disorders can compromise physical and emotional health and affect the social, educational, vocational and recreational aspects of life. Hearing loss, loss of speech and other communication disorders can lead to feelings of isolation and a lack of connection with family, friends and community.
Veterans have higher rates of hearing loss and tinnitus than the general public due to the occupational injury that can be incurred as a result of the noise levels encountered while in the service, including gunfire, aircraft, machinery and much more. Tinnitus and hearing loss are the top two service-connected disabilities among Veterans enrolled in VA for care. In 2016, more than 190,000 Veterans were awarded service-connection for tinnitus and more than 103,000 Veterans were awarded service-connection for hearing loss. In total, more than 2.7 million Veterans currently receive disability benefits for hearing loss and/or tinnitus.
Although noise-induced hearing loss can be permanent, rehabilitative technology such as hearing aids can significantly improve users’ quality of life. Yet, only about one in four of those who could benefit from hearing aids have ever used them. This is why VA provides comprehensive hearing health care services to Veterans as part of their medical benefits and Veterans have direct access to audiology clinics for evaluation and treatment of hearing loss.
VA’s delivery of hearing health services includes:
- Access to a full continuum of hearing health care from prevention to diagnostics to treatment, continued follow up and maintenance
- Screening, assessment, evaluation, treatment, and/or management of hearing loss, tinnitus and balance disorders
- Fitting and programming of hearing aids, wireless accessories, and other assistive listening devices (e.g., TV and telephone amplifiers) and post-surgical rehabilitation for cochlear and other osseointegrated auditory implants
- Hearing screening and prevention services; auditory rehabilitation services to optimize residual hearing
- Progressive Tinnitus Management which includes education, sound therapy (including hearing aids) and interdisciplinary counseling
- Vestibular Diagnostics and Rehabilitation
- Audiology Compensation and Pension Exams
- Utilizing an evidence base for delivery of best practices and services, supported by expertise at VA regional and national centers of excellence (e.g., Cochlear Implant centers, Research Centers)
- Utilizing multiple contracts to provide high quality technology for digital hearing aids, wireless communication systems, assistive/alerting devices, cochlear implants to provide devices needed to meet communication needs of the Veteran (i.e., six hearing aid companies currently on national contract)
- Widespread utilization of audiology telehealth for remote diagnostics, hearing aid fittings and maintenance, and both tinnitus and auditory rehabilitation education
- Partnering with community providers to contract and offer hearing health care in a timely manner closer to home. VA also collects clinical outcomes for patients using hearing aids reported across multiple categories (e.g., Hearing Aid Use, Perceived Benefit, Satisfaction, Impact on Others, Activity Limitation, and Quality of Life). Across all categories, reported clinical outcomes are consistently high for Veterans receiving hearing health services within VA, and exceed those reported for general norms.
Dr. Rachel McArdle is VA’s national program director for Audiology & Speech.