ceive spoken communication auditorily without a hearing aid. Many people with 71-90 dB hearing loss have not been successful hearing aid or cochlear implant users and function primarily in the deaf world. Such claimants may be at a significant disadvantage in the workplace.
In the following sections we present our recommendations for the testing of hearing and the determination of disability based on hearing loss. These changes will improve the validity and reliability of tests for disability determination and will provide additional information on residual function for use in Steps 4 and 5 of the determination process. The text of all recommendations and the rationale supporting them is found in the body of the report and the complete range of recommendations is referenced here.
The committee recommends that the standard otolaryngological examination follow the audiological examination (but by no more than 6 months), because a physician cannot provide a competent report without recent audiometric data (see Action Recommendation 4-1).
The otological examination should be performed by an otolaryngologist who has completed at least five years of residency training following receipt of the M.D. or D.O. (doctor of osteopathy) degree and who is certified by the American Board of Otolaryngology (see Action Recommendation 4-1).
The audiological tests for determining a disability based on hearing impairment should be conducted by a clinical audiologist who holds state licensure (if applicable) or, if no state licensure is available, is certified by the American Speech-Language-Hearing Association (Certificate of Clinical Competence in Audiology, or CCC-A) or by the American Board of Audiology (see Action Recommendation 4-3).
Equipment should meet American National Standards Institute (ANSI) standards or other established standards when no ANSI standards are available. The environment for assessment of auditory threshold should conform to current ANSI standards (see Action Recommendation 4-4).
Audiometric testing should not be performed within 72 hours of significant noise exposure or if there is recent exposure to ototoxic drugs or, in cases of fluctuating hearing loss, on a day when hearing is noticeably poorer (see Action Recommendation 4-5).