might require pausing, for example, the presence of cognitive
impairment. It is up to the examiner to determine when to use
pausing and the length of the pauses.
Need for a modified performance-intensity function: The normal
speech recognition performance is 94% or better for a full (50 word)
list. If speech recognition is worse than 94% after presentation of a
full list, then a modified performance-intensity function must be
obtained to determine best performance (see Narrative for
description of procedures).
When describing speech recognition performance, use these terms:
Percent Correct Description
100-94% Excellent (Normal)
92-80% Good
78-70% Fair
Less than 70% Poor
D. Diagnostic and Clinical Tests:
1. Report middle ear status, confirm type of loss, and indicate
need for medical follow-up. In cases where there is poor
inter-test reliability and/or positive Stenger test results,
obtain and report estimates of hearing thresholds using a
combination of behavioral testing, Stenger interference
levels, and electrophysiological tests.
2. Include results of all diagnostic and clinical tests conducted
in the examination report.
E. Diagnosis:
1. Summary of audiologic test results. Indicate type and degree of
hearing loss for the frequency range from 500 to 4000 Hz. For type of
loss, indicate whether it is normal, conductive, sensorineural, central,
or mixed. For degree, indicate whether it is mild (26-40 HL), moderate
(41-54 HL), moderately severe (55-69HL), severe (70-89 HL), or
profound (90+HL).
[For VA purposes, impaired hearing is considered to be a disability
when the auditory threshold in any of the frequencies 500, 1000, 2000,
3000, and 4000 Hz is 40 dB HL or greater; or when the auditory
thresholds for at least three of these frequencies are 26 dB HL or
greater; or when speech recognition scores are less than 94%.]
2. Note whether, based on audiologic results, medical follow-up is
needed for an ear or hearing problem, and whether there is a problem
that, if treated, might cause a change in hearing threshold levels.