Hearing Loss and Tinnitus
Answering these questions helps the VA understand how your hearing loss or tinnitus began, how it affects your daily life, and how it connects to your military service. The VA won’t award compensation just because you say you have hearing issues—they need clear, detailed information to verify when it started, what caused it, and how severe it is now. Your answers can make the difference between a denied claim and a service-connected rating that results in monthly compensation and access to care. Be specific and honest—your input is crucial to getting the benefits you've earned.
Name
First Name
Middle Name
Last Name
Email
example@example.com
Who are you working with at OSDRI?
Please Select
Amie Monti, Esq.
Ashley Julien
Liam Boyle
Tara Adams
Tyrelle Greene
I’m Not Sure
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How long were you in the active duty military?
This includes when you served on active duty, active duty for training, and/or inactive duty training
What was your Military Occupational Specialty (MOS) or job role while you were in service? Please list ALL, including any changes in duties or assignments.
What types of loud noises were you exposed to in service? Select ALL that apply
🔫 Rifle or pistol fire – Shooting from small guns during training or in combat
💥 Machine guns – Firing from bigger automatic guns (like on Humvees or at the range)
🎯 Mortars or rockets – Firing or being near launched explosives
🧨 Hand grenades or small explosions – Throwing grenades or being near other small blasts
💣 Big artillery (like cannons or Howitzers) – Hearing or firing large explosive weapons
🚗 IEDs or roadside bombs – Being near surprise explosions while driving or walking
🧱 Demolitions or blowing things up on purpose – Like training to break through walls or destroy things
✈️ Helicopters or jet engines – Working around or flying in loud aircraft
🛫 Flightline or runway noise – Working near where planes take off and land
🔊 Vehicle weapons – Big guns mounted on trucks, tanks, or ships
🛡 Tanks or armored vehicles – Riding in or being near loud, heavy military vehicles
🚢 Ships or boats – Loud engines or equipment on Navy ships
⚙️ Heavy machines – Like forklifts, bulldozers, or construction equipment
🔌 Generators or loud power equipment – Machines used to make electricity or power stuff
🎧 Radios or headsets – Wearing loud communication gear all the time
🪖 Combat training ranges – Practicing with weapons in noisy training areas
🏘 Fighting in buildings or close combat – Gunfire or noise from fighting in tight spaces
None of the Above
Other
Please describe specific examples of how you were exposed to loud noises in service (what, where, how often, etc.):
Example: “While deployed to Afghanistan in 2009, I regularly fired a .50 cal machine gun without ear protection.”
When you were around loud noises in the military, how long were you usually around the noise on those days?
Please Select
Just a few minutes
About 30 minutes
1 to 2 hours
3 to 4 hours
Most of the day (5+ hours)
It was off and on all day
I don’t remember
Did you ever report your hearing problems while in service?
Please Select
Yes
No
When did you report hearing loss in service? Provide detailed information.
When did you start experiencing symptoms of hearing loss and/or tinnitus?
Please Select
While in service
Within 1 year of discharge
2+ years after discharge
5+ years after discharge
10+ years after discharge
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Current Symptoms
How have your symptoms gotten worse over time?
Have you been diagnosed with hearing loss by a doctor or audiologist?
Please Select
Yes
No
Provide the NAME AND ADDRESS of the doctor or facility where you were diagnosed with hearing loss.
WHEN were you diagnosed with hearing loss?
Best estimate (year)
Are you currently using hearing aids or receiving treatment for hearing issues?
Please Select
Yes
No
Do you experience ringing or buzzing in your ears?
Please Select
Yes
No
How frequently do you experience ringing or buzzing in your ears?
Please Select
Never
Some Days
Most Days
Constantly
How do your symptoms interfere with your day-to-day life and your ability to work?
Please provide multiple specific examples: ie. workdays missed due to condition, lower productivity, strained family relationships, trouble traveling etc.
Is there anything else you would like to include in your statement?
Upload any additional documents to include with your statement.
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