Vac claim. Questions

[blackberet17]

Hearing loss and tinnitus are two different and distinct conditions.

Tinnitus is the ringing in your ears (or other like symptoms). A masking device is to assist in "hiding" the tinnitus, so it has less of an effect on your activities of daily living.

Tinnitus may be present with or without what's called pensionable hearing loss.

Example: you experience ringing in your ears due to exposure to gunfire/artillery/jet engines etc., while you weren't wearing hearing protection. The ringing never goes away, etc.

However, the noise exposure was not enough to decrease your ability to hear to such a point you meet the VAC Entitlement Eligibility Guidelines for hearing loss.

So, a masking device helps with hiding the tinnitus. A hearing aid helps with hearing loss. Two different things. You may have hearing loss, but not sufficient to warrant a prescription for a hearing aid; you may have tinnitus, and have been prescribed a masking device.

Occam, exact advice. It's in thunderbolt's best interest to request a Departmental Review. Don't burn your Review and Appeal levels with VRAB until you have exhausted the Department's levels of review/appeal.

 

[Occam]

blackberet17 - I think thunderbolt's situation is exactly the same as mine unfolded.  The audiologist prescribed a hearing aid (to act as a masker) for me to deal with my tinnitus.  My hearing loss alone wasn't sufficient to justify a hearing aid.  That confused the bejeesus out of VAC, and they initially turned it down.  At the departmental review, once they were presented with expert advice (which oddly enough, they pulled from VAC case law) that shows hearing aids can act as maskers, VAC sorted themselves out and approved it.  The frustrating part, according to the BPA lawyer I had, was that VAC does this type of thing all the time - it's almost as if they can't be bothered to check the case law on a particular subject before rendering a decision, forcing the veteran to enter a cycle of departmental reviews to sort out what should be simple fact-finding exercises.

 

[blackberet17]

blackberet17 - I think thunderbolt's situation is exactly the same as mine unfolded.  The audiologist prescribed a hearing aid (to act as a masker) for me to deal with my tinnitus.  My hearing loss alone wasn't sufficient to justify a hearing aid.  That confused the bejeesus out of VAC, and they initially turned it down.  At the departmental review, once they were presented with expert advice (which oddly enough, they pulled from VAC case law) that shows hearing aids can act as maskers, VAC sorted themselves out and approved it.  The frustrating part, according to the BPA lawyer I had, was that VAC does this type of thing all the time - it's almost as if they can't be bothered to check the case law on a particular subject before rendering a decision, forcing the veteran to enter a cycle of departmental reviews to sort out what should be simple fact-finding exercises.

Part of the issue is tinnitus is a subjective medical condition. While there is a way of identifying it "exists", it's only in the patient's response to the frequencies being sent to his/her ear, what is called tinnitus matching. It's not like lumbar disc disease or an ACL tear or hearing loss, which can be diagnosed via objective testing means.

For years, tinnitus and hearing loss were medical conditions which were grouped together, both for entitlement and assessment. It wasn't until the Nelson Federal Court case the two were finally separated.

The fact your audiologist prescribed a hearing aid, as opposed to a tinnitus masking device, to act as said masking device, didn't help it's almost like prescribing a cane for whiplash, when you need a cervical collar. Getting a medical opinion to support the prescription goes a long way - and there's plenty of previous decisions at multiple levels at VAC/VRAB to show it. But having one to your specific case, even if "just" from your audiologist, should be sufficient - the audiologist is the expert in this case.

 

[Occam]

It's been a couple of years since seeing an ENT on the subject, so I'm not sure if this information is current or not.  The last ENT I saw was younger, one who clearly kept up to date on the latest info in the field of medicine.  It was his opinion (which was apparently shared by most in the profession at the time) that maskers are actually of little benefit.  The notion of introducing one noise to mask another seems bizarre, and apparently there was recent research to support that.  The recommended treatment at the time was to use a hearing aid to act as a masker, raising the level of speech, music, etc. above the perceived level of the tinnitus.  I tried the CD with the pink noise on it, and it worked for a short time, but stopped.  That was what pushed him to recommend the hearing aid, and it worked well and is still working 6 years later.  The ENT I was seeing before my most recent one was considered a dinosaur and was pretty gung ho on the masker ideas...but I'm not sure he kept up with recent research.  YMMV. 

 

[thunderbolt]

Excellent information! Thanks to both of you for the help. If my letter doesn't reach Dartmouth today, I'll call and get them to look at getting a review of my case going.

 

[thunderbolt]

As it turns out, a review wasn't necessary. I had my specialist reword and resubmit my prescription as a masking device, not hearing aid. Within a few days I was approved for my prescription and received a call from VAC asking why I wanted a review for something that was being approved...

 

[Occam]

Shaking my head here (at VAC)...but I'm glad it worked out favourably for you!

 

[blackberet17]

Shaking my head here (at VAC)...but I'm glad it worked out favourably for you!

Don't get me started...

 

[iltis1994]

what is the average wait time for an adjudicative review after a departmental reviewÉit only took 3 weeks from the time the bpa got my info etc until it was submitted to the vac for an adjudicative review...anyone....

 

[blackberet17]

what is the average wait time for an adjudicative review after a departmental reviewÉit only took 3 weeks from the time the bpa got my info etc until it was submitted to the vac for an adjudicative review...anyone....

Do you mean a review to the Veterans Review and Appeal Board?

 

[iltis1994]

i had a departmental review done.in it i sent my masker prescriptions for my tinnitus and my argument that my original statement was that i suffer tinnitus 24/7 yet my adjusicator never questioned that my audiologist made it sound like it came and went.the audiologist prescribed the aids etc and the BPA sent all the info to the VAC for the DPR...i was denied december 7th.from what i read of the denial letter it sounds as though the adjudicator didn't even receive the info from the BPA regarding the receipts for the hearing aid maskers etc...anyone else ever run into this?totally absurd and i sent a letter off to kent hehr explaing all of it...here is hoping... :subbies:

 

[thunderbolt]

The wording in the denial letter is key. In regards to my case they initially denied my claim because my "hearing loss" wasn't enough to substantiate needing the masking hearing aids. Once they reviewed it for tinnitus, it was approved right away...

one or two key words can make a significant impact on the outcome.

 

[AirDet]

So has anyone actually had their answer within the targeted 16 weeks from receipt of med docs? Anyone know if they are behind or on time these days?

I'm asking because I submitted in July and after an email from me they moved my file to stage 3 the beginning of October. By my calculations they have until the first week of Feb.

I'm not complaining just curious what timelines others are observing.

 

[loadiecc150]

I've had two claims in stage 3 since September. I sent an email a while ago and finally received a response today saying they were upgrading my claim to whomever they are going to send it to, to be denied.

 

[AirDet]

So much for the 16 week thing.

Mine were filled out by a VAC rep for me in July. I checked my service records and see they sent my med records in August. In October I asked VAC what was going on and all of the sudden my file jumped to Step3. The time they reported receiving everything was mid October (not really the truth).

It's now been 7 months. 2 secure emails sent 22 and 26 Jan have gone unanswered.

Is this the norm?

I'm still serving so sending a letter to an MP is out of the question. Any advice?

 

[BinRat55]

So much for the 16 week thing.

Mine were filled out by a VAC rep for me in July. I checked my service records and see they sent my med records in August. In October I asked VAC what was going on and all of the sudden my file jumped to Step3. The time they reported receiving everything was mid October (not really the truth).

It's now been 7 months. 2 secure emails sent 22 and 26 Jan have gone unanswered.

Is this the norm?

I'm still serving so sending a letter to an MP is out of the question. Any advice?

VAC Ombudsman. Access their website, you can call or send them an email. Also there is an online form you can also fill out.

 

[AirDet]

After the last couple of posts I've had people PM me and share their horror stories of the current treatment they've received at the hands of VAC. This has me wondering how many others are at their wits end trying to deal with VAC.

My personal journey with them has only been 7 months and counting. Compared to others that's nothing.

I don't believe in bringing a complaint to my CofC without a recommendation to improve the situation. In this case I was thinking VAC could ease a lot of people's concerns if they were to simply publish a "now working on date" on their website. For instance, if you see that your disability application moved to "step3" on 1 Dec 2015 and they are working on step 3s from Nov 6; you have rough idea where you stand... a SITREP if you will.

In many cases, it would surely help relieve the anxiety.

 

[Steve_D]

BinRat55 is correct. Contact the VAC Ombudsman. The number is on their website. I also have a member who was released back in August 2015 and has heard nothing. I advised that he contact the Ombudsman and he informed me that he got some answers.

 

[AirDet]

Thanks BinRat and Phoenix.

I did just that at 10 AM this morning and I had a secure message from the adjudicator within the hour. The letter will be sent out and I should have it early next week.

They kept apologizing for it taking so long.

I'm left with the impression that they really want to do good by us but they are still severely understaffed.

For anyone who is still waiting I recommend you follow BinRat's advice. It sure worked for me.

 

[BinRat55]

Thanks BinRat and Phoenix.

I'm left with the impression that they really want to do good by us but they are still severely understaffed.

I get that impression as well. Anyone I have ever spoke to on the phone at VAC has been nothing but courteous and in some cases genuinely apologetic!