VA Hearing Loss and Tinnitus Claims: Navigating the Noise of Service

9-06-2025

By Dr. Howard Friedman MD | Veteran | U.S. Army Medical Corps | Internal Medicine | HHOM LLC

The battlefield may fade, but the echoes remain—noise reshapes the brain long after service ends

Range-day thunder, rotor blade.

Jet wash turning noon to shade.

Foam plugs in—the thin, cheap pair—

Still the shock cut through the air.

Years went quiet; duty done.

Then the ringing—never gone.

No scar to show, no cast to wear—

But sound rewired the pathways there.

—Dr. Howard Friedman, M.D.

Introduction – The Soundscape of Service

No one who has served forgets the soundscape: the sharp crack of gunfire on the range, the relentless chop of helicopter rotors, the metallic slam of vehicles, and for Air Force veterans, the deafening roar of jets overhead. I remember standing outside the hospital at Fort Dix, just beside McGuire Air Force Base, when reserve pilots flew F-4 Phantoms on weekends. The roar shook the ground and your chest alike. On the firing range, the Army handed out earplugs—the kind you’d buy before boarding an airplane. They dulled the noise but never erased it. For many, those thin defenses were never enough. Countless veterans left service with ‘normal’ hearing tests, only to discover years later the ringing, the muffled echoes, the creeping silence. These changes are not imagined. They are the delayed scars of service—the trauma written into the delicate structures of the inner ear. For many, this becomes the uphill battle of VA hearing loss and tinnitus claims

The Science – Trauma in the Inner Ear

Sound is vibration, and inside the cochlea those vibrations meet rows of microscopic hair cells. Each one is tuned to a frequency, bending with the wave and sending an electrical signal to the brain. They are finite, and they do not regenerate. Once damaged by noise, they die permanently, leaving silent gaps the brain can no longer fill.

For many veterans, the first sign of this injury is tinnitus—a phantom ringing or buzzing created when damaged hair cells misfire instead of transmitting normally. Over time, delayed hearing loss emerges. This is well documented: service members may separate with “normal” hearing tests, only to develop measurable deficits years later as the accumulated damage declares itself. The cause isn’t just one blast or one flight line. It is the cumulative effect—the endless sum of exposures from engines, rotors, gunfire, and machinery—that slowly drives the auditory system past its threshold.

The damage may not be immediate, but it is permanent. Noise leaves its mark not in bruises or scars, but in the silence that follows.

Clinical Note – The Veteran’s Struggle

Veterans often tell the same story: “I can’t hear my family at the dinner table.” “The ringing keeps me awake at night. “In crowds, I can’t follow a conversation.” These are not small inconveniences. They erode relationships, strain sleep, and chip away at mental health.

Too often, the VA denies claims because a separation exam appeared ‘normal’ or because in-service documentation of tinnitus is absent. But tinnitus has no objective test. It is a clinical diagnosis based on history, and it is the core of countless VA hearing loss and tinnitus claims. But tinnitus has no objective test. It is a clinical diagnosis based on history. When a veteran reports ringing or buzzing that began with service, that report is the evidence. The science of delayed onset and cumulative noise injury has been established for decades, yet denials persist.

As a physician, I have seen the deep frustration when invisible wounds are discounted. Unlike scars or fractures, hearing loss is measured in decibels and waveforms—cold numbers that fail to capture the lived experience of isolation, exhaustion, and despair. Behind every chart lies a story the metrics alone cannot tell.

Resilience – Finding a Voice Through Recognition

Recognition matters. When the VA grants service connection, it validates that tinnitus or hearing loss is not “just aging,” but part of the price of service. This acknowledgment carries weight beyond compensation—it restores dignity.

With recognition comes access: hearing aids, assistive technologies, therapies, and the support that helps restore daily function. Veterans adapt—through lip reading, careful positioning, or technology—but the deeper resilience lies in the act of speaking up. Filing the claim, telling the story, and insisting that noise exposure is written into the record is itself an act of strength.

Resilience here is not about pretending the ringing is less intrusive or the silence less isolating. It is about refusing to be dismissed, demanding acknowledgment, and carrying forward with the validation that what was endured in service is real and recognized.

Sidebar: Tinnitus Beyond the Ringing

Tinnitus is more than a sound in the ear. The constant ringing, buzzing, or hissing often seeps into every corner of life. For many veterans, it disrupts sleep, making nights restless and unrefreshing. The strain of living with a noise that never stops can also trigger headaches or intensify migraines. Over time, the unrelenting presence of tinnitus wears on mood, feeding anxiety, depression, and social withdrawal. Even concentration can suffer, as the brain expends energy trying to filter conversations through the internal noise. In this way, tinnitus is not only an ear condition—it becomes a whole-body burden, reshaping daily life and mental health alike.

Conclusion – The Sound That Stays

Noise leaves no scar to trace with a finger, no wound to dress, no cast to remove. Yet its legacy is etched in silence, ringing, and words lost in conversation. Veterans who stood beneath jets, beside artillery, or on endless ranges carry that legacy long after service.

Recognition is more than paperwork. It is the difference between dismissal and dignity, between suffering alone and being supported. When the VA acknowledges tinnitus and hearing loss as service-connected, it restores not only access to care but the truth that these injuries are real.

The soundscape of service may fade, but for many, the echoes remain. Our duty is to listen now—to the voices of veterans asking not for sympathy, but for recognition of the price already paid.

The guns fall silent, the jets move on,

Yet the ringing stays when the day is gone.

No scar to show, no wound to see,

But sound has carved its legacy.

Through sleepless nights and words unheard,

Through quiet rooms where silence stirred,

A voice remains, both faint and strong—

The proof that service echoes long.

—Dr. Howard Friedman, M.D.

—Dr. Howard Friedman MD

Board-Certified | Internal Medicine | Veteran | U.S. Army Medical Corps

Founder of Howard’s House of Medicine (HHOM LLC)

https://www.hhomllc.com

Frequently Asked Questions:

Q: Why do so many veterans develop hearing loss or tinnitus years after leaving service?

A: Because noise damage accumulates over time. The tiny hair cells in the cochlea don’t regenerate, so even if a separation exam looks “normal,” the damage may already be underway. Years later, the cumulative trauma declares itself as hearing loss or phantom ringing. It’s not imagined — it’s delayed injury.

Q: Why does the VA so often deny hearing-related claims?

Many denials hinge on “normal” separation exams or lack of in-service documentation. But tinnitus has no objective test — it’s diagnosed by history. When a veteran reports ringing or buzzing that began in service, that is medical evidence. The disconnect comes from bureaucracy not catching up with decades of medical science.

Q: What does recognition from the VA really mean for veterans with tinnitus or hearing loss?

A: It’s not just about compensation. Recognition validates that the condition is real, service-connected, and deserving of treatment. It opens doors to hearing aids, therapies, and support systems, but more importantly, it restores dignity. It tells veterans that what they carry is understood and honored.