╨╧рб▒с>■  .0■   -                                                                                                                                                                                                                                                                                                                                                                                                                                                ье┴M Ё┐иbjbjт=т= "$АWАWи      lJJJJJJJ^"""" .^╟NNNNNNNNFHHHHHH$╒ їЪlJNNNNNlhJJNNБhhhNFJNJNFhNFh▐hFJJFNB └Y¤╙С╛╟^─"Ф|FFЧ0╟FПXПFh^^JJJJ┘C- 044-34-8461 Cotnoir, Charles J. I have reviewed your УSupplemental Stement of the CaseФ (SSOC) dated April 17, 2007 and I wish to respond. I disagree with your findings for both ears for the following reasons: 1) I was given two speech recognition tests. The first test was given in the following manner. First the examinee was seated in the booth with the headphones on. Then, the examinee was exposed to the words that would be used in the evaluation. The speaking volume of this part of the test was set so that the examinee would clearly hear and understand the words that would be used in the test and would recognize them when he heard them in the actual test. I disagree with this method of testing, where the examinee already has in his memory the words that he is supposed to hear. The examinee is using his memory to put parts of what he hears together with the words that are in his memory. Since the examinee has heard the words twice, it is more likely that the speech recognition score is going to be falsely higher than if the examinee heard the words once as in a normal conversation. This method of hearing evaluation does not adequately reflect real speech recognition ability. This method of testing seems to defeat the purpose of a true measurement of the ability of the examinee to recognize random words. Prior to the test, I asked the examiner what I should do if I didnТt recognize a word. The examiner told me that I should guess at the word. Again, guessing at a word that is being repeated for the second time uses memory, rather than auditory ability and following this instruction will only falsely inflate the score. Not withstanding the above, I believe that my speech recognition score on this first test was much lower than 98% because many of the words were not recognizable other than as a murmur of sound, to which I did not respond because I could not recognize the word. The second test was conducted at a much higher volume than the first test. In fact it was conducted at a volume that was much higher than normal conversational speech. On at least two answers, I could not discriminate the word and I answered with two words. The examiner at each of those times stopped the exam and rewound the tape to repeat the word. I believe that the result of this test was inflated because of the volume and I also believe that of the two speech recognition tests the VA chose to ignore the resusts of the first test that had a lower score and chose to use the test where higher results were achieved, contrary to >>>>>>> CMR. 2) In all of the previous VA denials, the rational for denial was that 38 CFR 3.385 applies: за3.385аааDisability due to impaired hearing. For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. [59 FR 60560, Nov. 25, 1994] In this case, the following was stated by the VA: УWhile there is hearing loss at the 400 Hertz range, the audiologist noted that you had a considerable amount of impact ear wax in the right ear. In addition, there was 15 db air-bone gap at the 1000 Hertz rang and a 10 db air-bone gap at 4000 Hertz. Therefore, the examiner could not conclude that you had true high frequency hearing loss in the right earФ. This statement errs in numerous ways. First, the examiner, prior to testing, examined both ears and did discover wax in the right ear and did remove some wax from the right ear with a loop. Second, since if the examiner, after removing wax from the right ear, knew that wax remained in the ear, was bound to make a judgement that the impact wax would either affect the test score or would not affect the test score.If the examiner concluded that the results of the test would be false, then the examiner should have taken steps to remove the wax, prior to testing in order that the test results would be true. Conversely, if the examiner, using her experience as an examiner, concluded that any remaining wax would not affect the test, then the test results must stand. Further, for the examiner to retroactively conclude that the test results for the 4000 db range are false because of impact wax in the right ear is of opinion rather than of fact. Therefore, since the results of the test show that there is sufficient hearing loss of 45 db in the 4000 db range This regulation says nothing that would substantiate the denial reasoning of the VA that ВMи∙ OJQJ^J#$ПР╫╪> ? 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