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Hearing Journal:
doi: 10.1097/01.HJ.0000429420.76785.e6
Article

Work-Related Hearing Loss Claims: Conclusive Data Prove Elusive

Pallarito, Karen

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While hearing loss remains a significant problem in certain noisy industries—manufacturing, in particular—federal data show the average rate of job-related hearing loss among private-sector employees has steadily declined in recent years. That trend may reflect the exclusion of certain industries from the calculation, or it could be a sign that ongoing efforts to reduce excessive noise exposure, train workers about the dangers of high levels of noise, and provide them with hearing protection is having an effect.

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Even less clear, though, is whether claims for job-related hearing loss or tinnitus will drop as well. Noisy work environments can cause hearing loss that's compensable under state and federal workers’ compensation laws.

“We know that hearing loss is a huge problem in the United States, but we don't know how many people are filing claims on it,” said John Ratliff, a member and former chair of the American Industrial Hygiene Association's noise committee. He suspects a lot of employees with hearing impairments retire without filing a claim “because they don't know that they can.”

There's also a reluctance to go after an employer for benefits, explained Jeffrey P. Boyd, MBA, JD, an attorney with Hill Boren, PC, in Jackson, TN.

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“Employees who have not been dislodged from their employment don't even think about hearing loss as a possible claim, and so they don't fool with it, usually, until somebody shuts down a plant,” said Mr. Boyd, who represents 750 hearing loss clients.

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To control workers’ compensation costs, some states have tightened rules for paying claims. Pennsylvania did so in 1995, making it harder for plaintiffs to meet hearing loss thresholds for compensation and reducing the number of cases filed, observed Alfred J. Carlson, MBA, JD, a partner with Martin LLC in Philadelphia.

“Very rarely, if ever, will they voluntarily pick up any type of repetitive trauma case,” Mr. Carlson said. “You have to litigate that case out because they're going to want to get an examination with their own doctor and see if there are other causes for the hearing loss.”

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LOWER RATES

According to the National Institute for Occupational Safety and Health (NIOSH), about 22 million people are exposed to potentially hazardous noise levels at work, and another nine million are exposed to ototoxic chemicals that may result in a hearing loss (see FastLinks on page 30). An estimated $242 million is spent annually on workers’ compensation for hearing loss disability.

The rate of work-related hearing loss in private industry has declined over time, dropping from 3.2 to 2.2 cases per 10,000 full-time workers between 2004 and 2010, reported Luis Felipe Martinez, an economist with the Bureau of Labor Statistics (BLS), in Monthly Labor Review (see FastLinks on page 30). Primary metal manufacturing had the highest hearing loss rate in 2004, at 40.1 cases per 10,000 workers, and remained the highest in 2010, with 33.8 cases per 10,000 workers. In BLS data for 2011, released last October, the private industry hearing loss rate had gone down again, this time to 2.1 cases per 10,000 workers (see FastLinks on page 30).

Trends in workers’ compensation claims for hearing loss are not as transparent, as there is no central repository for such information.

An executive at one of the nation's largest workers’ compensation insurers, who preferred to remain anonymous, did not have industry-wide data but noted that, at his company, “claims data seem to be pretty flat over the past few years in both frequency and severity [payout] of hearing loss claims.”

The California Workers’ Compensation Institute, a private, nonprofit organization of workers’ compensation insurers, has seen a similar pattern, noted communications director Bob Young. The Institute maintains the Industry Claims Information System, which reflects about 3.5 million California workers’ compensation claims from 2000 to 2012.

“For each year since 2004, claims in which the primary diagnosis was hearing loss have accounted for between 0.05% and 0.06% of all claims in the ICIS database, so the volume of claims is extremely small and the trend is flat,” Mr. Young said.

In terms of payouts, benefit payments averaged $6,688 between 2000 and 2012 for the 888 closed hearing loss claims in the database. That compares with an average payout of $10,325 for all 2.69 million closed workers’ compensation claims in the database during that period, “which tells you [hearing loss claims] are relatively inexpensive compared with many other types of injuries,” Mr. Young noted.

Mr. Boyd, on the other hand, has seen payouts in his cases ranging from $11,835 up to $98,000, he said.

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ROLE OF PREVENTION

Preventing or minimizing noise exposure, of course, is the best way to reduce rates of hearing loss and, presumably, the claims it generates.

The Occupational Safety and Health Administration (OSHA) requires employers in general industry to maintain a hearing conservation program whenever noise exposure meets or exceeds an eight hour time-weighted average of 85 dBA (see FastLinks on page 30). Programs must include baseline and annual audiograms, employee training, and hearing protection.

“The audiogram gives you a chance to demonstrate to the employee the fact that if they don't protect themselves from noise, they are going to lose their hearing,” said Len Welsh, JD, chief of workplace safety at California's State Compensation Insurance Fund, the state's largest provider of workers’ compensation insurance. “Just the fact that the employer is investing in that sends a message,” he added.

OSHA's current permissible exposure limit for general industry is 90 dBA over an eight-hour period at a 5-dB doubling rate. In other words, when noise exposure increases by 5 dBA, the amount of time a person may be exposed to that noise must be cut in half. NIOSH, however, recommends a more protective exposure limit: 85 dBA over eight hours with a 3-dB doubling rate. Last year, a group of industrial hygiene professionals and organizations formed the 85-3 Coalition, which advocates the more conservative standard and recognizes employers and organizations that adopt it (see FastLinks on page 30).

The difference is “quite dramatic,” Mr. Ratliff observed. NIOSH data show that over a 40-year working lifetime, the “excess risk” of hearing impairment is 25% at 90 dBA but plummets to 8% at 85 dBA.

Another factor that could impact future claims activity, experts said, is the increased use of MP3 players, cell phones, and headphones.

“With the new generation being directly plugged into everything, I think baselines will start off much lower than with previous generations,” predicted Teresa Long, director of injury management strategies for the Institute of WorkComp Professionals in Asheville, NC.

The aging of the workforce also could boost workers’ compensation claims volume.

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Figure. Teresa LSong...
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“I think you're going to see more [claims] because you're going to have people working longer, which would expose them to longer periods of occupational noise,” Mr. Carlson noted. “I don't think it's going to be the way it was years ago, but I still think there are going to be very viable claims.”

Mr. Welsh suspects that the aging of the population will make it more difficult to distinguish noise-induced hearing loss from age-related hearing loss in these older workers with many years of occupational noise exposure.

“I do think we are going to see a lot more workers with hearing problems, and that is going to raise issues about whether the hearing loss occurred at work,” he said.

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FastLinks

* Access statistics from NIOSH on hazardous noise level exposure: http://bit.ly/NIOSH-Noise.

* Read the Monthly Labor Review article on occupational hearing loss: http://1.usa.gov/BLS-2010.

* Review the Bureau of Labor Statistics’ 2011 data: http://bit.ly/BLS-2011.

* Learn OSHA's rules for hearing conservation programs: http://1.usa.gov/OSHA-Programs.

* Find out more about the 85-3 Coalition: http://bit.ly/85-3Coalition.

© 2013 Lippincott Williams & Wilkins, Inc.

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