Hearing loss and your medical

June 2, 2014

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Warren Silberman

Warren Silberman

  • Former Manager, FAA Aerospace Medical Certification 
  • Doctor of Osteopathic Medicine 
  • Expert in Aerospace/Preventive Medicine 
  • Pilot since 1986

An airman recently phoned into AOPA's Medical Certification section and told the specialist that his hearing has diminished and wanted to know the FAA's policy on wearing hearing aids. He noted that he had to turn his iPhone up louder and louder to hear music from one of his music applications. He went to his family physician who examined him and sent him to an audiologist who performed an audiogram. For this test, the specialist has you sit in a quiet room or in a soundproof booth. The patient wears a headset, and the technician outside the booth runs through a series of tone sounds. This tests the ability of each ear to hear sounds from the low range all the way up to the high ones. This airman flew the UH-1 Huey gunship as a U.S. Army helicopter pilot in Vietnam. He then went on to work as a helicopter pilot flying workers out to oil rigs in the Gulf of Mexico. He currently flies privately. 

The most common type of hearing loss that we develop is called sensorineural hearing loss, a hearing loss in the high frequency ranges. Eventually, the hearing loss worsens and involves the lower frequencies as well. The audiologist who examined this airman also tested him for the ability to hear the spoken word. This is called the speech reception threshold, and it is the minimum intensity in decibels at which an individual can understand 50 percent of spoken words. This fellow could hear 90 percent in each ear. The FAA standard for all classes is that an airman must hear at least 70 percent in one ear.

The hearing medical standard for all classes requires that the airman be able to meet one of three different hearing tests. One is the conversational voice test in which the applicant stands six feet away from the aviation medical examiner, not facing the medical examiner. The AME then reads something in a conversational voice level and the airman must repeat what he or she says. The next is the audiogram that I mentioned above. The FAA has a good ear/worse ear policy for passing this test. Last is the speech reception threshold test. The conversational voice test is the test most commonly used by AMEs. If that test doesn’t go so well, then the audiometric testing would be done. 

Interestingly, an airman can meet the hearing standard even if hearing aids are required. The medical certificate will include a limitation that states, "MUST WEAR HEARING AMPLIFICATION." If the airman feels that he/she can hear well enough with just a headset, the FAA may require a medical flight test. This procedure is done through the local flight standards district office (FSDO). The airman will make a short flight with an aviation safety inspector who will determine that the pilot can hear and understand ATC transmissions while wearing a headset. If the pilot does, then the aviation safety inspector will issue a statement of demonstrated ability (SODA).   

High-decibel noise is all around us, and is cumulative, so it’s a good idea to wear hearing protection not only when you fly, but also while using the lawnmower or other internal combustion machines, while attending NASCAR races, or at loud music concerts. And don’t turn up the volume too high while listening to music apps on your iPhone or other smart devices.