Managing occupational hearing loss in the public sector

June 2, 2023

An elderly man being fitted with a hearing aide.
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According to the Centers for Disease Control and Prevention (CDC), 22 million Americans are exposed to hazardous noise levels at work each year. Whether it’s sustained over time, like long-term proximity to sirens or loud machinery, or a one-time event, like a gunshot or explosion, significant noise exposure can kill nerve endings in the inner ear, leading to irreparable hearing damage.

Many of those at high risk for occupational hearing loss are employees in the public sector, including law enforcement, emergency responders, utilities specialists and other service workers. Based on 10 years of data from Sedgwick’s U.S. workers’ compensation book of business for public entity clients (nearly 1.12 million claims):

  • .24% involved hearing loss. More than half of those injured workers were in safety professions, such as police and fire.
  • The average cost of a WC claim involving hearing loss was double that of other public sector WC claims.
  • The average age of a public sector injured worker with hearing loss was 52 — 20 years older than other public sector injured workers during the same period.

In the interest of protecting employees and valuable public resources, public entities should take a closer look at preventing occupational hearing loss, controlling the cost of hearing-related claims, and how they can better educate and support their workforce.

An ounce of prevention

Employers have a responsibility to provide safe working environments, and that includes noise levels. There are multiple strategies for limiting employee exposure to harmful noise and preventing job-related hearing loss, including:

  • Substituting quieter equipment and tools
  • Distancing workers from loud noise
  • Reducing the duration, frequency or level of noise exposure (through work breaks, scheduling, etc.)
  • Providing protective devices (like earplugs and earmuffs) and enforcing proper and consistent use

Another proactive tactic is audiometric testing in the workplace, wherein employers administer a baseline hearing test within a few months of employees starting new roles. Follow-up screenings are then administered at least once a year. This helps educate employees about the importance of monitoring and protecting their hearing, determines whether they had any impairment before taking the job, and identifies employees who should be referred for treatment.

These and other best practices are included in the U.S. Occupational Safety and Health Administration’s hearing conservation program, with which most American employers must comply. However, many governmental organizations are exempt from the OSHA requirements for fear of overburdening the public sector; it’s estimated that fewer than 50% of U.S. municipalities have hearing conservation programs. While public entities may save some money up front by declining to participate in hearing conservation efforts, the risks to employee safety and long-term costs associated with compensable hearing loss far outweigh any short-term gains.

Keeping costs in check

Cases involving occupational hearing loss represent a small percentage of workers’ compensation claims; however, hearing aids are, on average, the second-most expensive pieces of durable medical equipment (DME) — behind only prosthetic devices. This is attributable to the largely unregulated and fluctuating pricing of hearing aids. Only three U.S. states have established WC fee schedules establishing a maximum allowed cost for hearing aids. Additionally, nearly all hearing aids sold in the U.S. are produced by six major manufacturers, but they’re marketed under many different brand names. Nearly identical devices made in the same factory can have widely different price points, depending on the branding attached.

Knowing that employers are responsible for providing hearing aids to employees with job-related hearing loss, some clinics and providers may try to use these factors to their advantage and market the most expensive devices to their WC patients — even if they’re not the best fit for those individuals’ needs. One study found that more than 95% of initial recommendations to WC patients employed by organizations without established cost controls are for hearing aids in the highest pricing tier, while only 23% of self-paying patients purchase devices at the premium level.

There is also a risk of misuse of the WC system to procure hearing aids for losses unrelated to work. Because coverage for hearing aids and exams through Medicare, Medicaid and group health plans can be limited, some workers may try to use a WC claim to avoid paying out of pocket for costly devices. This trend is expected to continue as the baby boomer population develops hearing loss with age and looks toward retirement. To protect against misuse of public funds, public entities must engage highly trained medical professionals in the process of determining the compensability of occupational hearing loss claims.

Supporting employees with hearing loss

While employers may see some attempts to misuse WC, the majority of occupational hearing loss claims are legitimate and those employees need to be treated with empathy and care. The goal should be to get employees assessed and fitted by qualified professionals for appropriately priced hearing aids that suit their professional and lifestyle needs.

Hearing aid technology has come a long way in recent years (many now have rechargeable batteries and dual microphones to reduce background noise), and the popularity of AirPods and other Bluetooth earpieces has eliminated much of the stigma associated with in-ear devices. With the right device, adjustments and patient education, there’s a very high likelihood that an employee with hearing loss can remain productive and safe on the job. Further, matching employees with devices that work for them and making sure they use them regularly enhances their overall health and well-being; untreated hearing loss can lead to social isolation, cognitive decline, depression, balance issues and other debilitating symptoms associated with a higher risk of workplace injury.

A great way for public entities of any size to control expenses while supporting employees with work-related hearing impairments is by enlisting a managed care partner on an audiology program within their workers’ compensation solution. Sedgwick’s highly regarded audiology program provides continuity of care for our clients’ injured workers through a nationwide network of 6,200 audiologists with deep experience in addressing occupational hearing loss. Our providers ensure every device is cost effective, properly fitted, comfortable and easy to use; unlimited office visits are included for the first year. Hearing aids issued through our program are under warranty for five years (the industry average is three), and our bundled approach includes all supplies (batteries, filters and domes) for the life of the device. Our program not only saves employers about $675 per injured worker over the course of five years, but also provides each employee with well-rounded support as they adjust to life as a wearer of hearing aids.

If you’d like to know more about Sedgwick’s audiology program offerings and the risks of occupational hearing loss, please contact me.

Special thanks to Jordan Burch of Advanced Hearing Providers for his valuable contributions to this blog.

Learn more — read about Sedgwick’s audiology program and other best-in-class ancillary care solutions for workers’ compensation, chat with our team of experts at the PRIMA conference, or visit the OSHA website for resources on occupational noise exposure