Comment from Page, Sue , Maryland Disability Determination Services

The proposed revisions to SSA hearing listings better reflect current medical terminology, practices, and treatment. Particularly noteworthy are the evaluation criteria for cochlear implants and the elimination of the requirement to use hearing aids for audiometric testing. Additionally, the proposed revisions for evaluating hearing impairments in children are much more realistic than the current listings. Below are some specific comments/questions: 1. The section on word recognition for persons not fluent in English is good in theory, but it may be difficult provide the testing in practice. 2. The section that discusses the timing of the otologic examination and the audiometric testing is unclear. The beginning segment indicates that they should be done within two months of each other. Later reference indicates that once there is a MDI, a repeat otologic examination is not necessary. 3.The requirement for an otoscopic exam within two months of audiometric testing is appropriate if the DDS is purchasing a consultative examination. How will this apply, however, to medical evidence of record - will audiometrics be acceptable without a recent otoscopic exam? 4. The comment referring to redesignating current listing 2.00B2 for vertigo associated disorders and loss of speech, because these conditions are not always associated with a hearing loss, could be better defined and enhanced to provide clearer guidance. Thank you for the opportunity to provide comments.