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Hearing Loss Medical EASA. Any experiences?

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Old 4th Jul 2022, 17:47
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Exclamation Hearing Loss Medical EASA. Any experiences?

Hello (wannabe) pilots,

After working in another flied for some years, i wanted to chase my childhood dream and become airline pilot! I did an assesment for the KLM Flight Acadamy and passed it. The only formality was to pass my medical examination. It didn't turn out to be just a formality.... it appeared i have a hearing loss of about 45db on my right ear (on 1000hz). I never knew i had this, neither did i experience any negative effects because of this. My left hearing is perfect, and probably i have this hearing form birth and my left ear compensates for it.
The KLM doctor sent me to an ENT doctor (specialized in aviation) and to make it short: the conclusion is that my hearing is (according to her opinion) good enough for flying, i perform a speech discrimination test very good and a MRI scan showed that i don't have a active pathological process going on (so it's unlikely it will degrade further).
This rapport was sent back to the KLM doctor and he told me i don't comply with the requirements: not more than 35db loss on either ear seperately on 500,1000 and 2000hz. (In that he is right: on my right ear, i can't perform a audiometry on 1000hz that will show less then 35db loss. And i never will). He consultated the IL&T (the Dutch NAA), but they also stated that i don't comply with the requirements with the same argument, hence denial of type 1 certificate (hooray i can get a type 2 medical certificate, i can do everything as long as i don't need an IR. Not very convinient when i want a ATPL).

As i am diving in the EASA rules, it states indeed that initial applicants shall not have a hearing loss of more than 35db on the above specified frequencies (MED.B.080, (a, 1, ii)).

***Italic is copied from the EASA rules***

It also states that "A comprehensive ear, nose and throat examination shall be undertaken for the initial issue of a class 1 medical certificate and periodically thereafter when clinically indicated." (MED.B.080 (a, 2)).

Then it states (MED.B. 080, (b)): Applicants with any of the following medical conditions shall undergo further examination to establish that the medical condition does not interfere with the safe exercise of the privileges of the applicable licence(s): (1) hypoacusis (among onther, but i only write here what matters to my case).

Lastly the regulations state:
MED.B.080, (c), (1): Applicants for a class 1 medical certificate with any of the medical conditions specified in points (1 hypoacusis), (4) and (5) of point (b) shall be referred to the medical assessor of the licensing authority.

That are the regulations. The EASA requirements than go on with the General Means of Compliance:
AMC 1 MED.B.080, (2): Applicants with hypoacusis may be assessed as fit if a speech discrimination test or functional flight deck hearing test demonstrates satisfactory hearing ability. A vestibular function test may be appropriate. and (3) If the hearing requirements can only be met with the use of hearing aids, the hearing aids should provide optimal hearing function, be well tolerated and suitable for aviation purposes.

In my opinion, it doesn't state that it is not allowed to be assesed as fit on an initial test when you have hypoacusis. How i read it, you should then do a comprehensive investigation (i did just that at an ENT specialist), show appropriate hearing on a speech discrimination test (i also showed that) and show that it's no active pathology (the MRI shows that in my case). And although the ENT specialist said i don't need hearing aids, if I have to to chase my dream, i will use them ofcourse. But none of that was discussed, my medical simply will be denied because i don't meet this requirement of less then 35DB loss on 1000hz.

I just wonder: did anyone ever experienced something similar to this? How do you interpret these rules? Do you think the Dutch NAA (IL&T) made a proper decision considering the EASA rules or did maybe a NAA in another country made another decision in a case similar to this?

And lastly: does anybody have any idea why the CAA (United Kingdom) rules are similar to the EASA rules, but add much more guidance material which covers exactly this topic? I mean it's strange right: i live in the Netherlands and can't get a medical, but would i move 350km to the UK, i could get a medical. I would be able to work for a English airliner, fly to Amsterdam and land there with a medical license that the EASA would consider invalid. I think that's really arbitrary.

I hope somebody can give me some tips/advise/share his or her experiences because ofcourse i am gonna object to the decision and want to make my case as strong as possible.

Sorry for the long post and maybe the grammar mistakes.

Kind regards and thanks in advance,

Lex
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Old 5th Jul 2022, 11:21
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Does the UK CAA allow you a >35db loss at 1000Hz? I read that you say the rules are similar but does it actually state this in the UK rules?

The last part shouldn't confuse you. Different authorities have different acceptable requirements. Aircraft land in the UK and EASA everyday from countries with vastly different standards.
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Old 5th Jul 2022, 12:41
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Hello A320LGW,

The regulations and the general means of compliance state the same in the CAA as in the EASA rules. But looking at the guidance material, the CAA states:Initial applicants with a hearing loss of more than 35dB at any of the frequencies 500Hz, 1000Hz or 2000Hz, or more than 50dB at 3000Hz, in either ear separately should have an assessment carried out by a consultant ENT specialist to identify or exclude underlying pathology, assess stability of hearing loss and establish suitability for a hearing aid. The application should then be referred to a medical assessor.

A newly diagnosed hearing loss at an initial medical, with no evidence of stability, may require a number of months to elapse and then repeat audiometry to be undertaken before certification can be considered.

Class 1 applicants, with hearing aids that are well tolerated and suitable for aviation purposes and which enable them to meet the audiogram requirements, should follow the guidance below.
Initial Class 1 applicants with hearing outside the standards set out in MED.B.080 (a)(1)(ii), who can demonstrate stability and no significant underlying pathology, may be considered for Class 2 certification initially with a satisfactory report from a functional hearing test (see Profound Hearing Loss below). Following the issue of a Class 2 medical certificate, the successful completion of PPL training will be considered to demonstrate that hypoacusis does not interfere with the safe exercise of the privileges and Class 1 certification will be considered with SSL (Special Restriction as Specified) limitation “Functional Hearing Assessment Required within 3 months of renewal/revalidation medical”.

I don't say it's an easy way, but there is a way to get your type 1 medical in the UK with the hearing loss i experience.
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Old 5th Jul 2022, 13:02
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For the UK CAA, get yourself a Functional Hearing Test. https://publicapps.caa.co.uk/modalap...detail&id=2875

Also, have a chat with an AME who will be able to help.

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Old 5th Jul 2022, 13:54
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That would be my plan b, i first try to get my medical in Europa by object to the decision.
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Old 5th Dec 2022, 14:56
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Originally Posted by Pilotlex
That would be my plan b, i first try to get my medical in Europa by object to the decision.
Hi Pilotex, have you had any progress with obtaining an initial EASA Class One? I'm in a similar situation requiring one. I've actually held a UK Class One for years now and have to do a Functional Hearing Test for each renewal and never had a problem. Now I need to obtain an EASA one and weighing up if this would be an issue.

I think the decision from the Dutch Authorities is harsh since the regulations also suggest you are allowed hearing aids and hypoacusis cases can be sorted with a FHA and stability assessment, as was the case for me years ago with the initial CAA class one. Maybe it depends on which authority you apply?

Cheers
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Old 19th Mar 2023, 09:51
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Hello PilotEX, hope you are alright. I just found this and something similar is happening to me. I want to know what happened in the end with your medical class 1 easa? did you geit it under certain restrictions or conditions? or not tall all? thank you so much
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Old 19th Mar 2023, 09:53
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class 1 medical hearing loss

Originally Posted by hawker_hunter
Hi Pilotex, have you had any progress with obtaining an initial EASA Class One? I'm in a similar situation requiring one. I've actually held a UK Class One for years now and have to do a Functional Hearing Test for each renewal and never had a problem. Now I need to obtain an EASA one and weighing up if this would be an issue.

I think the decision from the Dutch Authorities is harsh since the regulations also suggest you are allowed hearing aids and hypoacusis cases can be sorted with a FHA and stability assessment, as was the case for me years ago with the initial CAA class one. Maybe it depends on which authority you apply?

Cheers

Hello hawker_hunter, hope you are doing alright. just wanted to ask if you managed to renew or revalidate or get a new medical classs1 certificate? i am asking because i just did a inital class 1 and the hearing is a no so i am wondering what i can do. thank you
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Old 23rd May 2023, 12:29
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Hi All,

It took me 10 months, but the Dutch authorities did consider my case as an unique and individual case and thankfully decided that it is possitle for me to obtain my class 1 certificate. As proof of my flight safety I went to 2 ENT specialist with specialism in aviation (speech discrimination was an important aspect obviously). I also did a flight in a 737NG simulator with multiple TRI's, who tested my functional hearing in different simulated flight desk situation.

The main consideration eventually was that I could prove that my hearing loss is not a threath to flight safety.

I hope you all have good luck with your medicals.

Kind regards,

Alex
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Old 24th May 2023, 10:54
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Hey @Pilotlex


Thanks so much for sharing. Listen, I really would appreciate it if I could ask a few questions and you would answer me. Is this situation to get your Initial Class 1 Medical? I am asking this because I basically did an Initial Class 1 and the Audiogram shows some hearing loss, so the aviation authority is saying that I do not qualify for it. When I suggested doing anything on top of that Audiogram , like a hearing functional test, to test my hearing and see if it affects my performance or not, they said I can not because " I am not yet part of the industry ", like I am not in an Airline. So I feel that they are cutting my legs, in a way, because I can not do any other type of exams, tests and they say it is a must for the Initial to not have that hearing loss, so i do not know really what to do.

Last edited by Eddy91; 24th May 2023 at 11:05.
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Old 24th May 2023, 13:33
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Originally Posted by Eddy91
Hey @Pilotlex


Thanks so much for sharing. Listen, I really would appreciate it if I could ask a few questions and you would answer me. Is this situation to get your Initial Class 1 Medical? I am asking this because I basically did an Initial Class 1 and the Audiogram shows some hearing loss, so the aviation authority is saying that I do not qualify for it. When I suggested doing anything on top of that Audiogram , like a hearing functional test, to test my hearing and see if it affects my performance or not, they said I can not because " I am not yet part of the industry ", like I am not in an Airline. So I feel that they are cutting my legs, in a way, because I can not do any other type of exams, tests and they say it is a must for the Initial to not have that hearing loss, so i do not know really what to do.

Hello Eddy91,

I am not at all used to this forum, but if possible, than sent me a privat message with you questions and I will try to answer them.

Kind regards,

Lex
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Old 25th May 2023, 13:35
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Hi Lex,

First of all thank you for sharing your story regarding your medical and hearing loss. I've been experiencing quite some similair problems but with hearing loss on more frequency's and both of my ears. It's nice to find someone who's is facing the similair problems I have. I'm really happy for you that you have sucesfully obtained the class 1 medical! Unfortunately I received the same answer from Dutch CAA as Eddy91.

Fortunately with hearing aids my hearing is passing the benchmarks stated by EASA and the Dutch authority. Unfortunately my hearing is too bad according to the Dutch CAA and I am aware of the guidelines in place by the UK CAA as well. The dutch authority doesn't want to allow hearing aids on the first intial assesment. In the UK however they are granting a class 2 initially and after completing PPL training they're will reconsider the case and could give a class 1 if the hearing is not interfered with the safety of flying. Please see below the quote from UK CAA and it's guidelines regarding this matter.

"Initial Class 1 with Hearing Loss

Initial applicants with a hearing loss of more than 35dB at any of the frequencies 500Hz, 1000Hz or 2000Hz, or more than 50dB at 3000Hz, in either ear separately should have an assessment carried out by a consultant ENT specialist to identify or exclude underlying pathology, assess stability of hearing loss and establish suitability for a hearing aid. The application should then be referred to a medical assessor.

A newly diagnosed hearing loss at an initial medical, with no evidence of stability, may require a number of months to elapse and then repeat audiometry to be undertaken before certification can be considered.

Class 1 applicants, with hearing aids that are well tolerated and suitable for aviation purposes and which enable them to meet the audiogram requirements, should follow the guidance below.

Initial Class 1 applicants with hearing outside the standards set out in MED.B.080 (a)(1)(ii), who can demonstrate stability and no significant underlying pathology, may be considered for Class 2 certification initially with a satisfactory report from a functional hearing test (see Profound Hearing Loss below). Following the issue of a Class 2 medical certificate, the successful completion of PPL training will be considered to demonstrate that hypoacusis does not interfere with the safe exercise of the privileges and Class 1 certification will be considered with SSL (Special Restriction as Specified) limitation “Functional Hearing Assessment Required within 3 months of renewal/revalidation medical”."
I've send you a PM as I want to get in touch with you regarding this issue you've had. For example I would like to get in touch with the ENT specialist who's specialized with aviation so that they can advice me in this matter as well. I hope you could help me a bit further!

I wish you manny happy flying hours and landings!
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Old 26th May 2023, 07:58
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Originally Posted by Dr_Kroepoek
Hi Lex,

First of all thank you for sharing your story regarding your medical and hearing loss. I've been experiencing quite some similair problems but with hearing loss on more frequency's and both of my ears. It's nice to find someone who's is facing the similair problems I have. I'm really happy for you that you have sucesfully obtained the class 1 medical! Unfortunately I received the same answer from Dutch CAA as Eddy91.

Fortunately with hearing aids my hearing is passing the benchmarks stated by EASA and the Dutch authority. Unfortunately my hearing is too bad according to the Dutch CAA and I am aware of the guidelines in place by the UK CAA as well. The dutch authority doesn't want to allow hearing aids on the first intial assesment. In the UK however they are granting a class 2 initially and after completing PPL training they're will reconsider the case and could give a class 1 if the hearing is not interfered with the safety of flying. Please see below the quote from UK CAA and it's guidelines regarding this matter.

"Initial Class 1 with Hearing Loss

Initial applicants with a hearing loss of more than 35dB at any of the frequencies 500Hz, 1000Hz or 2000Hz, or more than 50dB at 3000Hz, in either ear separately should have an assessment carried out by a consultant ENT specialist to identify or exclude underlying pathology, assess stability of hearing loss and establish suitability for a hearing aid. The application should then be referred to a medical assessor.

A newly diagnosed hearing loss at an initial medical, with no evidence of stability, may require a number of months to elapse and then repeat audiometry to be undertaken before certification can be considered.

Class 1 applicants, with hearing aids that are well tolerated and suitable for aviation purposes and which enable them to meet the audiogram requirements, should follow the guidance below.

Initial Class 1 applicants with hearing outside the standards set out in MED.B.080 (a)(1)(ii), who can demonstrate stability and no significant underlying pathology, may be considered for Class 2 certification initially with a satisfactory report from a functional hearing test (see Profound Hearing Loss below). Following the issue of a Class 2 medical certificate, the successful completion of PPL training will be considered to demonstrate that hypoacusis does not interfere with the safe exercise of the privileges and Class 1 certification will be considered with SSL (Special Restriction as Specified) limitation “Functional Hearing Assessment Required within 3 months of renewal/revalidation medical”."
I've send you a PM as I want to get in touch with you regarding this issue you've had. For example I would like to get in touch with the ENT specialist who's specialized with aviation so that they can advice me in this matter as well. I hope you could help me a bit further!

I wish you manny happy flying hours and landings!
Hey @Dr_Kroepoek, thank you for sharing and looking for answers and help. So, from what I understand here, you are also on a situation where they are not giving the option of doing a functional hearing flight and or going on a simulator? and also, are they saying that they don't want you to use hearing aids as initial? Well, to me, he was the doctor from the IAA, that mentioned that maybe I could use it. So, it is not a guarantee. I am being followed by an ENT Specialist but not in aviation and now i am not sure what to do because also my money is not infinite lol Anyway if you would not mind to give more updates in the near future so I could have some help too or guidance.

Thank you and good luck.

Eddy
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Old 1st Aug 2023, 14:04
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I just wanted to post my experience with getting a Class 1 medical as someone with a hearing impairment.

I initially had much difficulty with this from the CAA as (at least back then) the requirements for initial applicants and those renewing/revalidating their medicals are slightly different. My situation is that I wear two bone-anchored hearing aids, and that is practically where all my hearing ability comes from. My hearing is excellent in reality, but I use a slightly adapted setup in an aircraft to manage listening to air traffic control. As a result, the CAA didn't want to consider me as their only view on the matter was meeting the audiogram requirements, which I didn't. But as others here have mentioned, you can do a Functional Hearing Assessment which should enable you to get the medical.

I have had a few people contact me experiencing difficulties with this on some levels with other national regulatory bodies – but it is possible! My main advice as someone who spent five years arguing my case is to keep trying!

I have an article on LinkedIn explaining my experience in more depth if anyone wants to read it. It is slightly outdated, however, as I have gained my PPL since writing and hope to try for a place on a cadet programme.

https://www.linkedin.com/pulse/so-ho...im-heptinstall
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