How does FDA Approval of Over-the-Counter Hearing Aids Impact Occupational Hearing Loss? 

According to the CDC, about 25% of all workers have been exposed to hazardous noise. Many of these claims go unreported due to the gradual onset and a lack of awareness of the risk and symptoms. Many workers are simply not aware that their work environment can put them at risk, especially in industries with moderate, but still damaging, noise levels. A significant number of adults who have noise-induced hearing damage still report their own hearing as "good" or "excellent," highlighting a major gap between perception and reality. 

Noise surveillance and use of hearing protection in the workplace is often overlooked, despite its significant impact on employee health and productivity. Many organizations don’t completely understand or fail to implement adequate monitoring systems to measure and control noise levels, leading to prolonged exposure to harmful noise. This can result in hearing loss, increased stress, and reduced concentration among workers. 

Occupational hearing loss presents a multifaceted challenge in the workplace, as it not only results in a reported injury but also qualifies as an OSHA recordable incident. Employers often perceive these claims as nuanced, given that they may not involve substantial monetary compensation but have profound, lifelong implications. Once an individual suffers from occupational hearing loss, the damage is irreversible, necessitating the use of hearing aids for the remainder of their life.  

FDA Approval and Regulatory Milestones 

In recent years, a major regulatory shift has occurred: the United States Food and Drug Administration (FDA) approved the sale of over the counter (OTC) hearing aids. However, due to the regulatory red tape of workers’ compensation claims, harmony between the reported injuries and the OTC hearing aid has not been achieved. Traditionally, hearing aids in the U.S. could only be purchased through licensed hearing health professionals, such as audiologists, and were often expensive, with prices ranging from $1,500 to $3,500 apiece. 

In August 2022, the FDA issued its final rule establishing a new category of OTC hearing aids. This rule made it legal for adults (18 and older) with perceived mild to moderate hearing impairment to purchase hearing aids online or in stores without a medical exam, prescription, or professional fitting. The new regulation took effect in October 2022, opening the market to a range of new products and manufacturers. 

Significance of OTC Hearing Aids 

• Increased Access and Affordability: By removing prescription and fitting requirements, OTC hearing aids have become more accessible and affordable. 

• Market Innovation: The opening of the OTC market spurred competition and innovation, with consumer electronics companies and new startups introducing advanced, user-friendly hearing aids. 

• Public Health Impact: Untreated hearing loss is linked to social isolation, depression, cognitive decline, and reduced quality of life. Easier access to hearing aids can help mitigate these risks and improve overall well-being. 

There are limitations of over-the-counter hearing aids, and they can only be used for mild to moderate hearing loss. While specific data around occupational hearing loss is hard to get to, numbers vary, studies show mild and moderate occupational hearing loss (OHL) are far more common than severe cases, with mild/moderate impairment affecting a large portion (e.g., 52% mild, 27% moderate in one study) of noise-exposed workers, whereas severe or profound loss represents a smaller, though still significant, minority (e.g., 2.7% severe in metalworkers, 3% moderate-or-worse in general workers), indicating a steep drop-off in prevalence as severity increases. 

Workers’ Compensation and OTC Hearing Aids 

An injured worker cannot self-report hearing loss and subsequently purchase hearing aids online due to regulatory and compliance issues. The standard procedure requires the injured worker to be evaluated by a physician, undergo a hearing test, and then be fitted for a hearing aid by a hearing professional. This has been the established process until now. 

It is well understood that workers’ compensation claims for hearing loss do not result in lost wages, and therefore, these claims are typically managed by a medical-only adjuster. The duration for which these claims remain open is generally short. However, the typical lifespan of a hearing aid is approximately three years. During this period, the injured worker will still require various accessories such as batteries, domes, or filters, necessitating the reopening of the file. Often, the original medical-only adjuster may have moved on, requiring a new adjuster to reopen the file, contact the injured worker, and complete other administrative tasks. Consequently, over the lifespan of a hearing aid, the file may be assigned to multiple adjusters, resulting in unnecessary hours of work. This inefficiency can be mitigated by the right partner. 

If you have ever heard me speak, you know I feel these types of claims are silent claims because they don’t incur lost wages, but can have a high permanent impairment rating, therefore changing the dynamics of the claim and how it affects your experience modification. We should be paying a little more attention to these types of injuries.  

Ready for a Hybrid Hearing Aid Model? 

In my efforts to innovate within the industry, I discovered a company named Audicus. Their program not only simplifies the process for the injured worker but also benefits the claims handling entity. Audicus provides hearing aids from two major industry manufacturers that are classified as over the counter due to their direct delivery method. Despite this classification, these hearing aids are synonymous with their prescription-grade counterparts. 

After an injured worker completes their hearing test, the results can be uploaded to the Audicus website where it is reviewed by a staff Doctor of Audiology. Audicus then custom programs the hearing aids tailored to the injured worker's needs and ships them directly, eliminating the need for additional appointments. Upon receiving hearing aids via mail, the injured worker participates in an onboarding appointment that includes a sound verification process, assistance with Bluetooth device setup, and an overview of daily wear expectations and next steps. Over the next three years, all necessary work, supplies, and touchpoints are managed by the Audicus team. This approach allows most hearing loss claims to be effectively closed for three years, while ensuring the injured worker continues to receive all required supplies and treatment. 

Closing 

As the landscape of hearing health continues to evolve, the workers’ compensation industry has an opportunity—and a responsibility—to evolve with it. The FDA’s approval of over‑the‑counter hearing aids marks a pivotal shift in accessibility, affordability, and innovation, yet the regulatory framework of occupational claims has not fully caught up. By embracing hybrid models that blend clinical oversight with modern delivery methods, we can close long‑standing gaps in care, reduce administrative burden, and improve outcomes for injured workers. 

Occupational hearing loss may be a “silent claim,” but its impact is anything but quiet. These injuries carry lifelong consequences, influence experience modification, and demand thoughtful, efficient management. Forward‑thinking solutions like the Audicus model demonstrate that it is possible to honor clinical integrity while streamlining the claims process—ultimately supporting both the worker and the employer. 

The future of hearing loss management in workers’ compensation will belong to those willing to rethink traditional pathways and adopt smarter, more sustainable approaches. With the right partners and a willingness to innovate, we can transform a historically complex claim type into one that is predictable, cost‑effective, and centered on the well‑being of the people we serve. 

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