Blue Book listings 2.10 and 2.11
Hearing Loss and Social Security Disability Benefits
Audiometric scores decide how SSA reads hearing loss: listing 2.10 applies without a cochlear implant and 2.11 applies with one. Listing 2.10 requires average air conduction of 90 decibels or greater with bone conduction of 60 or greater, or word recognition of 40 percent or less, in the better ear.
A hearing claim at SSA turns almost entirely on a test taken in a sound booth. The thresholds are exact, the test conditions are spelled out, and an audiogram that skips a required step may not count no matter how severe the loss looks.
For Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), SSA splits hearing claims by one fact: whether you have a cochlear implant. Below we cover both listings, the residual functional capacity route for hearing loss that falls short of them, the testing and records that decide these claims, and the denial pattern we see most often in hearing files.
SSA Blue Book listing
2.10, 2.11
Vision and hearing
The criteria are set out below in plain language.
What does listing 2.10 require for hearing loss without an implant?
The audiometry covers pure tone air and bone conduction, a speech reception threshold and word recognition.
Listing 2.10 in the Blue Book special senses section covers hearing loss not treated with cochlear implantation. It measures the better ear, and you need to meet only one of two paragraphs.
Paragraph A requires an average air conduction hearing threshold of 90 decibels or greater and an average bone conduction threshold of 60 decibels or greater. Both numbers must be met together. Air conduction tests sound traveling through the ear canal, and bone conduction tests sound delivered through the skull, so this paragraph looks for a deep loss along both pathways.
Paragraph B requires a word recognition score of 40 percent or less, using a standardized list of phonetically balanced one-syllable words. This paragraph matters for people whose thresholds fall short of 90 decibels but who cannot make sense of the speech they do hear.
Section 2.00 sets the test conditions. The audiometry covers pure tone air and bone conduction, a speech reception threshold and word recognition. It is done in a sound-treated booth or room that meets national standards, with each ear tested separately, after an otoscopic exam immediately beforehand, and without hearing aids. Word recognition is tested in quiet, with no visual cues, usually 35 to 40 decibels above your speech reception threshold.
Listing 2.11 and hearing loss treated with a cochlear implant
Listing 2.11 works on a different clock. Under paragraph A, SSA considers you disabled for 1 year after initial implantation. That year does not depend on any test score.
After that first year, paragraph B applies. It requires a word recognition score of 60 percent or less on the Hearing in Noise Test (HINT). Section 2.00 specifies that the HINT is given in quiet, in a sound field, at 60 decibels hearing level, with no visual cues, and with the implant functioning and set to its normal settings. Any version of the HINT may be used.
The cutoff is higher than the 40 percent in listing 2.10, and the test is different too: it measures how well you understand sentences with the implant working. A score above 60 percent does not end the claim. It moves it to the residual functional capacity route below.
Because the implant date sets the end of the paragraph A year, your surgical records belong in the file from the start. If you are filing near or after that anniversary, plan for a HINT result before SSA asks for one.
The RFC route when hearing loss does not meet the listing
There SSA assesses your residual functional capacity (RFC), the most you can still do despite your limitations.
Section 2.00 says the listings are examples, and an impairment that does not meet or equal one moves to steps four and five. There SSA assesses your residual functional capacity (RFC), the most you can still do despite your limitations. The RFC regulation lists hearing impairments among the conditions that restrict work abilities beyond lifting and walking, along with conditions that call for environmental restrictions.
Hearing loss produces a specific set of RFC limits. The ones we look for in the record are no work that requires telephone use; no frequent spoken communication with the public or coworkers; a cap on workplace noise, because background noise can wipe out what speech recognition you have; and no work around moving machinery or traffic where you must hear warning signals. When tinnitus or balance problems come with the loss, those belong in the RFC as well.
Many lower-exertion jobs center on talking with customers, taking calls or working in loud settings. An RFC that accurately records these limits narrows the work that remains in a way a threshold number alone does not.
The testing and records that decide a hearing loss claim
Section 2.00 generally requires two things: an otologic examination and audiometric testing. The otologic exam must be performed by a licensed physician (a medical or osteopathic doctor) or an audiologist. The audiometry must be performed by, or under the direct supervision of, a licensed audiologist or otolaryngologist, and it should take place within 2 months of the otologic exam.
- A full audiogram for each ear, showing air and bone conduction, the speech reception threshold and word recognition, not just a pass or fail screening.
- The otologic exam report, dated within 2 months of that audiogram.
- For implant users, the surgery date, programming and mapping notes, and HINT results recorded under the 2.00 conditions.
- Work and daily life evidence, such as accommodation requests, written-only communication at work, or statements from family and coworkers about missed conversations and alarms.
If your last full audiogram is old, a current one run to these standards usually does more for the file than any letter. Our guide to applying for disability covers gathering records before you file.
Why are hearing loss disability claims denied?
The listing tests are run in quiet, and an aided conversation in a quiet exam room can go fine.
The pattern we see most in denied hearing files is hearing in a quiet room read as hearing at work. The listing tests are run in quiet, and an aided conversation in a quiet exam room can go fine. Neither tells SSA what happens on a loading dock, at a register or on a conference call. When the file has no record of how you function in noise, the gap gets filled with the clinic picture.
The second pattern is testing that does not meet section 2.00. A screening test at a primary care visit, an audiogram without bone conduction, testing done with hearing aids in, or an otologic exam months away from the audiogram can each keep a real loss from counting toward the listing.
The third pattern is the cochlear implant timeline. A claim filed after the paragraph A year, with no HINT score in the record, has nothing to measure against paragraph B. If your claim was turned down on any of these grounds, our page on what to do after a disability denial covers the deadlines for the next step.
Hearing Loss Disability Claim Questions
Does tinnitus qualify for Social Security disability on its own?
Section 2.00 has no separate listing for tinnitus. It appears only as part of listing 2.07 for Ménière's disease and similar inner ear disorders. Tinnitus without a qualifying hearing loss is evaluated through the residual functional capacity route, so records describing how the ringing affects sleep, concentration and tolerance for noise carry more weight than the diagnosis code.
Can Ménière's disease qualify for disability under the hearing listings?
Ménière's disease has its own listing, 2.07, for disturbance of labyrinthine-vestibular function. It requires a history of frequent attacks of balance disturbance, tinnitus and progressive hearing loss, plus both disturbed vestibular function shown by caloric or other vestibular tests and hearing loss established by audiometry. Section 2.00 calls for a neuro-otolaryngologic exam documenting how often attacks happen and how long they last.
What happens to my benefits after the first year with a cochlear implant?
When SSA later reviews a claim approved under paragraph A, section 2.00 says continuing disability decisions follow separate review rules, 20 CFR 404.1594 for SSDI and 416.994 for SSI, rather than the rules for a new claim. Keep your HINT results and implant programming records current, because those records show how you hear with the implant today, after the first year.
Sources: SSA Blue Book, 2.00 Special Senses and Speech (Adult); 20 CFR 404.1545, Your residual functional capacity (eCFR).
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