Abstract:

In medical--legal evaluation of persons with hearing loss, allocation means the clinical process of estimating the relative contributions of different causes (noise, aging, etc.) or of different time periods. Allocation is not age correction; the practice of age correcting an audiogram prior to calculation of a hearing handicap score is fundamentally unfair. Allocation is an exercise of informed clinical judgment, requiring a solid understanding of the epidemiology of age-related and noise-induced hearing loss. While data specific to the individual, such as history, noise exposure measurements, and serial audiograms, should be given the greatest weight, quantitative methods based on epidemiological standards can also assist the clinician in making reasonable and unbiased allocation estimates.