Malingering of Hearing Loss

Timothy C. Hain, MD Return to hearing page Page last modified: December 21, 2010

As hearing loss and tinnitus are subjective conditions, when there is a potential to gain by convincing another group of people that one has these disorders, it is common to encounter individuals claiming to have lost hearing or to have tinnitus.

For hearing loss, this is a foolish undertaking, as there are abundant methods of showing that someone actually hears better than they admit. We will not go through the methods here, for fear of "giving them away", but suffice it to say that in hearing testing, there are a large number of ways to compare subjective to objective measures, as well as a few straightforward tests that are simply put - -lie detectors.

A simple method of screening for hearing inconsistency is to compare subjective hearing (audiometry) with a measurement that does not require cooperation - -such as OAE testing.

Methods of proving a patient is NOT malingering

OAE testing can also clearly document that the patient is not malingering.  An example of this is shown below.  A patient was involved in an automobile accident and developed tinnitus after the collision. Her tinnitus was "matched" in the right ear to 7100 hz.

A regular audiogram was not very revealing --

However, a more careful audiogram that covered the frequencies around the tinnitus was abnormal.

Audiograms are subjective tests, and in theory at least, someone could pretend not to hear at this frequency. However, an objective test is available -- the sweep OAE.

The sweep OAE shows poor inner ear function between 6500 and 9000 Hz, which is the same region that this person has hearing loss and tinnitus. 

From the combination of the tinnitus match, detailed and careful audiogram, and sweep OAE, it is clear that this patient has objectively confirmed inner ear damage.