Washington L&I's Office of the Medical Director provides this one-page worksheet to calculate a worker's hearing loss for an occupational hearing loss impairment award. Using audiogram thresholds at 500, 1000, 2000 and 3000 Hz, the examiner computes each ear's monaural loss with the 1969 ANSI formula, adds up to 5% for tinnitus, then combines both ears into a binaural percentage weighted toward the better ear.
The attending doctor or consultant rating the hearing loss completes it from the audiogram. L&I's policy bases the degree of impairment on an audiogram interpreted by a physician.
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Hearing Impairment Calculation Worksheet
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The worksheet uses the 1969 ANSI method. For each ear, average the thresholds at 500, 1000, 2000 and 3000 Hz, subtract 25 dB and multiply by 1.5, then add 0 to 5% for tinnitus. Binaural loss is five times the better ear plus the worse ear, divided by six.
More than 14 hours. The worksheet has a field for hours since the last exposure to noise and states it must be more than 14. It also records the date of the audiogram, since the whole calculation is based on that test's thresholds.