Exaggerated hearing loss in compensation claimants.

Overestimation of hearing loss is a significant problem in the assessment of workers exposed to industrial noise. Audiometric and epidemiologic aspects of this problem are examined in 2,528 compensation claimants. Electric Response Audiometry (ERA) using the cortical Slow Vertex Response (SVR) is accurate and very useful for quantification of true hearing levels. Based on this technique, 8% of claimants were shown to have volunteered excessively high behavioral thresholds. Using the term "exaggerated hearing loss" (EHL) as an umbrella for this phenomenon, true thresholds of EHL and non-EHL groups were identical. Several demographic and occupational factors appear to be associated with EHL. The performance of various audiometric rules for EHL prediction was highly dependent on the criteria adopted; all rules were better than chance, though none was impressive. Clinical acumen and ERA both play a vital part in accurate assessment of the compensation claimant.