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Q&A with Gary Roush, US Army Veteran

Gary Roush is a Vietnam Veteran who served in the US Army as a helicopter pilot. He flew in Vietnam from 1968 to 1969 and was diagnosed with service connected bilateral hearing loss during his exit physical from the Army in 1970. He began wearing aids purchased from a private practice audiologist in 1981. After a local veterans’ service organization officer noticed his hearing aids, he was encouraged to seek hearing healthcare support from the local VA in 1985. He discovered that veterans could be compensated for tinnitus caused by service-related noise exposure in 2003 after reading about it in an audiologist’s waiting room. His journey to a cochlear implant began ten years later.

Q: How did your CI journey begin? Did anyone from the VA suggest you might benefit from cochlear implants? Who told you that you might be a candidate for a cochlear implant?

A:  I experienced additional hearing loss in late 2013 likely exacerbated by a tooth implant procedure.  I was referred to the Cleveland Clinic and told by an ENT there that I was a candidate for a hybrid cochlear implant.  I followed up with my VA audiologist in Bath, NY who referred me to the VA hospital in Buffalo, NY to be evaluated for a cochlear implant in late 2014.  No one at the VA had ever talked to me about cochlear implants up to this point, though one of my audiologists had a cochlear implant. After several appointments, I had the cochlear implant surgery in late 2015.  Some of the delay was likely due to this being the early days of hybrid implants as well my personal situation with my wife’s medical problems.

Q: How did you learn about the services at the VA?

A:  By chance from the local county veterans’ service agency and also reading about them in veterans’ publications.

Q: What was the hardest part about the process of getting a cochlear implant? 

A:  Having to hire someone to take care of my wife while I spent most of many days traveling 125 miles each way to Buffalo, NY for repeated appointments that lasted an hour or more each.  I had to work around my wife’s medical appointments (surgery, chemo, radiation), trips to the emergency room, multiple hospital and nursing home stays along with the schedule of the VA ENT cochlear implant surgeon—who was only available one day per month.

Another frustration I am still experiencing is reimbursement for travel, which is automatically based on the closest VA audiologist which is in Bath, NY.  However, that hospital is not equipped to treat someone for CI services; hence the reimbursement system must be adjusted for each trip I need to take to Buffalo.  After almost four years of complaining about this, I still have to explain each trip in order to get the proper travel reimbursement. It is tedious!

Q: What could be done to improve the process of getting a cochlear implant for veterans?

A:  Having access to a patient advocate similar to what the county veterans’ service agency provides to help someone through the process and also having the VA audiologists be proactive in explaining available hearing healthcare to veterans.

Q: What worked well for you?  What compliment(s) can you make of the VA process?

A:  Receiving hearing aids, batteries, etc. from the VA is very efficient.  Most of the VA audiologists I worked with over the years have been knowledgeable, friendly, and helpful.

Q: Who performed your surgery and where was it done?  What about the follow up services?  Was follow-up hard for you (i.e., travel, getting appointments scheduled)?

A:  The surgery was done by Dr. Ernesto Diaz-Ordaz, a civilian under contract with the VA.  Surgery was done at the Buffalo, NY VA Hospital.  Follow-up with the surgeon was not offered until I requested it. I then had to work with his one day per month availability so it was almost a full year before I saw him for a follow-up appointment.  I already discussed the challenges of travel and scheduling appointments. Mapping with the VA audiologist required many visits to the Buffalo VA Hospital.

Q: I understand that there were hiccups in the process, such as losing paperwork.  What was the nature of those mishaps and how long did it take to get them resolved?

A: There are two tracks here: one is treatment and the other is disability compensation.  Eight months after filing for disability payments, I received a letter saying my original paper work had been lost.  Another eight months after re-filing the claim, I received another letter asking for more information.  Nine months after that I was awarded disability retroactive for nine months.  One process does not automatically trigger the other.  It would seem to me that almost every step in the treatment process should automatically trigger a disability compensation review.  That never happened so I went years not receiving earned disability compensation. It was due to chance encounters with county veterans’ service officers that prompted me to explore compensation evaluations.  It is almost as if VA audiologists are under orders not to offer compensation advice unless specifically asked about it by the veteran.

Q: Can you provide some suggestions on what would have made the process of dealing with the VA better? 

A:  Having a VA patient advocate to help navigate through the process, having audiologists who offer full information to veterans and streamlining the process so that treatment and disability are related.

Q: Did you have any auditory rehabilitation besides mapping your sound processor?

A:  No. It just occurred to me that the services of a speech language therapist might have been helpful to me.

Q: Do you have any tips for those veterans who might be candidates for a CI?

A:  Contact their local county veterans’ service agency for help and be a self advocate.  If you do not ask for something, you are not likely to get it.  The key is knowing what to ask for. The website of American Cochlear Implant Alliance has excellent information about the process of cochlear implantation, candidacy, and outcomes.

Mr. Roush’s experience highlights that often a veteran must self-advocate for compensation and services. It also underscores ongoing issues with an insufficient amount of time allocated for appointments with VA CI surgeons as well as the complications of long-distance travel. Nonetheless, there are individuals within the VA and with veterans’ service organizations that are able to assist including The key can be knowing what to ask. Gary Roush hopes that by sharing his experiences and insights, other veterans will have a head start in their own journey.

The mission of the American Cochlear Implant (ACI) Alliance is to advance access to the gift of hearing provided by cochlear implantation through research, advocacy and awareness.