The Army hearing test, known as an audiogram, serves as a fundamental medical screening tool to ensure all personnel meet the demanding auditory requirements of military service. This test evaluates an individual’s capacity to hear sounds across different pitches and volumes, which is directly related to operational fitness, especially in high-noise environments. The results are a formal assessment of a Soldier’s ability to localize sound, understand verbal commands, and maintain situational awareness, all necessary for safety and mission success. The military uses a standardized process to measure hearing thresholds and apply specific regulatory standards that determine eligibility for entry and continued service.
Understanding the Army Audiogram Structure
The Army audiogram is a standardized chart used to plot an individual’s hearing sensitivity across a range of frequencies. The horizontal axis (X-axis) measures frequency, or pitch, quantified in Hertz (Hz). The Army typically tests critical frequencies, including 500, 1000, 2000, 3000, 4000, and 6000 Hz.
The vertical axis (Y-axis) represents the intensity or loudness of sounds, measured in decibels (dB). The quietest sounds are at the top of the chart, often starting at -10 dB, with loudness increasing as numbers descend. Zero decibels represents the softest sound a person with normal hearing can perceive at a given frequency. The thresholds plotted on this chart represent the quietest sounds an individual can hear 50% of the time.
Interpreting the Test Results
The plotted data points on the audiogram show how sound travels through the ear and where any potential loss occurs. Air conduction testing, performed with headphones, evaluates the entire auditory pathway, from the outer ear to the auditory nerve. Right ear thresholds are marked with a red circle (‘O’), and left ear thresholds are marked with a blue ‘X’.
Bone conduction testing uses a vibrator placed on the mastoid bone to bypass the outer and middle ear, directly stimulating the inner ear. Comparing air and bone conduction results determines the type of hearing loss. If both thresholds are equally depressed, the loss is sensorineural, indicating damage to the inner ear or auditory nerve. If air conduction is significantly worse than bone conduction, it is conductive hearing loss, suggesting a problem blocking sound transmission in the outer or middle ear.
Hearing loss severity is classified by the average decibel level of the thresholds. Normal hearing is considered to be between 0 and 25 dB. Mild hearing loss (25–40 dB) means soft sounds are difficult to hear. Moderate hearing loss (40–60 dB) makes understanding conversational speech challenging.
Army Accession and Retention Standards
The Army’s application of audiogram results is governed by specific medical fitness standards, establishing criteria for initial entry (accession) and continued service (retention). The entry standard, used at locations like the Military Entrance Processing Station (MEPS), requires that the average hearing loss in the better ear does not exceed 30 dB at the frequencies of 500, 1000, and 2000 Hz.
The standard also imposes limits on individual frequencies. No single frequency loss in the better ear can exceed 35 dB at 500, 1000, or 2000 Hz, or 45 dB at 3000 Hz. If an applicant’s hearing loss exceeds these numerical thresholds, they are considered medically disqualified for military service. Applicants may be eligible to apply for a medical waiver, which is a formal review process.
Retention standards for currently serving Soldiers are slightly less strict than accession criteria, recognizing the common occurrence of noise exposure during military duty. A Soldier is generally considered qualified for most military occupational specialties (MOS) if the pure tone average loss in the better ear remains at or below 30 dB at 500, 1000, and 2000 Hz. Specific auditory requirements may increase for specialized roles, such as aviation or special operations, which necessitate superior hearing capability.
Medical Profiles and Follow-Up Actions
A Soldier’s medical status, including hearing, is formally documented using the Physical Profile Serial System, known as PULHES. The ‘H’ factor addresses Hearing and ears, and it is assigned a numerical designator from 1 to 4.
PULHES Designations
A designation of H-1 indicates a high level of medical fitness, meaning the Soldier meets the most stringent standards for unrestricted duty. A rating of H-2 suggests a moderate hearing loss that still permits worldwide duty, though it may preclude assignment to specific noise-hazardous environments or MOSs. An H-3 profile is assigned when thresholds indicate a significant hearing deficit, requiring duty limitations and often triggering a Medical Evaluation Board (MEB) to determine fitness for continued service. This designation may restrict the Soldier to certain administrative roles or geographical locations.
A significant threshold shift (STS) is an important metric used in the Army’s Hearing Conservation Program (HCP). An STS is defined by the Department of Defense as an average change of 10 dB or more at 2000, 3000, and 4000 Hz in either ear compared to the initial reference audiogram. When an STS is detected, the Soldier is immediately enrolled in the HCP, which mandates re-testing, counseling on hearing protection use, and follow-up medical actions within 30 days to determine if the shift is permanent.