There is not one answer to this question. There are situations in which medical clearance is an absolute necessity, there are situations in which medical clearance is recommended, and then there are situations in which medical clearance can be covered via a medical waiver which discloses that hearing aids are a medical device. So, when is it necessary, recommended, or optional?
When is Medical clearance absolutely necessary?
Medical clearance for the use of hearing aids is absolutely necessary when anyone under the age of 18 is being fitted with hearing aids. Regardless of what state the child lives in federal guidelines require medical clearance for the use of hearing aids. In most cases adults (anyone age 18 or older) have the ability to sign a medical waiver and can choose to be fitted without medical clearance.
When is medical clearance recommended?
As previously discussed, medical clearance is absolutely necessary for any individual under the age of 18 however it is recommended in several situations for adults. In any case where a conductive or mixed hearing loss is diagnosed medical intervention should be explored and no hearing aids should be fitted until after medical clearance is received. In the case of conductive and mixed hearing loss, there is a possibility that there may be possible medical intervention which should be explored prior to wearing hearing aids. Even if a patient has a conductive or mixed hearing loss, they may not be eligible for or willing to go though other medical treatments such as surgery. They should still be evaluated by their PCP and / or E.N.T. to obtain medical clearance prior to being fitted with hearing aids.
Asymmetric Hearing Loss
Another time when medical clearance should be received prior to utilizing hearing aids is in the case of asymmetric hearing loss. An asymmetric hearing loss is when one ear hears better than the other ear. It can also be considered an asymmetric hearing loss when word recognition (comprehension) abilities are better in one ear than the other. So why should a person with an asymmetric hearing loss obtain medical clearance prior to being fitted with hearing aids? Well, as we age our ears usually progress through the different stages of hearing loss together and similarly. The concern with an asymmetric hearing loss is that the hearing loss is a symptom of another underlying medical condition rather then the problem itself. Since there is a possibility that an asymmetric hearing loss is a symptom of other medical condition medical clearance is recommended.
Sudden Hearing Loss
Lastly, sudden hearing loss is a time when medical clearance should be obtained prior to being fitted with hearing aids. A sudden hearing loss can have several causes however most experts and research agree that a sudden hearing loss has a short window in which treatment via medication may return some of the hearing abilities lost. Treatment within the first 72 hours is most effective at returning some hearing abilities. Even if the sudden loss occurred several weeks, months, or years ago they should receive medical clearance to be fitted with hearing aids.
It is important to remember that in most states, adults can choose to decline medical clearance and be fitted with hearing aids. As long as test results are complete, and fully explained to the patient, they should have the ability to choose their course of treatment. Please make sure all test results are explained to you and you ask any questions including if there is any reason / necessity for you to seek medical intervention prior to being fitted with hearing aids.