Produced in Cooperation with the American Association of Retired People
November 1992
More than 21 million Americans suffer from some type of hearing impairment. Fortunately, many of these people can benefit from the use of a hearing aid. However, hearing aids cannot work for everyone. Those who can be helped need to be carefully fitted. This on-line brochure provides information about hearing loss and things to look for when shopping for a hearing aid. It stresses the importance of a medical exam and the value of a trial period.
Types of Hearing Loss
The two basic types of hearing loss are conductive and sensorineural. Conductive hearing loss involves the outer and middle ear. It can result from a blockage of wax, a punctured eardrum, birth defects, ear infections or heredity. Usually, conductive hearing loss can be corrected medically or surgically. Sensorineural, or “nerve” hearing loss, involves damage to the inner ear. It can be caused by aging, prenatal and birth-related problems, viral and bacterial infections, heredity, trauma (such as a severe blow to the head), exposure to loud noises, the use of certain drugs, fluid buildup in the inner ear or a benign tumor in the inner ear.
Only in rare cases can sensorneural hearing loss be medically or surgically corrected. It is the type of hearing loss that is most commonly managed with a hearing aid. Sensorineural hearing loss can affect selective portions of a person’s range of hearing. Therefore, the degree of hearing loss and the specific levels of pitch (frequencies) affected will vary from person to person. Even in instances where the pattern of the loss is the same, the degree of sound clarity may vary from person to person or may differ between ears for one individual. As a result, individuals suffering from sensorineural hearing loss often require a hearing aid tailored to the specific sensitivity and the pattern of hearing loss.
Purchase Suggestions
A hearing aid is an electronic device that picks up sound waves with a tiny microphone. The microphone makes weaker sounds louder and sends them to the ear through a tiny speaker. Because a hearing aid is an amplification device, a person must have some hearing to benefit from its use. In addition, because hearing loss has a variety of patterns and degrees of severity and affects people in different ways, no single hearing aid is right for everyone.
The Federal Trade Commission (FTC) offers the following suggestions if you are considering the purchase of a hearing aid.
Consider Getting an Ear Examination
The Food and Drug Administration (FDA) recommends that you have your ears examined by a licensed physician. Ear examinations are universally recommended by the medical community to ensure there are no underlying diseases or medical problems causing the hearing loss. A hearing loss may be a symptom of another medical problem that needs a doctor’s attention. Also, the cause and severity of a hearing loss vary widely from person to person.
Be wary of any advertisements for hearing aids that play down the need for a medical examination and a hearing test. Dispensers or providers that encourage you to sign a waiver for a medical examination may be selling products that do not meet industry standards.
Get a hearing evaluation from a dispenser or an audiologist. Have your hearing tested to assess your ability to hear with and without a hearing aid. This test will enable a dispenser or audiologist to select and fit a hearing aid to your individual needs. (The term “dispenser” refers to anyone selling hearing aids, whether the person is a hearing aid dealer or an audiologist.)
Check Out the Dispenser
Before you buy, check the reliability of local hearing aid dispensers with your local Better Business Bureau (BBB), consumer protection agency, or state attorney general. You also may want to verify the reliability of dispensers and physicians with their licensing boards in your state capital. Ask if there are any complaints on file, and how the company or professional has responded to the complaint.
Ask the Dispenser or Audiologist about a Trial Period
Many manufacturers, hearing specialists, and consumer groups recommend, and some state laws require, that consumers be given at least a 30-day trial period with only a small service fee (varying from five to 20% of the purchase price) if the consumer returns the product. In fact, manufacturers routinely make adjustments and permit hearing aid returns within 60 to 90 days at no charge to the dispenser. A trial period is strong protection for such an important purchase, so ask before you buy.
Remember, if you purchase a hearing aid from a door-to-door salesperson you have the right under the FTC(Federal Trade Commission)’s Door-to-Door Sales Rule to cancel within three business days of any sale for $25 or more. The sale may take place in your home, or at a location that is not the seller’s regular place of business.
If you are thinking of buying a hearing aid through the mail, consider the difficulty of getting the right hearing aid for your needs and a proper fit. Although there is no federal law against the mail order sale of hearing aids, several states have banned hearing aid sales by mail. In states that do allow the sale of aids by mail, the transaction is subject to the FTC(Federal Trade Commission)’s Mail Order Rule. This rule requires companies to ship purchases made by mail when promised or give consumers the option to cancel their order for a refund.
Be Aware of Sales Practices
Avoid being pressured into buying a hearing aid. As with any other medical decision, you should be given the opportunity to seek additional information or a second opinion. Sales personnel using high-pressure approaches demonstrate little concern for your well being.
Purchase Agreements
The hearing aid purchase agreement, or contract, should contain all terms of the transaction in writing, including an explanation of all verbal promises. In reviewing your agreement, remember to consider the following:
- Is there a written warranty?
- Is the warranty honored by the manufacturer or by the dispenser? (In some cases warranties by the manufacturer may not be recognized unless the hearing aid is purchased from a seller authorized by the manufacturer.)
- What services, if any, will be provided free of charge, and how long will they be provided?
- Will you receive a “loaner” if your hearing aid needs to be repaired?
Federal Standards for SalesDo business with a dispenser who will clarify these details and put all verbal commitments into the written contract.
The FTC(Federal Trade Commission) is responsible for monitoring the business practices of hearing aid dispensers and vendors. Under the Federal Trade Commission Act, the FTC(Federal Trade Commission) can take action against a company that misleads or deceives consumers. Such a company may use misleading sales and advertising practices — giving inaccurate information about hearing loss, performance of a hearing aid, refund policies, or warranty coverage. The Magnuson-Moss Warranty Act, which the FTC(Federal Trade Commission) enforces, provides consumers with certain protections relating to warranties. This act requires a company offering a warranty to fully disclose all its terms and conditions.
The Food and Drug Administration (FDA) enforces regulations that deal specifically with the manufacture and sale of hearing aids, because these products are recognized as medical devices. FDA(Food and Drug Administration) regulations have the force of federal law. According to the FDA(Food and Drug Administration), the following conditions must be met by all dispensers before selling a hearing aid:
- Dispensers must obtain a written statement from the patient signed by a licensed physician. It must be dated within the previous six months, state that the patient’s ears have been medically evaluated, and state that the patient is cleared for fitting with a hearing aid.
- A patient, age 18 or older, can sign a waiver for a medical examination, but dispensers must advise the patient that waiving the examination is not in the patient’s best health interest.
- Dispensers must avoid encouraging the patient to waive the medical evaluation requirement.
- Dispensers must advise patients who appear to have a hearing problem to consult promptly with a physician.
- The FDA(Food and Drug Administration) regulations require that an instruction brochure be provided with the hearing aid that illustrates and describes its operation, use, and care. The brochure also must list sources for repair and maintenance and include a statement that the use of a hearing aid may be only part of a rehabilitative program.
In addition to federal regulation, many states have laws that apply to the sale of hearing aids. Most states license hearing aid dispensers, and several states prohibit the sale of hearing aids through the mail. Purchasers also may be protected by implied warranties, created by state law. Your state Attorney General’s Office can provide you with particular information about state laws that apply to the sale of hearing aids.State Standards for Sales
The state Attorney General’s Office also will have information on whether hearing aid dispensers must be licensed or certified by the state. Some hearing professionals, such as physicians and audiologists, may be licensed by a state regulatory agency. These agencies may provide helpful information for individuals considering a hearing aid purchase.
Where to Complain
If you have questions or complaints concerning the sales practices of a hearing aid dispenser, contact your state Attorney General’s Office, local consumer protection agency, the Better Business Bureau, and write:
Federal Trade Commission
Correspondence Branch
Washington, DC 20580
Although the FTC(Federal Trade Commission) usually does not resolve individual disputes, the agency may take action against a company if there is evidence of a pattern of deceptive or unfair practices.
The National Fraud Information Center (NFIC) maintains a toll-free Consumer Assistance Service, 1-800-876-7060, to provide consumers with answers to questions about telephone or mail solicitations, information about how and where to report fraud, referral services, and help in filing complaints.
The NFIC(National Fraud Information Center) Consumer Assistance Service is available from 9:00am to 5:30pm EST, Monday through Friday. The toll-free number is in service in the United States, Puerto Rico, and Canada. Spanish-language service is available.
The consumer complaint information is instantly available to assist law enforcement agencies through a database operated by the Federal Trade Commission and the National Association of Attorneys General.