Tinnitus in the Courtroom

The advent of the functional magnetic resonance imaging (fMRI) has advanced tinnitus research to go beyond the gross identification of tinnitus cohorts to a more refined evaluation of the brain networks that constitute tinnitus symptoms. This is especially useful in the medical-legal arena, where establishing the existence of tinnitus can be difficult because of the absence of a known objective test to identify tinnitus, resulting in potential compensation and malingering for a defendant or plaintiff.

Challenges in Objective Diagnosis

In patients not in litigation, proof of tinnitus and comorbid hyperacusis is built upon establishing an incidental or medical causation, specific complaints and patterns, responses to questionnaires and ratings, medical and environmental histories, interview, and behavioral observations. In additional replicable and complimentary audiological test findings, an absence of malingering or feigning, and an assessment of the patient’s psychological profile complete the examination. From this information, a constellation of findings reveals the onset, causation, medical complications, course of the disease process, and the severity and annoyance levels. Furthermore, impingements on the patient’s quality of life and degree of impairment.