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Employers who implement hearing wellness programs frequently encounter a question from workers or HR: “Is this a real hearing test or just a screening?” The distinction matters — not because one is necessarily better for employee health, but because the two serve different purposes, create different records, and have different clinical and legal implications. This guide explains the difference between occupational audiometric screening (what OSHA requires and Soundtrace provides) and diagnostic audiological evaluation (what a clinical audiologist provides in a medical setting), when each is appropriate, and why OSHA-compliant screening with professional supervision creates legally defensible records that diagnostic testing alone cannot provide.
Audiometric screening is a standardized test of hearing threshold sensitivity at specified frequencies, designed to identify workers whose hearing has changed from a prior baseline or who may require further clinical evaluation. In occupational health, “audiometric screening” typically refers to pure-tone threshold audiometry conducted:
The output of an occupational audiometric screen is a pure-tone threshold audiogram at 500, 1000, 2000, 3000, 4000, and 6000 Hz in each ear, with calibration documentation. This audiogram is used to calculate standard threshold shift (STS) relative to the worker’s established baseline, to identify audiometric patterns suggesting specific etiologies, and to create the longitudinal record of hearing health that is the employer’s primary WC defense document.
Diagnostic audiological evaluation is a comprehensive clinical assessment conducted by a licensed audiologist in a medical setting. It goes beyond pure-tone threshold audiometry to include some or all of the following:
The output of a diagnostic evaluation is a comprehensive clinical report with differential diagnosis, functional assessment, and treatment recommendations if warranted.
| Feature | Occupational Screening (OSHA-compliant) | Diagnostic Evaluation (Clinical Audiologist) |
|---|---|---|
| Pure-tone threshold measurement | Yes — air conduction at 500–6000 Hz | Yes — air and bone conduction, extended range possible |
| Speech audiometry | Not required by OSHA; not standard | Yes — standard component of full evaluation |
| Middle ear assessment | Not included | Yes — tympanometry standard |
| Calibration documentation | Required (ANSI S3.6, biologic check daily) | Typically calibrated but documentation emphasis differs |
| Longitudinal comparison capability | Yes — annual records compared to baseline; STS calculation | Not standard; depends on whether prior audiograms are available for comparison |
| Legal defensibility for WC | High — OSHA-compliant records under professional supervision | High for clinical diagnosis; lower for longitudinal occupational record |
| Cost per test | $30–$75 per worker | $150–$400+ per evaluation |
| Best use | Annual monitoring, pre-employment baseline, STS detection, WC defense documentation | Follow-up evaluation when screening identifies concerning results; clinical diagnosis; treatment planning |
OSHA 1910.95(g) specifies the audiometric testing requirements for enrolled workers:
Soundtrace’s platform meets all of these requirements for mandatory HCP workers and applies the same standards to voluntary wellness screening for all employees. The professional supervision requirement is satisfied by Dr. Subinoy Das, Soundtrace’s CMO and Professional Supervisor, who reviews flagged audiograms and provides the medical oversight that makes the program’s records legally defensible.
The legal defensibility of an occupational audiometric record rests on three pillars:
A single diagnostic evaluation — however comprehensive — cannot produce the longitudinal record that a series of annual occupational audiograms creates. The WC defense value of the audiometric record comes from the year-over-year comparison: the baseline audiogram at hire, the annual audiograms showing stable or changing thresholds, and the pattern of progression (or non-progression) during employment. A diagnostic evaluation conducted after a WC claim is filed cannot reconstruct this history.
Occupational audiometric screening identifies which workers need further clinical evaluation. The referral triggers for diagnostic evaluation include:
The optimal employer workflow uses occupational audiometric screening as the primary monitoring and documentation tool, with diagnostic evaluation as a referral pathway when warranted:
OSHA 1910.95 requires occupational audiometric testing — specifically pure-tone threshold measurement using ANSI S3.6-calibrated equipment in an Appendix D-compliant environment, under the supervision of a licensed audiologist, otolaryngologist, or physician, or a qualified technician supervised by one of these professionals. OSHA does not require full diagnostic audiological evaluation for routine annual testing. Diagnostic evaluation is the appropriate referral pathway when occupational screening identifies results that warrant further clinical assessment.
Yes, when conducted on ANSI S3.6-calibrated equipment in an environment meeting OSHA Appendix D background noise limits and administered under qualified professional supervision. These three elements — calibration documentation, environmental documentation, and professional supervision — establish the audiogram’s technical reliability and admissibility in WC and civil proceedings.
Consumer hearing test applications do not meet ANSI S3.6 calibration requirements, are not administered in acoustically controlled environments, and are not conducted under professional supervision. Their results cannot be used for OSHA STS calculations, do not meet the 1910.95 audiometric testing standard, and would not be recognized as a valid audiometric record in WC or civil proceedings. Only testing on calibrated equipment in a controlled environment under professional supervision creates the legally useful audiometric record.
Soundtrace provides OSHA-standard audiometric testing under professional audiologist supervision for all employees — creating legally defensible records whether they are enrolled in the mandatory HCP or a voluntary wellness program.
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