Wow, I'm always amazed at how every post and it's replies sound so familiar that I could have written it. I work in a very loud "quick paced restaurant" (you order like it's fast food, but the service is akin to what you'd get at a restaurant) and literally all day I'm straining to hear what people are ordering over the extremely loud environment. I succeed only because I have memorized the menu, and therefore I only need to "kind of" hear what people are saying. The only issues arise when people ask me off-the-wall random questions; then I have to actually lean in and sometimes even close my eyes to try to focus only on that person's voice. (And I always have to double check if someone asked for 'Hi-C' or 'iced tea' to drink.)
It's another problem when people speak too quickly or without getting my attention first; when my bosses try to give me directions quickly without looking at me... like they walk by and say my name, followed by a blur of words that I can't understand at all until I turn around and look at them and have them repeat themselves. Or, in another common case, when my boyfriend says anything while tv is on, or while I'm involved in a task. I sometimes have to ask him to repeat himself up to 4 times, which is incredibly frustrating for him which makes me feel bad for not being able to understand what he's saying. Volume isn't really the issue, but proper annunciation is. When people mumble or slur their words together in any way, I cannot understand them. Sometimes I wonder how many things I've misheard without knowing it... I can't tell you how many times I've gotten "in trouble" because someone specifically told me to do some kind of task, but I thought I had heard them say that they were the one doing the task. If I can't tell immediately if something is a question or a statement, then there's an added several moments of deciphering added on before I can respond.
I haven't been to an occupational therapist yet. I'm really hoping they can help with some of this... Good luck to you.

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Does anyone else have trouble understanding anyone with an accent other than the one you're used to? Specifically Scottish and Haitian accents, I cannot understand a single word. I feel terrible about it, especially because I get very frustrated when I can't understand something or someone, and I fear it probably makes me sound racist when I flat out say (as politely as possible) "I'm really sorry, but I can't understand what you're saying." I actually have to get a coworker to take orders from people with accents sometimes because I just can't understand what they're saying no matter how hard I try.