Ear Disorders
Ear Disorders
Overview of VA Ear Disorder Ratings
Ear disorders affect hearing, balance, and ear function, impacting your ability to communicate and navigate daily life. Military service can lead to ear disorders through noise exposure, blast injuries, infections, or traumatic injuries. This section explains how the VA rates ear disorders and provides detailed guidance for the most common conditions.
General Rating Principles for Ear Disorders
The VA rates ear disorders based on several factors:
- Objective test results: Such as audiometric testing, speech discrimination scores, or vestibular function tests
- Frequency and severity of symptoms: How often symptoms occur and how severe they are
- Impact on daily activities: How the condition affects your ability to work, communicate, and perform daily tasks
Establishing Service Connection for Ear Disorders
To establish service connection for ear disorders, you generally need:
- Current diagnosis of an ear disorder by a qualified medical professional
- In-service event or injury that could have caused the ear disorder (such as noise exposure, blast injury, or ear infection)
- Medical nexus linking your current ear disorder to the in-service event or injury
For hearing loss and tinnitus specifically, if you were exposed to hazardous noise during service (combat, artillery, aircraft, etc.), the VA should concede that you experienced acoustic trauma, which can help establish the in-service event requirement.
Hearing Loss
Hearing loss is a reduction in the ability to perceive sounds, which can range from mild to profound. Military service often involves exposure to hazardous noise levels from weapons fire, explosions, aircraft, vehicles, and machinery, which can cause permanent hearing damage.
VA Rating Criteria for Hearing Loss
Hearing loss is rated under Diagnostic Code 6100 based on the results of controlled speech discrimination tests (Maryland CNC) and puretone audiometry tests. The VA uses a specific formula to calculate the hearing loss rating:
- Calculate the average puretone threshold for each ear by adding the decibel results at 1000, 2000, 3000, and 4000 Hz and dividing by 4
- Find the corresponding Roman numeral for each ear using Table VI, which considers both the puretone average and speech discrimination score
- If the puretone threshold at each of the specified frequencies (1000, 2000, 3000, and 4000 Hz) is 55 decibels or more, or if the puretone threshold is 30 decibels or less at 1000 Hz and 70 decibels or more at 2000 Hz, use Table VIa instead, which is based solely on puretone threshold average
- Find the percentage evaluation using Table VII, which combines the Roman numerals from both ears
Understanding Audiometric Results
Audiometric test results are presented in a format that can be confusing. Here's what you need to know:
- Puretone thresholds are measured in decibels (dB) at different frequencies (Hz)
- Normal hearing ranges from 0 to 20 dB
- Mild hearing loss ranges from 21 to 40 dB
- Moderate hearing loss ranges from 41 to 70 dB
- Severe hearing loss ranges from 71 to 90 dB
- Profound hearing loss is 91 dB or greater
- Speech discrimination scores measure your ability to understand speech, expressed as a percentage
The VA only considers the frequencies of 1000, 2000, 3000, and 4000 Hz for rating purposes, even though your audiogram may include other frequencies.
Hearing Loss Rating Tip
Most veterans with hearing loss receive a 0% rating, even with significant hearing difficulties. This is because the VA's rating formula is based on very specific audiometric measurements that may not fully capture the real-world impact of hearing loss. However, even a 0% rating is important because:
- It establishes service connection, making you eligible for free VA hearing aids and treatment
- It can be combined with other service-connected conditions for an overall higher rating
- It can be reevaluated if your hearing worsens in the future
Focus on getting service connection established, even if the initial rating is 0%.
Building a Strong Hearing Loss Claim
Evidence Checklist for Hearing Loss Claims
Required Medical Evidence
Military Records
Supporting Statements
Additional Evidence (if applicable)
Tinnitus
Tinnitus is the perception of noise or ringing in the ears when no external sound is present. It's one of the most common disabilities among veterans due to exposure to loud noises during military service. Tinnitus can manifest as ringing, buzzing, hissing, whistling, or other sounds that only the affected person can hear.
VA Rating Criteria for Tinnitus
Tinnitus is rated under Diagnostic Code 6260 with a single rating level:
Important Tinnitus Rating Information
The maximum schedular rating for tinnitus is 10%, regardless of whether the tinnitus affects one ear, both ears, or is perceived in the head. The VA will not assign separate ratings for tinnitus in each ear.
While 10% may seem low, tinnitus is one of the easiest conditions to get service-connected, and the 10% rating can be combined with other service-connected conditions for a higher overall rating.
Building a Strong Tinnitus Claim
Evidence Checklist for Tinnitus Claims
Required Medical Evidence
Military Records
Supporting Statements
Additional Evidence (if applicable)
Tinnitus Claim Tip
Be very specific in your personal statement about when your tinnitus began. If it started during service, say so clearly. If you can recall a specific incident that triggered it (like an explosion or firing range training without proper hearing protection), describe that incident in detail. Since tinnitus is subjective and can't be measured objectively, your credible testimony about its onset is crucial for establishing service connection.
Meniere's Disease
Meniere's disease is a disorder of the inner ear that causes episodes of vertigo, fluctuating hearing loss, tinnitus, and a feeling of fullness or pressure in the ear. It can be caused by head or ear trauma, which can occur during military service.
VA Rating Criteria for Meniere's Disease
Meniere's disease is rated under Diagnostic Code 6205 based on the frequency and severity of attacks:
Alternative Rating Option
The VA regulation for Meniere's disease (DC 6205) includes a note stating that Meniere's disease can be rated either under the criteria above OR by separately rating vertigo (as a peripheral vestibular disorder), hearing impairment, and tinnitus, whichever method results in a higher overall evaluation.
This means you could potentially receive:
- Up to 30% for peripheral vestibular disorder (DC 6204)
- Up to 100% for hearing impairment (DC 6100)
- 10% for tinnitus (DC 6260)
The VA should calculate your rating both ways and assign the higher evaluation.
Building a Strong Meniere's Disease Claim
Evidence Checklist for Meniere's Disease Claims
Required Medical Evidence
Military Records
Supporting Statements
Additional Evidence (if applicable)
Case Study: Successful Hearing Loss and Tinnitus Claim
Veteran Profile
Marine Corps veteran who served as an Artillery Cannoneer from 2004-2008, including deployment to Iraq.
Condition
Bilateral hearing loss and tinnitus diagnosed in 2015, seven years after separation from service.
Symptoms & Presentation
- Difficulty hearing in noisy environments
- Trouble understanding speech, especially women's and children's voices
- Constant high-pitched ringing in both ears
- Tinnitus interfering with sleep and concentration
- Audiogram showing moderate high-frequency hearing loss
- Speech discrimination scores of 88% in right ear and 84% in left ear
Evidence Submitted
- DD-214 showing MOS as Artillery Cannoneer (0811)
- VA Fast Letter 10-35 showing Artillery Cannoneer has "Highly Probable" noise exposure
- Service treatment records showing normal hearing at enlistment
- Private audiogram and diagnosis of noise-induced hearing loss and tinnitus
- Medical opinion from audiologist linking hearing loss and tinnitus to military noise exposure
- Personal statement describing extensive exposure to artillery fire without adequate hearing protection
- Statement from fellow Marine confirming exposure to artillery noise
- Statement from spouse describing veteran's hearing difficulties and tinnitus symptoms
- Employment history showing no significant noise exposure after military service
Outcome
The veteran was awarded service connection for both bilateral hearing loss (0% rating) and tinnitus (10% rating). Despite the 0% rating for hearing loss, the veteran became eligible for VA-provided hearing aids and audiology services. The 10% rating for tinnitus contributed to the veteran's overall combined disability rating.
Key Takeaways
- The VA conceded noise exposure based on the veteran's MOS as an Artillery Cannoneer
- The medical opinion linking the conditions to service was crucial for establishing service connection
- The lack of significant post-service noise exposure strengthened the claim
- Even though the hearing loss was rated at 0%, service connection was established, making the veteran eligible for treatment
- The 10% rating for tinnitus was granted based on the veteran's credible testimony about constant ringing in the ears